Chemical Dependency Counselor License Exam Case Management 5 — Questions and Answers
Question 1: A case manager is working with a pregnant client with opioid use disorder. Which treatment approach is consistent with current evidence-based guidelines?
- Recommend immediate abstinence from all opioids to protect the fetus
- Support medically supervised opioid agonist therapy (e.g., methadone or buprenorphine) as the standard of care (Correct answer)
- Advise the client to manage withdrawal at home to avoid medications
- Defer all treatment until after delivery
Correct answer: Support medically supervised opioid agonist therapy (e.g., methadone or buprenorphine) as the standard of care
Opioid agonist therapy during pregnancy is the evidence-based standard of care and significantly reduces risks to both mother and fetus compared to unsupported abstinence.
Question 2: What distinguishes 'case management' from 'counseling' in chemical dependency treatment?
- Case management involves psychotherapy; counseling involves service coordination
- Case management focuses on linking clients to resources and coordinating services; counseling focuses on therapeutic interventions (Correct answer)
- There is no meaningful distinction between the two roles
- Case management is performed only by licensed psychiatrists
Correct answer: Case management focuses on linking clients to resources and coordinating services; counseling focuses on therapeutic interventions
Case management emphasizes brokering, coordinating, and monitoring services, while counseling focuses on therapeutic processes and behavioral change.
Question 3: A client's treatment plan has not been updated in 18 months. This is a problem because:
- Insurance companies require monthly updates regardless of client progress
- Treatment plans must reflect the client's current status, needs, and evolving goals to be clinically relevant (Correct answer)
- Outdated plans indicate the case manager is overworked
- It violates a federal law requiring quarterly updates
Correct answer: Treatment plans must reflect the client's current status, needs, and evolving goals to be clinically relevant
Treatment plans must be regularly reviewed and updated to reflect the client's current circumstances, progress, and changing clinical needs.
Question 4: When a client relapses after a period of sustained recovery, the case manager should FIRST:
- Restart the client at the beginning of the treatment program
- Assess the circumstances of the relapse and collaboratively revise the treatment plan (Correct answer)
- Place the client on a 30-day probation from services
- Immediately refer the client to a detoxification facility without assessment
Correct answer: Assess the circumstances of the relapse and collaboratively revise the treatment plan
Assessing the relapse context identifies what led to the return to use and informs targeted modifications to the treatment plan.
Question 5: A case manager is discharging a client from outpatient treatment. Which action is most important for supporting long-term recovery?
- Advising the client they no longer need professional support
- Developing an individualized continuing care plan with identified relapse prevention strategies and community supports (Correct answer)
- Simply closing the case in the electronic health record
- Scheduling one final session and then ending all contact
Correct answer: Developing an individualized continuing care plan with identified relapse prevention strategies and community supports
A structured continuing care plan with relapse prevention strategies and community support connections significantly reduces post-discharge relapse risk.
Question 6: Which of the following best describes the 'broker' function in case management?
- Providing direct therapeutic counseling to the client
- Identifying needed services and connecting clients with appropriate community resources (Correct answer)
- Negotiating treatment fees with insurance companies
- Supervising other staff members' caseloads
Correct answer: Identifying needed services and connecting clients with appropriate community resources
The broker function involves identifying what services a client needs and making effective referrals to link them to appropriate resources.
Question 7: A client with alcohol use disorder also presents with untreated hypertension. The case manager's responsibility is to:
- Provide direct medical treatment for the hypertension
- Coordinate a referral to primary care and ensure follow-through while addressing how alcohol affects blood pressure (Correct answer)
- Focus exclusively on the alcohol use disorder and disregard medical issues
- Advise the client to research hypertension treatment on their own
Correct answer: Coordinate a referral to primary care and ensure follow-through while addressing how alcohol affects blood pressure
Case managers address medical needs by facilitating referrals and monitoring follow-through, while educating clients on the interaction between substance use and physical health.
