Chemical Dependency Counselor CCDC Exam Risk Assessment & Management 3 — Questions and Answers
Question 1: A client who uses stimulants heavily presents with paranoia and aggression. What is the counselor's first safety priority?
- Conduct a full biopsychosocial assessment
- Ensure the environment is safe and de-escalate the situation (Correct answer)
- Refer immediately to outpatient therapy
- Administer a standardized risk tool
Correct answer: Ensure the environment is safe and de-escalate the situation
De-escalation and environmental safety take precedence before any formal assessment when acute agitation is present.
Question 2: The CAGE questionnaire is primarily used to screen for:
- Opioid misuse
- Alcohol use disorder (Correct answer)
- Polysubstance dependence
- Benzodiazepine withdrawal risk
Correct answer: Alcohol use disorder
The CAGE tool uses four questions to identify problematic alcohol use in clinical settings.
Question 3: Which protective factor most consistently reduces suicide risk in clients with substance use disorders?
- Financial stability
- Social support and reasons for living (Correct answer)
- Absence of chronic pain
- Employment history
Correct answer: Social support and reasons for living
Strong social connectedness and identified reasons for living are among the most robust protective factors against suicide.
Question 4: A client on methadone maintenance is also prescribed a benzodiazepine by another provider. What risk does this combination primarily create?
- Reduced methadone efficacy
- Increased risk of fatal respiratory depression (Correct answer)
- Accelerated liver damage
- Higher likelihood of drug diversion
Correct answer: Increased risk of fatal respiratory depression
Both methadone and benzodiazepines depress the central nervous system, and their combination significantly increases the risk of fatal respiratory depression.
Question 5: Under the Duty to Warn doctrine, a counselor is obligated to take action when a client:
- Expresses frustration with a family member
- Makes a credible, specific threat against an identifiable third party (Correct answer)
- Discloses past violent behavior
- Reports feeling angry while intoxicated
Correct answer: Makes a credible, specific threat against an identifiable third party
Tarasoff-derived duty to warn applies when there is a credible, specific, and imminent threat to an identifiable victim.
Question 6: What does a 'safety plan' developed with a suicidal client primarily include?
- A no-suicide contract signed by the client
- Warning signs, coping strategies, support contacts, and means restriction steps (Correct answer)
- A referral letter to a psychiatrist
- A schedule of daily group sessions
Correct answer: Warning signs, coping strategies, support contacts, and means restriction steps
Evidence-based safety plans outline personalized warning signs, coping skills, social supports, and means restriction rather than relying solely on contracts.
Question 7: When assessing a client's risk of returning to drug use after treatment, which factor is considered a dynamic (changeable) risk factor?
- Family history of substance use disorder
- Age at first use
- Current coping skills (Correct answer)
- Childhood trauma history
Correct answer: Current coping skills
Dynamic risk factors like coping skills can change through treatment, making them targets for intervention.
Chemical Dependency Counselor CCDC Exam Risk Assessment & Management 3
A client who uses stimulants heavily presents with paranoia and aggression.
What is the counselor's first safety priority?