Preparing for the CASAC exam takes focused, consistent study across a wide range of counseling competencies. This free CASAC practice test PDF gives you a printable set of exam-style questions covering substance use disorders, the 12 Core Functions, motivational interviewing, ethics, and co-occurring disorders — exactly the content areas tested by the New York State Office of Addiction Services and Supports (OASAS).
Whether you are working toward your initial CASAC credential or upgrading from a CASAC-T trainee status, reviewing these questions offline helps reinforce the concepts you need to pass. Print the PDF, work through the questions at your own pace, and return to this page for additional practice tests and study resources.
A thorough understanding of substance use disorders is the foundation of the CASAC exam. You need to know the diagnostic criteria for alcohol use disorder, opioid use disorder, stimulant use disorder, and other substance-related conditions as defined in the current DSM. Questions in this area test your ability to distinguish between substance use, substance abuse, dependence, and withdrawal, and to identify the physiological and psychological effects of specific substances including alcohol, opioids, benzodiazepines, stimulants, cannabis, and hallucinogens.
Assessment skills are equally important. CASAC candidates must demonstrate competency in conducting biopsychosocial assessments, interpreting screening instruments such as the AUDIT, DAST, and CAGE, and formulating an accurate clinical picture of the client's needs. The exam will test your understanding of how to gather information from multiple sources, document findings appropriately, and use assessment results to inform the treatment planning process.
The 12 Core Functions are the organizing framework of the CASAC credential and represent the practical skills every credentialed counselor must demonstrate. Each function has its own set of competencies, and exam questions are drawn from across all 12.
Screening involves using validated tools to determine whether a client has a substance use disorder and is appropriate for a given level of care. Intake covers the administrative and clinical procedures for admitting a new client to services. Orientation means educating the client about available services, program rules, and what to expect from treatment. Assessment goes deeper than screening, gathering comprehensive information to identify strengths, needs, and barriers. Treatment planning involves developing a written individualized plan with measurable goals and objectives. Counseling encompasses individual, group, and family sessions. Case management means coordinating services across systems. Crisis intervention involves stabilizing acute situations and connecting clients to emergency resources. Client education covers providing accurate information about substance use, health, and recovery. Referral means linking clients to appropriate external services. Reports and recordkeeping involves maintaining accurate, confidential clinical documentation. Consultation means seeking guidance from supervisors or colleagues to improve client outcomes.
Exam questions may present case vignettes requiring you to identify which core function is being applied or to select the most appropriate counselor response within a given function.
Motivational interviewing (MI) is a client-centered, directive counseling approach designed to strengthen a person's own motivation and commitment to change. It is a mandatory content area for the CASAC exam, and questions test both conceptual knowledge and applied technique.
The four core processes of MI are engaging, focusing, evoking, and planning. The foundational spirit of MI rests on partnership, acceptance, compassion, and evocation — abbreviated as PACE. The core counseling skills used in MI are summarized by the acronym OARS: Open-ended questions, Affirmations, Reflective listening, and Summaries. You should be able to differentiate between simple and complex reflections, identify change talk versus sustain talk in client statements, and describe how the counselor responds to each.
Ambivalence is a central concept in MI. The exam will test your ability to recognize ambivalence in a client's language and to use MI-consistent responses that honor autonomy while gently directing attention toward change. Rolling with resistance — now called sustaining the relationship in updated MI literature — and avoiding the righting reflex are key principles. Questions may also address how MI differs from confrontational approaches historically used in substance abuse treatment and why MI is considered more effective with certain populations.
The ethics content area covers the NAADAC Code of Ethics, OASAS regulations, confidentiality requirements under 42 CFR Part 2, HIPAA compliance, mandatory reporting obligations, dual relationships, and professional boundaries. These are heavily tested on the CASAC exam because ethical violations are among the most serious professional risks in addiction counseling.
42 CFR Part 2 provides stricter confidentiality protections for substance use disorder treatment records than HIPAA does for general health records. You must know the conditions under which records can be disclosed, how to obtain proper consent, what constitutes a medical emergency exception, and how Part 2 interacts with court orders. The exam may present scenarios involving law enforcement requests, family inquiries, or interagency communication and ask you to identify the correct ethical response.
Professional boundaries questions often involve recognizing boundary crossings versus boundary violations, understanding transference and countertransference in the counseling relationship, and knowing how to handle gifts, self-disclosure, and social contact with clients. Co-occurring disorders — the presence of both a substance use disorder and a mental health condition — are addressed across multiple content areas. Counselors must understand integrated treatment models, screening tools for common co-occurring conditions, and how to collaborate with mental health providers without practicing outside their scope.
Consistent practice with realistic exam questions is the most reliable way to build confidence before your CASAC exam date. Work through this PDF at least twice — once to identify weak areas and once to confirm mastery. For full-length timed practice sessions and additional question sets organized by content area, visit our casac practice test page.