CAC Cheat Sheet 2026

The 30 highest-yield CAC facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which ethical principle supports a client's right to make their own treatment decisions, even ones the counselor disagrees with? → Autonomy
2. The term 'dual diagnosis' refers to: → Having both a substance use disorder and a psychiatric disorder simultaneously
3. Which intervention is most appropriate when a client presents with a 'slip' (single use after a period of abstinence)? → Use motivational techniques to prevent a full relapse and reinforce coping skills
4. Cannabis withdrawal syndrome commonly includes which symptoms? → Irritability, anxiety, insomnia, and decreased appetite
5. Acamprosate (Campral) treats alcohol use disorder primarily by: → Reducing post-acute withdrawal symptoms such as anxiety and dysphoria that trigger relapse
6. Which model is most commonly used to guide crisis intervention in addiction counseling settings? → The Six-Step Model of Crisis Intervention (Roberts)
7. Which option correctly represents the Stages of Change Model? → Pre-contemplation, contemplation, preparation, action and maintenance
8. What does the ethical principle of 'nonmaleficence' obligate a counselor to do? → Avoid causing harm to clients
9. Which level of care in the ASAM criteria is considered 'intensive outpatient' (IOP)? → Level 2.1
10. Naltrexone (Vivitrol) for alcohol use disorder or opioid use disorder works by: → Blocking opioid receptors, reducing the pleasurable effects of alcohol and opioids
11. Which opioid withdrawal symptom helps a counselor assess whether a client is in early withdrawal? → Yawning, lacrimation (tearing), and gooseflesh (piloerection)
12. The following substances are all stimulants, except: → Xanax
13. According to the DSM-5, which symptom is not included in the criteria for an alcohol use disorder? → Consuming alcohol in the morning to relieve the shakes
14. The concept of 'apparently irrelevant decisions' (AIDs) in relapse prevention refers to: → Small seemingly unrelated choices that covertly move a client toward relapse
15. Which term describes an ethical violation in which a counselor uses their professional position to exploit a client for personal gain? → Boundary violation
16. A client calls in a crisis stating they have relapsed after 6 months of sobriety. What is the counselor's FIRST priority? → Assess immediate safety and risk of harm
17. Which element of a treatment plan describes HOW the counselor will help the client achieve an objective? → Intervention
18. In group therapy for substance use disorders, what is the PRIMARY therapeutic benefit unique to the group setting? → Universality — realizing others share similar struggles
19. When should a treatment plan be formally reviewed and updated? → At regular intervals specified by the program and when significant changes occur
20. Which type of progress note format structures documentation around Subjective, Objective, Assessment, and Plan? → SOAP note
21. Which tool is specifically designed to identify a client's individual high-risk relapse triggers? → The Situational Confidence Questionnaire (SCQ)
22. Which class of substances produces withdrawal symptoms that can be life-threatening without medical management? → Alcohol and benzodiazepines
23. A counselor discovers that a colleague is seeing clients while impaired by alcohol. What is the MOST appropriate first action? → Report the colleague to a supervisor or licensing board
24. When a client who has recently relapsed returns to treatment, the counselor's MOST therapeutic response is to: → Maintain a non-judgmental stance and use the relapse as a learning opportunity
25. Under what circumstances is a counselor ethically permitted to break confidentiality during a client crisis? → When the client presents an imminent danger to self or others
26. What distinguishes a treatment goal from a treatment objective? → Goals are broad outcomes; objectives are specific, measurable steps toward those outcomes
27. A counselor using a strengths-based approach to relapse prevention would MOST likely: → Identify and build upon the client's existing coping resources and protective factors
28. Which of the following is an example of an emotional relapse warning sign according to the relapse prevention model? → Isolating, skipping meetings, and suppressing emotions
29. Which criterion is MOST important when determining the appropriate level of care for a client? → The severity of the client's substance use and related problems across ASAM dimensions
30. Naloxone (Narcan) is relevant to crisis intervention in addiction counseling primarily because it: → Reverses opioid overdose and can save a life in a crisis