IC RC ADC Exam Questions

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61.

Which of the following BEST describes the cause of relapse?

  • Many factors contribute to relapse

  • Relapse is a failure of commitment 

  • Relapse is a function of the reward system

  • Relapse is a failure of the initial abstinence plan

Correct answer: Many factors contribute to relapse

Relapse is not a failure of planning or commitment by the client or therapist, nor is it strictly a function of the reward system in the brain. It is a complicated phenomenon made up of many different factors—behavioral, environmental, and so on. Relapse in an individual could be situational, a response to stress, or due to a combination of many factors. 

62.

What does the acronym HALT mean with respect to substance use? 

  • Hungry, Angry, Lonely, Tired

  • Hungry, Agitated, Lonely, Tired 

  • Hateful, Angry, Lonely, Tired

  • Hungry, Angry, Lonely, Traumatized 

Correct answer: Hungry, Angry, Lonely, Tired

People in recovery are prone to risks of relapse. The acronym HALT (Hungry, Angry, Lonely, Tired) is a useful mnemonic to offer clients about affective states in which they may find themselves at risk of relapse. It is in these affective states that the person in recovery is most prone to reach out for their former source of comfort, i.e., the drug of choice.

63.

What does a substance-use diagnosis according to the DSM-5 leave out? 

  • Developmental course

  • Problematic use 

  • Lack of control 

  • Assessment of cravings 

Correct answer: Developmental course

Though the DSM-5 criteria for substance-use disorders are highly descriptive as far as the diagnosis goes, including such things as assessment of the severity of problematic use, control of use, and the presence of cravings, much information is not contained in the diagnosis itself. For example, it does not include the context of a person's individual use, their personal narrative about use, or the developmental course of their problem and attempts at recovery. The diagnosis establishes the problem according to specific criteria, which must then be fleshed out to create a whole assessment of a person's problem at that time. 

64.

What is the Abstinence Violation Effect?

  • An overreaction to a slip

  • A cessation of treatment

  • A confrontation with the counselor

  • An overreaction to abstinence behavior

Correct answer: An overreaction to a slip

The Abstinence Violation Effect is the way in which some clients overreact to their own slips by losing hope in the process and taking on a strongly defeatist attitude. This can be a significant barrier to treatment. 

It does not have to do with treatment cessation, confrontation, or an overreaction to abstinence.

65.

According to 12-step thinking, which of the following is MOST characteristic of family members of substance users?

  • Overinvolvement

  • Underinvolvement

  • Remote attachment

  • Blunted attachment

Correct answer: Overinvolvement

According to 12-step thinking, family members of substance users tend to be overinvolved, often enabling or making excuses for the habits of their loved one. This makes their participation in treatment problematic.

"Remote attachment" and "blunted attachment" are fabricated terms.

66.

Does confidentiality apply to supervisory relationships?

  • Yes, in every circumstance

  • No, unless otherwise agreed

  • Yes, in specific areas described by the agreement

  • No, under no circumstances

Correct answer: Yes, in every circumstance

Confidentiality in supervisory relationships applies in every way, implicit and explicit, just as in counseling relationships. It is not a matter of the nature of the supervisory agreement. In this way, the rights of supervisees and clients are preserved.

67.

Which of the following is NOT a financial risk of treating clients with substance abuse issues?

  • Insurance may not reimburse

  • Patients may choose not to pay

  • Patients are inconsistent with treatment

  • Patients may not be able to pay

Correct answer: Insurance may not reimburse

There are many financial risks of treating people with substance abuse issues. They may be irresponsible and not pay, they may drop out of or be inconsistent with treatment and payment, and their circumstances may make it difficult for them to pay. 

However, insurance plans generally have an understanding of the effectiveness of substance abuse treatment and will reimburse, if even for a short time.

68.

Which of the following would be the LEAST likely indicator of lack of control over use?

  • Setting and circumstances of use

  • Inordinate priority given to use

  • Irresistible compulsions to use

Correct answer: Setting and circumstances of use

The setting and circumstances of substance use are diagnostically important, but have less to do with a loss of control than inordinate priority given to use and compulsions to use. Lack of control does not imply total lack of ability to control one's pattern of use, only that some element of control has been compromised.

69.

Which of the following correctly describes the relative effects of methamphetamine and cocaine?

  • Methamphetamine's effects last longer

  • Methamphetamine is less potent

  • Methamphetamine is equally potent

  • Methamphetamine is more potent in smaller doses

Correct answer: Methamphetamine's effects last longer

Methamphetamine's effects are longer lasting than those of cocaine, producing a high that lasts 6 to 8 hours. By contrast, the intoxication effects of cocaine, depending on means of use, last less than an hour. 

70.

Which of the following BEST defines microtraining? 

  • A recorded simulation of task performance 

  • A focused training session about a diagnosis 

  • A short, purpose-driven training highlighting several skills 

  • A training that concentrates on group capabilities 

Correct answer: A recorded simulation of task performance 

Microtraining in substance-use supervision generally consists of simulating a clinical situation that may be recorded but is reviewed afterward to give feedback about an individual skill that is desired, such as rapport, assessment, or dealing with suicidal statements. It is usually not about diagnosis but is skill-based and covers one skill at a time. 

71.

How transferable are skills and methods from group therapy to group supervision? 

  • Many insights and methods are transferable 

  • The same skills and methods can be used 

  • There is little crossover in practice 

  • The two modalities are entirely separate 

Correct answer: Many insights and methods are transferable 

Group supervision is analogous to group therapy in many ways. It depends on the work of the group for its value and not strictly on the guidance of the supervisor or leader. It also allows for a freeform, mutually participatory dialogue and solicits insights from the group. In this way, many of the skills and methods from group therapy can be used to help make group supervision as effective as possible. The skills and methods are not the same, however, and require adaptation to the needs of emerging professionals rather than the needs of persons seeking mental health treatment. 

72.

Which of the following drugs is MOST likely to result in sudden death?

  • Cocaine

  • Cannabis

  • Alcohol

Correct answer: Cocaine

Though it is relatively rare, sudden death is more likely in the abuse of cocaine than it is in the abuse of cannabis or alcohol. In the case of cannabis and alcohol, the deleterious affects of the substance are more likely to be evident in organ damage and impairment over time.

73.

What should supervisees do if they find personal issues interfering with their effectiveness? 

  • Seek competent help and inform their supervisor 

  • Excuse themselves from supervision 

  • Appeal to the state behavioral sciences board 

  • Continue with supervision and work out their problems on their own 

Correct answer: Seek competent help and inform their supervisor 

With the status of a supervisee comes the responsibility of being effective. There may be times during the supervisory period when a supervisee's personal issues begin to interfere with their effectiveness and progress in supervision. Just as in cases when a working counselor is compromised, the supervisee must seek competent help. In the supervisory relationship, the supervisee must inform their supervisor of what is going on. There may or may not be a need to excuse oneself from supervision or to appeal to the state behavioral sciences board. 

74.

Which of the following is NOT a common withdrawal symptom of opioid use?

  • Stroke

  • Restlessness

  • Runny nose

Correct answer: Stroke

Opioid withdrawal results in some common symptoms, such as restlessness, runny nose, and gastrointestinal discomfort. As with many symptoms, these are variable in individual presentations.

Stroke is not common as a symptom of opioid withdrawal.

75.

What does the treatment literature say about engagement on the part of a substance abusing client's significant others?

  • It is important in producing positive outcomes

  • It distracts the client from their recovery

  • It should be kept at a minimum during recovery

Correct answer: It is important in producing positive outcomes

Treatment literature in substance abuse confirms that the engagement of family members of a substance abusing client is important in producing positive outcomes. This is in contrast with traditional 12-step treatment guidance, which is to minimize such engagement so that the client will not be distracted and can focus on recovery. 

76.

Which of the following is the BEST characterization of the traditional addiction treatment model before such developments as motivational interviewing?

  • Confrontational

  • Inconsistent

  • Compassionate

Correct answer: Confrontational

For many decades before the appearance of motivational interviewing, the traditional approach to substance use treatment was confrontational in nature; this approach did not handle ambivalence or resistance effectively.

This approach was not especially compassionate, but it was relatively consistent in the culture of substance use treatment.

77.

Which of the following is TRUE about the idea of an "addictive personality"?

  • There is little empirical support for the concept

  • There is adequate empirical support for the concept

  • It is the standard assumption of most substance-use treatment providers 

  • It has been conclusively disproven 

Correct answer: There is little empirical support for the concept

Though it has become a common term in the culture and among providers, the notion of an "addictive personality" has little empirical support. The idea is that there is a sort of personality that finds itself highly vulnerable to issues of substance use. Though the idea has not been conclusively disproven, there is not adequate empirical support to suggest it is the case. On the other hand, research suggests that a client's personality is changed by substance use rather than that a certain personality type is predisposed to substance use or addiction. 

78.

What does extinction mean in the context of substance use and cravings? 

  • With each successful resistance of cravings, resistance increases 

  • Cravings diminish and disappear entirely with abstinence 

  • With each indulgence of cravings, resistance increases 

  • With each successful resistance of cravings, resistance decreases 

Correct answer: With each successful resistance of cravings, resistance increases 

Extinction is a term from the behaviorist school of psychology that refers to the fact that an undesirable behavior tends to slowly diminish and disappear if not reinforced. In the world of substance use, this means that if a specific instance of craving is not indulged and a pattern of non-indugence is realized, cravings themselves will diminish and resistance to all cravings will increase. 

Cravings may or may not disappear entirely when abstinence is established. Resistance to a craving does not usually lead to worse cravings. 

79.

How can one BEST get information about drug-related sexual acting-out behaviors?

  • Ask directly

  • Wait for the client to volunteer it

  • Administer a written inventory

Correct answer: Ask directly

Many patients will not willingly volunteer the potentially embarrassing information about their sexual acting-out behaviors while under the influence or when naive to treatment for their problem, and they must be asked directly. 

Administering a written inventory may or may not be effective; a more effective approach is to use the rapport of interpersonal contact.

80.

Which of the following is a psychodynamic supervisor MOST likely to ask their supervisee? 

  • "How do you feel your inner conflict emerges in your practice?"

  • "What skills do you bring to the table in your practice?"

  • "What do you need to learn in order to be a better counselor?"

  • "Which objectives do you need to meet in order to consider supervision successful?"

Correct answer: "How do you feel your inner conflict emerges in your practice?"

The psychodynamic perspective in psychology concentrates on the inner conflicts and competing drives within an individual. Psychodynamic supervision uses this perspective to examine the supervisee's psychodynamic issues and their influence on the supervisee's identity as an emerging professional. 

Questions about achievement and skills are more consistent with skills-based supervision.