CASAC Relapse Prevention and Recovery Support 4 — Questions and Answers
Question 1: A client in recovery reports feeling restless, irritable, and discontent but has not used substances. According to HALT-R, what additional state does the 'R' represent?
- Resentment (Correct answer)
- Rejection
- Relapse
- Regret
Correct answer: Resentment
HALT-R expands the classic HALT acronym by adding Resentment as a high-risk emotional state that can trigger cravings and relapse.
Question 2: Which of the following best describes the 'abstinence violation effect' (AVE) in relapse prevention?
- A client's belief that one slip means total failure, leading to continued use (Correct answer)
- A pharmacological rebound that increases cravings after stopping opioids
- The counselor's decision to remove abstinence as a treatment goal after a lapse
- A legal term for violating probation conditions tied to substance use
Correct answer: A client's belief that one slip means total failure, leading to continued use
The abstinence violation effect describes the cognitive-emotional response where a person attributes a lapse to personal failure and uses this as justification for continued substance use.
Question 3: A client's recovery support plan should ideally include which of the following as a 'recovery capital' component?
- Only formal treatment services
- Solely medication-assisted treatment
- Social, human, physical, and cultural resources that support recovery (Correct answer)
- Legal documentation of prior substance use history
Correct answer: Social, human, physical, and cultural resources that support recovery
Recovery capital encompasses the breadth and depth of internal and external resources—social networks, skills, housing, and cultural identity—available to support long-term recovery.
Question 4: During a relapse prevention session, a client says, 'I can have just one drink at a wedding without it being a problem.' What cognitive distortion is this client demonstrating?
- Catastrophizing
- Apparently irrelevant decisions (AIDs)
- Controlled use rationalization (Correct answer)
- Black-and-white thinking
Correct answer: Controlled use rationalization
Controlled use rationalization is a common cognitive distortion where a client minimizes their loss of control by believing they can manage substance use socially without risk of relapse.
Question 5: Which statement about peer recovery support specialists (PRSS) is most accurate in the context of relapse prevention?
- PRSS replace clinical counselors in formal treatment settings
- PRSS provide lived experience-based support and are not bound by clinical licensure requirements (Correct answer)
- PRSS are only effective during the acute withdrawal phase
- PRSS are prohibited from discussing relapse triggers with clients
Correct answer: PRSS provide lived experience-based support and are not bound by clinical licensure requirements
Peer recovery support specialists use their own lived experience with recovery to provide non-clinical mentoring and support, operating under different credentialing than licensed counselors.
Question 6: A client has identified 'driving past the bar where I used to drink' as a high-risk situation. The most appropriate relapse prevention strategy for this specific trigger is:
- Urge surfing until the craving passes while driving the same route
- Stimulus control through avoiding or altering exposure to the trigger (Correct answer)
- Increasing medication dosage on days the route is unavoidable
- Encouraging the client to confront the trigger daily to desensitize
Correct answer: Stimulus control through avoiding or altering exposure to the trigger
Stimulus control strategies in relapse prevention involve modifying the environment to reduce exposure to conditioned cues that elicit cravings.
Question 7: According to the SAMHSA's four major dimensions of recovery, which dimension encompasses stable housing, meaningful daily activities, and financial security?
- Health
- Home
- Purpose (Correct answer)
- Community
Correct answer: Purpose
The 'Purpose' dimension of SAMHSA's recovery framework includes engaging in meaningful activities such as employment, education, volunteerism, and having independence and financial stability.
CASAC Relapse Prevention and Recovery Support 4
A client in recovery reports feeling restless, irritable, and discontent but has not used substances.
According to HALT-R, what additional state does the 'R' represent?