Chapter 2: First Hours of Treatment

Test Bank

Multiple Choice

1. Trust is essential to the therapeutic alliance. Which of the following is an important element in the establishment of trust?

A. catch the client in a lie

B. If you say you are going to do something, do it.

C. self-disclose one of your own issues

D. manipulate a client to gain a positive outcome

Learning Objective: 2-2: Explain the importance of trust at the beginning of the therapeutic alliance and how that will help a client deal with early denial.

Cognitive Domain: Medium

Answer Location: The Importance of Trust

Difficulty Level: Easy

2. A counselor should establish and maintain relationships with community resources to ______.

A. identify service gaps and help address unmet needs

B. help address unmet needs and ensure appropriate referrals

C. ensure appropriate referrals and identify service gaps

D. identify service gaps, help address unmet needs, and ensure appropriate referrals.

Learning Objective: 2-4: Summarize the initial assessment and decide when a crisis intervention is needed.

Cognitive Domain: Knowledge

Answer Location: Referral

Difficulty Level: Easy

3. Which of the following are referenced as important elements of the initial contact?

A. unconditional positive regard

B. offering a facility tour to the family separate from the client

C. encouraging the family to linger until they are comfortable

D. validating the insurance

Learning Objective: 2-1: Describe the first hours of treatment, including how to greet a new client and make them feel at home.

Cognitive Domain: Knowledge

Answer Location: How to Greet Clients

Difficulty Level: Easy

4. The author expresses the importance of screening for organic brain dysfunction. A referral to a medical professional should be made if ______.

A. they fall above the cutoff scores of the screening instruments

B. clients display unusual speech patterns

C. clients display unusual eye movements

D. clients display unusual dietary needs

Learning Objective: 2-3: Recognize the symptoms of organic brain dysfunction.

Cognitive Domain: Comprehension

Answer Location: How to Check for Organic Brain Dysfunction

Difficulty Level: Medium

5. The purpose of the initial assessment is to determine ______.

A. degree of problem with addiction and level of motivation

B. level of motivation and do they have the resources for treatment

C. do they have the resources for treatment, level of motivation, and degree of problem with addiction

D. do they have the resources for treatment and degree of problem with addiction

Learning Objective: 2-4: Summarize the initial assessment and decide when a crisis intervention is needed.

Cognitive Domain: Comprehension

Answer Location: The Initial Assessment

Difficulty Level: Medium

6. The Addiction Severity Index (ASI) assesses seven dimensions involved in many addicted persons. Which of the following is one of the dimensions assessed?

A. financial status

B. resistance to change

C. psychiatric status

D. education status

Learning Objective: 2-4: Summarize the initial assessment and decide when a crisis intervention is needed.

Cognitive Domain: Comprehension

Answer Location: Referral

Difficulty Level: Medium

7. John D came into treatment willingly following an intervention facilitated by family and friends. He identifies having a problem and needs to change. What ASAM dimension would this fit within?

A. acute intoxication and/or withdrawal complications

B. biomedical conditions and complications

C. emotional, behavioral, or cognitive conditions and complications

D. readiness to change

Learning Objective: 2-5: List the criteria for diagnosis used by the American Society of Addiction Medicine and the Diagnostic and Statistical Manual.

Cognitive Domain: Application

Answer Location: American Society of Addiction Medicine Patient Placement Criteria

Difficulty Level: Hard

8. Jill was court ordered to treatment following a series of drunken driving mishaps. She has been sober for 2 weeks and is medically stable. While she admits being anxious, most of this is related to her legal consequences. She lives alone and has a friend in recovery. Using the DSM scales, Jill meets the criterion for ______.

A. detoxification

B. inpatient treatment

C. outpatient treatment

D. private counseling

Learning Objective: 2-7: Describe the criteria for outpatient and inpatient care for adults and adolescents.

Cognitive Domain: Application

Answer Location: Criteria for Outpatient Treatment (Adults)

Difficulty Level: Hard

9. Lorenzo has been a daily drinker with a history of domestic violence when using. He has recently been diagnosed as positive for hepatitis C. He has been detoxed in the past but never followed up by going to treatment. He currently lives with a group of college friends who are also heavy drinkers. Using the DSM scales, Lorenzo meets the criterion for ______.

A. detoxification

B. inpatient treatment

C. outpatient treatment

D. private counseling

Learning Objective: 2-7: Describe the criteria for outpatient and inpatient care for adults and adolescents

Cognitive Domain: Application

Answer Location: Criteria for Inpatient Treatment (Adults)

Difficulty Level: Hard

10. Which of the following are elements of an effective intervention?

A. Participants validate that this is the client’s fault and they need help.

B. participants writing letters reflecting specific incidents in which they were impacted by the client’s use

C. A treatment facility is not lined up, but choices are provided.

D. The clients should commit to a target date where they will enter treatment.

E. conducted at a location where the client feels comfortable, like their home of office

Learning Objective: 2-4: Summarize the initial assessment and decide when a crisis intervention is needed.

Cognitive Domain: Comprehension

Answer Location: How to Conduct a Crisis Intervention

Difficulty Level: Medium

11. After ______ year(s) of sobriety, relapse rates fall to near zero.

A. 1

B. 2

C. 3

D. 5

Learning Objective: 2-4: Summarize the initial assessment and decide when a crisis intervention is needed.

Cognitive Domain: Comprehension

Answer Location: How to Conduct a Crisis Intervention

Difficulty Level: Medium

12. American Society of Addiction Medicine (ASAM) Patient Placement Criterion considers which of the following when evaluating a client for treatment?

A. Clients must be able to read all the material.

B. Clients must be physically fit.

C. Clients must be off all other medications for health-related issues.

D. Clients must be intellectually aware of what is happening to them.

Learning Objective: 2-5: List the criteria for diagnosis used by the American Society of Addiction Medicine and the Diagnostic and Statistical Manual.

Cognitive Domain: Knowledge

Answer Location: American Society of Addiction Medicine Patient Placement Criteria

Difficulty Level: Easy

13. Criterion for diagnosis of Substance Use Disorders is guided by criterion from the ______.

A. diagnosis manual

B. American Medical Association

C. Diagnostic and Statistical Mental Disorders

D. American Society of Addiction Medicine

Learning Objective: 2-5: List the criteria for diagnosis used by the American Society of Addiction Medicine and the Diagnostic and Statistical Manual.

Cognitive Domain: Knowledge

Answer Location: Diagnostic and Statistical Manual

Difficulty Level: Easy

14. Substance Abuse Disorder should have specifiers regarding ______.

A. whether it is chemical dependency or not

B. whether physiological dependence is or is not present

C. whether biological dependence is or is not present

D. the client’s stage of change

Learning Objective: 2-6: Identify the characteristics of substance abuse disorder and determine the level of care a client needs.

Cognitive Domain: Comprehension

Answer Location: Diagnosis: Substance Use Disorder

Difficulty Level: Medium

15. Which of the following are recognized “levels of care?”

A. crisis intervention

B. residential inpatient

C. half-way house

D. medically managed intensive outpatient treatment

Learning Objective: 2-6: Identify the characteristics of substance abuse disorder and determine the level of care a client needs.

Cognitive Domain: Comprehension

Answer Location: How to Determine the Level of Care Needed

Difficulty Level: Medium

True/False

1. Consistency is a critical element in establishing trust.

Learning Objective: 2-2: Explain the importance of trust at the beginning of the therapeutic alliance and how that will help a client deal with early denial.

Cognitive Domain: Knowledge

Answer Location: The Importance of Trust

Difficulty Level: Easy

2. Denial must be addressed, at least minimally, in the initial hours of treatment.

Learning Objective: 2-2: Explain the importance of trust at the beginning of the therapeutic alliance and how that will help a client deal with early denial.

Cognitive Domain: Knowledge

Answer Location: Dealing With Early Denial

Difficulty Level: Easy

3. Initially, counselors must only focus on the clients’ addiction. Ancillary referrals should only be considered after the client is in the action stage.

Learning Objective: 2-4: Summarize the initial assessment and decide when a crisis intervention is needed.

Cognitive Domain: Comprehension

Answer Location: The Initial Assessment

Difficulty Level: Medium

4. The text identifies several highly sophisticated toxicology technologies capable of rendering diagnosis.

Learning Objective: 2-4: Summarize the initial assessment and decide when a crisis intervention is needed.

Cognitive Domain: Comprehension

Answer Location: Referral

Difficulty Level: Medium

5. Level of care criterion is the same for both adolescents and adults.

Learning Objective: 2-5: List the criteria for diagnosis used by the American Society of Addiction Medicine and the Diagnostic and Statistical Manual.

Cognitive Domain: Knowledge

Answer Location: American Society of Addiction Medicine Patient Placement Criteria

Difficulty Level: Easy

Short Answer

1. A clinician should be knowledgeable in the community demographics and cultures. Why is this referral in treatment or the selection of referrals sources?

Learning Objective: 2-4: Summarize the initial assessment and decide when a crisis intervention is needed.

Cognitive Domain: Comprehension

Answer Location: Referral

Difficulty Level: Medium

2. Typically, addiction impacts multiple areas of a person’s life. What are some typical complicating issues and needs a person may have? What are some community resource systems that may be important to be familiar with?

Learning Objective: 2-4: Summarize the initial assessment and decide when a crisis intervention is needed.

Cognitive Domain: Comprehension

Answer Location: Referral

Difficulty Level: Medium

3. One of the elements critical to treatment placement is recovery/living environment. Why is this important to consider? Give an example of how a living environment can aid recovery. Be a barrier to recovery.

Learning Objective: 2-5: List the criteria for diagnosis used by the American Society of Addiction Medicine and the Diagnostic and Statistical Manual.

Cognitive Domain: Application

Answer Location: American Society of Addiction Medicine Patient Placement Criteria

Difficulty Level: Hard

4. John is self-referred to treatment for opiate use. He was diagnosed with an opiate use disorder with physiological dependence. He has no complicating medical concerns, works full time, and has no treatment resistance. Presently, he lives in an apartment with a friend who uses opiate pain medicine daily. This means opiate medication is in the household. Which of the ASAM dimensions would have the most concern?

Learning Objective: 2-5: List the criteria for diagnosis used by the American Society of Addiction Medicine and the Diagnostic and Statistical Manual.

Cognitive Domain: Application

Answer Location: American Society of Addiction Medicine Patient Placement Criteria

Difficulty Level: Hard

5. Alexis is a 17-year-old female diagnosed with drug dependence. Her parents are supportive and have removed all drugs of abuse from the home. She is presently behind in school. What would be the ideal level of care? Why?

Learning Objective: 2-5: List the criteria for diagnosis used by the American Society of Addiction Medicine and the Diagnostic and Statistical Manual.

Cognitive Domain: Application

Answer Location: American Society of Addiction Medicine Patient Placement Criteria

Difficulty Level: Hard