CADC Alcohol and Drug Counselor Core Counseling Theories 5 — Questions and Answers
Question 1: The concept of 'enabling' in family systems approaches to addiction describes behavior that:
- Empowers family members to set healthy limits with the addicted person
- Allows the addicted person to avoid the natural consequences of their use (Correct answer)
- Enables the counselor to engage the family in structured treatment
- Provides practical support to facilitate a family member's recovery
Correct answer: Allows the addicted person to avoid the natural consequences of their use
Enabling refers to behaviors by family members or others that inadvertently shield the addicted person from consequences, thereby supporting continued use.
Question 2: In CBT for addiction, 'cognitive restructuring' involves:
- Redesigning the client's daily schedule to minimize exposure to triggers
- Identifying and challenging maladaptive thoughts that support substance use (Correct answer)
- Reprocessing traumatic memories using bilateral stimulation
- Restructuring the client's social network to exclude substance users
Correct answer: Identifying and challenging maladaptive thoughts that support substance use
Cognitive restructuring is a CBT technique in which clients learn to identify, challenge, and replace distorted or unhelpful thoughts about substance use.
Question 3: A key distinguishing feature of Motivational Interviewing compared to traditional confrontational approaches is its emphasis on:
- Achieving abstinence as the only acceptable treatment goal
- Eliciting the client's own reasons for change rather than imposing them (Correct answer)
- Using peer confrontation in group settings to break through denial
- Providing detailed psychoeducation about addiction as a disease
Correct answer: Eliciting the client's own reasons for change rather than imposing them
MI is fundamentally non-confrontational; it elicits and strengthens the client's own intrinsic motivation for change through reflective listening and strategic questioning.
Question 4: Narrative Therapy, when applied to addiction counseling, encourages clients to:
- Write detailed accounts of their drug use history for the court record
- Separate their identity from the problem and reauthor their life story (Correct answer)
- Narrate the exact sequence of events leading to relapse for analysis
- Tell their story to the group so members can offer advice
Correct answer: Separate their identity from the problem and reauthor their life story
Narrative therapy uses 'externalization' to help clients see themselves as separate from their problems and create new, preferred narratives about their identity.
Question 5: In Acceptance and Commitment Therapy (ACT) for substance use, 'experiential avoidance' is considered:
- A healthy coping strategy to manage acute withdrawal symptoms
- A core process that maintains addictive behavior by avoiding uncomfortable inner experiences (Correct answer)
- The deliberate avoidance of high-risk people, places, and things
- A mindfulness exercise used to reduce cravings
Correct answer: A core process that maintains addictive behavior by avoiding uncomfortable inner experiences
ACT views substance use as a form of experiential avoidance—an attempt to escape or suppress unwanted thoughts, feelings, or sensations.
Question 6: The 'decisional balance' exercise used in Motivational Interviewing helps clients by:
- Teaching them how to weigh legal risks against personal health risks
- Examining the perceived pros and cons of both changing and not changing (Correct answer)
- Balancing the client's caseload between the counselor and psychiatrist
- Helping clients decide between inpatient and outpatient treatment options
Correct answer: Examining the perceived pros and cons of both changing and not changing
Decisional balance explores the advantages and disadvantages of substance use and of change, helping to resolve ambivalence by making it explicit.
Question 7: Which theoretical framework specifically uses the concept of 'identified patient' to describe how one family member's symptoms serve a function for the whole family system?
- Cognitive-Behavioral Therapy
- Family Systems Theory (Correct answer)
- Motivational Interviewing
- Reality Therapy
Correct answer: Family Systems Theory
Family Systems Theory uses 'identified patient' to describe the family member who presents with symptoms that may actually reflect dysfunction distributed throughout the family system.
CADC Alcohol and Drug Counselor Core Counseling Theories 5
The concept of 'enabling' in family systems approaches to addiction describes behavior that: