CDCA CDCA Co-occurring Disorders & Dual Diagnosis 2 — Questions and Answers
Question 1: When a client presents with psychotic symptoms during an intake assessment, the CDCA's FIRST responsibility is to:
- Consult with a supervisor or refer to a qualified mental health professional for immediate evaluation (Correct answer)
- Diagnose the client with schizophrenia
- Discharge the client from the program as they are not appropriate for SUD treatment
- Administer an antipsychotic medication
Correct answer: Consult with a supervisor or refer to a qualified mental health professional for immediate evaluation
A CDCA is not qualified to diagnose or treat psychosis and must escalate to qualified mental health or medical professionals immediately.
Question 2: A client in early recovery reports ongoing symptoms of depression. The CDCA should:
- Document the symptoms, discuss them with the treatment team, and facilitate a referral for psychiatric evaluation if clinically indicated (Correct answer)
- Tell the client the depression will go away once they have been sober for 30 days
- Prescribe an antidepressant to support the client's recovery
- Diagnose the client with major depressive disorder
Correct answer: Document the symptoms, discuss them with the treatment team, and facilitate a referral for psychiatric evaluation if clinically indicated
CDCAs document and report symptoms to the treatment team and facilitate appropriate referrals rather than diagnosing or prescribing.
Question 3: Which standardized screening tool is commonly used to identify co-occurring mental health symptoms in clients presenting for substance use treatment?
- The Mental Health Screening Form (MHSF-III) or GAIN-SS (Correct answer)
- The Breathalyzer
- The AUDIT-C alone
- The ASI Physical Health Section only
Correct answer: The Mental Health Screening Form (MHSF-III) or GAIN-SS
Tools like the MHSF-III and GAIN-SS are validated instruments designed to screen for co-occurring mental health disorders in SUD populations.
Question 4: Medication-Assisted Treatment (MAT) such as buprenorphine for opioid use disorder is:
- An evidence-based practice that reduces cravings and overdose risk and can be used alongside counseling (Correct answer)
- A sign that the client is not truly committed to recovery
- Prohibited in programs that use a 12-step philosophy
- Only appropriate for clients without any co-occurring disorders
Correct answer: An evidence-based practice that reduces cravings and overdose risk and can be used alongside counseling
MAT is an FDA-approved, evidence-based approach that significantly reduces opioid use, overdose deaths, and criminal activity when combined with counseling.
Question 5: A client with bipolar disorder who is in substance use treatment stops taking their prescribed mood stabilizer. The CDCA should:
- Alert the treatment team and encourage the client to discuss medication concerns with their prescriber (Correct answer)
- Support the client's decision as it is their right to refuse medication
- Remove the client from the treatment program immediately
- Provide the client with herbal supplements as an alternative
Correct answer: Alert the treatment team and encourage the client to discuss medication concerns with their prescriber
The CDCA must communicate medication non-adherence to the treatment team while encouraging the client to engage with their prescriber about their concerns.
Question 6: Motivational Interviewing (MI) is considered particularly effective with clients who have co-occurring disorders because:
- It is non-confrontational and works with ambivalence, which is common among clients with both SUD and mental health challenges (Correct answer)
- It provides direct advice and instructions that clients with dual diagnosis need
- It focuses exclusively on sobriety and ignores mental health symptoms
- It replaces the need for psychiatric medication in most clients
Correct answer: It is non-confrontational and works with ambivalence, which is common among clients with both SUD and mental health challenges
MI's collaborative, non-confrontational style is well-suited to clients with dual diagnosis who often have complex motivations and significant ambivalence about change.
CDCA CDCA Co-occurring Disorders & Dual Diagnosis 2
When a client presents with psychotic symptoms during an intake assessment, the CDCA's FIRST responsibility is to: