Substance Abuse Counseling Practices, Exams of Nursing

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What are the two key mental health treatment paradigms of Western medicine? A. Objectivity and the scientific method B. Theoretical and applied practice C. Pharmacological therapy and psychotherapy D. Biological and environmental perspectives - Answers -C. Pharmacological therapy and psychotherapy Topics addressed in psychoeducational groups are typically A. sequenced by concept for maximal effectiveness. B. presented as requested or needed by group participants. C. selected randomly by the group educator or presenter. D. determined by the group's prevailing drug of choice. - Answers -A. sequenced by concept for maximal effectiveness. How does the Center for Substance Abuse Treatment (CSAT) recommend that substance abuse be considered and treated? A. A psychological disorder B. An acute disease C. A chronic treatable condition D. A degenerative treatment disorder - Answers -C. A chronic treatable condition Which of the following is the BEST definition of insight? A. A problem-solving strategy involving the elimination of unworkable solutions.

TCADC/CADC

EXAM QUESTIONS

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B. A sudden understanding of self, or realization of how a problem can be solved. C. A Freudian defense mechanism that is used unconsciously but not maliciously. D. A confrontation technique used in conjunction with Gestalt therapy. - Answers -B. A sudden understanding of self, or realization of how a problem can be solved. MAT refers to: A. A common screening tool for alcoholism. B. A lengthy personality inventory used to identify gross psychopathology. C. The use of medications such as suboxone in the treatment of addiction. D. A non-medical detox protocol. - Answers -C. The use of medications such as suboxone in the treatment of addiction. Aisha has completed her treatment at an in-patient facility and is ready to be discharged. She has asked her counselor to recommend a therapist to work with her and her husband on an out-patient basis. This process is BEST viewed as an example of: A. A referral. B. A consultation. C. Case management. D. An aftercare plan. - Answers -A. A referral. Which type of therapy is most directive, offering the greatest potential for abuse of power by the counselor? A. Adlerian B. Rational-emotive C. Gestalt D. Person-centered - Answers -C. Gestalt The primary purpose of professional credentialing for counselors is to: A. Advance the field by ensuring that counselors are recognized as dignified professionals. B. Ensure that counselors share and understand the accepted philosophies of practice. C. Protect public safety by ensuring that counselors meet minimum standards of competency. D. Ensure that counselors receiving third-party payments have professional credentials.

• Answers -C. Protect public safety by ensuring that counselors meet minimum standards of competency. Which of the following is NOT a CNS depressant? A. Alcohol B. Xanax

C. Nembutal D. Benzedrine - Answers -D. Benzadrine The concept of informed consent requires that before agreeing to accept treatment, clients should know their rights and obligations, therapeutic goals, fees for services and ______________. A. Availability of referral services B. Community resources to be used C. With whom they will be participating in group activities D. The limits of their confidentiality - Answers -D. The limits of their confidentiality Attitudes, policies, and practices that are destructive to other cultures and their members are examples of lack of cultural ____________. A. Blindness B. Competence C. Destructiveness D. Incapacity - Answers -B. Competence Restlessness, nervousness, flushed face, muscle twitching, tachycardia or cardiac arrhythmia are all signs or symptoms of: A. Caffeine intoxication B. Cocaine intoxication C. Alcohol intoxication D. Opioid intoxication - Answers -A. Caffeine intoxication Studies indicate that counseling is most effective when: A. Culture and values are taken into account B. The counselor relies on humanistic methods C. The therapist and the client come from similar backgrounds D. A therapeutic contract is clarified in the first session - Answers -A. Culture and values are taken into account One basic principle of documentation requires the counselor to: A. Describe events as vaguely as possible in case records are requested for a court case. B. Describe events in objective terms, using measurable language that can be easily understood. C. Only document group notes, because any twelve step work is not counseling. D. Document emotions based only on what the client reports, because the counselor's assessment will always be subjective. - Answers -B. Describe events in objective terms, using measurable language that can be easily understood

The _______________ model of addiction explains addiction as a consequence of personal choice. A. Disease B. Moral C. Social D. Sociocultural - Answers -B. Moral How does solution-focused brief therapy differ from many of the other approaches to counseling? A. Emphasis is placed on the present and future while devaluing the past. B. It emphasizes the use of more abstract techniques, such as empty chair. C. Greater attention is paid to the particular pathology and associated problems. D. More time is spent attempting to understand the problem. - Answers -A. Emphasis is placed on the present and future while devaluing the past. Case reviews: A. Encourage the sharing of information B. Promote client growth C. Allow the client the opportunity to offer feedback D. Enable the counselor to assess progress and make any necessary changes in the treatment plan - Answers -D. Enable the counselor to assess progress and make any necessary changes in the treatment plan The tendency of the family to try and maintain balance when dealing with a loved one's substance use disorder is called: A. Equilibrium B. Stability C. Homeostasis D. Accommodation - Answers -C. Homeostasis Your client expresses growing feelings of rage. He has recurring nightmares in which he attacks random women on the street. If you followed through with what you believed was a duty to warn, under what circumstance would you be least likely to be disciplined? A. If the nightmares had escalated in intensity B. If the client was already a convicted criminal C. If the client refuses to answer questions about violent behavior D. If the client discloses the name of a person he plans to harm - Answers -D. If the client discloses the name of a person he plans to harm

In his second counseling session, a client reveals to the counselor that he is gay. Having never worked with a member of this special population, the counselor's BEST course of action is to: A. Inform the client of his lack of knowledge of the gay community and commitment to learn B. Offer to refer the client to someone with experience in special issues associated with the gay community C. Send the client a letter informing him that he has been transferred to another counselor's caseload D. Say nothing because counseling should be value-neutral anyway - Answers -B. Offer to refer the client to someone with experience in special issues associated with the gay community Determining a client's eligibility and appropriateness for treatment occurs during the ______________ process. A. Intake B. Assessment C. Admission D. Screening - Answers -D. Screening Highly structured daily routines, a system of rewards and punishments, and frequent group confrontation are characteristics of: A. Intensive out-patient treatment B. Therapeutic communities C. Any primary care setting D. Gestalt therapy - Answers -B. Therapeutic communities Collateral interviews: A. Involve asking significant others about their opinions as to whether or not a person has a substance abuse or dependency problem. B. Do not require release of information documents if the information is voluntarily given C. Involve gathering information from other persons who are, or have been, associated with the person being assessed D. Should only be done with immediate family members and no one else - Answers -C. Involve gathering information from other persons who are, or have been, associated with the person being assessed A major criticism of the ____________ is that the questions are so obvious that this test cannot possibly detect alcoholics who deny having a problem. A. MAST B. ASI

C. SASSI

D. POSIT - Answers -A. MAST The goal of complete abstinence is most consistent with the _____________ model of addiction. A. Moral B. Disease C. Sociocultural D. Psychological - Answers -B. Disease _______________________ can develop between natural and synthetic opiates, but not between opiates and CNS depressants. A. Non-synergistic interaction B. Gestalt C. Cross tolerance D. Negative symptoms - Answers -C. Cross tolerance Appropriate treatment goals must be: A. Observable and measurable, in order to facilitate monitoring progress. B. Typed and signed in order to ensure compliance by an unwilling client. C. Written in the order that they will be addressed in treatment. D. Finalized by the time the client is admitted for services. - Answers -A. Observable and measurable, in order to facilitate monitoring progress. When is confrontation probably least appropriate? A. Prior to establishing rapport with the client. B. When directed at the client's strengths. C. When addressed to specific aspects of a client's behavior. D. When used to point out a discrepancy between a client's verbal statements and his or her behavior. - Answers -A. Prior to establishing rapport with the client. The goal of screening is to: A. Provide clients with an opportunity to discuss their past problems. B. Determine whether a client is appropriate and eligible for a particular treatment service. C. Gathering some general information about the future goals of the potential client. D. Assign a counselor who fits the client's personality best. - Answers -B. Determine whether a client is appropriate and eligible for a particular treatment service.

Jamal believes that he has everything he will ever need materially and financially, so he has decided to devote his time to music and other creative outlets for self-expression. Jamal's motivation is best accounted for by: A. Psychoanalytic theory B. Humanistic theory C. Cognitive-behaviorism D. Classical conditioning - Answers -C. Cognitive-behaviorism ___________________ drugs are used to treat mental disorders. A. Psychoactive B. Psychotropic C. Psychosomatic D. Psychointeractive - Answers -B. Psychotropic The idea that people have an in-born desire to self-actualize is associated with: A. Psychoanalytic theory B. Humanistic theory C. Cognitive-behaviorism D. Classical conditioning - Answers -B. Humanistic theory Methadone, Tramadol, and Morphine are all _______________________. A. Schedule V drugs B. CNS stimulants C. Barbiturates D. Opiates - Answers -D. Opiates The central focus or "charge" of the twelfth step of Alcoholics Anonymous is: A. Service to others B. Relapse prevention C. Abstinence D. Making amends to others - Answers -A. Service to others A counselor's personal values: A. Should never show lest they cause a client's decision to be biased. B. Should be disclosed in order to influence the client to make healthier decisions. C. Are irrelevant to the counseling process D. Are communicated through the therapeutic goals they offer and how they attempt to reach those goals with the client. - Answers -D. Are communicated through the therapeutic goals they offer and how they attempt to reach those goals with the client.

Non-maleficence is the ethical principle that means: A. Show unconditional positive regard B. Show equal respect for gender C. Do no harm D. Respect confidentiality - Answers -C. Do no harm _____________________ interventions have been developed or are being south to block the effects of abused drugs, reduce cravings for drugs and block the toxic effects of drugs. A. Socially acceptable B. Pharmacological C. Biological D. Free - Answers -B. Pharmacological The terminology now being used in the DSM-5 for diagnostic categories is: A. Substance Abuse Disorders B. Substance Dependence Disorders C. Substance Use Disorders D. Substance Addictive Disorders - Answers -C. Substance Use Disorders Which statement BEST describes the relevance of counselor self-exploration? A. The counselor's personal identity should not be disclosed to the client because of the risk of transference. B. Counselors can benefit greatly from being clients themselves, at some point. C. Counselors who are in therapy themselves are putting their own clients at risk. D. Counselors learn what is most important by helping other people. - Answers -B. Counselors can benefit greatly from being clients themselves, at some point. _________________ is the term used to describe the mental activities involved in acquiring, retaining and using any type of knowledge. A. Thinking B. Memory C. Cognition D. Perception - Answers -C. Cognition In the DSM-5, for substance use disorder severity indicator of mild, how many criteria must be present? A. Two to three B. Four to five C. Five to six

D. Six or more - Answers -A. Two to three In which situation is it acceptable to release confidential information without prior consent from the client? A. When the client has a sexually transmitted disease. B. If law enforcement officials request information in writing. C. After learning that a client was once involved in a crime. D. When the client admits to abusing a child. - Answers -D. When the client admits to abusing a child. Substance _______________ is a syndrome that develops temporarily after ingestion of a psychoactive substance. A. Withdrawal B. Overdose C. Intoxication D. Anhedonia - Answers -C. Intoxication Tonya is a 35 y/o AA woman who brought her toddler to the ER with her. The baby is lethargic/irritable. The mom doesn't know what is wrong with the baby. The mom seems erratic. The ER doctor has called you in the consult on the mom, while he treats the child. In the course of your convo, you learn that the mom takes Valium daily because she "has nerves." She insists that it isn't a problem. Later you learn that the baby found his mom's Valium and swallowed a few pills. The dad, an AA, age 36 arrives and says he thinks his wife is addicted, however he won't even make eye contact with you. During your interview with the mom, she has insisted she doesn't have a problem. What should you do? A. Thank her for her time and give her your contact info in case she changes her mind. B. Talk w/ the husband about planning an intervention, using other family/friends to assist. C. Seek a court commitment for a more detailed eval. - Answers -B. Talk w/ the husband about planning an intervention, using other family/friends to assist. Tonya is a 35 y/o AA woman who brought her toddler to the ER with her. The baby is lethargic/irritable. The mom doesn't know what is wrong with the baby. The mom seems erratic. The ER doctor has called you in the consult on the mom, while he treats the child. In the course of your convo, you learn that the mom takes Valium daily because she "has nerves." She insists that it isn't a problem. Later you learn that the baby found his mom's Valium and swallowed a few pills. The dad, an AA, age 36 arrives and says he thinks his wife is addicted, however he won't even make eye contact with you. Do you have a responsibility to report the incident involving the child to authorities?

A. Yes, b/c the child was put in danger b/c of the mom's addiction B. No, b/c the doctor told you it was only a minor incident and to let it go this time C. Yes, b/c the husband's lack of eye contact hints at evasiveness of a larger problem - Answers -A. Yes, b/c the child was put in danger b/c of the mom's addiction Tonya is a 35 y/o AA woman who brought her toddler to the ER with her. The baby is lethargic/irritable. The mom doesn't know what is wrong with the baby. The mom seems erratic. The ER doctor has called you in the consult on the mom, while he treats the child. In the course of your convo, you learn that the mom takes Valium daily because she "has nerves." She insists that it isn't a problem. Later you learn that the baby found his mom's Valium and swallowed a few pills. The dad, an AA, age 36 arrives and says he thinks his wife is addicted, however he won't even make eye contact with you. The dad stated that his wife was an addict and needed help, but he could not seem to make eye contact. What does this suggest? A. The dad is covering his involvement; lack hints at dishonesty B. The lack of ec suggests he is not really willing to let his wife seek treatment C. Nothing, some cultures view direct ec as disrespectful - Answers -C. Perhaps nothing, some cultures view direct eye contact as disrespectful "Referral" means: A. Assisting a client to utilize the support systems and community resources available. B. Identifying and ranking problems. C. Meeting with other professionals for discussions and planning. D. Attending an AA or NA meeting with a client. - Answers -A. Assisting a client to utilize the support systems and community resources available. __________________ are a problem associated with consuming alcohol and Valium together. A. Synergistic effects B. Tremors C. Cross allergic reactions D. Negative Symptoms - Answers -A. Synergistic effects _______________ is the belief that one's own culture is superior to others. A. Reverse racism B. Ethnocentrism C. Nationalism D. Cultural Realism - Answers -B. Ethnocentrism "Excessive use of alcohol is a result of personal choice and therefore should be punished." This statement is consistent with the ______________ model of addiction.

A. Disease B. Moral C. Social D. Sociocultural - Answers -B. Moral A common problem for beginning counselors is: A. Trying to use a variety of techniques, rather than becoming skilled at one approach. B. Failing to identify an approach that is appropriate to the client. C. Their bias against working with clients who have a dual diagnosis. D. That they allow for conflicting values to exist in the counseling relationship. - Answers -B. Failing to identify an approach that is appropriate to the client. A counselor wants to record a counseling session with a client so that the counselor could listen to the tape, along with her supervisor, as part of ongoing training. According to ethical best practices, the counselor's plans are: A. Ethical B. Unethical C. Ethical, as long as the client granted permission beforehand D. Unethical, unless the supervisor observes the session - Answers -C. Ethical, as long as the client granted permission beforehand A major criticism of self-report instruments is that the questions are so obvious that thee tests cannot possible detect alcoholics who deny having a problem. This issue is the dilemma of _____________ questions. A. Measurable B. Face valid C. Multi-factor D. Analytical - Answers -B. Face valid A mental status exam does NOT assess: A. Education level B. Appearance C. Speech D. Thought Processes - Answers -A. Education level Abstinence is to harm reduction as: A. IV drug use is to drinking. B. Controlled drinking is to willpower. C. AA is to needle exchange. D. Methadone is to Antabuse. - Answers -C. AA is to needle exchange.

Appropriate treatment goals must be: A. Stated generally, in order to encourage small progress. B. Typed and signed in order to ensure compliance by an unwilling client. C. Written in the order that they will be addressed in treatment. D. Agreed upon by the client and counselor. - Answers -D. Agreed upon by the client and counselor. Arbitrary inferences and selective abstractions are examples of: A. Cognitive distortions B. Defense mechanisms C. Attention-seeking D. Developmental difficulties - Answers -A. Cognitive distortions Beneficence is the ethical principle that means: A. Help B. Show equal respect for gender C. Do no harm D. Respect confidentiality - Answers -A. Help Client education on HIV and other sexually transmitted diseases: A. Is only done at the request of the client. B. Should be given in specialty to groups to those clients that are considered "high risk" to protect confidentiality. C. Should be contracted out to a physician or professional medical personnel who have expertise in this area. D. Is important information to incorporate in the treatment process of every client. - Answers -D. Is important information to incorporate in the treatment process of every client. Completing necessary documentation for admission to a particular treatment program occurs during the ___________ process. A. Intake B. Assessment C. Admission D. Screening - Answers -A. Intake Concise and accurate reporting is necessary in order to: A. Assist in client education B. Ensure continuity of client care

C. Identify client strengths and weaknesses D. Demonstrate counselor competence - Answers -B. Ensure continuity of client care Counselor self-disclosure is BEST limited to: A. The time when the client is ready for discharge. B. Ideas and emotional reactions in the counseling session. C. Early childhood experiences. D. Opinions the counselor has about the client and his or her family. - Answers -B. Ideas and emotional reactions in the counseling session. Drowsiness or coma, slurred speech, impairment in attention or memory are all signs or symptoms of: A. Caffeine intoxication B. Cocaine intoxication C. Alcohol intoxication D. Opioid intoxication - Answers -D. Opioid intoxication Generally, the Tarasoff requirement has been interpreted as: A. A duty to hospitalize or otherwise confine the person making the threat. B. A duty to make a reasonable effort to prevent the patient from carrying out the threat. C. A duty to warn the client of possible consequences. D. A duty to warn the intended victim and/or the police. - Answers -D. A duty to warn the intended victim and/or the police. In his second counseling session, a client reveals to the counselor that he is HIV positive. The counselor's BEST course of action is to: A. Discharge the client as a precautionary measure against infecting other clients. B. Offer to refer the client to a counselor with AIDS, since that counselor will understand the special issues involved. C. Send the client a letter informing him that he will be transferred to another facility. D. Discuss the client's case with a clinical supervisor in order to meet the needs of this client. - Answers -D. Discuss the client's case with a clinical supervisor in order to meet the needs of this client. In which situation is it NOT acceptable to release confidential information without prior consent from the client? A. When the client has stolen property from the treatment facility. B. If law enforcement officials request information in writing. C. If the client is in a serious accident requiring medical care. D. When the client admits to abusing a child. - Answers -B. If law enforcement officials request information in writing.

