Effective Counseling Strategies for Substance Abuse Treatment, Exams of Advanced Education

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The essential first step in determining the possible causes of addiction for the person and the most appropriate treatment modality for his or her needs. a. Screening b. Assessment c. Intake d. Orientation - * b. Assessment

2. A client tells a counselor that she is unhappy with the way her treatment is progressing. The counselor should: a. draw up a new contract with the client. b. talk to the client about possible denial. c. create new goals and objectives, and suggest alternate forms of therapy. d. discuss these concerns with the client and make necessary changes in treatment goals. - *d. discuss these concerns with the client and make necessary changes in treatment goals.
3. A common error that counselors make when conducting an assessment is: a. asking too many questions. b. moving too quickly from data collection to treatment planning. c. focusing on strengths and weaknesses. d. processing the data collected from the client. - b.moving too quickly from data collection to treatment planning A female client reports concerns about the relationship between her husband and her 14-year- old daughter from a previous marriage. She reports that her husband and daughter frequently argue, her daughter refuses to take direction from her stepfather, regularly complains about her stepfather's "faults"and describes how her biological father is better. The MOST relevant professional to whom a referral should be made is a: a. Social worker. b. Clinical psychologist. c. Licensed professional counselor. d. Marriage and family therapist. - d. Marriage and family therapist A key factor for counselors to consider is that in a counseling relationship, the counselor has differential power. One of the best safeguards is: a. to be alert to and understand the power relationship. b. to utilize the differential power to motivate the client. c. to realize the importance of this power in client interventions.

d. to use differential power to get the client to try new behaviors. - a. to be alert to and understand the power relationship. A pre-treatment period is frequently the result of waiting lists or client reluctance to become fully engaged in primary treatment. What might be a danger of this pre-treatment period? a. The pre-treatment period may be when clients lose interest in treatment. b. A client may receive enough help so as not to need the services of the program or agency. c. Successful pre-treatment may result in a client needing services that an agency doesn't have, thus losing the potential admission. d. There is really no danger with pre-treatment - recovery will require much more programming than pre-treatment can offer. - a. The pre-treatment period may be when clients lose interest in treatment.

7. According,to Marlatt's model of the relapse process, which of the following statements is NOT true? a. Clients should be taught skills for anticipating, avoiding, and coping with their personal high-risk situations. b. Clients should be taught constructive responses to cope with lapses when they do occur. c. Clients should be helped to recognize that one or more temporary lapses are likely to occur and are permitted. d. Any positive expectations that clients have about drug use should be countered with reminders about the lows that follow the highs and about the long-term negative consequences of substance abuse. - c. Clients should be helped to recognize that one or more temporary lapses are likely to occur and are permitted. According to the DSM-IV-TR, all of the following are criteria for psychoactive substance dependence EXCEPT: A. Substance often taken in larger amounts than the person intended. B. Marked lack of initiative, interest or energy. C. Frequent intoxication when expected to fulfill major role obligations. D. One or more unsuccessful efforts to cut down substance use. - B, Marked lack of initiative, interest, or energy. All of the following are goals of person-centered therapy EXCEPT: A. Teaching clients to formulate and carry out plans to change their behavior. B. Focusing on the person instead of the presenting problem. C. Assisting clients in enhancing their coping skills. D. Individualizing the treatment plan. - A, teaching clients to formulate and carry out plans to change their behavior.
8. Bob is a case manager in an intensive inpatient treatment facility. He recently was assigned a client, Mary, who presents not only with alcoholism but has also been diagnosed with AIDS.

To assist Mary in her treatment and recovery needs, Bob would probably need to have knowledge of all of the following areas EXCEPT: A. AIDS epidemiology and transmission routes. B. The disease's clinical progression. C. New medication used in treatment regimens. D. Available social services for AIDS clients. - C, New medication used in treatment regimens.

11. Therapeutic communities differ from Synanon because: a. these communities try to return clients to society. b. these communities are based on individual psychotherapy rather than group encounter. c. these communities keep the patients busy rather than engaging in contemplative thought. d. these communities rely on professional psychologists rather than former addicts or abusers. - a. these communities try to return clients to society. During the screening process, a critical task that the counselor has is to: A. Complete a mental status exam. B. Engage the client's family in treatment. C. Develop a treatment plan. D. Establish rapport with the client. - D, Establish rapport with the client. During the assessment process, your alcohol and tranquilizer abusing client reveals a history of self-destructiveness when frustrated and an inability to delay impulses. The MOST appropriate assessment battery in this case is: A. The Beck Depression Scale, the MAST test, and the MMPI. B. The Beck Depression Scale , the MAST test, and the Stanford-Binet. C. The MAST test, the Strong-Campbell, and the Stanford-Binet. D. The MMPI, the Strong-Campbell, and the Stanford-Binet. - A, The Beck Depression Scale, the MAST test, and the MMPI
12. The primary purpose of the screening process is to: A. Develop a treatment plan. B. Have the client sign appropriate documents. C. Determine one's appropriateness and eligibility for admission. D. Identify the client's strengths and weaknesses. - C, Determine one's appropriateness and eligibility for admission. Effective case management for persons in need of multiple services requires: A. Monitoring, feedback, and evaluation of services. B. Frequent face-to-face contact with the client. C. Collaboration with family members. D. Careful matching with appropriate 12-step groups. - A. Monitoring, feedback, and evaluation of services.

