CAADC Evidence-Based Counseling Models 3 — Questions and Answers
Question 1: What is the 'spirit' of Motivational Interviewing?
- A set of confrontational techniques
- The philosophy of partnership, acceptance, compassion, and evocation guiding the therapeutic relationship (Correct answer)
- A religious framework
- Mandatory use of stages of change
Correct answer: The philosophy of partnership, acceptance, compassion, and evocation guiding the therapeutic relationship
The spirit encompasses Partnership, Acceptance, Compassion, and Evocation (PACE).
The spirit is more important than techniques. Partnership replaces expert authority, Acceptance includes unconditional regard and autonomy support, Compassion prioritizes client welfare, and Evocation draws out intrinsic motivation.
Question 2: How does the Marlatt and Gordon Relapse Prevention model conceptualize relapse?
- A single event without warning
- A gradual process involving a predictable chain of events that can be interrupted at multiple points (Correct answer)
- Only due to physical dependence
- Purely a willpower failure
Correct answer: A gradual process involving a predictable chain of events that can be interrupted at multiple points
The model views relapse as a process with identifiable cognitive and behavioral patterns.
The chain includes lifestyle imbalance, urges, apparently irrelevant decisions, high-risk situations, inadequate coping, decreased self-efficacy, positive outcome expectancies, lapse, and the Abstinence Violation Effect. Multiple intervention points exist.
Question 3: What approach uses a 'decisional balance' exercise to explore ambivalence?
- Psychoanalysis
- Motivational Interviewing / Motivational Enhancement Therapy (Correct answer)
- Applied Behavior Analysis
- Electroconvulsive Therapy
Correct answer: Motivational Interviewing / Motivational Enhancement Therapy
Decisional balance systematically explores pros and cons of both continuing use and making changes.
The four-quadrant grid examines benefits and costs of both current use and change. When clients fully explore both sides, they are more likely to tip toward change than when pressured to see only negatives.
Question 4: Which evidence-based treatment was tested in Project MATCH alongside CBT and MET?
- EMDR Therapy
- Twelve-Step Facilitation (TSF) (Correct answer)
- Gestalt Therapy
- Psychodynamic Therapy
Correct answer: Twelve-Step Facilitation (TSF)
TSF is a structured protocol that systematically introduces clients to 12-step concepts and facilitates engagement.
TSF is a manualized 12-week program that educates about 12-step philosophy, guides through the first three steps, and facilitates active fellowship engagement. Project MATCH found it comparable to CBT and MET.
Question 5: How does Acceptance and Commitment Therapy (ACT) approach substance use disorders?
- ACT is medication-based
- ACT uses psychological flexibility, mindfulness, and values-based action to change the function of substance use rather than directly targeting thoughts (Correct answer)
- ACT means accepting substance use as inevitable
- ACT requires committing to a session count
Correct answer: ACT uses psychological flexibility, mindfulness, and values-based action to change the function of substance use rather than directly targeting thoughts
ACT changes the relationship between the person and their urges rather than trying to eliminate them.
ACT's six processes applied to addiction include acceptance of cravings, cognitive defusion, present moment awareness, self-as-context, values clarification, and committed action aligned with values.
Question 6: What does research indicate about the relative effectiveness of different evidence-based treatments?
- One treatment is definitively superior
- Multiple approaches produce comparable outcomes, with therapeutic alliance and client factors being more predictive than specific models (Correct answer)
- Only pharmacological treatments work
- Research has not studied this
Correct answer: Multiple approaches produce comparable outcomes, with therapeutic alliance and client factors being more predictive than specific models
Research consistently shows that common factors like alliance and motivation predict outcomes more strongly than the specific model.
The therapeutic alliance accounts for approximately 30% of outcome variance. Counselor skill and treatment matching matter more than which model is used, supporting competency in multiple approaches.
CAADC Evidence-Based Counseling Models 3
What is the 'spirit' of Motivational Interviewing?