CAADC Evidence-Based Counseling Models 5 — Questions and Answers
Question 1: The 'empty chair' technique used in Gestalt therapy for addiction counseling is BEST suited for:
- Practicing assertive refusal skills in role-play
- Facilitating unfinished emotional business with significant others or aspects of self (Correct answer)
- Cognitive restructuring of core beliefs about substances
- Desensitizing clients to environmental substance use cues
Correct answer: Facilitating unfinished emotional business with significant others or aspects of self
The empty chair technique allows clients to externalize and dialogue with unresolved feelings or internal conflicts that often underlie addictive behavior.
Question 2: In Seeking Safety, a trauma-informed model for co-occurring PTSD and substance use, the primary treatment focus is on:
- Trauma processing through prolonged exposure before addressing substance use
- Establishing safety as the first and overriding goal of treatment (Correct answer)
- Pharmacological stabilization prior to any counseling intervention
- Identifying childhood trauma origins of current substance use
Correct answer: Establishing safety as the first and overriding goal of treatment
Seeking Safety explicitly prioritizes safety — safe coping in both trauma and substance use domains — before any trauma processing work begins.
Question 3: A counselor employing Solution-Focused Brief Therapy (SFBT) with an addicted client would MOST characteristically ask:
- 'What childhood experiences do you think contributed to your substance use?'
- 'What would your life look like if you woke up tomorrow and the problem was solved?' (Correct answer)
- 'How does your substance use function to regulate your emotions?'
- 'What are the cognitive distortions maintaining your addictive thinking?'
Correct answer: 'What would your life look like if you woke up tomorrow and the problem was solved?'
The 'miracle question' is a signature SFBT technique that orients clients toward a preferred future rather than the history of the problem.
Question 4: Which statement BEST describes the role of 'values clarification' in Motivational Interviewing?
- It is a confrontational strategy to expose contradictions in the client's stated values
- It helps clients explore discrepancies between their values and current substance use behavior to elicit change talk (Correct answer)
- It assigns a numerical score to the client's readiness for change
- It is used only in the planning phase, not the evoking phase
Correct answer: It helps clients explore discrepancies between their values and current substance use behavior to elicit change talk
Values clarification in MI surfaces the gap between what clients care about most and how their substance use affects those things, naturally generating intrinsic motivation to change.
Question 5: Integrated Cognitive Affective Therapy (ICAT) for bulimia with co-occurring substance use differs from standard CBT primarily by emphasizing:
- Longer-term, insight-oriented exploration of developmental conflicts
- The interplay of emotions, cognitions, and urges across both conditions simultaneously (Correct answer)
- Strict food and substance use monitoring logs as the primary intervention tool
- Pharmacological management as the first-line intervention
Correct answer: The interplay of emotions, cognitions, and urges across both conditions simultaneously
ICAT targets the cognitive-affective processes that simultaneously drive binge-purge cycles and substance use, treating them as functionally linked.
Question 6: In the Matrix Model for stimulant use disorders, the therapeutic relationship is described as being like:
- A sponsor in a 12-step program who has personal recovery experience
- A coach who is knowledgeable, supportive, and keeps the client on task (Correct answer)
- A blank screen onto which the client projects unconscious material
- An authority figure who sets firm limits on destructive behavior
Correct answer: A coach who is knowledgeable, supportive, and keeps the client on task
The Matrix Model explicitly frames the therapist as a knowledgeable coach — non-judgmental, supportive, and focused on skill-building and accountability.
Question 7: When using Behavioral Couples Therapy (BCT) for alcohol use disorder, the 'sobriety contract' component requires:
- The client to sign a legal document committing to abstinence for one year
- Daily verbal affirmations of intent to stay sober, witnessed by the partner, often with medication compliance (Correct answer)
- The couple to attend separate individual therapy for the duration of treatment
- Financial penalties paid to the partner for each lapse during treatment
Correct answer: Daily verbal affirmations of intent to stay sober, witnessed by the partner, often with medication compliance
BCT's sobriety contract is a daily ritual where the client states their intent to remain sober and the partner expresses support, building trust and accountability within the relationship.
CAADC Evidence-Based Counseling Models 5
The 'empty chair' technique used in Gestalt therapy for addiction counseling is BEST suited for: