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Caade study questions and answers
GRADED A
What pattern of personality change includes apathy, lack of concern for the future and loss of ambition that occurs in some marijuana users Amotivational ________ is the essential first step in determining the possible causes of addiction for the person and the most appropriate treatment modality for his or her needs. Assessment
- A client tells a counselor that she is unhappy with the way her treatment is progressing. The counselor should: a. create new goals and objectives, and suggest alternate forms of therapy b. talk to the client about possible denial c. refer the client for more appropriate treatment d. draw up a new contract with the client e. discuss these concerns with the client and make necessary changes in treatment goals. This is one of those "more than one correct" responses. A, b, c, and d could be considered the right thing to do. However, doing the "e" response would include all four of the others.
- A female client reports that she has some concerns about the relationship between her husband and her 14-year- old daughter from a previous marriage. She reports that her husband and daughter frequently argue, that her daughter refuses to take direction from her stepfather, and that her daughter regularly complains about her stepfather's "faults" and describes how her biological father is better. The MOST relevant professional to whom a referral should be made is a:
a. Social worker. b. Clinical psychologist. c. Licensed professional counselor. d. Marriage and family therapist. e. School psychologist. While all of the other professionals may be helpful, there is no guarantee that they would
- A key factor for counselors to consider is that in a counseling relationship, the counselor has differential power. One of the best safeguards is: a. To be alert to and understand the power relationship. b. To utilize the differential power to motivate the client. c. To realize the importance of this power in client interventions. d. To not become involved in a dating relationship until the client has completed treatment. e. To use differential power to get the client to try new behaviors. D is an obviously wrong response (and unethical, too), but the other three may sound appropriate. However, differential power has a place and purpose of use based on the client and their needs. The "a" response is the best choice to answer the question.
- A pretreatment period is frequently the result of waiting lists or client reluctance to become fully engaged in primary treatment. What might be a danger of this pretreatment period? a. The pretreatment period may be when clients lose interest in treatment. b. A client may receive enough help so as not to need the services of the program or agency. c. Successful pretreatment may result in a client needing services that an agency doesn't have, thus losing the potential admission. d. Typically, pretreatment services are not paid for by insurance services. e. There is really no danger with pretreatment - recovery will require much more programming than pretreatment can offer. Losing a client's interest is the biggest concern we always face in the field. Denial, delusion, "feeling better" are always good excuses not to get help. Not being able to engage the client quickly and get them started is always a risk.
- Case management is needed because services tend to be fragmented and inadequate to meet the needs of the substance-abusing population. This lack of coordinated services may result from all of the following factors EXCEPT: a. funding focused on single modalities rather than a continuum of care b. waiting lists caused by inadequate funding c. barriers between systems (e.g., mental health vs. substance abuse, criminal justice vs. mental health and substance abuse) d. eligibility/admission criteria that focus on special need clients e. lack of incentives for programs to work together "Except" again. The "d" response is the correct response because programs all tend to have special eligibility or admission criteria, or may offer services for special need clients. This is not a problem in case management, but actually is an enhancement for continuum of case issues.
- Counselors rely heavily on the work of developmental theorists as they attempt to stimulate clients to initiate relevant growth. According to Erickson, one of the leaders in developmental theory, the task to be accomplished in adulthood is: a. Trust vs. Mistrust. b. Initiative vs. Guilt. c. Integrity vs. Despair. d. Identity vs. Role Confusion. e. Intimacy vs. Isolation. Straight "theory" question. Need to be sure you've reviewed basics of all of the major theorists like Erickson, Rogers, Adler, etc.
- Drug use by adolescents is: a. not affected by parental drug use b. not affected by peer drug use c. most affected by parental drug use d. most affected by peer drug use e. equally affected by parental and peer drug use
Many resources on adolescent needs and issues focus on the peer group as being one of the most influential things with regards to adolescent drug using behavior.
- During the intake, a counselor can expect to address all of the following issues EXCEPT: a. a client's fears and denial b. confidentiality c. information gathering d. preliminary identification of client goals e. treatment planning This is a core function question. When answering core function question, make sure you know their definitions. Treatment planning does not occur in the intake process, but all of the others do.
