CAADE Crisis Intervention 4 — Questions and Answers
Question 1: Which stage of Caplan's crisis theory describes the period when a person's usual problem-solving methods fail to resolve the stressor?
- Stage 1: Initial rise in tension
- Stage 2: Failure of usual coping (Correct answer)
- Stage 3: Emergency resources mobilized
- Stage 4: Major disorganization
Correct answer: Stage 2: Failure of usual coping
In Stage 2 of Caplan's model, habitual problem-solving methods prove ineffective, increasing tension and distress.
Question 2: A client who recently lost their job discloses heavy alcohol use and expresses hopelessness. Using a biopsychosocial lens, the counselor recognizes this crisis involves:
- Only a substance abuse disorder requiring detoxification
- Interconnected biological, psychological, and social stressors (Correct answer)
- Primarily a social problem requiring vocational counseling
- A spiritual crisis requiring pastoral intervention
Correct answer: Interconnected biological, psychological, and social stressors
The biopsychosocial model recognizes that biological effects of alcohol, psychological hopelessness, and social stressors (job loss) all interact in this crisis.
Question 3: Which of the following best describes 'lethality' when assessing a client's suicidal crisis?
- How recently the client has thought about suicide
- The medical severity and likelihood of death from the planned method (Correct answer)
- Whether the client has a history of psychiatric hospitalization
- The client's level of emotional distress at the time of assessment
Correct answer: The medical severity and likelihood of death from the planned method
Lethality refers to the degree to which the chosen method could cause death, which directly informs risk level and intervention urgency.
Question 4: During crisis intervention, the term 'cognitive mastery' refers to:
- Teaching the client advanced CBT techniques
- Helping the client develop a realistic understanding of the crisis event (Correct answer)
- Ensuring the client passes a mental status exam
- Training the client in mindfulness-based relapse prevention
Correct answer: Helping the client develop a realistic understanding of the crisis event
Cognitive mastery involves helping the client make sense of what happened and develop a realistic perspective on the crisis and its causes.
Question 5: A counselor receives a call from a client's spouse stating the client is threatening suicide at home. Under the 5150 hold criteria in California, an involuntary hold may be initiated when the person is:
- Experiencing mild depression and refusing therapy
- A danger to self, danger to others, or gravely disabled due to mental disorder (Correct answer)
- Under the influence of alcohol or drugs alone
- Unwilling to comply with an outpatient treatment plan
Correct answer: A danger to self, danger to others, or gravely disabled due to mental disorder
California's 5150 permits a 72-hour involuntary psychiatric hold when someone poses a danger to self, danger to others, or is gravely disabled due to a mental disorder.
Question 6: Which intervention is CONTRAINDICATED when working with a client experiencing acute alcohol withdrawal delirium (delirium tremens)?
- Monitoring vital signs frequently
- Maintaining a calm, low-stimulation environment
- Encouraging the client to use breathing exercises independently (Correct answer)
- Arranging immediate medical evaluation and hospitalization
Correct answer: Encouraging the client to use breathing exercises independently
Delirium tremens is a medical emergency requiring hospitalization; expecting the client to manage symptoms with breathing exercises is inappropriate and dangerous.
Question 7: In the context of crisis intervention, 'secondary trauma' in counselors is best prevented through:
- Limiting the number of crisis sessions per client to one
- Regular supervision, self-care practices, and professional support (Correct answer)
- Avoiding work with clients who have trauma histories
- Maintaining strict emotional neutrality during all sessions
Correct answer: Regular supervision, self-care practices, and professional support
Regular clinical supervision, intentional self-care, and peer support are the primary evidence-based strategies to prevent secondary traumatic stress in crisis counselors.
CAADE Crisis Intervention 4
Which stage of Caplan's crisis theory describes the period when a person's usual problem-solving methods fail to resolve the stressor?