In determining whether a chemically dependent patient should be treated in an inpatient or outpatient program, all of the following should be considered EXCEPT: A. Whether the patient has a history of sobriety during the last several years. B. Whether the patient's job and family are likely to give him another chance if this treatment fails. C. Whether the patient has family support for sobriety. D. Whether the patient has a history of failed treatment on an outpatient or inpatient basis. - B, Whether the patient's job and family are likely to give him another chance if this treatment fails. Alcohol decreases resistance to HIV infection by: A. Compromising T-cell functions. B. Impairing frontal cortical functions. C. Increasing serotonin levels in the synaptic gap. D. Decreasing cardiopulmonary functioning. - A, Compromising T-cell functions. It is crucial for the case manager to be aware of what may inhibit minorities' participation in the substance abuse treatment continuum. Suppose you are a case manager, working in an outpatient program with a Somali client. AA is an integral part of your program, yet you are aware of the fact that while "accepting one's powerlessness" is a central tenet of 12-Step self- help programs, members of oppressed groups may not accept it, given their own societal powerlessness. What would be the best thing to do in such a case? a. Ask the client to participate, never-the-less, and suggest he simply "do his best" when dealing with the issue of powerlessness. b. Let the client know that participation in AA is mandatory, and that if he doesn't participate, he could be discharged for "noncompliance." c. Be sensitive to such cultural differences and seek out other recovery resources that are relevant to the individual's values. d. Seek out another Somali who is in a local AA group and ask the he or she sponsor your client.

• C, Be sensitive to such cultural differences and seek out other recovery resources that are relevant to the individual's values. It is important to understand clients and their expectations for counseling. Clients coming in for treatment carry with them both helpful and harmful expectations. Which of the following is a harmful client expectation? a. "This counselor is a stranger, but maybe I can learn to trust her." b. "My counselor will direct me to do what I need to do, and everything will be OK." c. "My counselor will be a resource that I can use to resolve my problems." d. "The counselor's main concern and responsibility is to help me achieve my goals and objectives." - B, "My counselor will direct me to do what I need to do, and everything will be OK."

Joe is a 27-year old addict who has begun counseling, but has not yet been able to give up using drugs. During one session, he tells his counselor he is beginning to feel "it is useless to try to stop," and "sometimes life is not worth living." The counselor is concerned that Joe could be suicidal. The counselor should: a. assess Joe's potential for suicide without directly asking him about suicide plans, but assess his high-risk factors. b. assess Joe's potential for suicide by asking him about his intent, and evaluating high risk factors. c. determine if Joe has a gun or other weapon. d. initiate involuntary hospitalization procedures. - B, Assess Joe's potential for suicide by asking him about his intent, and evaluating high risk factors. If the orientation process is neglected or incomplete a client may: a. remain in denial about his/her addiction. b. have incorrect information and unanswered questions about the program. c. need to be referred to an outside agency. d. need additional education about addiction. - B, Have incorrect information and unanswered questions about the program. One of case management's hallmark characteristics. a. Advocacy b. Cooperation c. Stabilization d. Flexibility - A, Advocacy When language is a barrier to treatment planning, this situation can be overcome by: a. employing an interpreter. b. training the counselor in cultural sensitivity. c. requiring the client to utilize a family member as an interpreter. d. getting the client a language tutor. - A, Employing an interpreter. The first contact that a potential client would have with an agency would likely be for the purpose of: a. family therapy. b. education. c. psycho-social assessment. d. screening. - C, Screening. The MOST SIGNIFICANT barrier to effective treatment for alcohol and other drug abuse for single parents is lack of: a. job skills. b. child care services. c. educational training. d. primary health care. - B, Child care services.

Sarah, a counselor in a drug treatment center, grew up in an alcoholic home and still has strained relationships. Which statement BEST describes Sarah's situation? a. Sarah can expect her unresolved conflicts to rise to the surface because of her work in the treatment center. b. Sarah can resolve her personal pain by working professionally with addicted family units in a treatment center. c. Sarah may be more comfortable with her clients because she is familiar with their behavior. d. Sarah may have unfinished business with her parents. - A, Sarah can expect her unresolved conflicts to rise to the surface because of her work in the treatment center. You are asked to see a client in the emergency room for a consultation. The nursing notes read: pupils dilated; goose flesh; lacrimation; muscle jerks; flu syndrome; vomiting; diarrhea; nervousness; Yawning; and severe anxiety. You conclude that the client is withdrawing from: a. Hallucinogens. b. CNS depressants. c. Opioids. d. Dextroamphetamines. - C, Opioids. The organization founded as an alternative to programs with spiritual overtones, whose publication is called "The Small Book," is: a. Rational Recovery. b. Secular Organization for Sobriety. c. Men and Women for Sobriety. d. Codependents Anonymous. - A, Rational Recovery. Effective communication occurs in groups when: a. message receivers hear "you" messages. b. message receivers do not speak. c. message senders use third-person pronouns. d. message senders use "I" messages. - D, Message senders use "I" messages. A single mother with three young children enters your clinic and begins to discuss her current drug use. She tells you that she hasn't been home for several days and has left the 8 year old in charge. What do you do? a. Contact child protective services to report this incident. b. Explain to her the limits of confidentiality regarding drug use. c. Admit her for treatment and arrange childcare services. d. Contact law enforcement to have her arrested for child abuse and neglect. - A, Contact child protective services to report this incident. One of the counselor's tasks is to guide the client in relating and communicating in specific terms, rather than in general or abstract terms. That characteristic or ability is called: a. Confrontation.

b. Immediacy. c. Potency. d. Concreteness. - D, Concreteness. One of the.earliest models for case management services in the criminal justice system was created in 1972, when the White House launched a demonstration program known as: a. Treatment Alternatives to Street Crime (TASC). b. Treatment Approaches for Criminal Offenders (TACO). c. Treatment Resources for Chronic Repeat Offenders (TRCRO). d. Helping Services for the Criminal Element (HSCE). - A, Treatment Alternatives to Street Crime or TASC Ralph is a recovering alcoholic. He has been sober for several months, and managed to find gainful employment and re-establish family relationships. He is in a 12-step program as well as individual counseling. One day, he arrives to a counseling session quite upset. He reveals he had a "slip" and drank a beer at a party. He did not get drunk, but feels terribly remorseful and has promised himself he will not do it again. Which of the following is MOST true? a. Although Ralph did have a relapse, recovery should be easier the second time around. b. This constitutes a relapse, and Ralph may need to begin the recovery process all over again. c. Ralph should be reassured this behavior is permissible as long as he did not lose control and become drunk. d. The counselor should talk to Ralph about the implications of dangerous situations like this, but assure him it is possible to continue his recovery process. - d. The counselor should talk to Ralph about the implications of dangerous situations like this, but assure him that it is possible to continue his recovery process. Record keeping is an important part of the counseling process. Which of the following best reflects the type of information which should be kept in a client's record? a. The name of an attending physician, referrals made, diagnostic procedures used b. Information about consultations, diagnosis, treatment, prognosis, and progress c. Names of family members, emergency numbers, DSM-IV-TR diagnosis d. Personal notes, insurance information, treatment notes - b. Information about consultations, diagnosis, treatment, prognosis, and progress Stress inoculation focuses primarily on: a. increasing self-control. b. increasing coping skills. c. decreasing anxious responding. d. decreasing negative thought patterns. - b. increasing coping skills Providing the client with information regarding program rules, and infractions that can lead to discharge, normally occurs during the:

a. screening. b. orientation. c. assessment. d. group therapy sessions. - b. orientation. Which of the following is NOT a commonly used technique for crisis intervention? a. Help the client to express feelings generated by the crisis b. Eliminate negative beliefs that contributed to the crisis c. Assign specific behavior tasks such as spending time with people d. Immediately refer the client to an agency to help change the situation - d. Immediately refer the client to an agency to help change the situation The CAGE test is a simple assessment that is administered to individuals with a drinking problem. The questions on this test refer to: a. cutting down on drinking, feeling annoyed and guilty, and dealing with hangovers. b. making a distinction between problem drinkers and alcoholics. c. craving a drink, drinking alone, feeling guilty, and employment difficulties. d. client perceptions, guilt, and "eye-openers." - a. cutting down on drinking, feeling annoyed and guilty, and dealing with hangovers. The focus of intervention in the criminal justice system is first to: a. rehabilitate offenders. b. use the threat of incarceration as a motivator to change. c. protect the health, safety, and welfare of the public. d. keep the chronic, chemically dependent person off the streets. - c. protect the health, safety, and welfare of the public. The goal of Al-Anon is: a. to provide group and individual therapy for family members of alcoholics. b. to provide a fellowship and support for individuals in relationships with alcoholics. c. to educate family members of their risk of becoming alcoholics. d. to provide families of alcoholics with the intervention necessary to prevent their substance abuse. - b. to provide a fellowship and support for individuals in relationships with alcoholics. Which of the following modes of sexual transmission provides the LOWEST risk of HIV transmission? a. Male to male b. Male to female c. Female to female d. Female to male - c. Female to female

Counselors rely heavily on the work of developmental theorists as they attempt to stimulate clients to initiate relevant growth. According to Erickson, one of the leaders in developmental theory, the task to be accomplished in adulthood is: a. Trust vs. Mistrust. b. Integrity vs. Despair. c. Identity vs. Role Confusion. d. Intimacy vs. Isolation. - d. Intimacy vs. Isolation. The description of the client's rights typically occurs during the: a. assessment. b. intake. c. orientation. d. referral. - c. orientation. During the intake, a counselor can expect to address all of the following issues EXCEPT: a. a client's fears and denial. b. confidentiality. c. information gathering. d. treatment planning. - d. treatment planning. Comprehensive client documentation: a. is best achieved when done independently from direct client care. b. facilitates communication and enhances accountability. c. is used primarily by the primary counselor. d. is a standardized process. - b. facilitates communication and enhances accountability. Relapse prevention efforts are aimed at: a. developing a therapeutic relationship for sobriety and maintenance. b. changing expectations regarding the effects of intervention. c. identifying high-risk situations and learning alternative coping skills. d. discussing aspects of evaluation and treatment. - c. identifying high-risk situations and learning alternative coping skills. Before therapy or counseling begins, clients may be given information about the treatment they will receive, as well as possible risks involved. This process is known as: a. self-disclosure. b. releasing information. c. protecting confidentiality. d. obtaining informed consent to treatment. - d. obtaining informed consent to treatment. Which statement BEST describes how a counselor can avoid professional burnout? a. Move from direct care to an administrative position. b. Contact a supervisor and ask for fewer work hours.

