IC&RC Screening, Assessment & Engagement 4 — Questions and Answers
Question 1: Which principle of motivational interviewing involves expressing empathy through reflective listening?
- Rolling with resistance
- Developing discrepancy
- Expressing empathy (Correct answer)
- Supporting self-efficacy
Correct answer: Expressing empathy
Expressing empathy is one of the four core principles of motivational interviewing and involves using reflective listening to understand the client's perspective.
Question 2: When screening a client who recently used opioids, which withdrawal symptom would the counselor most expect to observe or be reported?
- Hypersomnia and increased appetite
- Muscle aches, sweating, and anxiety (Correct answer)
- Seizures and hallucinations
- Euphoria and increased energy
Correct answer: Muscle aches, sweating, and anxiety
Opioid withdrawal commonly presents with muscle aches, sweating, anxiety, nausea, and insomnia rather than seizures, which are associated with alcohol or benzodiazepine withdrawal.
Question 3: Which of the following best describes the difference between screening and assessment in addiction counseling?
- Screening diagnoses the disorder; assessment identifies risk level
- Screening identifies potential problems; assessment provides a comprehensive clinical picture (Correct answer)
- Screening is done by physicians only; assessment is done by counselors
- Screening takes several hours; assessment takes only minutes
Correct answer: Screening identifies potential problems; assessment provides a comprehensive clinical picture
Screening is a brief process to identify whether a problem may exist, while assessment is a comprehensive evaluation to fully understand the nature and severity of the problem.
Question 4: What does the term 'diagnostic orphan' refer to in the context of DSM-5 SUD criteria?
- A client who refuses to accept a diagnosis
- A client who meets one or two criteria but does not meet the threshold for any diagnosis (Correct answer)
- A client whose records are lost or unavailable
- A client with multiple co-occurring diagnoses
Correct answer: A client who meets one or two criteria but does not meet the threshold for any diagnosis
A diagnostic orphan is someone who endorses one or two DSM criteria for a substance use disorder but does not meet the minimum threshold of two criteria required for a mild SUD diagnosis.
Question 5: Under HIPAA and 42 CFR Part 2, which of the following requires special written consent before disclosing substance use disorder records?
- Releasing records to the client themselves
- Sharing records with a court-mandated probation officer without client consent (Correct answer)
- Discussing general treatment approaches with a colleague in supervision
- Providing a referral list to the client
Correct answer: Sharing records with a court-mandated probation officer without client consent
42 CFR Part 2 provides extra protections for substance use disorder records and prohibits disclosure to probation officers without specific written client consent.
Question 6: Which assessment tool provides a structured clinical interview to assess the full range of psychiatric diagnoses including co-occurring disorders?
- CAGE
- SCID-5 (Structured Clinical Interview for DSM-5) (Correct answer)
- AUDIT
- DAST-10
Correct answer: SCID-5 (Structured Clinical Interview for DSM-5)
The SCID-5 is a structured clinical interview that systematically evaluates DSM-5 criteria across a range of psychiatric diagnoses, making it useful for co-occurring disorder assessment.
Question 7: A client with alcohol use disorder reports drinking 15 standard drinks per day. Which ASAM Dimension 1 concern should the counselor prioritize?
- Risk of prolonged withdrawal and potential seizures (Correct answer)
- Risk of stimulant-induced psychosis
- Risk of opioid overdose
- Risk of cannabis-induced anxiety
Correct answer: Risk of prolonged withdrawal and potential seizures
High-volume alcohol use creates significant withdrawal risk including potentially life-threatening seizures and delirium tremens, which must be prioritized in ASAM Dimension 1 assessment.
IC&RC Screening, Assessment & Engagement 4
Which principle of motivational interviewing involves expressing empathy through reflective listening?