MAC Counseling Techniques 4 — Questions and Answers
Question 1: A client states: 'I know I should quit drinking, but I'm not sure I can.' A counselor responding with 'You're feeling torn between wanting to stop and doubting your ability to do so' is using which MI skill?
- Affirmation
- Double-sided reflection (Correct answer)
- Simple reflection
- Open-ended question
Correct answer: Double-sided reflection
A double-sided reflection captures both sides of the client's ambivalence, which validates their experience and can help them explore the tension between their desires and doubts.
Question 2: In Solution-Focused Brief Therapy (SFBT) for addiction, the 'exception question' asks clients about:
- Times when their substance use was most problematic
- Times when the problem did not occur or was less severe (Correct answer)
- Hypothetical scenarios where the problem is solved
- Their previous failed attempts at treatment
Correct answer: Times when the problem did not occur or was less severe
Exception questions identify times when the problem wasn't present or was less intense, revealing existing strengths and successful coping strategies that can be amplified.
Question 3: A client with methamphetamine use disorder struggles with impulsivity. Which therapeutic technique is MOST directly targeted at improving impulse control?
- Narrative therapy
- HALT (Hungry, Angry, Lonely, Tired) awareness (Correct answer)
- Free association
- Psychoeducation about pharmacology
Correct answer: HALT (Hungry, Angry, Lonely, Tired) awareness
HALT is a practical self-monitoring tool that helps clients recognize physical and emotional states that increase vulnerability to impulsive decisions and relapse.
Question 4: The Transtheoretical Model's 'processes of change' that are MOST relevant during the contemplation stage include:
- Stimulus control and helping relationships
- Consciousness raising and dramatic relief (Correct answer)
- Counterconditioning and reinforcement management
- Self-liberation and social liberation
Correct answer: Consciousness raising and dramatic relief
Consciousness raising (increasing information about self and problem) and dramatic relief (experiencing and expressing feelings about the problem) are experiential processes most active during contemplation.
Question 5: When a counselor says to a client, 'That took a lot of courage to share with the group today,' this is an example of which motivational interviewing skill?
- Affirmation (Correct answer)
- Reflection
- Summarizing
- Eliciting change talk
Correct answer: Affirmation
Affirmations in MI acknowledge and recognize the client's strengths, efforts, and positive qualities, which supports self-efficacy and the therapeutic relationship.
Question 6: A counselor using Contingency Management (CM) for cocaine use disorder would MOST likely:
- Provide vouchers or prizes contingent on negative drug screens (Correct answer)
- Withhold services until the client achieves sobriety
- Use natural consequences of drug use as deterrents
- Apply aversion conditioning to cocaine cues
Correct answer: Provide vouchers or prizes contingent on negative drug screens
Contingency Management uses positive reinforcement through tangible rewards (vouchers, prizes) that are provided immediately when clients demonstrate target behaviors such as drug-free urine screens.
Question 7: Which technique involves having clients write a detailed narrative describing their future self who has successfully overcome addiction?
- Autobiography writing
- Future self journaling / letter writing (Correct answer)
- Narrative exposure therapy
- Life review therapy
Correct answer: Future self journaling / letter writing
Future self-letter writing helps clients envision and connect emotionally with a positive recovery identity, which strengthens intrinsic motivation and commitment to change.
MAC Counseling Techniques 4
A client states: 'I know I should quit drinking, but I'm not sure I can.' A counselor responding with 'You're feeling torn between wanting to stop and doubting your ability to do so' is using which MI skill?