Jackie is recently discharged from the Air Force. His counselor suspects that he has PTSD, due to his experiences during active duty in Afghanistan. The counselor contacted the Veteran's Administration and located a clinic in the area with special groups for Vets with PTSD. The counselor then made arrangements for Jackie to attend these groups while he is still in primary treatment for substance abuse. The counselor's actions are best described as: A. Consultation B. Case management C. Client education D. Ethical responsibility - Answers -B. Case management Methadone maintenance programs can BEST be described as: A. Continued substance abuse in disguise B. Harm reduction focused C. A secular recovery method D. A community organization intervention - Answers -B. Harm reduction focused Niko is a client who has been gaining weight steadily since entering treatment. When confronted about his constant snacking and lack of activity, he told his counselor that he needed to eat this way in order to keep his mind off of his drug of choice. He felt that he deserved to indulge, since he was giving up the primary source of satisfaction he had used from years. The counselor would rightly conclude that the ego defense mechanism of _____________ is at work here. A. Reaction formation B. Denial C. Projection D. Rationalization - Answers -D. Rationalization One basic principle of documentation requires the counselor to: A. Describe events in as much detail as possible in case records are requested for a court case. B. Record material in a manner that allows a new counselor to understand the general progress of any client. C. Record all incoming and outgoing phone calls by clients, as these calls may have bearing on the client's emotional state during treatment. D. Document only a client's behavior and refrain from any interpretation of that behavior that can be construed as subjective. - Answers -B. Record material in a manner that allows a new counselor to understand the general progress of any client. Rajish is avoiding social situations which involve drinking or drugs. He is worries that others may encourage him to drink. The counselor suggests that they act-out such a

situation in order to develop responses if such a situation arises. This counseling technique is: A. Practicing the use of "I" statements B. Cognitive restructuring C. Empty chair D. Role-play - Answers -D. Role-play Rates of opioid use are higher in ___________ than in ___________. A. Males; females B. Adults; adolescents C. Asian Americans; African Americans D. Geriatric populations; adolescent populations - Answers -A. Males; females Reinforcement and punishment are associated with _____________ therapy. A. Cognitive B. Behavior C. Gestalt D. Person-centered - Answers -B. Behavior Some researchers have concluded that no one pattern of dysfunctional substance abuse exists. They also conclude that there is more than one personality type that happens to be more prone to addiction than some others. This multivariate focus is MOST consistent with the: A. Medical model B. Biopsychosocial model C. Multimodal model D. Disease concepts - Answers -B. Biopsychosocial model Studies have linked substance abuse among African Americans to three factors: economic deprivation, stress, and _____________. A. Availability B. Racism C. Cultural norms D. Machismo - Answers -B. Racism The concept of informed consent requires that before agreeing to accept treatment, clients should know ___________________, their rights and obligations, feed for services and limits of confidentiality. A. Availability of referral services B. Community resources to be sued

C. With whom they will be participating in group activities D. The goals of therapy - Answers -D. The goals of therapy The cultural philosophy of "noninterference" is associated with alcohol-related problems among: A. Native Americans B. Hispanic Americans C. African Americans D. Asian Americans - Answers -A. Native Americans The DSM-5 includes criteria sets specific to intoxication for each substance category except for ___________________. A. Marijuana B. Cocaine C. Inhalants D. Tobacco - Answers -D. Tobacco The first step of Alcoholics Anonymous requires: A. An admission that one's life is unmanageable B. The acceptance of willpower as central to recovery C. A commitment to help others in recovery D. Making amends to others - Answers -A. An admission that one's life is unmanageable The initial stage of crisis intervention involves: A. Identifying relapse triggers B. Confronting the crisis C. Recognizing the crisis D. Determining a solution - Answers -C. Recognizing the crisis The primary goal of a mental status exam is to measure the client's orientation to __________, ___________, and __________. A. Reality, fantasy, future B. Problems, needs, goals C. Emotions, thoughts, ideas D. Person, place, time - Answers -D. Person, place, time The primary principles behind AA are spirituality, self-improvement, and __________________. A. Personal empowerment