- Effective case management for persons in need of multiple services requires: a. Monitoring, feedback, and evaluation of services. b. Frequent face-to-face contact with the client. c. Collaboration with family members. d. Consent for full disclosure of information among all service providers. e. Careful matching with appropriate 12-step groups. Key words here are "multiple services" - that makes "b", "c", and "e" incorrect. "D" may sound like a good answer, but full disclosure is not needed to monitor or evaluate services.
- In determining whether a chemically dependent patient should be treated in an inpatient or outpatient program, all of the following should be considered except: a. whether the patient has a history of sobriety during the last several years b. whether the patient believes he can succeed in an outpatient program c. whether the patient has family support for sobriety d. whether the patient has a history of failed treatment on an outpatient or inpatient basis e. whether the patient's job and family are likely to give him another chance if this treatment fails Again, it's the "EXCEPT" that determines the response. All four of the other responses do help determine placement. Consequences of failure are not a determining factor.
- Long-term effects of alcoholism may include:
e. "The counselor and I can have a relationship in which we are both equally responsible." Key word is "harmful." The other four responses are all "helpful" making "b" the only choice.
- Joe is a 27-year old addict who has begun counseling, but has not yet been able to give up using drugs. During one session, he tells his counselor that he is beginning to feel that "it is useless to try to stop," and that "sometimes life is not worth living." The counselor is concerned that Joe could be suicidal. The counselor should: a. assess Joe's potential for suicide without directly asking him about suicide plans, but assess his high-risk factors b. assess Joe's potential for suicide by asking him about his intent, and evaluating high risk factors c. determine if Joe has a gun or other weapon d. initiate hospitalization procedures e. list all the reasons he has for living Dealing with suicidal behavior can never be danced around. Asking direct questions about intent and looking for high risk factors like having the means and opportunity to carry through with suicidal behavior is always the direction to take. "C" does address the high risk factor, but just having a gun is not an issue unless Joe also says "I'm going to shot myself in the head," or something similar.
- One of the counselor's tasks is to guide the client in relating and communicating in specific terms, rather than in general or abstract terms. That characteristic or ability is called: a. Confrontation. b. Immediacy. c. Potency. d. Concreteness. e. Clarification. This is a Basic Counseling 101 question. Straight definition of concreteness. Be sure to know all of the definitions for basic counseling skills like this.
- One of the earliest models for case management services in the criminal justice system was created in 1972, when the White House launched a demonstration program known as: a. Treatment Alternatives to Street Crime (TASC) b. Treatment Approaches for Criminal Offenders (TACO) c. Treatment Resources for Chronic Repeat Offenders (TRCRO)
d. Helping Services for the Criminal Element (HSCE) e. Project for Drug and Alcohol Offenses (PDAO) This is a history type question that would require you to have ready this somewhere. Not an easy one to get unless you have.
- Ralph is a recovering alcoholic. He as been sober for several months, and has managed to find gainful employment and re-establish family relationships. He is in a twelve-step program as well as individual counseling. One day, he arrives to a counseling session quite upset. He reveals that he had a "slip" and drank a beer at a party. He did not get drunk, but feels terribly remorseful and has promised himself that he will not do it again. Which of the following is most true? a. This constitutes a relapse, and Ralph may need to begin the recovery process all over again. b. Ralph should be reassured that this behavior is permissible as long as he did not lose control and become drunk. c. The counselor should talk to Ralph about the implications of dangerous situations like this, but assure him that it is possible to continue his recovery process. d. Ralph should avoid friends who serve alcohol e. Although Ralph did have a relapse, recovery should be easier the second time around. Many theories and approaches to relapse talk about slips and their implications. All agree that while not desired, slips can and do occur. They should not impede future recovery and are especially beneficial if we look at the reasons behind the use.
- Record keeping is an important part of the counseling process. Which of the following best reflects the type of information which should be kept in a client's record? a. the name of an attending physician, referrals made, diagnostic procedures used b. names of family members, emergency numbers, DSM-IV diagnosis c. personal notes, insurance information, treatment notes d. information about consultations, diagnosis, treatment, prognosis, and progress e. this depends upon the procedures adhered to by the counselor and the agency Again, a "best" response question. The "d" response would cover all of the other things listed in some why, shape, or format.
e. making a distinction between problem drinkers and alcoholics CAGE is a quite common screening tool that spells out four questions based on the C, A, G, and E. Cutting down, being annoyed by questions, feeling guilty, and the "eye-opener" are what they stand for.
- The focus of intervention in the criminal justice system is first to do which of the following? a. Protect the health, safety, and welfare of the public. b. Rehabilitate offenders. c. Use the threat of incarceration as a motivator to change. d. Keep the chronic, chemically dependent person off the streets. e. Punish the offender for their behavior. A basic criminal justice type question. With both ICRC and NAADAC, they tend to have a small handful of questions from information areas that have become mainstream - meaning that they've been around for at least 2 years or more. Right now, criminal justice, especially Therapeutic Communities, seem to be the newest information. That doesn't mean you need to take the time to study this (if you haven't already). There will not be enough questions in such an area to determine whether or not you pass the exam.
- The initial stage of crisis intervention involves: a. discussing the client's plans for the future b. helping the client adapt c. determining the problem d. determining a solution e. contacting the appropriate referral agency Another example of all of the responses being technically correct. But in this case, one thing has to happen first before anything else can. Determining the problem helps to do all of the other things.
- The measurement of progress toward treatment plan goals is best assessed by: a. Reviewing documentation in progress notes. b. Consulting with the client's significant others. c. Referring the client to a professional outside your agency for an objective review. d. Asking the client to write a personal evaluation of his/her own progress. e. Comparing the client's progress to another client's progress.
This could also be a case management question. Think about how we document progress in treatment. It's the progress notes that tie the treatment plan to the programming we perform. Makes this the only viable response.
- The PRIMARY purpose of a professional code of ethics is to: a. Serve as a guide in helping clients while behaving in a fair way to colleagues. b. Strengthen the appearance of professionalism among addiction counselors. c. Clarify the difference between acceptable and unacceptable client behavior. d. Provide legal recourse and concrete consequences for unethical behavior. e. Ensure that disadvantaged people receive services without discrimination. This comes both from NAADAC's ethical guidelines, but also from LeClair Bissell's book on ethics. Should know this, and should have a good handle on ethics in general - expect 4-5 questions specific to this area.
- The PRIMARY purpose of professional standards of practice is to: a. Provide recognition of demonstrated competency in addictions counseling. b. Ensure that each client receives equal treatment regardless of ability to pay. c. Help programs qualify for Medicaid and other third-party reimbursement. d. Allow unlicensed counselors to work in licensed facilities. e. Provide guidelines to counselors for developing treatment plans.
- The tendency of the family to try and maintain balance is called: a. equilibrium b. stability c. homeostasis d. accommodation e. harmony
- The therapeutic reasoning for self-disclosure in group counseling is to: a. Provide the group members with insight into the counselor's background. b. Convince group members that the counselor has more life experiences than they do. c. Provide a means by which the counselor can also benefit from the group process. d. Demonstrate how to react when other group members disclose personal information. e. Facilitate the growth of the group by relating to client or group issues.
- Therapeutic communities differ from Synanon because:
d. Hallucinations (auditory, visual, or tactile). e. Decreased appetite, nausea, and vomiting. Alcohol, being a depressant drug, does cause a decreased sensitivity to sound (hearing is typically impaired), but deadens nerve endings, causing a loss of tactile sensations. In withdrawal, however, these effects are generally reversed and magnified. That would mean an increased sensitivity to sound and oversensitivity to tactile sensations.
- When conducting an assessment, what is the counselor's primary focus? ICRC Domain: Assessment / NAADAC Content: Theoretical Bases a. identifying the client's problems and needs, strengths and weaknesses b. explaining the rules of the program c. having the client sign Release of Information forms d. confronting the client's denial e. exploring treatment options The definition of assessment. Again, make sure you know your core function definitions - they will help greatly when answering questions.
- Which of the following is the BEST indicator that an individual is physically dependent upon alcohol or another drugs? a. the amount consumed daily b. the length in years of heavy drinking or drug use c. presence of withdrawal symptoms d. the frequency of memory blackouts e. presence or absence of tolerance Though not all drugs have withdrawal symptoms, it is still the best true indicator of physical dependence. Amount of use and length of time used don't determine addiction. Blackouts can occur when abusing or misusing alcohol or other drugs. Tolerance is also a natural phenomenon that even develops with social drinkers.
- Which of the following statements about dysfunctional families is true? a. The family cannot get well until the dependent person seeks help. b. The children in a dysfunctional family can be protected from the problems cause by chemical dependency. c. The divorce rate in dysfunctional families is highest after recovery has been initiated.
d. All of the above statements are true. e. None of the above statements are true. Here's that "all" and "none" response, but neither is correct. The "a" and "b" responses are both common myths - the family can get well in spite of the dependent person not seeking help, and children are always impacted, even with the spouse or other family members try to protect them. The sad reality is that indeed, the divorce rate tends to be highest after recovery has been initiated. This is when the family sees a person they've never experience before, or at least for a long time. They may not like the recovering person any better than when they were using.
- Before beginning treatment a counselor must: a. establish rapport b. reassure the client and reduce anxiety c. make a formal diagnosis d. identify the problem e. make appropriate referrals Five good answers, but only one is best. Again, think about the core functions and how the unfold. You screen a client, do an assessment, make a diagnosis, and refer to treatment. When you screen, you see if there is even a problem to be concerned about. No rapport is needed, you don't always need to reassure the client and reduce anxiety.
- Which statement MOST accurately describes the relationship between Alcoholics Anonymous and the professional treatment community? a. AA policy clearly states that recovery can often be frustrated by contact with professionals. b. AA has made no statements for or against the professional treatment community. c. There are inherent conflicts between AA and the professional treatment community which are unlikely to be resolved. d. A partnership between AA and the professional community was repeatedly emphasized by the founders of AA. e. For the most part, the professional treatment community has been skeptical of the AA program because it is not scientific. This is a history question that relates to AA. Expect to see 3-4 questions about self-help on the exam.
- Which term refers to a client's projecting past emotional feelings and/or attitudes onto the counselor?
c. Encourage your client to look for another, more understanding sponsor. d. Have the client discontinue involvement in AA until antidepressant medication is no longer needed. e. Encourage your client to follow the sponsor's advice. Anytime you need to bring others into the care system, or anytime you need to share information about treatment, a release of information is needed. Talking with the sponsor is critical to avoid conflict in the recovery process, but do it the right way by getting the release before the contact is made.
- A common error that counselors make when conducting an assessment is: a. asking too many questions b. moving too quickly from data collection to treatment planning c. focusing on strengths and weaknesses d. processing the data collected from the client e. determining the clients level of denial The keyword is "error" - all of the responses but "b" are appropriate things to do in the assessment process. Treatment planning doesn't occur at this stage, except for identification of immediate goals. The formal treatment planning process happens after more assessment work is done, and in conjunction with the client and the other members of the treatment team.
- Jack stays in treatment after talking to his wife's mother and arranging for Nancy to travel to her mother's home with her aunt, who will also assist in watching over their children. The very next day, you receive a call from Jack's work supervisor inquiring "how Jack is doing." You discover that Jack has not signed a release of information form allowing you to talk with his supervisor. How do you respond to this call a. you ask the supervisor for his phone number so you can call him back after you have talked with your supervisor. b. you tell the supervisor you can not share that information but urge him to call Jack's wife for her opinion on Jack's progress. c. you tell Jack's supervisor that confidentially laws prevent you from telling him how Jack is doing, and hope Jack will not lose his job because of this. d. you take the supervisor's number and speak with Jack, getting the needed release of information signed, allowing you to provide treatment updates to the supervisor.
Since you do not have written authorization to disclose any information to Jack's supervisor, to do so would not only be an ethical violation, but would also violate federal law.
- Prior to his discharge from treatment, Jack's wife refuses to participate in family programming, stating that she's angry that Jack didn't leave treatment to drive her to her parent's home. Which of the following alternatives would be your BEST response to this situation?: a. You schedule an appointment with Jack's wife with the intention of getting her to change her mind. b. You schedule an appointment with Jack to explore his feelings and help him develop a plan of action to deal with the situation. c. You schedule an appointment with a local marriage and family therapist for Jack and his wife after the completion of treatment. d. You urge Jack to find a good attorney for legal advice about divorcing his wife for lack of support. Jack will need lots of support from you or other members of your treatment team to deal with his wife's threats. Individual counseling can assist him to develop a plan of action to deal with his feelings and interact with his wife in a way that hopefully will encourage them to seek marital counseling from a marriage and family therapist referral. To simply set up an appointment with a marriage and family therapist is premature at this time.
