CADC Alcohol and Drug Counselor Case Management and Referrals 3 — Questions and Answers
Question 1: Which element is MOST essential when coordinating care between a substance use counselor and a client's primary care physician?
- Sharing the client's complete psychiatric history without consent
- Obtaining a signed Release of Information before exchanging any client information (Correct answer)
- Calling the physician directly to discuss the case without informing the client
- Sending a detailed treatment summary via unencrypted email for efficiency
Correct answer: Obtaining a signed Release of Information before exchanging any client information
A signed Release of Information is legally and ethically required before any client information can be shared with outside providers.
Question 2: A case manager is developing a continuing care plan for a client completing residential treatment. Which factor is MOST predictive of long-term recovery success?
- The client's educational attainment level
- Engagement in ongoing recovery support services post-discharge (Correct answer)
- Length of the residential treatment episode
- The geographic location of the treatment facility
Correct answer: Engagement in ongoing recovery support services post-discharge
Research consistently shows that continued engagement in recovery support services after discharge is among the strongest predictors of sustained recovery.
Question 3: A client presents with co-occurring major depression and alcohol use disorder. The case manager's referral plan should IDEALLY include:
- Sequential treatment: address alcohol first, then depression
- Integrated dual-diagnosis treatment addressing both disorders simultaneously (Correct answer)
- Referral to a psychiatrist only, since mental health is the primary issue
- Separate counselors for each disorder to maintain specialization
Correct answer: Integrated dual-diagnosis treatment addressing both disorders simultaneously
Integrated treatment that addresses co-occurring disorders simultaneously produces better outcomes than sequential or parallel approaches.
Question 4: Under 42 CFR Part 2, substance use disorder treatment records receive special confidentiality protections. These records can be disclosed without patient consent in which situation?
- When requested by an employer for background checks
- To report a client's ongoing drug use to law enforcement
- When there is a medical emergency threatening the client's life (Correct answer)
- When another treatment provider requests records for insurance purposes
Correct answer: When there is a medical emergency threatening the client's life
42 CFR Part 2 permits disclosure without consent in a bona fide medical emergency to protect the life of the patient.
Question 5: A counselor needs to refer a client to a medication-assisted treatment (MAT) program for opioid use disorder. Which medication is approved by the FDA for this purpose?
- Naltrexone (oral or extended-release injectable) (Correct answer)
- Alprazolam (Xanax)
- Gabapentin
- Quetiapine (Seroquel)
Correct answer: Naltrexone (oral or extended-release injectable)
Naltrexone (oral or extended-release injectable Vivitrol) is FDA-approved for opioid use disorder as part of medication-assisted treatment.
Question 6: Which case management activity is classified as a 'linkage' function?
- Assessing a client's current level of functioning
- Connecting a client to a vocational rehabilitation program (Correct answer)
- Monitoring a client's attendance at treatment sessions
- Developing individualized treatment goals with the client
Correct answer: Connecting a client to a vocational rehabilitation program
Linkage refers to connecting clients with needed community resources and services, such as vocational rehabilitation programs.
Question 7: A client expresses ambivalence about attending aftercare following detoxification. The MOST appropriate case management response is to:
- Accept the client's decision and close the case
- Use motivational interviewing techniques to explore the ambivalence (Correct answer)
- Threaten consequences if aftercare is not attended
- Contact the client's family to pressure them into attending
Correct answer: Use motivational interviewing techniques to explore the ambivalence
Motivational interviewing is an evidence-based approach for helping clients explore and resolve ambivalence about treatment engagement.
CADC Alcohol and Drug Counselor Case Management and Referrals 3
Which element is MOST essential when coordinating care between a substance use counselor and a client's primary care physician?