CARN Recovery and Relapse Prevention 2 — Questions and Answers
Question 1: According to SAMHSA's four dimensions of recovery, which dimension encompasses meaningful daily activities, employment, and financial independence?
- Health
- Home
- Purpose (Correct answer)
- Community
Correct answer: Purpose
SAMHSA's 'Purpose' dimension includes engaging in meaningful daily activities such as a job, school, volunteering, and achieving financial independence.
Question 2: The 'abstinence violation effect' (AVE) describes which phenomenon?
- Physical withdrawal symptoms that emerge after stopping substance use
- Guilt and self-attribution following a lapse that can precipitate full relapse (Correct answer)
- Legal consequences for violating conditions of probation or parole
- The therapeutic benefit of short-term, planned abstinence periods
Correct answer: Guilt and self-attribution following a lapse that can precipitate full relapse
The AVE refers to feelings of guilt, shame, and perceived personal failure following a lapse, which can trigger a cognitive-emotional cascade leading to full relapse.
Question 3: A patient 3 months into recovery states, 'I can go to parties where everyone is drinking — I have strong willpower now.' The nurse recognizes this as:
- A healthy sign of growing self-confidence in recovery
- Evidence of well-developed coping skills
- A cognitive distortion that significantly increases relapse risk (Correct answer)
- An appropriate goal for someone in late-stage recovery
Correct answer: A cognitive distortion that significantly increases relapse risk
Overconfidence and underestimating high-risk situations ('I'm cured') is a cognitive distortion common in early recovery that substantially elevates relapse risk.
Question 4: In Prochaska's Transtheoretical Model, which stage is characterized by the patient making specific plans to change behavior within the next 30 days?
- Contemplation
- Preparation (Correct answer)
- Action
- Maintenance
Correct answer: Preparation
The Preparation stage involves intending to take action soon (within 30 days) and beginning to make specific plans, such as calling a treatment center.
Question 5: Which craving management technique is MOST strongly supported by evidence in addiction treatment?
- Thought suppression — actively pushing away all thoughts about the substance
- 'Urge surfing' — mindfully observing the craving without acting on it (Correct answer)
- Immediately calling a sponsor every time any craving is experienced
- Engaging in strenuous exercise to eliminate all cravings
Correct answer: 'Urge surfing' — mindfully observing the craving without acting on it
'Urge surfing,' a mindfulness-based technique in which patients observe cravings nonjudgmentally until they naturally peak and subside, is well-supported by clinical evidence.
Question 6: Which statement about Medication-Assisted Treatment (MAT) and recovery is most accurate?
- Patients maintained on MAT medications are not in 'true' recovery
- MAT is only appropriate for acute detoxification and should not be used long-term
- MAT combined with counseling consistently improves long-term recovery outcomes (Correct answer)
- Participation in 12-Step programs requires patients to discontinue MAT medications
Correct answer: MAT combined with counseling consistently improves long-term recovery outcomes
Strong evidence shows that MAT (buprenorphine, methadone, naltrexone) combined with psychosocial treatment significantly improves retention, reduces relapse, and lowers mortality.
Question 7: A nurse counsels a patient with alcohol use disorder who has achieved 6 months of sobriety. What is accurate about ongoing relapse risk?
- Relapse risk returns to near zero after 6 months of sustained sobriety
- Relapse risk is highest in the first year and remains elevated for several years (Correct answer)
- Completing a 12-Step program eliminates significant relapse risk
- Relapse risk only exists when patients are exposed to environmental triggers
Correct answer: Relapse risk is highest in the first year and remains elevated for several years
Relapse risk is highest during the first year of recovery and remains significantly elevated for several years, reflecting the chronic nature of addiction.
CARN Recovery and Relapse Prevention 2
According to SAMHSA's four dimensions of recovery, which dimension encompasses meaningful daily activities, employment, and financial independence?