ALCOHOL AND DRUG COUNSELOR
EXAM FLASH CARDS SET 2OF 2
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
1FofF6FListFfiveFcommonFsubstanceFabuseFtreatmentFprogramFmodalitiesF-
FANSWERFTheFmodalitiesFare:F1)FdetoxificationF(inpatientForFoutpatient),Ffocused
onFmanagingFwithdrawalFsymptomsFpriorFtoFenteringFaFlonger-term
treatmentFprogram;
2FofF6FListFfiveFcommonFsubstanceFabuseFtreatmentFprogramFmodalitiesF-
FANSWERF2)FresidentialFtreatmentFlong-vsFshort-term),
highlyFstructuredFintensiveFsettings,FincludingF"TherapeuticFCommunity"F(TC)FprogramsFusingFhierarchicalF
modelsFtoFenhance
3FofF6FListFfiveFcommonFsubstanceFabuseFtreatmentFprogramFmodalitiesF-
FANSWERFpersonalFandFsocialFresponsibility,FrestructureFpersonalityFandFsocialization,FincreaseFskills,FandFi
ntegrateFsocialFnorms,FwithFstaysFfromF12FtoF24FmonthsFdependingFonFfunding;F3)FoutpatientFdrug-
freeF(non-methadone),F6FtoF12FmonthsFofFdrugFeducationFandFcounseling;
4FofF6FListFfiveFcommonFsubstanceFabuseFtreatmentFprogramFmodalitiesF-
FANSWERF4)FdayFtreatment,F6ForFfewerFmonthsFofFintensiveFdayFactivitiesFandFhomeFatFnight;F5)Fmethadon
eFmaintenance,FdisplacingFheroinFuseFwithFmonitoredFmethadone,FoftenFindefinitely.
5FofF6FListFfiveFcommonFsubstanceFabuseFtreatmentFprogramFmodalitiesF-
FANSWERFProgramFphasesFoftenFinclude:F1)FengagementFandFstabilization;F2)FearlyFrecovery;F3)Fmaintenan
ceFofFrecovery;FandF4)FtransitionFtoFaftercare.
6FofF6FListFfiveFcommonFsubstanceFabuseFtreatmentFprogramFmodalitiesF-
FANSWERFAftercareFinvolvesFtransitionalFtherapyFandFparticipationFinF12-
stepFselfFhelpFgroupsF(AA,FCA,ForFNA)FtoFofferFsocialFsupportFandFnewFlifestyleFchoices.
,1FofF6FSummarizeFSimpson'sF1997Ffour-partFmodelFofFaFdrugFtreatmentFdeliveryFsystemF-
FANSWERFTheFmodelFspecifies:F1)Freferral;F2)Finduction;F3)Fintervention;FandF4)
transition.FReferralsFmayFbeFreceivedFfromFindividuals,Ffamilies,
2FofF6FSummarizeFSimpson'sF1997Ffour-partFmodelFofFaFdrugFtreatmentFdeliveryFsystemF-
FANSWERFemployeeFassistanceFprograms,FsocialFservicesFandFpublic
health/communityFagencies,FHIV/AIDSFoutreachFprograms,Fcentralized
intakeFunits,
3FofF6FSummarizeFSimpson'sF1997Ffour-partFmodelFofFaFdrugFtreatmentFdeliveryFsystemF-
FANSWERFandFtheFcriminalFjusticeFsystem.FInductionFrefersFto
entranceFintoFaFtreatmentFprogram.FInterventionFandFtreatment
strategiesFtypicallyFinvolveFdetoxificationFandFstabilization,Fmotivation
andFcommitmentFandFrehabilitation.
