Chemical Dependency Counselor License Exam Crisis Intervention 3 — Questions and Answers
Question 1: Roberts' Seven-Stage Crisis Intervention Model begins with which stage?
- Establishing rapport
- Planning treatment
- Assessing lethality and safety (Correct answer)
- Identifying major problems
Correct answer: Assessing lethality and safety
Stage 1 of Roberts' model is assessing lethality and safety needs, because physical safety must be established before any therapeutic work can proceed.
Question 2: A counselor is conducting a SLAP assessment. What does SLAP stand for?
- Suicide, Lethality, Alcohol, Plan
- Specificity, Lethality, Availability, Proximity (Correct answer)
- Severity, Level, Affect, Plan
- Safety, Likelihood, Access, Prevention
Correct answer: Specificity, Lethality, Availability, Proximity
SLAP assesses Specificity of plan, Lethality of method, Availability of means, and Proximity of support—key dimensions of suicide risk.
Question 3: A client in early recovery presents to an outpatient session in acute alcohol withdrawal with a blood pressure of 170/100 and tremors. The counselor's IMMEDIATE action should be to:
- Begin motivational interviewing to address the relapse
- Refer immediately to medical evaluation or emergency services (Correct answer)
- Provide psychoeducation about withdrawal symptoms
- Schedule a follow-up appointment for the next day
Correct answer: Refer immediately to medical evaluation or emergency services
Severe alcohol withdrawal (elevated BP, tremors) can progress to seizures and delirium tremens—immediate medical evaluation is a life-safety priority.
Question 4: Which element is ESSENTIAL in a safety plan developed with a suicidal client in substance use treatment?
- Identifying triggers and listing means restriction steps (Correct answer)
- Setting a firm discharge date from treatment
- Requiring the client to sign a no-suicide contract
- Informing the client's employer about the crisis
Correct answer: Identifying triggers and listing means restriction steps
A safety plan must include identifying warning signs, triggers, and means restriction because removing access to lethal means significantly reduces suicide risk.
Question 5: Psychological first aid (PFA) in the context of a substance use crisis emphasizes which core principle?
- Immediate exploration of childhood trauma
- Promoting a sense of safety, calm, and connectedness (Correct answer)
- Confronting denial as the primary therapeutic task
- Administering rapid cognitive assessments
Correct answer: Promoting a sense of safety, calm, and connectedness
PFA focuses on restoring a sense of safety, calm, self-efficacy, and social connectedness rather than trauma processing during acute crisis.
Question 6: Under HIPAA and most state laws, a counselor may breach confidentiality during a crisis ONLY when:
- The client has a history of substance use
- There is a serious, credible, and imminent threat to an identified person (Correct answer)
- The client refuses to consent to release of information
- The client's family requests information about the crisis
Correct answer: There is a serious, credible, and imminent threat to an identified person
Confidentiality may be breached when there is a specific, serious, and imminent threat to an identifiable third party, per Tarasoff principles and most state duty-to-warn statutes.
Question 7: A client who relapsed after six months of sobriety expresses shame and says 'I'm hopeless.' Which crisis counseling response is MOST therapeutic?
- Remind the client of the consequences of continued use
- Normalize struggle, affirm strengths, and explore what can be learned from the lapse (Correct answer)
- Advise the client to attend 90 meetings in 90 days immediately
- Reduce the treatment plan goals to minimize future failure
Correct answer: Normalize struggle, affirm strengths, and explore what can be learned from the lapse
Normalizing the experience, affirming prior successes, and adopting a learning orientation reduces shame and supports re-engagement with recovery.
