CASAC Screening, Assessment, and Diagnosis 5 — Questions and Answers
Question 1: A counselor administering the Addiction Severity Index (ASI) scores a client high in the Legal domain. What does this finding indicate in terms of treatment planning?
- The client should be referred for detoxification services
- Legal issues should be addressed as a problem area that may affect treatment engagement and outcomes (Correct answer)
- The diagnosis should be changed to antisocial personality disorder
- The client's substance use is likely not the primary concern
Correct answer: Legal issues should be addressed as a problem area that may affect treatment engagement and outcomes
High ASI scores in any domain, including Legal, identify problem areas that warrant attention in the treatment plan to support recovery.
Question 2: Which instrument is specifically designed to screen for alcohol use disorder in pregnant women and uses only three questions related to tolerance?
- TWEAK (Correct answer)
- AUDIT-C
- CRAFFT
- CAGE
Correct answer: TWEAK
The TWEAK (Tolerance, Worried, Eye-opener, Amnesia, K/Cut down) was developed to identify at-risk drinking in pregnant women and is sensitive to tolerance.
Question 3: During an intake assessment, a client discloses recent use of benzodiazepines without a prescription. The counselor should FIRST:
- Refer the client immediately to a detox facility
- Assess the amount, frequency, duration, and last use to evaluate withdrawal risk (Correct answer)
- Administer the CAGE questionnaire
- Contact the client's prescribing physician
Correct answer: Assess the amount, frequency, duration, and last use to evaluate withdrawal risk
Benzodiazepine withdrawal can be life-threatening, so the counselor must first gather detailed use history to determine the level of risk before deciding on next steps.
Question 4: Which of the following is a key difference between a screening and a comprehensive assessment in substance abuse counseling?
- Screenings are only conducted by physicians, while assessments are conducted by counselors
- Screenings identify the possible presence of a problem, while assessments gather detailed information to guide diagnosis and treatment planning (Correct answer)
- Assessments use only standardized instruments, while screenings rely on clinical judgment
- Screenings take more time to administer than assessments
Correct answer: Screenings identify the possible presence of a problem, while assessments gather detailed information to guide diagnosis and treatment planning
Screening is a brief process to identify individuals who may have a problem, whereas a comprehensive assessment provides detailed data for diagnosis and individualized treatment planning.
Question 5: A 16-year-old client presents for assessment after a school referral for marijuana use. Which screening tool is MOST appropriate for this population?
- AUDIT
- DAST-10
- CRAFFT (Correct answer)
- CAGE
Correct answer: CRAFFT
The CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) is a validated screening tool specifically designed for adolescents aged 12–21.
Question 6: A client meets DSM-5 criteria for both alcohol use disorder and major depressive disorder. The counselor should document this as:
- Alcohol-induced depressive disorder only
- A co-occurring disorder (dual diagnosis) (Correct answer)
- Major depressive disorder in remission
- Alcohol use disorder with depressive features
Correct answer: A co-occurring disorder (dual diagnosis)
When a client meets full diagnostic criteria for both a substance use disorder and an independent mental health disorder, it is accurately documented as a co-occurring or dual diagnosis.
Question 7: The DAST-10 (Drug Abuse Screening Test) is best suited for which purpose?
- Diagnosing the specific type of substance use disorder
- Quantifying the degree of problems related to drug misuse over the past 12 months (Correct answer)
- Screening exclusively for opioid use disorder
- Measuring blood alcohol concentration
Correct answer: Quantifying the degree of problems related to drug misuse over the past 12 months
The DAST-10 is a 10-item self-report tool that quantifies the severity of drug-related problems over the previous 12 months to guide clinical decision-making.
CASAC Screening, Assessment, and Diagnosis 5
A counselor administering the Addiction Severity Index (ASI) scores a client high in the Legal domain.
What does this finding indicate in terms of treatment planning?