Chemical Dependency Counselor License Exam Case Management and Referral 4 — Questions and Answers
Question 1: A client with substance use disorder is also involved in the criminal justice system. Which case management approach is MOST effective for this population?
- Treating the legal issues and substance use disorder as entirely separate concerns
- Integrating treatment and legal supervision through coordinated communication with probation/parole officers (Correct answer)
- Withholding treatment until legal matters are resolved
- Advising the client to avoid contact with their probation officer
Correct answer: Integrating treatment and legal supervision through coordinated communication with probation/parole officers
Integrated case management that coordinates between treatment and criminal justice systems improves outcomes for justice-involved clients with substance use disorders.
Question 2: Which of the following is an example of a community support resource that case managers commonly utilize for clients in recovery?
- Psychiatric hospitalization for stabilization
- Sober living homes, peer recovery support services, and vocational rehabilitation (Correct answer)
- Involuntary civil commitment proceedings
- Emergency detoxification services only
Correct answer: Sober living homes, peer recovery support services, and vocational rehabilitation
Community support resources like sober living, peer recovery specialists, and vocational rehab address the social and environmental needs that support long-term recovery.
Question 3: A client reports that their primary care physician is unaware of their substance use disorder. The counselor's BEST action is to:
- Advise the client to keep this information private to avoid stigma
- Discuss the benefits of integrated care and, with client consent, facilitate communication with the primary care provider (Correct answer)
- Contact the physician directly without obtaining the client's consent
- Document the situation and take no further case management action
Correct answer: Discuss the benefits of integrated care and, with client consent, facilitate communication with the primary care provider
Integrated care between behavioral health and primary care improves outcomes; facilitating this communication with client consent is a best practice in case management.
Question 4: When a counselor refers a client to a community resource and the client reports the resource was unhelpful, the counselor should FIRST:
- Accept the client's report and document the outcome without further follow-up
- Explore the client's specific concerns about the resource and assess whether an alternative referral is needed (Correct answer)
- Insist the client return to the same resource because the referral was appropriate
- Attribute the outcome to client non-compliance
Correct answer: Explore the client's specific concerns about the resource and assess whether an alternative referral is needed
Exploring the client's experience helps identify whether the resource was a poor fit or whether there were barriers to engagement that can be addressed.
Question 5: Under HIPAA and 42 CFR Part 2, sharing a client's substance use treatment records with their employer requires:
- Only verbal consent from the client
- A specific written consent that identifies the recipient, information to be disclosed, and purpose (Correct answer)
- Approval from the treatment program director only
- No consent if the employer is paying for treatment
Correct answer: A specific written consent that identifies the recipient, information to be disclosed, and purpose
42 CFR Part 2 requires a written consent form with specific elements including the recipient, the information disclosed, and the purpose before any substance use records may be shared.
Question 6: A counselor's client is a single parent whose child care arrangements have collapsed, preventing treatment attendance. The MOST appropriate case management step is:
- Discharge the client for failing to maintain treatment engagement
- Identify child care assistance programs or on-site child care services to support the client's participation (Correct answer)
- Reduce the client's treatment plan to phone check-ins only without exploring alternatives
- Refer the client to child protective services
Correct answer: Identify child care assistance programs or on-site child care services to support the client's participation
Addressing social determinants of health such as child care is a core case management function that reduces barriers and supports treatment access for single parents.
Question 7: Which factor is MOST important when evaluating the appropriateness of a community referral resource for a specific client?
- The resource's geographic proximity to the counselor's office
- The resource's cultural competence, eligibility criteria, and ability to meet the client's specific needs (Correct answer)
- The resource's reputation among other counselors regardless of client characteristics
- The cost of the resource to the treatment program
Correct answer: The resource's cultural competence, eligibility criteria, and ability to meet the client's specific needs
Effective referrals require matching client-specific needs, eligibility, and cultural factors to resources capable of providing appropriate, accessible services.
