CADC Alcohol and Drug Counselor Case Management and Referrals 5 — Questions and Answers
Question 1: A case manager is helping a client transition from residential to outpatient treatment. Which action BEST supports continuity of care?
- Instructing the client to self-refer to outpatient services upon discharge
- Scheduling the first outpatient appointment before discharge and sharing a treatment summary with consent (Correct answer)
- Waiting until the client contacts the outpatient program on their own
- Discharging without documentation since the outpatient provider will conduct their own intake
Correct answer: Scheduling the first outpatient appointment before discharge and sharing a treatment summary with consent
Scheduling follow-up appointments before discharge and sharing a treatment summary ensures continuity and reduces the risk of treatment dropout during transitions.
Question 2: An adolescent client's parent calls the counselor demanding information about their child's substance use treatment. The client is 16 years old. The counselor should:
- Share all information with the parent since the client is a minor
- Consult applicable state minor consent laws and 42 CFR Part 2 before disclosing any information (Correct answer)
- Disclose information only if the parent provides written authorization
- Refuse all communication with the parent regardless of circumstances
Correct answer: Consult applicable state minor consent laws and 42 CFR Part 2 before disclosing any information
Minor consent laws vary by state, and 42 CFR Part 2 may restrict disclosure even to parents; the counselor must review both before releasing information.
Question 3: A client who is homeless and has a substance use disorder presents for case management. According to a Housing First approach, the counselor should prioritize:
- Requiring sobriety before assisting with housing placement
- Securing stable housing immediately without sobriety as a precondition (Correct answer)
- Referring the client to detox before addressing housing
- Placing the client on a housing waitlist contingent on treatment compliance
Correct answer: Securing stable housing immediately without sobriety as a precondition
Housing First evidence shows that providing stable housing without preconditions leads to better substance use and health outcomes for homeless individuals.
Question 4: The CAGE questionnaire is a brief screening tool used to assess the likelihood of:
- Opioid dependence specifically
- Depression comorbid with substance use
- Alcohol use disorder (Correct answer)
- Post-traumatic stress disorder
Correct answer: Alcohol use disorder
The CAGE questionnaire was developed specifically as a brief, 4-question screen for alcohol use disorder and is widely used in clinical settings.
Question 5: A case manager notices a pattern of service gaps for clients from a specific cultural community. The MOST appropriate systemic response is to:
- Advise individual clients to adapt to available services
- Advocate for culturally responsive services and engage community stakeholders to address the gaps (Correct answer)
- Document the gaps and take no further action
- Refer all clients from that community to providers outside the agency
Correct answer: Advocate for culturally responsive services and engage community stakeholders to address the gaps
Case managers have an advocacy role that extends to identifying and addressing systemic barriers, including culturally unresponsive services.
Question 6: A client in long-term recovery asks about peer recovery support services (PRSS). The counselor should explain that PRSS are primarily provided by:
- Licensed clinical social workers
- Individuals with lived experience of addiction and recovery (Correct answer)
- Physicians specializing in addiction medicine
- Certified substance use counselors only
Correct answer: Individuals with lived experience of addiction and recovery
Peer recovery support services are delivered by trained individuals with lived experience of addiction and recovery, offering mentorship, support, and hope.
Question 7: When a client's treatment goals are not being met despite multiple interventions, the case manager should FIRST:
- Discharge the client for non-compliance
- Conduct a comprehensive reassessment to identify barriers and consider alternative approaches (Correct answer)
- Increase the frequency of counseling sessions without reassessment
- Transfer the case to another counselor immediately
Correct answer: Conduct a comprehensive reassessment to identify barriers and consider alternative approaches
Persistent unmet goals signal a need for reassessment to identify underlying barriers or whether the current treatment approach remains appropriate.
CADC Alcohol and Drug Counselor Case Management and Referrals 5
A case manager is helping a client transition from residential to outpatient treatment.
Which action BEST supports continuity of care?