CASAC Treatment Planning and Referral 4 — Questions and Answers
Question 1: A client with co-occurring opioid use disorder and PTSD is stabilized on buprenorphine. When developing a treatment plan, what is the most appropriate approach to addressing both conditions?
- Treat PTSD first before addressing opioid use disorder
- Integrate trauma-informed care into the substance use treatment plan concurrently (Correct answer)
- Discontinue buprenorphine once PTSD treatment begins
- Refer the client to separate providers with no coordination between them
Correct answer: Integrate trauma-informed care into the substance use treatment plan concurrently
Integrated, concurrent treatment of co-occurring disorders is the evidence-based standard, as each condition can exacerbate the other.
Question 2: A treatment plan goal states: 'Client will improve coping skills.' According to best practices, what is the primary problem with this goal?
- It is not relevant to substance use recovery
- It is not measurable or time-bound (Correct answer)
- It focuses too much on the client's strengths
- It requires family involvement
Correct answer: It is not measurable or time-bound
Effective treatment plan goals must be specific, measurable, achievable, relevant, and time-bound (SMART) to track client progress.
Question 3: Which of the following best describes the purpose of a Level of Care determination using ASAM criteria?
- To diagnose the client's substance use disorder severity
- To match the client's clinical needs to the appropriate intensity of treatment services (Correct answer)
- To determine the client's eligibility for insurance reimbursement
- To establish the client's prognosis for long-term recovery
Correct answer: To match the client's clinical needs to the appropriate intensity of treatment services
ASAM criteria provide a multidimensional framework to match clients to the appropriate level of care based on their biopsychosocial needs.
Question 4: A client refuses a referral to inpatient detoxification despite showing signs of severe alcohol withdrawal risk. What is the counselor's most appropriate immediate response?
- Document the refusal and proceed with outpatient treatment as requested
- Discharge the client for non-compliance
- Provide education on withdrawal risks, document informed refusal, and explore alternatives while ensuring safety (Correct answer)
- Contact the client's family without the client's consent to arrange admission
Correct answer: Provide education on withdrawal risks, document informed refusal, and explore alternatives while ensuring safety
Counselors must respect client autonomy while fulfilling their duty to inform about risks, document informed refusal, and explore all safe alternatives.
Question 5: During a treatment plan review, a client reports a relapse to cocaine use. How should the counselor incorporate this information into the treatment plan?
- Restart the client at the beginning of treatment as if starting fresh
- Use the relapse as clinical data to revise triggers, coping strategies, and possibly the level of care (Correct answer)
- Terminate treatment and refer the client elsewhere
- Document the relapse but make no changes to the existing plan
Correct answer: Use the relapse as clinical data to revise triggers, coping strategies, and possibly the level of care
Relapse is viewed as clinical information that informs treatment plan revisions, including identifying triggers and reassessing level of care needs.
Question 6: A client completing residential treatment needs ongoing support. Which referral would best address continuing care needs for long-term sobriety?
- Immediate discharge with no follow-up services
- Referral to intensive outpatient program (IOP) with peer support and case management (Correct answer)
- Referral to primary care only for physical health monitoring
- Recommendation to attend a single support group meeting
Correct answer: Referral to intensive outpatient program (IOP) with peer support and case management
A step-down to an intensive outpatient program with wraparound services provides structured continuing care that supports the transition from residential treatment.
Question 7: A CASAC counselor is writing a treatment plan for a client with methamphetamine use disorder. Which statement best reflects a client-centered objective?
- Counselor will assign readings about the dangers of stimulant use
- Client will identify three personal relapse triggers and corresponding coping strategies by the end of week two (Correct answer)
- Client will attend all scheduled group sessions without exception
- Counselor will provide weekly updates to the client's family
Correct answer: Client will identify three personal relapse triggers and corresponding coping strategies by the end of week two
Client-centered objectives are written from the client's perspective, are specific, and reflect individualized goals tied to the client's own recovery process.
CASAC Treatment Planning and Referral 4
A client with co-occurring opioid use disorder and PTSD is stabilized on buprenorphine.
When developing a treatment plan, what is the most appropriate approach to addressing both conditions?