MAC Master Addiction Counselor Exam 4 — Questions and Answers
Question 1: According to the stages of change model (Prochaska & DiClemente), a client who is weighing the pros and cons of stopping cocaine use but has not yet committed to change is in which stage?
- Precontemplation
- Contemplation (Correct answer)
- Preparation
- Action
Correct answer: Contemplation
Contemplation is characterized by ambivalence and weighing the benefits and costs of change without a firm commitment to act.
Question 2: Which federal regulation specifically governs confidentiality of substance use disorder patient records in federally assisted programs?
- HIPAA Privacy Rule (45 CFR Parts 160 and 164)
- 42 CFR Part 2 (Correct answer)
- ADA Title III
- FERPA (20 USC 1232g)
Correct answer: 42 CFR Part 2
42 CFR Part 2 provides stricter confidentiality protections than HIPAA specifically for substance use disorder treatment records in federally assisted programs.
Question 3: A client reports drinking to manage anxiety since stopping benzodiazepines prescribed by their physician. This pattern BEST illustrates:
- Tolerance development
- Cross-addiction or substitution (Correct answer)
- Protracted withdrawal syndrome
- Medication non-adherence
Correct answer: Cross-addiction or substitution
Substituting alcohol for benzodiazepines to manage anxiety exemplifies cross-addiction, where one substance replaces another to achieve similar effects.
Question 4: Buprenorphine's pharmacological 'ceiling effect' on respiratory depression is clinically important because it:
- Makes buprenorphine completely ineffective for opioid dependence
- Reduces overdose risk compared to full opioid agonists (Correct answer)
- Eliminates the need for medical monitoring during treatment
- Prevents any euphoric effects at all doses
Correct answer: Reduces overdose risk compared to full opioid agonists
Buprenorphine's partial agonist ceiling effect limits respiratory depression, significantly lowering overdose risk compared to full agonists like methadone.
Question 5: A counselor who shares their own recovery story with a client to build rapport is using:
- Countertransference acting out
- Therapeutic self-disclosure (Correct answer)
- Boundary violation
- Transference resolution
Correct answer: Therapeutic self-disclosure
Intentional, purposeful sharing of personal experience by a counselor to benefit the client is defined as therapeutic self-disclosure.
Question 6: In group therapy for addiction, the therapeutic factor described as clients finding hope through observing others' progress is called:
- Altruism
- Instillation of hope (Correct answer)
- Cohesiveness
- Universality
Correct answer: Instillation of hope
Yalom's therapeutic factor 'instillation of hope' refers to gaining optimism about recovery by witnessing improvement in other group members.
Question 7: Which of the following is the PRIMARY goal of a functional analysis in cognitive-behavioral addiction treatment?
- Establishing a timeline of substance use history
- Identifying antecedents, behaviors, and consequences of substance use (Correct answer)
- Measuring the severity of physical dependence
- Determining co-occurring psychiatric diagnoses
Correct answer: Identifying antecedents, behaviors, and consequences of substance use
Functional analysis maps the ABC chain—antecedents, behaviors, consequences—to understand what triggers and maintains substance use patterns.
MAC Master Addiction Counselor Exam 4
According to the stages of change model (Prochaska & DiClemente), a client who is weighing the pros and cons of stopping cocaine use but has not yet committed to change is in which stage?