4FofF6FSummarizeFSimpson'sF1997Ffour-partFmodelFofFaFdrugFtreatmentFdeliveryFsystemF-
FANSWERFFinally,FclientsFareFtransitionedFout
toF"aftercare"FprogramsF(eg,FAA,FCA,FNA).FComprehensiveFcareFrequiresFmanyFprogramsFandFservicesFtoFm
eetFdiverseFneedsFandFwidelyFrangingFrecoveryFstages.FOptimalFprogramsFinclude:
5FofF6FSummarizeFSimpson'sF1997Ffour-partFmodelFofFaFdrugFtreatmentFdeliveryFsystemF-
FANSWERF1)FpharmacotherapyFtoFreduceFdistressingFwithdrawalFsymptomsFandFminimizeFrelapse;F2)Fcogni
tiveFand/orFbehavioralFtherapyFtoFaddressFtheFunderlyingFpsychosocialFrootsFofFtheFproblem;
6FofF6FSummarizeFSimpson'sF1997Ffour-partFmodelFofFaFdrugFtreatmentFdeliveryFsystemF-
FANSWERF3)FsupportiveFservicesFforFcollateralFconcernsF[eg,FmedicalFcare,Femployment,Ftransportation,Fch
ildFcare).FFurther,FaftercareFisFneededFtoFaidFindividualsFinFresistingFurgesFtoFrelapse,FofFwhichFdrugFtestingFi
sFaFcrucialFpart.
1FofF6FTheFCircumstances,FMotivations,FReadiness,FandFSuitability,FCMRS,Fquestionnaire,FDeFLeonFetFal,F19
94,FisFaFtoolFforFassessingFreadinessFandFmotivationsFforFsubstanceFabuseFtreatment.FCiteFtheFfourFprimaryF
scalesFinFtheFCMRSF-FANSWERFTheFfourFprimaryFscalesFinFtheFCMRSFare:F1)FCircumstances;F2)
Motivation;F3lFReadiness;Fand
,2FofF6FTheFCircumstances,FMotivations,FReadiness,FandFSuitability,FCMRS,Fquestionnaire,FDeFLeonFetFal,F19
94,FisFaFtoolFforFassessingFreadinessFandFmotivationsFforFsubstanceFabuseFtreatment.FCiteFtheFfourFprimaryF
scalesFinFtheFCMRSF-FANSWERF4)FSuitability.F"Circumstances"FrefersFto
externalFmotivation;F"Motivation"FrefersFtoFinternalFmotivation;
3FofF6FTheFCircumstances,FMotivations,FReadiness,FandFSuitability,FCMRS,Fquestionnaire,FDeFLeonFetFal,F19
94,FisFaFtoolFforFassessingFreadinessFandFmotivationsFforFsubstanceFabuseFtreatment.FCiteFtheFfourFprimaryF
scalesFinFtheFCMRSF-
FANSWERF"Readiness"FrefersFtoFopennessFtoFtreatment;FandF"Suitability"FrefersFtoFaFperceptionFofFtheFclie
nt'sFappropriatenessFforFtheFproposedFtreatment
modality.
4FofF6FTheFCircumstances,FMotivations,FReadiness,FandFSuitability,FCMRS,Fquestionnaire,FDeFLeonFetFal,F19
94,FisFaFtoolFforFassessingFreadinessFandFmotivationsFforFsubstanceFabuseFtreatment.FCiteFtheFfourFprimaryF
scalesFinFtheFCMRSF-FANSWERFRatingFtheFclient'sFlevelFofFmotivationFandFreadinessFis
importantFbothFforFtheFclient'sFabilityFtoFbenefitFfromFaFgivenFprogram,
andFinFtermsFofFtheFimpactFtheFclientFwillFhaveFuponFothersFinFthe
program.FCurrently,FupFtoF70Fo/oFofFclientsFreferredFforFtreatmentFdon't
5FofF6FTheFCircumstances,FMotivations,FReadiness,FandFSuitability,FCMRS,Fquestionnaire,FDeFLeonFetFal,F19
94,FisFaFtoolFforFassessingFreadinessFandFmotivationsFforFsubstanceFabuseFtreatment.FCiteFtheFfourFprimaryF
scalesFinFtheFCMRSF-
FANSWERFevenFshowFupFforFevaluation,FandF40Fo/oFtoF60Fo/oFwillFdropFoutFduringFtheFcourseFofFtreatmentF
[usuallyFduringFtheFbeginningFphasesFofFtreatment).ToFmaximizeFtheFpotentialFforFsuccess,
6FofF6FTheFCircumstances,FMotivations,FReadiness,FandFSuitability,FCMRS,Fquestionnaire,FDeFLeonFetFal,F19
94,FisFaFtoolFforFassessingFreadinessFandFmotivationsFforFsubstanceFabuseFtreatment.FCiteFtheFfourFprimaryF
scalesFinFtheFCMRSF-FANSWERFallFbarriers
[childFcareFneeds,Ftransportation,Faccessibility,Fetc),FshouldFbeFminimizedForFeliminated,FandFaFtrustingFan
dFpositiveFtherapeuticFrelationshipFwithFinvolvedFcounselorsFshouldFbeFcarefullyFestablished.
1FofF5FDefineFtheFtermF"harmFreduction"FinFrelationFtoFsubstanceFabuseF-
FANSWERFTheFtermFrefersFtoFreducingFharmFviaFcleanFdrugFparaphernalia.FSyringeFexchangeFprogramsFfirst
FbeganFinFEuropeFinFresponseFtoFaFhepatitisFBFepidemicFandFtheFHIVFepidemic,FandFsinceFthatFtimeFi
, 2FofF5FDefineFtheFtermF"harmFreduction"FinFrelationFtoFsubstanceFabuseF-
FANSWERFnfectionFratesFplummeted,FdrugFuseFdidn'tFincrease,FandFmedicalFcostsFremainedFstable.FCitiesFi
nFEnglandFthatFemployedFsyringe-exchangeFprogramsFsawFHIVFratesFofFlessFthanF1%,
3FofF5FDefineFtheFtermF"harmFreduction"FinFrelationFtoFsubstanceFabuseF-
FANSWERFcomparedFwithFnearlyF60%FamongFIVFdrugFusersFinFnon-
exchangeFcities.FTheFNorthFAmericanFSyringeFExchangeFNetworkF(NASEN)FandFtheFHarmFReductionFCoaliti
onF(HRC)
4FofF5FDefineFtheFtermF"harmFreduction"FinFrelationFtoFsubstanceFabuseF-
FANSWERFadvocateFforFsuchFprogramsFinFtheFUnitedFStates,FalongFwithFinstructionsFonFhealth,FbadFdrugFw
arnings,FreferralsFforFtreatment,Fetc.
5FofF5DefineFtheFtermF"harmFreduction"FinFrelationFtoFsubstanceFabuseF-
FANSWERFHarmFreductionFcanFalsoFbeFachievedFviaF"moderationFtechniques"FsuchFasFtheF"DrinkersFCheck-
Up"FprogramFandFeducationFeffortsFthatFreduceFtheFamountFandFfrequencyFofFsubstancesFabused.
1FofF6FIdentifyFtheFfocusFofFHarmFReductionFPsychotherapyF(HRP)FinFrelationFtoFsubstanceFabuseF-
FANSWERFTheFfocusFofFHarmFReductionFPsychotherapyF(HRP)FisFteachingFclientsFtechniquesFtoFreduceFthei
rFsubstanceFabuse.FTheFcognitive-behavioralFtechniquesFemployedFinFHRP
2FofF6FIdentifyFtheFfocusFofFHarmFReductionFPsychotherapyF(HRP)FinFrelationFtoFsubstanceFabuseF-
FANSWERFcanFhelpFclientsFmoderateFtheirFsubstanceFabuseFpatterns,FlaterFleadingFtoFabstinence-
focusedFtreatment.FKeyFprinciplesFinclude:F1)FanyFstrategyFthatFleadsFtoFreducedFharmFisFgoodF(syringe-
exchange,FreducingFfrequency,
3FofF6FIdentifyFtheFfocusFofFHarmFReductionFPsychotherapyF(HRP)FinFrelationFtoFsubstanceFabuseF-
FANSWERFusingFlessFdamagingFdrugs,Fabstaining,Fetc);F2)FnoFpunitiveFsanctions,FasFtheyFinduceFdishonestyF
andFmayFescalateFharmfulFbehaviors;
4FofF6FIdentifyFtheFfocusFofFHarmFReductionFPsychotherapyF(HRP)FinFrelationFtoFsubstanceFabuseF-
FANSWERF3)FdrugFuseFisFnotFnecessarilyFpleasureFseekingF(Khantzian'sF"self-
medicationFhypothesis"FsuggestsFpeopleFseekFoutF"drugsFofFchoice"FtoFachieveFspecificFbenefits);