c. Attend to health through adequate sleep, an exercise program, and proper diet. d. Add more structure to work by using a commercial time management system. - c. Attend to health through adequate sleep, an exercise program, and proper diet. A cocaine-dependent client admits being fired from his job for absenteeism, losing his home and car by defaulting on his loans, and associating only with peers who use cocaine. He states he does not require residential treatment because his problem is not serious enough. He further states he has lost his house and car because his wife didn't work enough hours. Which defense mechanisms is this client displaying? a. Projection, denial, and displacement b. Denial, minimalization, and rationalization c. Sublimination, displacement, and compensation d. Identification, minimization, and sublimination - b. Denial, minimalization, and rationalization A client says to you, "I am getting to like you very much and I'd like us to get a lot closer." You should first: a. terminate the client's treatment and seek supervision. b. talk openly about transference issues. c. reciprocate your true feelings, but only if you are attracted to him/her. d. refer the client to another professional. - b. talk openly about transference issues.

51. The initial stage of crisis intervention involves: a. discussing the client's plans for the future. b. helping the client adapt. c. determining the problem. d. determining a solution. - c. determining the problem. The measurement of progress toward treatment plan goals is best assessed by: a. reviewing documentation in progress notes. b. consulting with the client's significant others. c. referring the client to a professional outside your agency for an objective review. d. asking the client to write a personal evaluation of his/her own progress. - a. reviewing documentation in progress notes. The PRIMARY purpose of a professional code of ethics is to: a. serve as a guide in helping clients while behaving in a fair way to colleagues. b. strengthen the appearance of professionalism among addiction counselors. c. clarify the difference between acceptable and unacceptable client behavior. d. provide legal recourse and concrete consequences for unethical behavior. - a. serve as a guide in helping clients while behaving in a fair way to colleagues. The PRIMARY purpose of professional standards of practice is to: a. provide recognition of demonstrated competency in addictions counseling.

b. ensure that each client receives equal treatment regardless of ability to pay. c. help programs qualify for Medicaid and other third-party reimbursement d. allow unlicensed counselors to work in licensed facilities. - a. provide recognition of demonstrated competency in addictions counseling. The tendency of the family to try and maintain balance is called: a. equilibrium. b. stability. c. homeostasis. d. accommodation. - c. homeostasis Of the following statements made by a client in a group, which would MOST warrant documentation in the client's progress notes? a. "I'm finding the support from this group to be very helpful." b. "Getting caught for drunk driving was a mixed blessing." c. "Ever since I stopped drinking, my emotional swings have been quite intense." d. "Let's change the subject Did anyone see the game last night?" - c. "Ever since I stopped drinking, my emotional swings have been quite intense." Your client, Eric, discloses to the group that he is homosexual. Another member of the group shifts in his seat and changes the subject, talking about a superficial incident that happened earlier in the day. The facilitator's MOST appropriate response would be to: a. interrupt the second speaker and remind him of the group rules. b. remind Eric that you are here to treat addiction and ask how this relates to his addiction. c. tell Eric that this disclosure is more appropriate for an individual session and you will meet with him later. d. ask questions which facilitate a group response to Eric's disclosure and elicit more feeling content from Eric. - d. ask questions which facilitate a group response to Eric's disclosure and elicit more feeling content from Eric. All of the following are benzodiazepines EXCEPT: a. Valium. b. Halcion. c. Trazodone. d. Xanax. - c. Trazodone. A major method of reinforcing the therapeutic alliance and spirit of collaboration between the client and the counselor is: a. including the client's family members in counseling. b. setting mutually-established goals. c. going to 12-step meetings with the client. d. offering to make home visits. - b. setting mutually-established goals.

A mental status exam does NOT assess: a. educational level. b. appearance. c. speech. d. thought processes. - a. educational level. The provision of information concerning alcohol and other drug abuse and the available services and resources, is termed: a. consultation. b. client education. c. counseling. d. case management. - b. client education. When making a referral you should do all of the following EXCEPT: a. share what you know about the referral agency with your client. b. follow through with the referral agency to ensure you get your referral fee. c. offer to make the initial contact in order to ensure that the client sees the right person. d. Have the client sign a release of confidentiality form before following through with the referral. - b. follow through with the referral agency to ensure you get your referral fee. Which situation requires a client's informed consent? a. A counselor refers a client back to the referring source at completion of treatment b. A counselor discusses a client's case with the counselor's supervisor c. A counselor discusses a client's case with another counselor in the treatment facility d. A client reports recent child abuse - d. A client reports recent child abuse Significant others should be involved in the treatment process: a. when the client requests interaction. b. from the client's first contact with the treatment center. c. after it has been determined that the clients treatment is going well. d. after it has been determined that the interaction will not interfere with the client's treatment. - b. from the client's first contact with the treatment center. The NIDA-financed Drug Abuse Reporting Program found that: a. short-term therapy is more effective for drug abusers than long-term therapy. b. heroin addicts had a higher relapse rate than cocaine addicts. c. most drug abusers who enter therapeutic communities remain drug free. d. therapeutic communities do reduce drug use relative to untreated clients or those who are simply detoxified and released. - d. therapeutic communities do reduce drug use relative to untreated clients or those who are simply detoxified and released Your dual-diagnosed client, stabilized on medication for his psychiatric disorder, decides he wants to quit smoking. You should: a. advise him to select a quit date within the next 2 weeks.

b. encourage him to use the nicotine patch or gum. c. consult with his physician regarding nicotine/medication interaction. d. suggest he cut down the number of cigarettes daily for 2 weeks before quitting. - c. consult with his physician regarding nicotine/medication interaction. Which of the following is a cognitive-based therapy, developed by Ellis, which is designed to confront a client's irrational thinking? a. Adlerian Therapy b. Client-Centered Therapy c. Rational-Emotive Therapy d. Reality Therapy - c. Rational-Emotive Therapy

68. Because addiction affects so many facets of the addicted person's life, ______ promotes recovery and enables the substance abuse client to fully integrate into society as a healthy, substance-free individual. a. detoxification and stabilization b. psychological evaluation and treatment c. integration into a self-help recovery program d. a comprehensive continuum of services - d. a comprehensive continuum of services A "Release of Information" form must include, in addition to the client's name, address and date of birth, which of the following? a. The client's ethnic background b. A signature by a medical doctor c. The purpose of the release of information d. The client's social security number - c. The purpose of the release of information When a client discloses suicidal thoughts, the counselor's first step is to: a. identify alternative courses of action. b. offer emotional support. c. contact emergency personnel. d. assess the degree of risk. - d. assess the degree of risk. When assessing the signs and symptoms of alcohol withdrawal, all of the following may be noted EXCEPT: a. restlessness, irritability, anxiety, agitation. b. tremor, elevated heart rate, increased blood pressure. c. decreased sensitivity to sounds, oversensitivity to tactile sensations. d. decreased appetite, nausea, and vomiting. - c. decreased sensitivity to sounds, oversensitivity to tactile sensations. When conducting an assessment, what is the counselor's primary focus? a. Identifying the client's problems and needs, strengths and weaknesses b. Explaining the rules of the program

c. Having the client sign Release of Information forms d. Confronting the client's denial - a. Identifying the client's problems and needs, strengths and weaknesses Which of the following is the BEST indicator if an individual is physically dependent upon alcohol or another drug? a. The amount consumed daily b. The length in years of heavy drinking or drug use c. The presence of withdrawal symptoms d. The frequency of memory blackouts - c. The presence of withdrawal symptoms In a crisis interview with a client, you are MOST concerned with: a. the client's family dynamics. b. getting all the information that you can. c. what your immediate response should be. d. focusing questions about the present situation and the client's means of coping with the stress. - d. focusing questions about the present situation and the client's means of coping with the stress. Which statement about the grief process is TRUE? a. Guilt and anger are painful emotions that are part of grieving b. Symptoms of grief typically disappear within six months c. The grieving process should be hurried so the client can resume his life d. Grief is only a response to situations involving death - A, Guilt and anger are painful emotions that are part of grieving Your client has been advised by his sponsor to discontinue a needed antidepressant medication. You believe this advice to be premature and possibly harmful. What action should you take as a first step? a. Obtain your client's authorization and contact the sponsor to discuss the situation further b. Have the client discontinue involvement in AA until antidepressant medication is no longer needed c. Encourage your client to ignore the sponsor's advice and continue the medication d. Encourage your client to look for another, more understanding sponsor - a. Obtain your client's authorization and contact the sponsor to discuss the situation further You are having difficulty with a client early on in the case. The BEST thing for you to do is: a. transfer the client to another counselor. b. let the relationship develop and try to work it out. c. challenge the client about his/her resistance to treatment.

d. seek out supervision with a colleague or supervisor. - d. seek out supervision with a colleague or supervisor. While taking an alcohol drug history, which of the following is a good clue to alcohol dependency? a. Increased tolerance and withdrawal symptoms when abstinence is attempted b. Continued use despite experiencing problems that result from drinking c. Recurring incidents of driving under the influent d. Depression and lethargy - a. Increased tolerance and withdrawal symptoms when abstinence is attempted

79. You have assessed your client and determined that he is a problem drinker. He insists that the reason he drinks is because of his wife's behavior. Your initial objective should be to help him: a. get his wife into counseling with him. b. take responsibility for his behavior. c. develop a more positive perception of himself. d. effect a behavioral intervention. - b. take responsibility for his behavior. In order to fill gaps in services to minority clients, communities should include all of the following EXCEPT: a. education and training. b. diagnosis and intervention. c. segregated treatment programs. d. integrated treatment programs with cultural programming.. - c. segregated treatment programs. An irresistible impulse is called a(an): a. compulsion. b. delusion. c. hallucination. d. obsession. - a. compulsion. All of the following statements about the effects of alcohol abuse on the body are true EXCEPT: a. malnutrition can occur in drinkers who eat well-balanced diets. b. stimulation of the brain's frontal lobe can occur. c. the second stage of liver deterioration can be reversed. d. a vitamin B6 deficiency can occur. - b. stimulation of the brain's frontal lobe can occur. The interpersonal style in which a member of a minority group has made a conscious or subconscious decision to reject the general attitudes, behaviors, customs, rituals, and

stereotypical behaviors associated with his/her own minority group to assimilate into the mainstream white culture is known as: a. the Acculturated Interpersonal Style. b. the Bi-Cultural Interpersonal Style. c. the Culturally-Immersed Interpersonal Style. d. the Traditional Interpersonal Style. - a. the Acculturated Interpersonal Style.

84. Brian is a 15-year old boy who has been admitted to a program for chemical dependency. He has a history of running away from home, erratic performance in school, and has been arrested twice for petty theft. In assessing Brian, the counselor should first consider which of the following before making a treatment recommendation? a. Brian's goals in life b. Brian's social resources c. If Brian really needs the program d. Brian's familial relationships and social milieu - d. Brian's familial relationships and social milieu Despite vast personality differences, virtually all substance abusers experience: a. denial, surrender, and acceptance. b. self-hatred, anger, and guilt c. remorse, self-hatred, and shame. d. shame, euphoric recall, and relapse. - c. remorse, self-hatred, and shame. The therapeutic reasoning for self-disclosure in group counseling is to: a. provide the group members with insight into the counselor's background. b. convince group members that the counselor has more life experiences than they do. c. demonstrate how to react when other group members disclose personal information. d. facilitate the growth of the group by relating to client or group issues. - d. facilitate the growth of the group by relating to client or group issues. Barbiturates can be sub-classified into groups based upon: a. how they are used. b. when they were discovered. c. their medical and non-medical use. d. the speed of the onset and duration of the effects. - d. the speed of the onset and duration of the effects. Heroin is an example of a(an): a. natural narcotic. b. semi-synthetic narcotic. c. synthetic narcotic. d. quasi-narcotic. - b. semi-synthetic narcotic.

There are several psychological and sociological differences between male and female alcohol abusers. Which of the following BEST describes one of those differences? a. Women more often than men will cite a traumatic event that precipitated their drinking. b. Female alcoholics are more likely to be sociopathic and male alcoholics are more likely to have affective problems. c. Female alcoholics are less frequently characterized as feeling depressed and guilty than male alcoholics. d. Women move more slowly from the early stages to the later stages of abusive drinking than men. - a. Women more often than men will cite a traumatic event that precipitated their drinking Which statement MOST accurately describes the relationship between Alcoholics Anonymous and the professional treatment community? a. AA policy clearly states that recovery can often be frustrated by contact with professionals. b. AA has made no statements for or against the professional treatment community. c. There are inherent conflicts between AA and the professional treatment community which are unlikely to be resolved. d. A partnership between AA and the professional community was repeatedly emphasized by the founders of AA. - d. A partnership between AA and the professional community was repeatedly emphasized by the founders of AA. Which of the following patterns of drinking is accurately associated with the term "alcoholism"? a. A lack of tolerance for alcohol b. Frequent short periods of sobriety c. The inability to control the amount one drinks d. Light drinking EXCEPT on weekends - c. The inability to control the amount one drinks Which of the following is MOST helpful for counselors in defining their professional roles for counseling clients? a. An understanding of self-help groups b. An ethical code of conduct c. Certification - b. An ethical code of conduct "Referral" pertains to: a. assisting a client to utilize the support systems and community resources available. b. meeting with other professionals for discussions and planning. c. providing drug and alcohol information to clients. d. attending an A.A. or N.A. meeting with a client. - a. assisting a client to utilize the support systems and community resources available. A treatment professional utilizing case management will do all of the following EXCEPT:

a. assist the client with needs generally thought to be outside the realm of substance abuse treatment. b. provide the client a single point of contact for multiple health and social services systems. c. advocate for the treatment center's approach to care. d. be flexible, community-based, and client-oriented. - c. advocate for the treatment center's approach to care. Pointing out parallels between a client's interpersonal relationships and the client/counselor interaction serves to focus awareness on: a. the "here and now." b. the client's weaknesses in communication. c. the counselor's feelings about the relation d. the unique qualities of the client/counselor relationship. - a. the "here and now." If a client appears to be in denial due to discrepancies stated during an intake interview, which of the following statements by the counselor would be MOST appropriate? a. "I'm not sure I understand. Let me check this out" b. "First you tell me one thing, then another. Which is really the truth?" c. "There's a lot of confusion in your story" d. "Addiction fosters denial" - a. "I'm not sure I understand. Let me check this out" The branch of pharmacology that deals with the biological, biochemical, and physical characteristics of natural drugs is: a. Pharmacokinetics. b. Pharmacognosy. c. Pharmacotherapeutics. d. Pharmacodynamics. - b. Pharmacognosy. The term "late-onset" as it applies to chemical dependency refers to: a. adolescents who avoid use till their late teen years. b. women who don't begin use till after marriage. c. elderly people who develop chemical dependency late in life. d. alcoholics who develop medical complications after years of exposure to alcohol. - c. elderly people who develop chemical dependency late in life. Written consent to release client information is required EXCEPT when the release is to the client's: a. spouse who participates in joint counseling sessions. b. employer when confirmation of attendance is needed for continued employment. c. attorney when verification of admission status is needed for a court hearing. d. physician when information on medications prescribed in treatment is requested. - a. spouse who participates in joint counseling sessions.

100. Some populations suffer greater rates of addiction than others. The Native

American population, for example, have addiction rates of: a. 20%. b. 30%. c. 40%. d. >50%. - d. >50%. The BEST way of dealing with individual needs in a group is to: a. use the group process to share mutual concerns. b. see the client for individual counseling outside of group. c. conduct one-on-one sessions in the group. d. not allow monopolizing by members in group. - a. use the group process to share mutual concerns. Assessment, according to the behavioral approach, involves: a. taking a client history and specifying problematic behavior. b. specification of the problematic behavior and collection of baseline data. c. identification of the problematic behavior and evaluation of the client's motivation to change. d. specification of the problematic behavior and evaluation of the client's motivation to change.

