CAADC Crisis Intervention and Management 5 — Questions and Answers
Question 1: A counselor working in a residential addiction facility notices a client displaying signs of excited delirium, including hyperthermia and combative behavior. The MOST appropriate response is to:
- Place the client in a seclusion room until the episode passes
- Immediately call 911, as this is a life-threatening medical emergency (Correct answer)
- Administer a PRN benzodiazepine from the medical cabinet
- Attempt physical restraint with available staff
Correct answer: Immediately call 911, as this is a life-threatening medical emergency
Excited delirium is a medical emergency with high mortality risk and requires immediate emergency medical services rather than facility-level management.
Question 2: In crisis negotiation with a client who is threatening self-harm, which communication technique is MOST effective during the early stage of contact?
- Offering immediate solutions to reduce the client's stress
- Establishing rapport through active listening and empathic reflection (Correct answer)
- Directly challenging the client's irrational beliefs
- Setting firm behavioral limits and consequences
Correct answer: Establishing rapport through active listening and empathic reflection
Active listening and empathic reflection build trust and reduce escalation during the early stage of crisis negotiation.
Question 3: Which factor is MOST predictive of completed suicide in individuals with a substance use disorder?
- Current enrollment in outpatient treatment
- Prior suicide attempt (Correct answer)
- Recent job promotion causing increased stress
- Mild alcohol use disorder diagnosis
Correct answer: Prior suicide attempt
A previous suicide attempt is the single strongest predictor of future suicide completion, especially when combined with substance use disorder.
Question 4: A group of clients in a treatment facility witnessed the accidental overdose death of a peer. The counselor should FIRST:
- Resume the normal group schedule to provide stability
- Conduct critical incident stress debriefing within the first hour
- Provide a safe space for clients to process their reactions and assess individual needs (Correct answer)
- Transfer all witnesses to inpatient psychiatric care
Correct answer: Provide a safe space for clients to process their reactions and assess individual needs
Providing a safe, supportive space for processing reactions and assessing individual needs is the first step after a traumatic shared event.
Question 5: A client experiencing methamphetamine-induced psychosis is brought to a crisis stabilization unit. Which intervention is LEAST appropriate during the acute phase?
- Minimizing environmental stimulation
- Using calm, slow speech and non-threatening body language
- Conducting an in-depth psychosocial history and trauma assessment (Correct answer)
- Ensuring medical monitoring of vital signs
Correct answer: Conducting an in-depth psychosocial history and trauma assessment
In-depth psychosocial history-taking is contraindicated during acute psychosis as it can overwhelm a dysregulated client and worsen agitation.
Question 6: According to ASAM criteria, when a client presents in crisis with moderate withdrawal symptoms and active suicidal ideation with a plan, the MOST appropriate level of care is:
- Level I: Outpatient services
- Level II.5: Partial hospitalization
- Level III.7: Medically monitored intensive inpatient
- Level IV: Medically managed intensive inpatient (Correct answer)
Correct answer: Level IV: Medically managed intensive inpatient
Active suicidal ideation with a plan combined with moderate withdrawal requires Level IV medically managed intensive inpatient care for both medical and psychiatric stabilization.
Question 7: After a crisis has been resolved, the MOST important follow-up action a counselor should take within 24-72 hours is:
- Closing the client's case to protect confidentiality
- Contacting the client to assess current safety and reinforce the safety plan (Correct answer)
- Submitting a detailed incident report to state licensing authorities
- Scheduling a family therapy session to address enabling behaviors
Correct answer: Contacting the client to assess current safety and reinforce the safety plan
Follow-up contact within 24-72 hours assesses ongoing safety, reinforces the safety plan, and maintains therapeutic connection during a vulnerable period.
CAADC Crisis Intervention and Management 5
A counselor working in a residential addiction facility notices a client displaying signs of excited delirium, including hyperthermia and combative behavior.
The MOST appropriate response is to: