CAADC Skills and Competencies 4 — Questions and Answers
Question 1: A CAADC is working with a client who has co-occurring PTSD and opioid use disorder. Which integrated treatment approach is most evidence-based?
- Treat PTSD first before addressing substance use
- Address opioid use disorder only, as PTSD will resolve with sobriety
- Provide concurrent treatment for both conditions using trauma-informed care (Correct answer)
- Refer the client to separate specialists and coordinate care informally
Correct answer: Provide concurrent treatment for both conditions using trauma-informed care
Concurrent integrated treatment of co-occurring PTSD and substance use disorder is the evidence-based standard, as each condition can perpetuate the other.
Question 2: During a motivational interviewing session, a client states 'I know I drink too much, but I'm not sure I want to change.' This statement reflects which stage of change?
- Precontemplation
- Contemplation (Correct answer)
- Preparation
- Action
Correct answer: Contemplation
Acknowledging a problem while expressing ambivalence about change is characteristic of the contemplation stage.
Question 3: A counselor notices a client becoming increasingly defensive when discussing family relationships. The MOST therapeutically useful response is to:
- Redirect to a different topic to reduce discomfort
- Point out the defensiveness directly and firmly
- Explore what makes this topic feel unsafe for the client (Correct answer)
- Document the resistance and move to psychoeducation
Correct answer: Explore what makes this topic feel unsafe for the client
Exploring the source of defensiveness therapeutically addresses underlying fears and builds the alliance rather than avoiding or confronting the behavior.
Question 4: Which of the following BEST describes the role of a functional analysis in addiction counseling?
- Assessing the client's ability to perform daily living tasks
- Identifying antecedents, behaviors, and consequences related to substance use (Correct answer)
- Evaluating neurological functioning affected by chronic substance use
- Determining financial and occupational impairment caused by addiction
Correct answer: Identifying antecedents, behaviors, and consequences related to substance use
Functional analysis examines the antecedents (triggers), behaviors (substance use), and consequences (outcomes) to understand the function substance use serves for the client.
Question 5: A CAADC is conducting group therapy when one member begins dominating the session and other members disengage. The BEST intervention is to:
- Allow the dominant member to continue to honor their process
- End the session early to reset group dynamics
- Gently redirect the group by inviting other members to share their perspectives (Correct answer)
- Speak privately with the dominant member after the session only
Correct answer: Gently redirect the group by inviting other members to share their perspectives
Redirecting the group to include other voices maintains therapeutic balance and models healthy communication without shaming the dominant member.
Question 6: When using the AUDIT-C screening tool, a score of 3 or higher for women typically indicates:
- Alcohol dependence requiring detoxification
- Hazardous or harmful alcohol use warranting further assessment (Correct answer)
- No significant alcohol-related concerns
- Severe alcohol use disorder requiring inpatient treatment
Correct answer: Hazardous or harmful alcohol use warranting further assessment
An AUDIT-C score of 3+ for women (4+ for men) indicates hazardous or harmful drinking and warrants a more comprehensive assessment.
Question 7: A client in early recovery reports that their family members constantly remind them of past mistakes. A counselor should FIRST:
- Schedule a family session to confront the problematic behavior
- Teach the client communication skills to set limits with family members
- Help the client explore how these interactions affect their recovery and emotions (Correct answer)
- Advise the client to reduce contact with family members temporarily
Correct answer: Help the client explore how these interactions affect their recovery and emotions
Exploring the client's emotional response and how it impacts recovery builds insight and self-awareness before introducing skills or systemic interventions.
CAADC Skills and Competencies 4
A CAADC is working with a client who has co-occurring PTSD and opioid use disorder.
Which integrated treatment approach is most evidence-based?