CAADC Evidence-Based Counseling Models 2 — Questions and Answers
Question 1: In Motivational Interviewing, what does OARS represent?
- Outcomes, Assessments, Referrals, Services
- Open questions, Affirmations, Reflections, Summaries (Correct answer)
- Observation, Analysis, Response, Support
- Orientation, Acceptance, Recovery, Sobriety
Correct answer: Open questions, Affirmations, Reflections, Summaries
OARS represents the four core MI communication skills.
Open questions invite exploration, Affirmations recognize strengths, Reflections demonstrate understanding and guide toward change talk, and Summaries reinforce key themes. These work together to evoke the client's own motivation.
Question 2: Which CBT component addresses automatic thoughts that trigger substance use urges?
- Systematic desensitization
- Cognitive restructuring (Correct answer)
- Dream analysis
- Free association
Correct answer: Cognitive restructuring
Cognitive restructuring helps identify, examine, and modify automatic thoughts and cognitive distortions.
The process involves identifying automatic thoughts, examining evidence, identifying distortions (all-or-nothing thinking, permission-giving beliefs), and developing balanced alternatives through thought records and behavioral experiments.
Question 3: What is the primary mechanism of change in Contingency Management?
- Insight into childhood
- Systematic use of tangible reinforcers to reward verified abstinence or treatment adherence (Correct answer)
- Medication-induced aversion
- Peer pressure in groups
Correct answer: Systematic use of tangible reinforcers to reward verified abstinence or treatment adherence
CM uses operant conditioning, providing tangible rewards contingent on verified positive behaviors.
Two common protocols are voucher-based reinforcement therapy (escalating values) and prize-based CM (fishbowl method). Key principles include immediate reinforcement, escalating magnitude, and reset contingencies.
Question 4: How does DBT address substance use disorders differently from standard CBT?
- DBT doesn't address substance use
- DBT adds distress tolerance, emotion regulation, mindfulness, and interpersonal effectiveness skills targeting emotional dysregulation (Correct answer)
- DBT replaces CBT with medication
- DBT uses only group therapy
Correct answer: DBT adds distress tolerance, emotion regulation, mindfulness, and interpersonal effectiveness skills targeting emotional dysregulation
DBT adds four skill modules targeting the emotional dysregulation underlying many clients' substance use.
DBT-SUD includes mindfulness (urge surfing), distress tolerance (surviving crises without substances), emotion regulation (understanding triggers), and interpersonal effectiveness (reducing conflict-driven use).
Question 5: What distinguishes the Community Reinforcement Approach from other treatments?
- It focuses on 12-step facilitation
- It systematically restructures the client's environment to make sobriety more rewarding than substance use (Correct answer)
- It only works inpatient
- It is purely pharmacological
Correct answer: It systematically restructures the client's environment to make sobriety more rewarding than substance use
CRA works to ensure the community and daily activities provide more reinforcement for sobriety than for use.
CRA addresses social/recreational, vocational, relationship, and behavioral domains. It recognizes that telling someone to stop is insufficient; the environment must be restructured so sobriety is genuinely more rewarding.
Question 6: What combination of components does the Matrix Model use for stimulant use disorders?
- Only individual therapy monthly
- Individual sessions, multiple group types, family education, social support, and urine testing over 16 weeks (Correct answer)
- Exclusively medication
- Only 12-step attendance
Correct answer: Individual sessions, multiple group types, family education, social support, and urine testing over 16 weeks
The Matrix Model integrates multiple therapeutic components in a structured 16-week protocol.
Components include individual sessions, early recovery groups, relapse prevention groups, family education groups, social support groups, and regular drug testing, using a non-confrontational but directive style.
CAADC Evidence-Based Counseling Models 2
In Motivational Interviewing, what does OARS represent?