Mixed Deck — All CAC Topics Flashcards

Which tool is specifically designed to identify a client's individual high-risk relapse triggers?

Answer: The Situational Confidence Questionnaire (SCQ)

The Situational Confidence Questionnaire (SCQ) assesses a client's self-efficacy across various high-risk situations, helping identify specific relapse triggers.

Which neurotransmitter is MOST centrally involved in the reward pathway dysregulation that underlies addiction?

Answer: Dopamine

Dopamine release in the nucleus accumbens (the brain's reward center) is the primary neurochemical mechanism through which addictive substances produce euphoria and reinforce use.

Which document bridges assessment findings and the actual treatment services a client will receive?

Answer: Treatment plan

The treatment plan translates assessment data into individualized goals, objectives, and interventions that guide the client's care.

Lee is coming into the clinic for a substance use assessment. He reports using Xanax occasionally, but is unsure if he has a problem. During the course of the assessment, you learn that when he first started taking Xanax he used about one pill at a time. He reports that he is now taking three pills during each use because "one just doesn't do it for me anymore." You also learn that he decided he wanted to stop using Xanax altogether, but that he "keeps going back to it." He denied any other issues related to Xanax. When assessing the severity of Lee's Xanax use, what severity specifier would be most appropriate?

Answer: Mild

According to the DSM-5, when 2-3 criteria are indicated, a mild severity specifier is appropriate. Based on the information provided, we can identify that he meets the criteria for two criteria. Needing three pills instead of one to get the same effect indicates tolerance. He also demonstrates a desire to cut down or eliminate use and being unsuccessful which is another criteria.

Joseph comes into your office for an intake assessment required by his Probation Officer. Joseph is reluctant to discuss his opiate use. However, he is compliant because he knows that the results of the intake would be reported to his PO. He shared that he is on probation as a result of being arrested for stealing. Joseph explained that he was stealing to support his heroin use and has continued to use since his arrest. Joseph began using Oxycodone recreationally at age 17 which progressed to daily use soon after. Joseph began using heroin approximately 8 months later due to the cost difference. Joseph has used to avoid withdrawal symptoms. He recently began to share needles and noted that he is aware of the health risk that this behavior poses. Joseph's family began distancing themselves from him when he continued using heroin after being arrested. With the information provided, how would you diagnose Joseph?

Answer: Opiate Use Disorder, Moderate

"The summary above falls into the moderate level of the DSM-V for Opiate Use Disorder. The severity rating scale is as follows: Mild: 2-3 Symptoms Moderate: 4-5 Symptoms Severe: 6 or more Symptoms - Symptoms identified in the summary were as follows. Joseph had continued use despite persistent social and interpersonal issues (discord with family). Joseph continued to use in physically dangerous situations (sharing needles). Joseph has developed a tolerance which led to him using larger amounts over time. Lastly, he has experienced withdrawal and uses to avoid symptoms. "

Which statement about electronic health records (EHR) and 42 CFR Part 2 is accurate?

Answer: EHR systems must be configured to segment and restrict SUD records from being shared without specific Part 2 consent

Electronic records containing SUD information must be segmented and access-controlled within EHR systems to prevent unauthorized disclosure in violation of 42 CFR Part 2.

When a counselor uses a 'double-sided reflection' in Motivational Interviewing, what are they doing?

Answer: Reflecting both the client's ambivalence and their reasons for change

A double-sided reflection acknowledges both sides of a client's ambivalence, validating their hesitation while highlighting their own change talk.

Which option correctly represents the Stages of Change Model?

Answer: Pre-contemplation, contemplation, preparation, action and maintenance

The Stages of Change Model was developed by Prochaska and DiClemente in the 1970&'s to allow professionals to gauge a client&'s readiness for change to aide in treatment planning.

When a client who has recently relapsed returns to treatment, the counselor's MOST therapeutic response is to:

Answer: Maintain a non-judgmental stance and use the relapse as a learning opportunity

A non-judgmental, compassionate response that treats relapse as information rather than failure preserves the therapeutic alliance and supports renewed engagement in recovery.

In Dialectical Behavior Therapy (DBT), which skill module focuses on tolerating distress without making it worse?

Answer: Distress Tolerance

The Distress Tolerance module in DBT teaches clients to survive crisis moments without resorting to harmful behaviors like substance use.

A DAP progress note includes which three sections?

Answer: Data, Assessment, Plan

DAP notes organize information into Data (what happened in session), Assessment (clinical interpretation), and Plan (next steps or interventions).

Which type of progress note format structures documentation around Subjective, Objective, Assessment, and Plan?

Answer: SOAP note

SOAP notes organize clinical documentation into four sections: Subjective (client's report), Objective (observable data), Assessment (clinical interpretation), and Plan (next steps).

Which type of release of information form is required specifically for substance use disorder records under 42 CFR Part 2?

Answer: A consent form that specifies the program, recipient, purpose, what is to be disclosed, and expiration date

42 CFR Part 2 requires a specific consent form with precise elements including who is releasing, who is receiving, the purpose, and a defined expiration — blanket or generic forms do not suffice.

Which term describes an ethical violation in which a counselor uses their professional position to exploit a client for personal gain?

Answer: Boundary violation

A boundary violation occurs when a counselor crosses professional limits in a way that exploits or harms the client, such as a sexual or financial relationship.

A client who is mandated to treatment by the court still has the right to:

Answer: Refuse specific treatment interventions

Even mandated clients retain the right to refuse specific treatments; however, refusal may have legal consequences such as probation violation.

Which technique involves the counselor asking a client to rate their readiness to change on a scale of 1–10?

Answer: Readiness ruler

The readiness ruler is an MI technique that quantifies motivation and opens discussion about what would move the client's number higher.

In Twelve-Step traditions, which step is "Came to believe a Power greater than ourselves could restore us to sanity?"

Answer: Step 2

"Came to believe a power greater than myself could restore me to sanity" is Step Two. Step 3 is "Made a decision to turn our will and our lives over to the care of God as we understood Him." Step 5 is "Admitted to God, to ourselves, and to another human being the exact nature of our wrongs." Step 8 is "Made a list of all persons we had harmed, and became willing to make amends to them all."

Under 42 CFR Part 2, substance use disorder treatment records have confidentiality protections that are:

Answer: Stricter than general HIPAA protections

42 CFR Part 2 provides heightened confidentiality protections for SUD treatment records, requiring specific consent even for disclosures permitted under standard HIPAA.

Which ethical principle supports a client's right to make their own treatment decisions, even ones the counselor disagrees with?

Answer: Autonomy

Autonomy recognizes the client's right to self-determination and to make their own choices about treatment.

Which type of progress note is MOST useful for documenting a client's presentation, the counselor's interventions, and the client's response to those interventions in a single session?

Answer: BIRP note (Behavior, Intervention, Response, Plan)

BIRP notes are structured specifically to document the client's Behavior, the counselor's Intervention, the client's Response, and the next Plan — ideal for capturing session dynamics.