CADC Alcohol and Drug Counselor Relapse Prevention 1 — Questions and Answers
Question 1: According to Gorski's CENAPS model, relapse is best understood as:
- A sudden return to substance use triggered primarily by peer pressure
- A process beginning with warning signs before substance use resumes (Correct answer)
- An inevitable consequence of addiction without proper medication management
- A single unpredictable event with no prior warning signs
Correct answer: A process beginning with warning signs before substance use resumes
Gorski defined relapse as a progressive process starting with dysfunctional thinking, feeling, and behavioral warning signs that precede the return to substance use.
Question 2: The HALT acronym used in relapse prevention stands for which combination of states?
- Happy, Angry, Lonely, Tired
- Hurt, Anxious, Listless, Troubled
- Hungry, Angry, Lonely, Tired (Correct answer)
- High-risk, Avoidance, Lapse, Triggers
Correct answer: Hungry, Angry, Lonely, Tired
HALT stands for Hungry, Angry, Lonely, and Tired — four states that increase vulnerability to relapse when left unaddressed.
Question 3: Which of the following best illustrates an 'apparently irrelevant decision' (AID) in relapse prevention?
- Calling a sponsor when experiencing a craving
- Agreeing to meet a sober friend at a bar 'just for coffee' (Correct answer)
- Attending a weekly relapse prevention group session
- Practicing mindfulness meditation before a stressful event
Correct answer: Agreeing to meet a sober friend at a bar 'just for coffee'
AIDs are seemingly harmless choices that cumulatively move a person toward a high-risk situation, such as voluntarily entering an environment associated with substance use.
Question 4: Post-acute withdrawal syndrome (PAWS) is clinically significant in relapse prevention because:
- It occurs exclusively in the first 72 hours after detoxification
- It only affects individuals dependent on opiates
- Its symptoms are purely physical and easily managed with medication
- It can persist for months and sustain ongoing vulnerability to relapse (Correct answer)
Correct answer: It can persist for months and sustain ongoing vulnerability to relapse
PAWS involves prolonged symptoms including mood instability, cognitive difficulties, and sleep disturbances that can last months and significantly elevate relapse risk.
Question 5: Urge surfing, a relapse prevention technique developed by Marlatt, involves:
- Avoiding all situations where cravings might arise
- Using medication to immediately suppress urges when they occur
- Observing cravings as temporary waves that rise and fall without acting on them (Correct answer)
- Calling a support person every time a craving is experienced
Correct answer: Observing cravings as temporary waves that rise and fall without acting on them
Urge surfing teaches clients to experience cravings mindfully as passing sensations rather than demands that must be acted upon, reducing relapse likelihood.
Question 6: In Marlatt's relapse prevention model, negative emotional states are classified as:
- Covert antecedents that are hidden and clinically irrelevant
- Irrelevant to relapse risk when the client has strong social support
- One of the most common high-risk situations associated with relapse (Correct answer)
- Manageable exclusively through pharmacotherapy
Correct answer: One of the most common high-risk situations associated with relapse
Marlatt's research identified negative emotional states such as anger, anxiety, and depression as among the most frequent triggers associated with relapse episodes.
Question 7: The abstinence violation effect (AVE) can escalate a lapse into a full relapse by:
- Causing immediate physiological dependence after a single use episode
- Triggering shame, guilt, and all-or-nothing thinking that promotes continued use (Correct answer)
- Removing the client's social support network following the lapse
- Inducing severe withdrawal symptoms that require immediate medical treatment
Correct answer: Triggering shame, guilt, and all-or-nothing thinking that promotes continued use
The AVE produces guilt and self-blame following a lapse; combined with cognitive distortions such as 'I've already ruined my sobriety,' it can lead to a full relapse.
CADC Alcohol and Drug Counselor Relapse Prevention 1
According to Gorski's CENAPS model, relapse is best understood as: