MAC Master Addiction Counselor Exam MCQ 5 — Questions and Answers
Question 1: Which relapse prevention concept involves identifying seemingly irrelevant decisions that cumulatively lead a client toward relapse?
- Abstinence violation effect
- Apparently irrelevant decisions (Correct answer)
- Stimulus control
- Covert antecedents
Correct answer: Apparently irrelevant decisions
Apparently irrelevant decisions (AIDs) are small choices that seem unrelated to relapse but create a chain of events that places the client in high-risk situations.
Question 2: A counselor working with adolescents should understand that compared to adults, adolescents with substance use disorders are more likely to:
- Have stable employment and housing
- Present with isolated substance use without co-occurring disorders
- Progress more rapidly from initiation to dependence (Correct answer)
- Respond better to confrontational intervention styles
Correct answer: Progress more rapidly from initiation to dependence
Adolescents' still-developing brains make them more vulnerable to rapid escalation from first use to substance use disorder compared to adults.
Question 3: Under 42 CFR Part 2, which of the following is REQUIRED before a substance use disorder treatment program can disclose patient records to another provider?
- A court order
- Patient written consent specifying the program, recipient, purpose, and expiration (Correct answer)
- Verbal consent documented in the chart
- Insurance authorization
Correct answer: Patient written consent specifying the program, recipient, purpose, and expiration
42 CFR Part 2 requires a specific written consent form that identifies the program disclosing, the recipient, the purpose, how much information, and an expiration date or event.
Question 4: Which of the following best describes the therapeutic technique of 'rolling with resistance' in motivational interviewing?
- Directly challenging a client's denial using factual confrontation
- Avoiding the topic when the client becomes defensive
- Acknowledging the client's perspective without argumentation to reduce defensiveness (Correct answer)
- Agreeing with everything the client says to build rapport
Correct answer: Acknowledging the client's perspective without argumentation to reduce defensiveness
Rolling with resistance means acknowledging the client's viewpoint without arguing, which reduces defensiveness and keeps the therapeutic conversation open.
Question 5: A client in a methadone maintenance program tests positive for cocaine. According to best practice, the counselor should:
- Immediately discharge the client from the methadone program
- Reduce the methadone dose as a consequence
- Assess for cocaine use disorder and intensify counseling or adjust the treatment plan (Correct answer)
- Notify law enforcement of the positive test
Correct answer: Assess for cocaine use disorder and intensify counseling or adjust the treatment plan
A positive test for a secondary substance signals a need for treatment plan modification and intensified support, not punitive dose reduction or discharge.
Question 6: The concept of 'neuroplasticity' is important in addiction recovery because it suggests that:
- Brain damage from substance use is always permanent
- The brain cannot form new pathways once addiction is established
- Recovery involves the brain's ability to reorganize and form new neural connections (Correct answer)
- Medications are the only effective means of reversing brain changes
Correct answer: Recovery involves the brain's ability to reorganize and form new neural connections
Neuroplasticity means the brain can restructure itself, supporting the development of new coping pathways and behavioral patterns during recovery.
Question 7: A counselor who shares their own recovery story with a client in session is using which technique, and what is the primary risk?
- Empathic confrontation; risk of minimizing client's experience
- Therapeutic self-disclosure; risk of shifting focus from client to counselor (Correct answer)
- Psychoeducation; risk of overwhelming the client with information
- Immediacy; risk of damaging the therapeutic alliance
Correct answer: Therapeutic self-disclosure; risk of shifting focus from client to counselor
Sharing personal recovery history is therapeutic self-disclosure; the risk is that it may shift the session's focus away from the client's needs.
MAC Master Addiction Counselor Exam MCQ 5
Which relapse prevention concept involves identifying seemingly irrelevant decisions that cumulatively lead a client toward relapse?