CRS Crisis Intervention & Relapse Prevention Techniques 4 — Questions and Answers
Question 1: When a recovery specialist identifies that a peer is experiencing a 'mental relapse' (ambivalence about staying sober), the BEST response is:
- Notify their treatment team immediately without discussing it with the person
- Acknowledge the ambivalence, validate the struggle, and explore reasons for recovery (Correct answer)
- Increase supervision and restrict their independence
- Remind them of the consequences of their past substance use
Correct answer: Acknowledge the ambivalence, validate the struggle, and explore reasons for recovery
Validating ambivalence and using motivational approaches helps the person reconnect with their own reasons for recovery without shame or coercion.
Question 2: The 'abstinence violation effect' (AVE) refers to:
- Physical withdrawal symptoms after stopping substance use
- The guilt and cognitive dissonance that follows a lapse, potentially worsening relapse (Correct answer)
- A legal consequence of violating probation sobriety requirements
- The medical monitoring required after detoxification
Correct answer: The guilt and cognitive dissonance that follows a lapse, potentially worsening relapse
AVE describes how a person's negative self-attribution after a lapse ('I'm a failure') can trigger continued use as a self-fulfilling prophecy.
Question 3: During a crisis intervention, using 'active listening' includes all of the following EXCEPT:
- Reflecting feelings back to the person
- Offering unsolicited advice and solutions immediately (Correct answer)
- Asking open-ended questions
- Summarizing what the person has shared
Correct answer: Offering unsolicited advice and solutions immediately
Active listening focuses on understanding the person's experience first; offering unsolicited advice interrupts the process and may feel dismissive.
Question 4: In safety planning for someone with co-occurring suicidal ideation and substance use disorder, it is MOST important to:
- Focus exclusively on the substance use disorder first
- Address both conditions simultaneously and include means restriction (Correct answer)
- Refer the person to psychiatric services only
- Prioritize employment and housing stability over immediate safety
Correct answer: Address both conditions simultaneously and include means restriction
Integrated safety planning addresses both suicide risk and substance use together, including removing access to lethal means.
Question 5: Which of the following BEST describes a 'high-risk situation' in Marlatt's relapse prevention model?
- Any situation that occurs after a person's first year of sobriety
- A situation that threatens a person's sense of self-control and increases relapse risk (Correct answer)
- Environments where only alcohol (not other drugs) is present
- Medical emergencies requiring prescription pain medication
Correct answer: A situation that threatens a person's sense of self-control and increases relapse risk
High-risk situations are defined by their threat to self-efficacy and sense of personal control, which increases the probability of relapse.
Question 6: When conducting a crisis assessment using the SAD PERSONS scale, the 'S' stands for:
- Substance use history
- Sex (gender as a risk factor) (Correct answer)
- Severity of current mental state
- Social isolation level
Correct answer: Sex (gender as a risk factor)
In the SAD PERSONS mnemonic, 'S' stands for Sex, as statistical risk of suicide completion differs by gender.
Question 7: A person in early recovery reports strong cravings after walking past their old neighborhood. This is an example of:
- Post-acute withdrawal syndrome (PAWS)
- Classical conditioning where environmental cues trigger cravings (Correct answer)
- Medication non-adherence causing withdrawal symptoms
- A psychotic episode requiring emergency evaluation
Correct answer: Classical conditioning where environmental cues trigger cravings
Environmental cues associated with past substance use can trigger conditioned cravings through classical conditioning, even years into recovery.
CRS Crisis Intervention & Relapse Prevention Techniques 4
When a recovery specialist identifies that a peer is experiencing a 'mental relapse' (ambivalence about staying sober), the BEST response is: