CADC Co-Occurring Disorders 3 — Questions and Answers
Question 1: According to SAMHSA, what percentage of individuals with serious mental illness also have a co-occurring substance use disorder?
- Approximately 10%
- Approximately 25%
- Approximately 50% (Correct answer)
- Approximately 75%
Correct answer: Approximately 50%
SAMHSA data consistently show that roughly half of individuals with serious mental illness also meet criteria for a substance use disorder.
Question 2: A client with schizophrenia begins using cannabis heavily. Which outcome is most supported by research?
- Cannabis use reduces psychotic symptoms through sedation
- Cannabis use is unrelated to psychotic symptom severity
- Cannabis use is associated with earlier onset and worsening of psychotic symptoms (Correct answer)
- Cannabis use has a protective effect against relapse in schizophrenia
Correct answer: Cannabis use is associated with earlier onset and worsening of psychotic symptoms
Research consistently links cannabis use to earlier onset of psychosis and increased severity and frequency of psychotic episodes in individuals with schizophrenia.
Question 3: The Assertive Community Treatment (ACT) model is most appropriate for which population with co-occurring disorders?
- Outpatient clients with mild symptoms and strong social support
- Clients who are highly motivated and treatment-compliant
- Clients with severe mental illness and high service utilization who have difficulty engaging in traditional treatment (Correct answer)
- Adolescents in school-based prevention programs
Correct answer: Clients with severe mental illness and high service utilization who have difficulty engaging in traditional treatment
ACT delivers intensive, community-based services to individuals with severe mental illness and co-occurring disorders who have not responded to standard outpatient care.
Question 4: Which motivational approach is considered most effective when a client with co-occurring disorders has low insight into their psychiatric diagnosis?
- Confrontational intervention
- Mandatory group therapy attendance
- Motivational Interviewing adapted for dual diagnosis (Correct answer)
- Immediate referral to inpatient care
Correct answer: Motivational Interviewing adapted for dual diagnosis
Motivational Interviewing adapted for dual diagnosis (MIDAD) engages clients in a non-confrontational way that explores ambivalence about both psychiatric treatment and substance use.
Question 5: What does the term 'primary diagnosis' mean in the context of co-occurring disorders assessment?
- The disorder that appeared first chronologically (Correct answer)
- The disorder that is most severe at the time of assessment
- The disorder that is the primary target of treatment in sequential models
- The disorder that the client identifies as their main problem
Correct answer: The disorder that appeared first chronologically
In co-occurring disorders, the primary diagnosis refers to the condition that developed first, which helps clarify the etiological relationship between the two disorders.
Question 6: A CADC should be cautious about prescribing or recommending benzodiazepines to a client with co-occurring anxiety disorder and alcohol use disorder primarily because:
- Benzodiazepines have no effect on anxiety symptoms
- Benzodiazepines are cross-tolerant with alcohol and carry high abuse potential (Correct answer)
- The FDA prohibits benzodiazepine use in substance use disorder treatment
- Benzodiazepines worsen alcohol cravings exclusively
Correct answer: Benzodiazepines are cross-tolerant with alcohol and carry high abuse potential
Benzodiazepines are cross-tolerant with alcohol, share similar mechanisms of addiction, and pose significant misuse risk for clients with alcohol use disorder.
Question 7: Which level of care is most appropriate for a client with co-occurring major depression and severe opioid use disorder who is medically stable but requires 24-hour psychiatric monitoring?
- Standard outpatient (Level 1)
- Intensive outpatient program (Level 2.1)
- Residential treatment (Level 3) (Correct answer)
- Medically managed intensive inpatient (Level 4)
Correct answer: Residential treatment (Level 3)
ASAM Level 3 residential treatment provides 24-hour support and structured psychiatric monitoring for clients who are medically stable but need round-the-clock supervision.
CADC Co-Occurring Disorders 3
According to SAMHSA, what percentage of individuals with serious mental illness also have a co-occurring substance use disorder?