CADC Alcohol and Drug Counselor Ultimate 2 — Questions and Answers
Question 1: A client in early recovery reports experiencing intense cravings triggered by passing a bar they used to frequent. Which intervention best addresses this trigger?
- Prescribe anti-craving medication immediately
- Use cue exposure therapy combined with coping skills practice (Correct answer)
- Advise the client to avoid all public places
- Discharge the client until cravings subside
Correct answer: Use cue exposure therapy combined with coping skills practice
Cue exposure therapy paired with coping skills helps clients learn to manage cravings triggered by environmental stimuli.
Question 2: Which of the following BEST describes the transtheoretical model's 'contemplation' stage?
- The client has no awareness of their problem and no intention to change
- The client is actively taking steps to modify their behavior
- The client acknowledges a problem exists and is considering change within the next six months (Correct answer)
- The client has sustained behavior change for more than six months
Correct answer: The client acknowledges a problem exists and is considering change within the next six months
In contemplation, individuals recognize their problem and intend to take action within the next six months but have not yet committed.
Question 3: Under HIPAA, which situation allows a counselor to disclose a client's substance use treatment information without written consent?
- A family member requests information to help support the client
- A potential employer asks for confirmation of treatment participation
- The client poses a serious and imminent threat to themselves or an identifiable third party (Correct answer)
- A colleague at the same agency asks about the client's progress
Correct answer: The client poses a serious and imminent threat to themselves or an identifiable third party
HIPAA permits disclosure without consent when necessary to prevent serious and imminent harm to the client or others.
Question 4: A counselor notices they are attracted to a client and begins scheduling extra sessions without clinical justification. This behavior PRIMARILY represents which ethical issue?
- Countertransference leading to boundary violation (Correct answer)
- Appropriate therapeutic relationship enhancement
- Cultural competency failure
- Scope of practice violation
Correct answer: Countertransference leading to boundary violation
Countertransference is the counselor's emotional reaction to a client; acting on it by scheduling unjustified sessions constitutes a boundary violation.
Question 5: Which neurotransmitter system is MOST directly implicated in the rewarding effects of alcohol and opioids?
- Serotonergic system
- Dopaminergic mesolimbic pathway (Correct answer)
- Noradrenergic locus coeruleus pathway
- GABAergic cortical system
Correct answer: Dopaminergic mesolimbic pathway
Both alcohol and opioids stimulate dopamine release in the mesolimbic pathway, producing reinforcing euphoric effects.
Question 6: When conducting a biopsychosocial assessment, which domain would include evaluating a client's history of trauma?
- Biological domain
- Psychological domain (Correct answer)
- Social domain
- Legal domain
Correct answer: Psychological domain
Trauma history falls within the psychological domain because it encompasses mental and emotional factors affecting the client's functioning.
Question 7: A client on methadone maintenance reports using heroin two days ago. The MOST appropriate counselor response is to:
- Immediately discharge the client from the methadone program
- Document the use, explore circumstances without shaming, and adjust the treatment plan as needed (Correct answer)
- Reduce the methadone dose as a consequence
- Report the relapse to law enforcement
Correct answer: Document the use, explore circumstances without shaming, and adjust the treatment plan as needed
Relapse is viewed as part of the recovery process; the counselor should document, explore non-judgmentally, and revise the treatment plan.
A client in early recovery reports experiencing intense cravings triggered by passing a bar they used to frequent.
Which intervention best addresses this trigger?