MAC Crisis Intervention 4 — Questions and Answers
Question 1: A client who completed detox two days ago presents to crisis services reporting auditory hallucinations and insomnia. What is the MOST likely clinical concern?
- Acute stress reaction
- Post-acute withdrawal syndrome
- Alcohol hallucinosis or protracted withdrawal (Correct answer)
- Malingering for medication
Correct answer: Alcohol hallucinosis or protracted withdrawal
Auditory hallucinations and sleep disturbance appearing days after alcohol detox may indicate alcohol hallucinosis or ongoing protracted withdrawal requiring medical evaluation.
Question 2: Which of the following is a PRIMARY principle of trauma-informed crisis intervention with addiction clients?
- Confronting denial to promote accountability
- Prioritizing safety, trustworthiness, and empowerment (Correct answer)
- Focusing primarily on substance use behaviors
- Using confrontational techniques to break through resistance
Correct answer: Prioritizing safety, trustworthiness, and empowerment
Trauma-informed care centers on establishing safety, building trustworthiness, and fostering client empowerment as foundational principles.
Question 3: During a telephone crisis intervention with a highly agitated caller, which communication technique is MOST effective for de-escalation?
- Speaking rapidly to match the caller's pace
- Using a calm, slow, steady voice tone (Correct answer)
- Challenging the caller's perception of the crisis
- Immediately providing solutions and advice
Correct answer: Using a calm, slow, steady voice tone
A calm, measured voice tone models regulation and can help co-regulate an agitated caller through prosodic attunement.
Question 4: A client's spouse calls the crisis line saying the client has locked themselves in a room and is threatening to overdose on their prescription medications. What step should be taken FIRST?
- Advise the spouse to break down the door
- Instruct the spouse to call 911 immediately (Correct answer)
- Ask the spouse to talk to the client about reasons for living
- Have the spouse gather the medications as evidence
Correct answer: Instruct the spouse to call 911 immediately
When someone is imminently threatening to overdose, activating emergency services is the immediate first step to preserve life.
Question 5: Which of Roberts' Seven-Stage Crisis Intervention Model stages involves establishing rapport and a therapeutic relationship?
- Stage 1 — Plan and conduct a thorough assessment
- Stage 2 — Establish rapport and rapidly establish a relationship (Correct answer)
- Stage 3 — Identify the major problems
- Stage 4 — Deal with feelings and emotions
Correct answer: Stage 2 — Establish rapport and rapidly establish a relationship
Stage 2 of Roberts' model specifically focuses on rapidly establishing rapport and a collaborative therapeutic relationship with the client in crisis.
Question 6: A client with methamphetamine use disorder presents to crisis services expressing grandiosity, decreased need for sleep, and racing thoughts. The counselor should FIRST consider:
- Bipolar I disorder as the primary diagnosis
- Methamphetamine-induced psychotic or manic episode (Correct answer)
- Borderline personality disorder crisis
- Antisocial personality disorder features
Correct answer: Methamphetamine-induced psychotic or manic episode
In crisis settings, substance-induced symptoms must be ruled out before assigning a primary psychiatric diagnosis, especially with active stimulant use.
Question 7: When de-escalating a client in crisis who is becoming physically threatening, which approach is MOST appropriate?
- Match the client's intensity to show empathy
- Move closer to the client to establish connection
- Maintain a calm demeanor, increase physical distance, and involve security if needed (Correct answer)
- Directly challenge the client's threats to establish authority
Correct answer: Maintain a calm demeanor, increase physical distance, and involve security if needed
Maintaining calm, creating physical distance, and involving appropriate security resources are the safest de-escalation steps when physical threat is present.
MAC Crisis Intervention 4
A client who completed detox two days ago presents to crisis services reporting auditory hallucinations and insomnia.
What is the MOST likely clinical concern?