MAC Counseling Techniques 2 — Questions and Answers
Question 1: A client with alcohol use disorder consistently minimizes the impact of drinking on their family. Which motivational interviewing technique is MOST appropriate to address this discrepancy?
- Confrontation
- Developing discrepancy (Correct answer)
- Reflective listening only
- Giving direct advice
Correct answer: Developing discrepancy
Developing discrepancy in MI helps clients see the gap between their current behavior and their stated values or goals, which can increase motivation to change.
Question 2: When using Socratic questioning in addiction counseling, the primary goal is to:
- Challenge irrational beliefs directly
- Guide clients to examine their own thinking and reach conclusions themselves (Correct answer)
- Provide psychoeducation about addiction
- Strengthen the therapeutic alliance
Correct answer: Guide clients to examine their own thinking and reach conclusions themselves
Socratic questioning uses guided discovery to help clients critically examine their own beliefs and reasoning rather than having the counselor impose conclusions.
Question 3: Which of the following best describes the 'empty chair' technique used in Gestalt therapy with addiction clients?
- A relaxation technique for withdrawal symptoms
- Dialogue with an imagined person or part of oneself to resolve unfinished business (Correct answer)
- A way to practice refusal skills with an imaginary peer
- A mindfulness exercise focusing on present awareness
Correct answer: Dialogue with an imagined person or part of oneself to resolve unfinished business
The empty chair technique in Gestalt therapy has clients engage in dialogue with an imagined person or disowned part of themselves to work through unresolved emotional conflicts.
Question 4: A counselor notices a client with opioid use disorder is experiencing ambivalence about treatment. The BEST response using motivational interviewing is to:
- Confront the client about the consequences of continued use
- Explore and reflect both sides of the ambivalence without judgment (Correct answer)
- Encourage the client to make a firm commitment immediately
- Refer the client to a psychiatrist for medication
Correct answer: Explore and reflect both sides of the ambivalence without judgment
MI views ambivalence as a normal part of change and counselors should explore both sides non-judgmentally to help clients resolve their own ambivalence.
Question 5: In Dialectical Behavior Therapy (DBT) for clients with co-occurring addiction and borderline personality disorder, the concept of 'dialectical abstinence' refers to:
- Complete abstinence from all substances simultaneously
- Combining a commitment to abstinence with non-judgmental acceptance of relapse when it occurs (Correct answer)
- Alternating between harm reduction and abstinence approaches
- Using dialectical reasoning to justify controlled use
Correct answer: Combining a commitment to abstinence with non-judgmental acceptance of relapse when it occurs
Dialectical abstinence in DBT balances a strong commitment to abstinence with radical acceptance and effective coping if a lapse does occur, avoiding both hopelessness and complacency.
Question 6: Which technique involves having a client observe their thoughts without judgment, recognizing them as mental events rather than facts?
- Cognitive restructuring
- Defusion (cognitive defusion) (Correct answer)
- Thought stopping
- Systematic desensitization
Correct answer: Defusion (cognitive defusion)
Cognitive defusion, a core ACT technique, teaches clients to observe thoughts as passing mental events rather than literal truths that must be acted upon.
Question 7: A client in early recovery reports craving substances when passing a bar on their commute. The counselor recommends planning an alternate route home. This intervention is an example of:
- Exposure therapy
- Stimulus control (Correct answer)
- Counterconditioning
- Response prevention
Correct answer: Stimulus control
Stimulus control involves modifying the environment to reduce exposure to cues that trigger cravings or substance use, such as changing routines to avoid high-risk locations.
MAC Counseling Techniques 2
A client with alcohol use disorder consistently minimizes the impact of drinking on their family.
Which motivational interviewing technique is MOST appropriate to address this discrepancy?