B. Service to others C. A healthy lifestyle D. Problem solving - Answers -B. Service to others Which core function of counseling is related to the term "didactic?" A. Case management B. Referral C. Client education D. Consultation - Answers -C. Client education Which neurotransmitter is most closely associated with feelings of well-being, appetite, and mental alertness? A. GABA B. Acetylcholine C. Serotonin D. Norepinephrine - Answers -C. Serotonin Which of the following is a CNS depressant? A. Xanax B. Nicotine C. Adderall D. Benzedrine - Answers -A. Xanax Which part of the following is an SSRI? A. Cylert B. Ritilin C. Prozac D. Valium - Answers -C. Prozac Which of the following is most closely associated with involuntary confinement, such as a prison setting? A. Intensive outpatient treatment B. The therapeutic community C. Al-anon D. Gestalt therapy - Answers -B. The therapeutic community Which of the following is the BEST definition of a "slip?" A. An episode of substance abuse following a period of abstinence B. A return to a pattern of substance abuse following treatment C. Returning to unhealthy patterns of substance abuse following a period of sobriety

D. A length period of relapse - Answers -A. An episode of substance abuse following a period of abstinence Which of the following is the BEST definition of denial? A. A coping strategy involving the elimination of unwanted thoughts B. A sudden understanding of self, or realization of how a problem can be solved C. An ego defense mechanism that allows one to pretend a problem is not real D. A confrontation technique used in conjunction with Gestalt therapy - Answers -C. An ego defense mechanism that allows one to pretend a problem is not real Which of these is the BEST examples of a substance-induced disorder? A. Alcohol tolerance B. Methamphetamine psychosis C. Alcohol withdrawal D. Methadone dependence - Answers -B. Methamphetamine psychosis Which statement is TRUE regarding counselor self-exploration? A. The counselor's personal issues should be disclosed to the client in order to encourage transference. B. Counselors should not rule out therapy for their own personal issues. C. Counselor self-exploration put the clients at risk for counter-transference. D. Counselors best help themselves by helping other people. - Answers -B. Counselors should not rule out therapy for their own personal issues. With the new DSM-5 nomenclature, clinicians will not specify severity of the addiction using ratings of: A. mild, moderate, and severe B. occasional, continuous, and binge C. mild, modest, and aggressive D. use, misuse, and abuse - Answers -A. mild, moderate, and severe You are seeing a patient whom you suspect may be suicidal. Which of the following factors most suggests that the risk of suicide is high? A. The patient is an African-American B. The patient is experiencing a mid-life crisis C. The patient is a female D. The patient's depressive symptoms have recently improved - Answers -D. The patient's depressive symptoms have recently improved Mike is a 25 y/o man who has been your client for several weeks in an outpatient program. He recently came to you and admitted during a group session that he relapsed

and had been involved in a hit & run. Mike told the group he had to get it off his chest in a "safe, and confidential place." Later, from the news, you learn a hit & run accident that involved the death of another driver and police are still searching for the individual. Your first responsibility is to: A. Insist that the client turn himself in B. Report to the authorities that you know the identity of the driver C. Assess the client's current status and re-screen him for transfer to an inpatient program - Answers -C. Assess the client's current status and re-screen him for transfer to an inpatient program Mike is a 25 y/o man who has been your client for several weeks in an outpatient program. He recently came to you and admitted during a group session that he relapsed and had been involved in a hit & run. Mike told the group he had to get it off his chest in a "safe, and confidential place." Later, from the news, you learn a hit & run accident that involved the death of another driver and police are still searching for the individual. A police officer visits your office and asks you for your records b/c someone told him that your client admitted to a crime during a group session. You should: A. Neither confirm nor deny that Mike is your client b/c he has not signed a ROI B. Give the info to the officer b/c this is a current criminal investigation C. Admit that Mike is your client but refuse to turn over records of his admissions in group - Answers -A. Neither confirm nor deny that Mike is your client b/c he has not signed a ROI Mike is a 25 y/o man who has been your client for several weeks in an outpatient program. He recently came to you and admitted during a group session that he relapsed and had been involved in a hit & run. Mike told the group he had to get it off his chest in a "safe, and confidential place." Later, from the news, you learn a hit & run accident that involved the death of another driver and police are still searching for the individual. Do you have an obligation to report your client's accident involvement to the police? A. Yes, b/c this is a capital crime, meaning you could be subpoenaed. B. Yes, b/c this is a current investigation while the client was under your care. C. No, b/c it is a past crime and there is no court order requiring you to disclose anything. - Answers -C. No, b/c it is a past crime and there is no court order requiring you to disclose anything. Which of the following is the BEST definition of "relapse?" A. An episode of substance abuse following a period of abstinence. B. The return to a pattern of substance abuse following treatment. C. Returning to unhealthy patterns of substance abuse following a period of sobriety.

D. A lengthy period of recovery followed by a brief slip. - Answers -B. The return to a pattern of substance abuse following treatment. When a drug initiates a physiological response when attaching to a receptor site in the brain, it is BEST classified as: A. An antagonist B. A barbiturate C. An agonist D. A neurotransmitter - Answers -C. An agonist A harm-reduction program is designed to: A. Minimize the problems associated with addiction B. Aid victims of violent crime committed by drug addicts C. Serve as a secular recovery method D. Aid the community in recovering from the crime and social upheaval associated with drug abuse - Answers -A. Minimize the problems associated with addiction During his treatment, Vic started having painful urination and feared he might have a STD. Vic had not been to a doctor in at least ten years and did not have a regular doctor to call. The counselor gave him the name of a local physician who would treat a new patient on a short notice. This process is BEST viewed as an example of: A. A referral B. A consultation C. Case management D. An aftercare plan - Answers -A. A referral A major focus of the principle of anonymity in the AA fellowship is directed specifically at _______________. A. press, radio, and film B. people outside the immediate family C. law enforcement officials D. anyone who is not in the fellowship - Answers -A. press, radio, and film Which of the following is the BEST definition of transference? A. Projection of uncomfortable feelings to a nonthreatening object. B. A sudden understanding of self, or realization of how a problem can be solved. C. Unconscious shifting of feelings and fantasies from significant others to the therapist. D. Assuming the values of others, similar to Stockholm syndrome. - Answers -C. Unconscious shifting of feelings and fantasies from significant others to the therapist.

__________________ includes the identification and ranking of problems needing resolution. A. Client education B. Treatment planning C. Assessment D. Case management - Answers -B. Treatment planning Appropriate documentation in the client's chart includes incidents, reports, and ________________. A. Ongoing information B. Details from the client's fourth step C. A record of all visitors D. Copies of the house log - Answers -A. Ongoing information Which statement about counseling is TRUE? A. Counselors are in the business of changing people. B. It is best to choose a single counseling approach to master and use with clients. C. Early childhood experiences are usually irrelevant in counseling. D. Counselors must be open to their own struggles and personal growth. - Answers -D. Counselors must be open to their own struggles and personal growth. When an actively-using, alcohol-dependent client presents with depressive symptoms: A. Cognitive approaches to treating depression should be the focus of treatment. B. The presence of a primary depressive disorder should be assessed as soon as possible. C. He/she frequently responds quickly to the use of antidepressant medication. D. Depressive symptoms in the majority of cases will be significantly diminished after detoxification and abstinence. - Answers -D. Depressive symptoms in the majority of cases will be significantly diminished after detoxification and abstinence. One method for increasing the effectiveness of counseling for Latino clients is: A. to assume an active approach with a goal-oriented inquiry. B. to maintain the individual's dignity by avoiding familiarity. C. to acknowledge the cultural difference and schedule appointments well in advance. D. to stress separation due to family enmeshment. - Answers -A. to assume an active approach with a goal-oriented inquiry Methadone is a drug used in: A. IV form to combat the synergistic effects of alcohol and other CNS depressants. B. Harm reduction programs, usually in urban environments.

C. Conjunction with alternative detoxification protocols for amphetamines. D. Emergency rooms to counteract the effects of overdose. - Answers -B. Harm reduction programs, usually in urban environments. Bertrand qualifies for job re-training because of a disability. His counselor made an appointment with the state rehabilitation commission to evaluate the type of training that might be beneficial for Bertrand. The counselor also made arrangements for Bertrand to be transported to the appointment, although he was still in primary treatment. The counselor's actions are BEST described as: A. Consultation B. Case management C. Client education D. Ethical responsibility - Answers -B. Case management One major problem associated with victimology and recovery is that: A. proclaiming powerlessness runs counter to the empowerment mentality needed to overcome victimhood B. sexual assault victims fear the exposure associated with attending meetings C. African Americans sometimes fear institutionalized racism as it may exist among support groups D. feminists are unwilling to accept the principle of anonymity that may shield perpetrators from justice - Answers -A. proclaiming powerlessness runs counter to the empowerment mentality needed to overcome victimhood Mike and his client have developed a personal attraction to one another. The BEST course of action for him is to: A. discuss his feelings with his clinical supervisor to determine the best course of action. B. talk with the client about transferring to another counselor so that they can date without the conflict of interest. C. send the client a letter formally ending the personal and therapeutic relationship. D. inform the client that they will have to wait at least one year before they can date. - Answers -A. discuss his feelings with his clinical supervisor to determine the best course of action. What BEST represents the information that should be kept in a client's treatment record? A. The name of an attending physician and contact information for referrals to be made. B. Names of family members and their emergency contact numbers. C. Personal notes, insurance information and samples from client journal. D. Information about consultations, diagnosis, treatment, prognosis, and progress. - Answers -D. Information about consultations, diagnosis, treatment, prognosis, and progress.

African Americans generally do not view alcohol as a prerequisite to fun because: A. there are other culturally acceptable ways to achieve relaxation and sociability. B. they do not perceive alcohol as a desirable social lubricant. C. cultural norms prohibit over-consumption of alcohol in public. D. machismo is a theme that overrides the desire for alcohol. - Answers -A. there are other culturally acceptable ways to achieve relaxation and sociability. A client presents with non-healing ulcers, abscesses, brittle fingernails, and bruxism. Abuse of which classification of drugs is MOST likely? A. Amphetamines B. Steroids C. Inhalants D. Narcotics - Answers -A. Amphetamines Juanita has been seeing a counselor for several weeks and has recently started responding in an argumentative fashion. Last time, she told the counselor "you are just like my father, always on my case!" This situation best exemplifies: A. A defense mechanism B. Transference C. Countertransference D. Negative reinforcement - Answers -B. Transference A client must be told the limits of confidentiality before the first therapy session, along with the cost of services. These issues are part of the process know as: A. Ethical practice B. Releasing information C. Protecting confidentiality D. Obtaining informed consent - Answers -D. Obtaining informed consent The most popular and yet most controversial theory of addiction views: A. Addiction as a chronic and incurable disease B. Punishment as an appropriate social response to alcoholism C. Harm reduction programs as an integral part of recovery D. Ongoing research as unnecessary anymore because of past findings - Answers -A. Addiction as a chronic and incurable disease Nervousness or anxiety, sleep difficulty (e.g. insomnia, disturbing dreams), decreased appetite or weight loss, depressed mood are all signs or symptoms of: A. Cannabis withdrawal

B. Cocaine withdrawal C. Sedative, hypnotic, or anxiolytic withdrawal D. Opioid withdrawal - Answers -A. Cannabis withdrawal According to the DSM-5 standards, controlled use of ________________ during religious observances is not to be considered a diagnosable condition. A. Peyote B. Alcohol C. Hallucinogens D. Opium - Answers -C. Hallucinogens ____________ symptoms are the most common psychiatric symptoms seen in AOD abusers. A. Depressive B. Narcissistic C. Social Anxiety D. Panic Attacks - Answers -A. Depressive Rational emotive behavior therapy is considered to be a _______________ approach to counseling. A. Cognitive behavioral B. Behavioral C. Social learning D. Person-centered - Answers -A. Cognitive behavioral Maslow's Hierarchy of Needs suggests that: A. Self-actualization is a primary concern for all clients regardless of socioeconomic status. B. Performance is a function of both motivation and ability. C. Self-actualization offers a viable treatment for substance abuse. D. Psychological needs do not become salient until security needs are met. - Answers - D. Psychological needs do not become salient until security needs are met. Bethany acknowledged in a group session that she was unfaithful to her husband for several months. Although she has ended the affair, she is now convinced that her husband is cheating on her. The counselor would rightly conclude that the ego defense mechanism of ___________________ is at work here. A. Reaction formation B. Denial C. Projection D. Rationalization - Answers -C. Projection

During a counseling session, a client recalls having been abused as a child. Prior to treatment, the client had no recollection of the abuse. The inability to recall the abuse earlier is an example of the defense mechanism called: A. Reaction formation B. Repression C. Projection D. Rationalization - Answers -B. Repression The desire and yearning for a specific substance or substances is known as: A. Loss of control B. Craving C. Adaptation D. Relapse - Answers -B. Craving Offering the client a tour of the treatment facility and information on the hours of operation are activities that occur during the _________________ process. A. Intake B. Orientation C. Admission D. Screening - Answers -B. Orientation Which core function of counseling is most closely associated with the terms "eligible and appropriate?" A. Case management B. Referral C. Client education D. Screening - Answers -D. Screening _______________________ is one of case management's hallmark characteristics. A. Advocacy B. Cooperation C. Clinical proficiency D. Stabilization - Answers -A. Advocacy Confidentiality of addction counseling records in the United States is governed by: A. FLS 9.1 Chapter 4 B. MHC administered by SAMHSA C. 42 CFR part 2 D. State and local laws - Answers -C. 42 CFR part 2