CAADE Co-Occurring Disorders 4 — Questions and Answers
Question 1: Research on the relationship between childhood trauma and adult COD suggests:
- Trauma history is unrelated to substance use disorder severity
- Adverse childhood experiences (ACEs) increase risk for both mental health and substance use disorders (Correct answer)
- Only physical abuse, not emotional abuse, predicts COD
- Trauma effects are fully resolved by adolescence
Correct answer: Adverse childhood experiences (ACEs) increase risk for both mental health and substance use disorders
The ACEs study and subsequent research demonstrate a strong dose-response relationship between childhood trauma and the development of both mental health and substance use disorders in adulthood.
Question 2: A counselor working with a client who has bipolar disorder and alcohol use disorder should be MOST alert to:
- Alcohol use only during depressive episodes
- The bidirectional relationship where alcohol can trigger mood episodes and mania can trigger binge drinking (Correct answer)
- The client stabilizing once mood episodes remit
- Lithium being contraindicated with alcohol
Correct answer: The bidirectional relationship where alcohol can trigger mood episodes and mania can trigger binge drinking
Alcohol use and bipolar disorder have a bidirectional relationship: alcohol disrupts mood stability, and mood episodes (especially mania or hypomania) increase impulsive drinking.
Question 3: Which intervention is most appropriate during a client's acute psychiatric crisis within a substance use treatment setting?
- Discharge the client and refer to an ER
- Continue standard substance use counseling and document the crisis
- Follow the crisis intervention protocol, stabilize, and coordinate with psychiatric services (Correct answer)
- Immediately initiate confrontation to break through denial
Correct answer: Follow the crisis intervention protocol, stabilize, and coordinate with psychiatric services
Acute psychiatric crisis requires immediate safety-focused crisis intervention, stabilization, and coordination with psychiatric services, not standard counseling.
Question 4: In the context of COD, 'integrated dual disorder treatment' (IDDT) was originally developed for which population?
- Adolescents with ADHD and cannabis use disorder
- Adults with severe mental illness and substance use disorder (Correct answer)
- Veterans with PTSD and alcohol use disorder
- Pregnant women with depression and opioid use disorder
Correct answer: Adults with severe mental illness and substance use disorder
IDDT was originally developed and validated for adults with severe mental illnesses such as schizophrenia and bipolar disorder who also had substance use disorders.
Question 5: A client with major depressive disorder and stimulant use disorder is most at risk for relapse when:
- They engage in consistent physical exercise
- Depressive symptoms intensify and they crave the stimulant's mood-elevating effects (Correct answer)
- They establish a stable sleep schedule
- Their social support network is strong
Correct answer: Depressive symptoms intensify and they crave the stimulant's mood-elevating effects
Worsening depression creates high-risk states for stimulant relapse because clients associate the drug with relief from depressive symptoms through self-medication.
Question 6: The stage-wise treatment model for COD proposes that counselors match interventions to the client's:
- Severity of psychiatric diagnosis
- Stage of change and level of insight regarding COD (Correct answer)
- Insurance coverage and treatment duration
- Age and cultural background exclusively
Correct answer: Stage of change and level of insight regarding COD
The stage-wise model aligns therapeutic interventions with the client's current stage of change (e.g., pre-contemplation, contemplation, action) regarding their co-occurring disorders.
Question 7: Which statement BEST describes the role of peer support specialists in COD treatment?
- They provide clinical diagnoses for co-occurring disorders
- They offer lived experience, hope, and recovery-oriented support as part of the treatment team (Correct answer)
- They replace licensed counselors in low-resource settings
- They primarily manage medication adherence independently
Correct answer: They offer lived experience, hope, and recovery-oriented support as part of the treatment team
Peer support specialists bring lived experience with COD recovery to provide hope, reduce stigma, and offer recovery-oriented support as part of an integrated treatment team.
CAADE Co-Occurring Disorders 4
Research on the relationship between childhood trauma and adult COD suggests: