CAADC Relapse Prevention and Recovery Support 4 — Questions and Answers
Question 1: A client in long-term recovery reports feeling invulnerable and skipping mutual aid meetings because 'I've got this figured out.' This attitude is best described as:
- Stable recovery confidence
- Complacency as a relapse warning sign (Correct answer)
- Healthy autonomy from support systems
- Evidence of successful self-efficacy
Correct answer: Complacency as a relapse warning sign
Overconfidence and reduced engagement with support structures is a classic complacency warning sign that often precedes relapse.
Question 2: Which neurocognitive function most directly impairs a client's ability to recognize their own relapse warning signs?
- Impaired working memory (Correct answer)
- Reduced gross motor coordination
- Hypersensitivity to physical pain
- Enhanced emotional reactivity
Correct answer: Impaired working memory
Working memory deficits compromise self-monitoring and the ability to recall and apply relapse prevention strategies in real time.
Question 3: In Marlatt's cognitive-behavioral model, a 'seemingly irrelevant decision' (SID) refers to:
- A conscious choice to use substances
- An apparently minor decision that moves the client closer to high-risk situations (Correct answer)
- A therapist's decision to adjust the treatment plan
- An irrational belief about substance use consequences
Correct answer: An apparently minor decision that moves the client closer to high-risk situations
SIDs are small, ostensibly unrelated choices that covertly set up relapse opportunities without the client acknowledging the risk.
Question 4: A client with opioid use disorder in medication-assisted treatment (MAT) relapses to alcohol. The counselor's first priority should be:
- Discontinuing MAT pending sobriety
- Assessing medical safety and adjusting the treatment plan collaboratively (Correct answer)
- Referring the client to inpatient detox immediately
- Requiring the client to restart from the beginning of the program
Correct answer: Assessing medical safety and adjusting the treatment plan collaboratively
Relapse to any substance requires immediate safety assessment and collaborative treatment adjustment while maintaining therapeutic alliance.
Question 5: Which strategy best addresses the 'abstinence violation effect' (AVE) after a lapse?
- Encouraging the client to recommit to abstinence immediately without discussion
- Helping the client attribute the lapse to controllable, situational factors rather than personal failure (Correct answer)
- Increasing the frequency of urine drug screens
- Reducing the client's treatment goals to harm reduction only
Correct answer: Helping the client attribute the lapse to controllable, situational factors rather than personal failure
Reframing the lapse as a situational learning opportunity rather than character failure reduces shame and decreases the likelihood of full relapse.
Question 6: A recovery support specialist (RSS) differs from a licensed addiction counselor primarily in that an RSS:
- Provides clinical diagnosis and treatment planning
- Offers peer-based lived experience support rather than clinical services (Correct answer)
- Is authorized to prescribe medication-assisted treatment
- Conducts formal psychological assessments
Correct answer: Offers peer-based lived experience support rather than clinical services
Recovery support specialists draw on personal recovery experience to provide non-clinical peer mentoring, navigation, and community connection.
Question 7: When developing a relapse prevention plan, including 'emergency contact scripts' for high-risk moments is most useful because:
- It removes the client's responsibility for decision-making
- It reduces cognitive load during craving peaks when planning ability is impaired (Correct answer)
- It satisfies insurance documentation requirements
- It replaces the need for a sponsor or mutual aid group
Correct answer: It reduces cognitive load during craving peaks when planning ability is impaired
Pre-written scripts lower the barrier to reaching out when stress and craving impair executive function and spontaneous help-seeking.
CAADC Relapse Prevention and Recovery Support 4
A client in long-term recovery reports feeling invulnerable and skipping mutual aid meetings because 'I've got this figured out.' This attitude is best described as: