CADC Alcohol and Drug Counselor Case Management and Referrals 2 — Questions and Answers
Question 1: When conducting a biopsychosocial assessment for a new client, which domain is MOST critical to evaluate first for immediate safety concerns?
- Family history of substance use
- Current withdrawal symptoms and medical stability (Correct answer)
- Employment status and financial resources
- Social support network strength
Correct answer: Current withdrawal symptoms and medical stability
Current withdrawal symptoms and medical stability must be assessed first because certain withdrawal syndromes (e.g., alcohol, benzodiazepines) can be life-threatening.
Question 2: A counselor identifies that a client needs residential treatment but the client's insurance only covers outpatient services. The BEST next step is to:
- Accept the insurance limitation and place the client in outpatient
- Advocate for the client by appealing the insurance decision or exploring alternative funding (Correct answer)
- Discharge the client since treatment cannot be funded
- Place the client in the highest funded level of care regardless of clinical need
Correct answer: Advocate for the client by appealing the insurance decision or exploring alternative funding
Case managers are obligated to advocate for clients to access clinically appropriate services, including appealing insurance decisions or identifying alternative funding sources.
Question 3: Which ASAM Patient Placement Criteria dimension addresses a client's readiness and motivation to change?
- Dimension 1 – Acute Intoxication/Withdrawal Potential
- Dimension 3 – Emotional/Behavioral/Cognitive Conditions
- Dimension 4 – Readiness to Change (Correct answer)
- Dimension 5 – Relapse/Continued Use Potential
Correct answer: Dimension 4 – Readiness to Change
ASAM Dimension 4 specifically evaluates a client's readiness, interest, and commitment to change as a factor in determining appropriate level of care.
Question 4: A client in case management repeatedly misses scheduled appointments with their psychiatrist. The counselor's MOST appropriate response is to:
- Document the missed appointments and take no further action
- Explore barriers to attendance and problem-solve solutions with the client (Correct answer)
- Contact the psychiatrist to cancel further appointments
- Report the client to their probation officer immediately
Correct answer: Explore barriers to attendance and problem-solve solutions with the client
Exploring barriers and collaboratively problem-solving maintains engagement and addresses the root cause of non-attendance.
Question 5: The primary purpose of a treatment plan review in addiction case management is to:
- Satisfy documentation requirements for accreditation bodies
- Assess progress toward goals and modify the plan based on the client's current needs (Correct answer)
- Provide the client with a copy of their records
- Determine whether the counselor is meeting performance metrics
Correct answer: Assess progress toward goals and modify the plan based on the client's current needs
Treatment plan reviews ensure the plan remains clinically relevant by evaluating progress and adjusting goals and interventions as the client's needs evolve.
Question 6: When making a referral to a community-based support group such as Alcoholics Anonymous, the counselor should:
- Require attendance as a mandatory condition of treatment without discussion
- Provide information about the group and allow the client to decide if it aligns with their values (Correct answer)
- Only refer clients who have completed primary treatment
- Avoid referrals to mutual aid groups since they are not evidence-based
Correct answer: Provide information about the group and allow the client to decide if it aligns with their values
Counselors should provide information and support client autonomy in deciding whether a mutual aid group fits their recovery goals and values.
Question 7: A client discloses housing instability during a case management session. According to best practices, the counselor should FIRST:
- Refer the client directly to a homeless shelter without further assessment
- Address housing as a critical recovery support need and assess urgency and available options (Correct answer)
- Inform the client that housing is outside the scope of substance use counseling
- Notify the client's family members about the housing situation
Correct answer: Address housing as a critical recovery support need and assess urgency and available options
Housing instability directly threatens recovery, so the counselor should assess the urgency and explore all available housing resources as part of comprehensive case management.
CADC Alcohol and Drug Counselor Case Management and Referrals 2
When conducting a biopsychosocial assessment for a new client, which domain is MOST critical to evaluate first for immediate safety concerns?