CBHCM CBHCM Recovery-Oriented Care and Wellness 5 — Questions and Answers
Question 1: A case manager is working with a client who has a co-occurring substance use disorder and schizophrenia. The client refuses psychiatric medication but is engaged in a peer recovery program. What is the most appropriate stance?
- Terminate services until the client agrees to medication
- Respect the client's autonomy while continuing to engage and monitor safety (Correct answer)
- Report the client to their psychiatrist as non-compliant
- Prioritize substance use treatment and defer mental health care
Correct answer: Respect the client's autonomy while continuing to engage and monitor safety
Recovery-oriented practice respects autonomy and self-determination; the case manager should maintain the therapeutic relationship and monitor safety while honoring the client's choices.
Question 2: Which of the following physical wellness strategies has the strongest evidence base for improving symptoms of depression in individuals with serious mental illness?
- Dietary supplementation with omega-3 fatty acids
- Regular aerobic exercise (Correct answer)
- Acupuncture and massage therapy
- Increased sleep duration beyond 9 hours
Correct answer: Regular aerobic exercise
Regular aerobic exercise has robust research support as an evidence-based intervention that reduces depressive symptoms and improves overall wellness in individuals with serious mental illness.
Question 3: In the context of recovery capital, 'community capital' refers to:
- Financial grants available to recovery organizations
- The attitudes, resources, and policies in a community that support recovery (Correct answer)
- The number of treatment facilities in a geographic area
- Tax incentives for employers who hire individuals in recovery
Correct answer: The attitudes, resources, and policies in a community that support recovery
Community capital includes the recovery-supportive attitudes, resources, policies, and relationships available in a person's broader community environment.
Question 4: A client asks their case manager about the difference between a psychiatric advance directive and a WRAP crisis plan. The most accurate distinction is:
- They are legally identical documents with different names
- A psychiatric advance directive is a legal document enforceable by law, while a WRAP crisis plan is a personal planning tool (Correct answer)
- WRAP crisis plans must be notarized, while advance directives do not
- Advance directives apply only to medication, while WRAP covers all wellness domains
Correct answer: A psychiatric advance directive is a legal document enforceable by law, while a WRAP crisis plan is a personal planning tool
A psychiatric advance directive is a legally binding document specifying treatment preferences, while a WRAP crisis plan is a personal wellness tool without legal enforcement.
Question 5: Which trauma-informed principle involves helping clients understand the impact of trauma without re-traumatizing them through the therapeutic process?
- Empowerment
- Trustworthiness
- Safety (Correct answer)
- Peer support
Correct answer: Safety
Creating physical and emotional safety is a core trauma-informed principle that ensures the care environment does not inadvertently reproduce traumatic experiences.
Question 6: A client in recovery from opioid use disorder is prescribed buprenorphine. A peer in their recovery support group tells the client they are 'not really in recovery' because they take medication. How should the case manager address this situation?
- Advise the client to leave the recovery support group
- Validate the peer's perspective as a common view in 12-step communities
- Educate the client that medication-assisted treatment is a legitimate, evidence-based recovery pathway (Correct answer)
- Reduce the client's buprenorphine dose to address the group's concerns
Correct answer: Educate the client that medication-assisted treatment is a legitimate, evidence-based recovery pathway
Medication-assisted treatment (MAT) with buprenorphine is a recognized, evidence-based recovery pathway, and case managers should counter stigma and affirm the client's recovery.
Question 7: When integrating wellness into case management, the 8 dimensions of wellness (SAMHSA model) include all of the following EXCEPT:
- Environmental wellness
- Financial wellness
- Neurological wellness (Correct answer)
- Social wellness
Correct answer: Neurological wellness
SAMHSA's 8 dimensions of wellness are emotional, spiritual, intellectual, physical, environmental, financial, occupational, and social—neurological is not one of the eight.
CBHCM CBHCM Recovery-Oriented Care and Wellness 5
A case manager is working with a client who has a co-occurring substance use disorder and schizophrenia.
The client refuses psychiatric medication but is engaged in a peer recovery program.
What is the most appropriate stance?