• b. specification of the problematic behavior and collection of baseline data Concise and accurate reporting is necessary in order to: a. assist in client education. b. ensure continuity of client care. c. promote team work among the clinical staff. d. identify client strengths and weaknesses. - b. ensure continuity of client care. In order to provide clients with updated information concerning addiction and recovery, the counselor must: a. regularly attend A.A. and/or N.A. meetings. b. stay well-informed and aware of recent developments in the field. c. teach classes about these topics. d. assume that the client will ask for what he/she needs. - b. stay well-informed and aware of recent developments in the field. Relating with in-house and other professionals to assure comprehensive, quality care for the client BEST describes the process of: a. assessment. b. referral. c. counseling. d. consultation. - d. consultation. A mutually-agreed-upon treatment plan should include: a. a detailed explanation of goals and objectives.

b. more than one goal established by the counselor. c. a well-developed outline for the discharge summary. d. clear expectations, specific goals, and methods of achievement. - d. clear expectations, specific goals, and methods of achievement. Which of the following statements about dysfunctional families is TRUE? a. The family cannot get well until the dependent person seeks help. b. The children in a dysfunctional family can be protected from the problems cause by chemical dependency. c. The divorce rate in dysfunctional families is highest after recovery has been initiated. d. Family problems develop in the later phases of the addiction process. - c. The divorce rate in dysfunctional families is highest after recovery has been initiated. The quality of counseling is directly related to the counselor's ability to: a. formulate and carry out realistic personal and professional goals. b. interpret the deeper meaning of problems. c. analyze client problems. d. convince clients to change. - a. formulate and carry out realistic personal and professional goals. A client says that his wife has vowed to leave him if he resumes drinking. The best response by the counselor would be: a. "she seems to be over-reacting" b. "does she usually threaten you?" c. "sounds like she needs Al-Anon" d. "she's really serious about your sobriety" - d. "she's really serious about your sobriety" Which self help group would be most appropriate for a mother whose drug and alcohol-abusing son is causing her distress? a. Alateen b. ACOA c. Al-Anon d. A.A. - c. Al-Anon The treatment plan is developed based on information collected during: a. screening. b. orientation. c. the assessment. d. intake. - c. the assessment. You begin working with a drinking alcoholic who recently had eight months of sobriety. He asks how he can stay sober. You respond by: a. getting him to gradually cut down on his drinking.

b. encouraging him to change sponsors. c. referring him for additional treatment d. asking him what worked before. - d. asking him what worked before. Which term refers to a client's projecting past emotional feelings and/or attitudes onto the counselor? a. Transference b. Countertransference c. Reaction formation d. Sublimation - a. Transference Which of the following responses would be helpful in establishing a therapeutic relationship with a client? a. "What's the matter with you? Why didn't you just take care of the problem yourself?" b. "Let's get right to the point. You've got a drinking problem" c. "Let's talk about each of our expectations for counseling" d. "Let me tell you what you need to stay sober" - c. "Let's talk about each of our expectations for counseling" Good case management requires the integration of services within a treatment plan. With this in mind, which of the following is TRUE? a. The counselor should coordinate regular meetings with all professionals involved in the client's treatment. b. Good integration of services requires team meetings with the client present. c. Once the treatment plan is written, the use of other services is determined and will remain unchanged. d. With a well-integrated team of professionals, the case manager's review of progress notes will alone determine how the treatment plan is being followed. - a. The counselor should coordinate regular meetings with all professionals involved in the client's treatment A reward is something given for a special behavior, whereas positive reinforcement is: a. a mutual reward to reinforce behavior by the same amount. b. something specifically designed to increase the occurrence of a particular behavior. c. the process of observing behavior of others. d. a type of learning in which behaviors are increased as the result of the, consequences. - b. something specifically designed to increase the occurrence of a particular behavior A 42-year-old male has just completed intake admission forms and is considered appropriate and eligible for treatment. Which step should occur next? a. A licensed physician should conduct a physical examination of the client. b. The client should complete psychological tests to be used in the evaluation.

c. The counselor should conduct an initial family therapy session in order to address problems caused by the client's use. d. The counselor should provide the client with an overview describing the goal, objectives, rules, and obligations of the program. - d. The counselor should provide the client with an overview describing the goal, objectives, rules, and obligations of the program. Personality disorders are: a. reactions to stress. b. episodic in nature. c. intrapsychic disturbances. d. maladaptive ways of perceiving, thinking, and relating. - d. maladaptive ways of perceiving, thinking, and relating. While the overall national suicide rate has increased slightly but consistently in recent years, disproportionate increases have occurred among: a. females and the elderly. b. females and the young. c. males and the elderly. d. males and the young. - b. females and the young. If Seconal is taken in combination with one of the following drugs, it leads to a "potentiation" of effect. Which drug will cause this effect? a. Alcohol b. Amphetamines c. Opiates d. Cocaine - a. Alcohol Morning drinking is not an uncommon occurrence with alcoholics. Which of the following is NOT a true statement? a. Morning drinking will reduce the symptoms of withdrawal b. Morning drinking will keep the alcoholic's blood alcohol level from dropping. c. Morning drinking will lessen the need for alcohol during the remainder of the day d. Morning drinking reduces anxiety that effects the alcoholic's ability to start the day - c. Morning drinking will lessen the need for alcohol during the remainder of the day To assist them in handling termination issues, effective counselors use appropriate levels of: a. counter-transference. b. investigation. c. self-disclosure. d. role-playing. - c. self-disclosure. Which of the following is a TRUE statement?

a. Alcohol accounts for one-half of the ten leading causes of death in the Native American population. b. Cultural issues no longer play a role in alcoholism rates with the Native American population. c. Past efforts to treat the Native American alcoholic have proven highly successful. d. Revia has proven to be a popular intervention in the effective treatment of Native American populations. - a. Alcohol accounts for one-half of the ten leading causes of death in the Native American population. During a session you notice that the client is getting progressively more agitated. You suspect a potential for violence unless something is done immediately. Your BEST course of action would be to: a. summarize the inappropriateness of the client's feelings. b. confront the client's behavior; c. instruct the client in relaxation techniques. d. call for assistance. - d. call for assistance. After a counselor has made a summary statement, the most important thing the counselor should do is: a. remain quite for a time to allow the client to consider the summarized material. b. document the summary as soon as possible as part of the treatment plan. c. recommend that the client discuss the session with his/her sponsor. d. terminate the session immediately. - a. remain quite for a time to allow the client to consider the summarized material. Bipolar mood disorder is distinguished from major depression by: a. at least one episode of mania. b. evidence of earlier cyclothymia. c. evidence of earlier dysthymia. d. chronic forms of depression. - a. at least one episode of mania. In a dysfunctional family system, the traditional role which the spouse plays is referred to as: a. the Hero. b. the Scapegoat. c. the Primary Enabler. d. the Mascot. - c. the Primary Enabler. A frequent client reaction during the termination phase of counseling is: a. defensiveness. b. acting out behavior. c. apathy. d. lack of trust. - b. acting out behavior.

The completion of various forms, including releases of information, financial, and consent for treatment, happens during the client's: a. intake. b. orientation. c. case review. d. psychosocial assessment. - a. intake. Which of the following is the BEST example of a counselor setting limits with a client? a. "We're here to discuss your alcohol problem - I don't want to talk about your marriage" b. "Counseling is a very unstructured process - anything goes" c. "Our meetings will consist of four 50 minute sessions at 10 a.m. each Wednesday" d. "What's important is that I help you. Ill counsel you no matter what" - c. "Our meetings will consist of four 50 minute sessions at 10 a.m. each Wednesday" One goal of an effective aftercare program is: a. to enhance a client's emotional rehabilitation. b. to minimize the client's use of denial. c. to support the gains made in treatment. d. to assign sponsors to clients. - c. to support the gains made in treatment.

132. According to the American Society of Addiction Medicine (ASAM), which the following is NOT one of the five categories of primary treatment? a. Early intervention b. Detoxification services c. Intensive outpatient or partial hospitalization d. Residential or inpatient services - b. Detoxification services Regarding a "seropositive" result, which of the following is NOT a meaning of HIV antibody test results? a. The person has the AIDS virus b. HIV infection occurred at some point in the past c. The person is infectious and will remain so for life d. The HIV infection has been in the system long enough to produce antibodies - a. The person has the AIDS virus Client files should be readily accessible to: a. the client. b. all staff of the facility. c. the agency board of directors. d. only those persons directly involved in providing clinical services. - d. only those persons directly involved in providing clinical services.

Which of the following issues must always be considered when consulting with out-of-agency professionals? a. Confidentiality b. Documentation of client problems c. The client's aftercare plan d. The level of commitment of the client to follow through - a. Confidentiality The process of termination should be discussed: a. when the client appears to have gained all that he or she can from therapy. b. at the point specified in the therapeutic contract. c. at the onset of therapy. d. when the client brings it up. - c. at the onset of therapy. All of the following are symptoms of the manic phase of bipolar mood disorder EXCEPT: a. deflated self-esteem. b. euphoria. c. high levels of verbal output. d. pressured speech. - a. deflated self-esteem. Based upon the initial interview, Bill was given a provisional Axis I diagnosis of "alcohol dependence" and admitted to an Intensive outpatient program. After completion of the initial interview, Bill was given a tour of the facility, a client handbook, and introduced to his primary counselor and scheduled an appointment the next day to discuss what the client could expect during treatment and what would be expected of him in return. During his treatment Bill worked with his counselor to develop four primary treatment goals:

1. To spend at least four hours every other weekend with his children;
2. To attend three A.A. meetings a week for the next three months;
3. To abstain from alcohol and all mind altering and mood enhancing substances; and
4. Complete the 12 week Intensive outpatient treatment program. Bill was quite resistant to attending A,A. meetings because of fear of being seen by his friends at meetings. The counselor helped Bill deal with his feelings by encouraging him to "A, B, C" his thoughts about what people might think of him if seen at meetings and documented the client's progress in his chart with a process note. In addition, Bill was provided a set of videotapes which provided information about the disease concept of addiction, family dynamics, relapse prevention and problem solving strategies to review during his first two weeks of treatment. In the sixth week of counseling, Bill became quite agitated and insisted he was going to have to stop treatment because his work schedule had been changed - four of his employees had quit their jobs and he was going to have to fill in their responsibilities. His counselor met with him and encouraged him to calm down and accept a change in his daily treatment schedule. Given his limited financial means and approximately $7,500 of debt on his Visa card and the fact that Bill talked excessively about his enormous debt, his counselor sought the advice of his clinical supervisor since financial problems were outside his scope of expertise. The clinical supervisor suggested that the counselor schedule an appointment with a non-profit credit