CASAC Relapse Prevention and Recovery Support 5 — Questions and Answers
Question 1: A client who has been sober for 18 months begins withdrawing from support meetings and isolating at home. In terms of relapse stages, this behavior most likely indicates:
- Physical relapse
- Chemical relapse
- Emotional relapse (Correct answer)
- Behavioral relapse
Correct answer: Emotional relapse
Emotional relapse, the first stage in the relapse process, is characterized by poor self-care, isolation, and not attending meetings—before any thoughts of using occur.
Question 2: Which of the following describes the primary purpose of a 'relapse autopsy' in counseling?
- To terminate treatment after a client relapses
- To analyze the sequence of events and thoughts leading to relapse as a learning opportunity (Correct answer)
- To document relapse for legal or insurance reporting purposes
- To confront the client about the consequences of their relapse
Correct answer: To analyze the sequence of events and thoughts leading to relapse as a learning opportunity
A relapse autopsy is a therapeutic technique used to examine the chain of events, thoughts, and feelings that led to a relapse in order to prevent future occurrences.
Question 3: When developing a relapse prevention plan, the MOST important reason to identify early warning signs is to:
- Give the counselor grounds to adjust the treatment plan without client input
- Enable the client to intervene early in the relapse process before substance use occurs (Correct answer)
- Satisfy documentation requirements for accreditation purposes
- Predict exactly when the client will relapse so supports can be deployed
Correct answer: Enable the client to intervene early in the relapse process before substance use occurs
Early warning signs are identified so the client can recognize the beginning of the relapse process and activate coping strategies before a lapse occurs.
Question 4: A client on medication-assisted treatment (MAT) with buprenorphine asks if they are 'truly in recovery' since they rely on medication. The counselor's BEST response is:
- Validate that MAT is a valid, evidence-based pathway to recovery and does not disqualify their recovery status (Correct answer)
- Agree that abstinence from all substances including medications is the standard definition of recovery
- Avoid the topic and redirect to coping skills to prevent conflict
- Advise the client to consult their physician about stopping the medication
Correct answer: Validate that MAT is a valid, evidence-based pathway to recovery and does not disqualify their recovery status
SAMHSA and major recovery organizations recognize MAT as a legitimate and effective recovery pathway; counselors should counter stigma and affirm the client's recovery identity.
Question 5: Which coping skill involves observing and accepting a craving as a temporary sensation without acting on it, allowing it to peak and subside naturally?
- Thought stopping
- Urge surfing (Correct answer)
- Covert sensitization
- Contingency management
Correct answer: Urge surfing
Urge surfing, developed by Alan Marlatt, teaches clients to observe cravings like waves—acknowledging them without fighting or yielding to them until they naturally diminish.
Question 6: A client's relapse prevention plan includes contact information for a sponsor, a crisis line, and a family member. This component of the plan is best described as a:
- Functional analysis worksheet
- Emergency contact support network (Correct answer)
- Social skills training inventory
- Recovery capital deficit list
Correct answer: Emergency contact support network
An emergency contact support network is a structured list of people and resources the client can reach during high-risk moments or crises to prevent relapse.
Question 7: Research on long-term recovery outcomes indicates that the GREATEST predictor of sustained recovery beyond five years is:
- The type of substance used prior to treatment
- Strength and quality of social support and community connection (Correct answer)
- Number of inpatient treatment episodes completed
- Age of first substance use onset
Correct answer: Strength and quality of social support and community connection
Studies consistently show that strong, prosocial support networks and community belonging are the most robust predictors of long-term recovery maintenance.
CASAC Relapse Prevention and Recovery Support 5
A client who has been sober for 18 months begins withdrawing from support meetings and isolating at home.
In terms of relapse stages, this behavior most likely indicates: