MAC Master Addiction Counselor Exam 2 — Questions and Answers
Question 1: A client on methadone maintenance reports using heroin two days ago. According to harm reduction principles, the counselor's FIRST priority is to:
- Immediately discharge the client from the program
- Explore reasons for the relapse and adjust the treatment plan (Correct answer)
- Increase the methadone dose without discussion
- Report the client to law enforcement
Correct answer: Explore reasons for the relapse and adjust the treatment plan
Harm reduction prioritizes keeping clients engaged in treatment; exploring the relapse context informs plan adjustments rather than punitive measures.
Question 2: Which neurotransmitter system is MOST directly implicated in the reinforcing effects of opioids?
- Serotonergic system
- Dopaminergic mesolimbic pathway (Correct answer)
- GABAergic cerebellar system
- Cholinergic basal forebrain system
Correct answer: Dopaminergic mesolimbic pathway
Opioids stimulate dopamine release in the nucleus accumbens via the mesolimbic pathway, producing rewarding effects.
Question 3: A counselor notices a supervisee consistently avoids confronting clients about dishonesty. This is BEST addressed through:
- Immediately reassigning the supervisee's caseload
- Clinical supervision focusing on countertransference (Correct answer)
- Mandatory ethics training only
- Peer consultation without supervisor involvement
Correct answer: Clinical supervision focusing on countertransference
Clinical supervision is the appropriate venue to explore countertransference reactions that interfere with effective counseling.
Question 4: The ASAM Patient Placement Criteria use six dimensions to guide level-of-care decisions. Which dimension addresses a client's readiness to change?
- Dimension 1: Acute Intoxication and Withdrawal Potential
- Dimension 3: Emotional, Behavioral, or Cognitive Conditions
- Dimension 4: Readiness to Change (Correct answer)
- Dimension 6: Recovery Environment
Correct answer: Dimension 4: Readiness to Change
ASAM Dimension 4 specifically evaluates the client's readiness and motivation to change as a placement factor.
Question 5: A client with alcohol use disorder also meets criteria for major depressive disorder. The MOST appropriate approach is to:
- Treat depression only after 90 days of sobriety
- Address both disorders concurrently with integrated treatment (Correct answer)
- Refer only to psychiatry and close the addiction case
- Delay psychiatric evaluation until detox is complete
Correct answer: Address both disorders concurrently with integrated treatment
Co-occurring disorders are best managed with integrated dual-diagnosis treatment that addresses both conditions simultaneously.
Question 6: Which of the following describes the ethical principle of 'veracity' as applied in addiction counseling?
- Protecting client confidentiality at all times
- Obligation to be honest and truthful with clients (Correct answer)
- Avoiding harm through careful intervention
- Respecting client autonomy in decision-making
Correct answer: Obligation to be honest and truthful with clients
Veracity refers to the counselor's duty to be truthful and non-deceptive in all communications with clients.
Question 7: During a structured relapse prevention session, a counselor helps a client identify internal cues that precede cravings. This technique is MOST associated with:
- Psychoanalytic free association
- Cognitive-behavioral relapse prevention by Marlatt and Gordon (Correct answer)
- Motivational enhancement therapy
- 12-step facilitation
Correct answer: Cognitive-behavioral relapse prevention by Marlatt and Gordon
Marlatt and Gordon's cognitive-behavioral relapse prevention model emphasizes identifying high-risk situations and internal cues that precede relapse.
MAC Master Addiction Counselor Exam 2
A client on methadone maintenance reports using heroin two days ago.
According to harm reduction principles, the counselor's FIRST priority is to: