MAC Screening and Assessment 5 — Questions and Answers
Question 1: A counselor administering the Beck Depression Inventory-II (BDI-II) notices the client skipped several items. The counselor should:
- Score only the completed items and interpret the result as valid
- Discard the assessment and use a different tool
- Ask the client to complete the skipped items before interpreting the score (Correct answer)
- Assume skipped items represent the lowest severity level
Correct answer: Ask the client to complete the skipped items before interpreting the score
Missing items compromise the total BDI-II score; the counselor should invite the client to answer skipped items to ensure a valid, complete result.
Question 2: Which of the following best illustrates the concept of 'specifiers' in DSM-5 substance use disorder diagnoses?
- Specifying the exact quantity of substance consumed per week
- Indicating severity as mild, moderate, or severe based on symptom count (Correct answer)
- Documenting the client's primary language and cultural background
- Listing all substances used regardless of frequency
Correct answer: Indicating severity as mild, moderate, or severe based on symptom count
DSM-5 uses specifiers such as mild (2–3 criteria), moderate (4–5 criteria), and severe (6+ criteria) to characterize the intensity of a substance use disorder.
Question 3: When assessing a client from a culture where discussing substance use is highly stigmatized, the counselor's most effective adaptation is to:
- Use a stricter confrontational approach to break through denial
- Avoid asking about substance use to respect cultural norms
- Frame questions in culturally sensitive ways and build trust before exploring sensitive topics (Correct answer)
- Rely exclusively on biological testing rather than self-report
Correct answer: Frame questions in culturally sensitive ways and build trust before exploring sensitive topics
Culturally adapted assessment involves using respectful, contextually appropriate language and establishing rapport before exploring stigmatized behaviors.
Question 4: The CAGE questionnaire's question 'Have you ever felt you needed to Cut down on your drinking?' primarily screens for which criterion?
- Tolerance
- Withdrawal
- Loss of control over use (Correct answer)
- Continued use despite consequences
Correct answer: Loss of control over use
The desire or failed attempts to cut down reflect loss of control over use, a core diagnostic criterion for alcohol use disorder.
Question 5: During assessment, a client discloses that they are currently experiencing suicidal ideation with a plan. According to ethical and legal standards, the counselor must:
- Document the disclosure and continue the substance use assessment as planned
- Immediately end the session and refer the client to an emergency room
- Conduct a structured suicide risk assessment and take protective action if warranted (Correct answer)
- Maintain confidentiality and address the ideation in the next scheduled session
Correct answer: Conduct a structured suicide risk assessment and take protective action if warranted
Active suicidal ideation with a plan requires an immediate, structured risk assessment to determine lethality and implement appropriate safety measures.
Question 6: Which of the following assessment findings would most support a diagnosis of stimulant use disorder rather than stimulant intoxication alone?
- Elevated heart rate and dilated pupils during the current visit
- A pattern of failed attempts to control stimulant use over the past 12 months (Correct answer)
- A single episode of cocaine use followed by a visit to the emergency room
- Agitation and insomnia reported only during the current episode
Correct answer: A pattern of failed attempts to control stimulant use over the past 12 months
A substance use disorder requires a persistent, maladaptive pattern of use over time; a single intoxication episode does not meet the DSM-5 criteria for a use disorder.
Question 7: In a comprehensive addiction assessment, the term 'treatment history' is most important because it:
- Establishes the client's financial ability to pay for services
- Identifies what has or has not worked in the past to inform current treatment planning (Correct answer)
- Satisfies mandatory reporting requirements for state licensing boards
- Determines whether the client is eligible for medication-assisted treatment
Correct answer: Identifies what has or has not worked in the past to inform current treatment planning
Prior treatment experiences reveal effective strategies, barriers to engagement, and relapse triggers that should shape the current individualized treatment plan.
MAC Screening and Assessment 5
A counselor administering the Beck Depression Inventory-II (BDI-II) notices the client skipped several items.
The counselor should: