CAADC Co-occurring Disorders 4 — Questions and Answers
Question 1: A client with bipolar disorder and alcohol use disorder reports that drinking helps stabilize their mood. This belief is best described as:
- Accurate self-medication
- A cognitive distortion reinforcing substance use (Correct answer)
- Evidence of untreated mania
- A sign of medication non-compliance
Correct answer: A cognitive distortion reinforcing substance use
The belief that alcohol stabilizes mood is a cognitive distortion; alcohol disrupts mood regulation and worsens bipolar cycling over time.
Question 2: Which screening tool is specifically validated to identify both substance use and mental health symptoms simultaneously in integrated assessment?
- CAGE questionnaire
- Global Appraisal of Individual Needs (GAIN) (Correct answer)
- Hamilton Anxiety Rating Scale
- Beck Depression Inventory
Correct answer: Global Appraisal of Individual Needs (GAIN)
The GAIN is a comprehensive biopsychosocial assessment tool validated for co-occurring substance use and mental health disorders.
Question 3: A client with PTSD and stimulant use disorder begins trauma processing therapy. The CAADC should prioritize:
- Completing trauma processing before addressing stimulant use
- Addressing stimulant use only after PTSD remission
- Integrating stabilization strategies that support both recovery and trauma safety (Correct answer)
- Referring the client exclusively to a trauma specialist
Correct answer: Integrating stabilization strategies that support both recovery and trauma safety
Integrated care that builds stabilization and coping skills concurrently addresses both conditions and reduces risk of destabilization.
Question 4: When assessing a client for co-occurring disorders, the counselor notices the client minimizes their cannabis use. The most effective motivational strategy is to:
- Confront the client directly about their denial
- Use reflective listening to explore ambivalence about cannabis use (Correct answer)
- Document the minimization and proceed with treatment
- Refer the client for a psychiatric evaluation before continuing
Correct answer: Use reflective listening to explore ambivalence about cannabis use
Motivational interviewing techniques like reflective listening reduce resistance and help clients explore their own ambivalence without triggering defensiveness.
Question 5: A client on buprenorphine for opioid use disorder is also prescribed an SSRI for depression. The counselor's role includes:
- Advising the client to taper off buprenorphine once depression improves
- Monitoring for interactions and supporting adherence to both medications (Correct answer)
- Discouraging the use of multiple medications simultaneously
- Reporting the prescriber to the state board for overprescribing
Correct answer: Monitoring for interactions and supporting adherence to both medications
The CAADC supports medication adherence and monitors for drug interactions as part of integrated co-occurring disorder treatment.
Question 6: Which of the following best characterizes the 'parallel treatment' model for co-occurring disorders?
- One clinician treats both substance use and mental health simultaneously
- Substance use and mental health are treated by separate providers without coordination (Correct answer)
- Treatment is sequenced so that one disorder is addressed before the other
- A multidisciplinary team provides coordinated care within one program
Correct answer: Substance use and mental health are treated by separate providers without coordination
In the parallel model, separate providers treat each disorder independently, often without systematic communication or coordination.
Question 7: A client with schizophrenia and cannabis use disorder reports that cannabis reduces their auditory hallucinations. Research indicates that cannabis use in schizophrenia typically:
- Reduces positive symptoms with minimal side effects
- Worsens psychotic symptoms and increases relapse risk (Correct answer)
- Has no measurable effect on symptom severity
- Is beneficial when used in low doses
Correct answer: Worsens psychotic symptoms and increases relapse risk
Cannabis use is associated with worsening positive symptoms, earlier onset of psychosis, and increased relapse rates in individuals with schizophrenia.
CAADC Co-occurring Disorders 4
A client with bipolar disorder and alcohol use disorder reports that drinking helps stabilize their mood.
This belief is best described as: