Chemical Dependency Counselor CCDC Exam Case Studies & Practical Application 5 — Questions and Answers
Question 1: A client who has been mandated to treatment by the court expresses resentment and states they do not have a problem. The counselor's BEST initial approach is to:
- Confront the client's denial firmly to break through resistance
- Use motivational interviewing to explore ambivalence and build intrinsic motivation (Correct answer)
- Inform the court immediately that the client is non-compliant
- Accept the client's self-assessment and focus on court requirements only
Correct answer: Use motivational interviewing to explore ambivalence and build intrinsic motivation
Motivational interviewing is the evidence-based approach for clients who are ambivalent or resistant to treatment.
Question 2: A client in recovery from cocaine use disorder reports that they visited a friend's house where cocaine was present and left without using. The counselor should:
- Praise the client without further exploration
- Explore the high-risk situation, coping skills used, and ways to avoid similar exposure in the future (Correct answer)
- Warn the client that this behavior will lead to relapse
- Document that the client is at imminent risk and increase treatment intensity
Correct answer: Explore the high-risk situation, coping skills used, and ways to avoid similar exposure in the future
Exploring the high-risk situation reinforces coping skills while identifying vulnerabilities for future relapse prevention planning.
Question 3: A client discloses they have been stockpiling prescribed medications 'just in case.' The counselor recognizes this as:
- A responsible health management strategy
- A potential warning sign for suicide risk requiring immediate safety assessment (Correct answer)
- Normal behavior that does not require clinical attention
- Evidence of medication non-compliance to report to the prescriber
Correct answer: A potential warning sign for suicide risk requiring immediate safety assessment
Stockpiling medications is a known means-restriction concern and potential suicide preparatory behavior requiring immediate assessment.
Question 4: A client's spouse attends a family session and blames the client entirely for the family's problems, minimizing their own role. The counselor should:
- Agree with the spouse to maintain their engagement in treatment
- Gently explore the family system dynamics and each member's role without taking sides (Correct answer)
- Ask the spouse to leave future sessions to protect the client
- Provide the spouse with psychoeducation on enabling behaviors only
Correct answer: Gently explore the family system dynamics and each member's role without taking sides
Family sessions require systemic exploration of all members' roles without the counselor aligning with any one perspective.
Question 5: A counselor is working with a client from a rural community where the nearest AA meeting is 60 miles away. The most practical resource to recommend is:
- Inform the client that participation in mutual aid groups is mandatory regardless of distance
- Explore telehealth and online mutual aid options such as virtual AA or SMART Recovery (Correct answer)
- Reduce treatment expectations given geographic limitations
- Require the client to relocate closer to services
Correct answer: Explore telehealth and online mutual aid options such as virtual AA or SMART Recovery
Online and telehealth mutual aid options remove geographic barriers and have demonstrated effectiveness for rural clients.
Question 6: A client with a history of trauma begins to dissociate during a counseling session when discussing their substance use history. The counselor should:
- Continue the session to maintain momentum in trauma processing
- Use grounding techniques to help the client return to the present moment (Correct answer)
- Immediately terminate the session and refer the client for psychiatric evaluation
- Ask the client to push through the discomfort to build resilience
Correct answer: Use grounding techniques to help the client return to the present moment
Grounding techniques help clients reconnect with the present during dissociative episodes, maintaining safety within the session.
Question 7: A counselor is transferring a client to a new provider due to the counselor leaving the agency. To ensure continuity of care, the counselor should:
- Provide the new provider with a verbal summary only to protect confidentiality
- Obtain a release of information, prepare a comprehensive transfer summary, and facilitate a warm handoff (Correct answer)
- Allow the client to initiate contact with the new provider independently
- Close the case and let the new provider conduct a fresh intake without prior records
Correct answer: Obtain a release of information, prepare a comprehensive transfer summary, and facilitate a warm handoff
A warm handoff with written documentation and a signed release ensures continuity of care and reduces the risk of client disengagement during transition.
Chemical Dependency Counselor CCDC Exam Case Studies & Practical Application 5
A client who has been mandated to treatment by the court expresses resentment and states they do not have a problem.
The counselor's BEST initial approach is to: