CAADE Intervention Techniques & Counseling Strategies 3 — Questions and Answers
Question 1: A counselor working with a dually diagnosed client (substance use disorder + major depression) should prioritize:
- Treating the depression first before addressing substance use
- Treating the substance use disorder exclusively until remission
- Addressing both disorders simultaneously with an integrated treatment approach (Correct answer)
- Referring the client to a psychiatrist and discontinuing counseling
Correct answer: Addressing both disorders simultaneously with an integrated treatment approach
Integrated dual diagnosis treatment addresses both the substance use disorder and the co-occurring mental health condition concurrently for the best outcomes.
Question 2: In contingency management (CM) interventions, behavior change is reinforced through:
- Therapeutic confrontation of denial and resistance
- Tangible rewards provided when clients demonstrate target behaviors such as negative drug tests (Correct answer)
- Punishment or privilege removal for relapse episodes
- Peer pressure within group counseling settings
Correct answer: Tangible rewards provided when clients demonstrate target behaviors such as negative drug tests
Contingency management uses operant conditioning principles by providing positive reinforcers (e.g., vouchers, prizes) contingent on verifiable abstinence or treatment compliance.
Question 3: When using the FRAMES model in brief interventions, the 'R' stands for:
- Referral
- Responsibility (Correct answer)
- Reflection
- Rapport
Correct answer: Responsibility
In FRAMES (Feedback, Responsibility, Advice, Menu, Empathy, Self-efficacy), 'R' stands for Responsibility, emphasizing that change is the client's own responsibility.
Question 4: A client says, 'I know I drink too much, but I'm not sure I want to quit.' This statement reflects which motivational concept?
- Lapse
- Ambivalence (Correct answer)
- Precontemplation
- Relapse
Correct answer: Ambivalence
Ambivalence — holding simultaneous desires to change and to continue the behavior — is a normal and expected part of the change process addressed in motivational interviewing.
Question 5: Psychoeducation as a counseling strategy in substance use treatment primarily serves to:
- Replace individual therapy with lectures about addiction
- Provide clients and families with accurate information about addiction to reduce stigma and support recovery (Correct answer)
- Diagnose clients with co-occurring mental health disorders
- Administer medication-assisted treatment protocols
Correct answer: Provide clients and families with accurate information about addiction to reduce stigma and support recovery
Psychoeducation equips clients and families with knowledge about the nature of addiction, its effects, and recovery processes, which supports informed decision-making and reduces shame.
Question 6: Which intervention technique involves the counselor summarizing what a client has said to reinforce change talk and transition in sessions?
- Affirmation
- Summarizing (Correct answer)
- Open-ended questioning
- Confrontation
Correct answer: Summarizing
Summarizing in motivational interviewing collects and reflects back change talk, helping clients hear their own arguments for change.
Question 7: Solution-focused brief therapy (SFBT) differs from problem-focused approaches in substance use counseling because SFBT:
- Requires extensive analysis of the client's addiction history
- Focuses on identifying existing strengths and exceptions to problem behavior (Correct answer)
- Uses confrontation to break through client denial
- Emphasizes exploring the root causes of addiction
Correct answer: Focuses on identifying existing strengths and exceptions to problem behavior
SFBT directs attention toward what is already working — times when the client is not using — and builds on those strengths rather than analyzing the problem in depth.
CAADE Intervention Techniques & Counseling Strategies 3
A counselor working with a dually diagnosed client (substance use disorder + major depression) should prioritize: