CADC Alcohol and Drug Counselor Relapse Prevention 2 — Questions and Answers
Question 1: In relapse prevention terminology, a 'lapse' is best defined as:
- A permanent return to prior substance use patterns
- A brief, isolated episode of substance use following a period of abstinence (Correct answer)
- The planning stage that occurs before a full relapse begins
- The complete breakdown of a client's treatment plan
Correct answer: A brief, isolated episode of substance use following a period of abstinence
A lapse is a brief, single use episode distinct from a relapse, which involves a sustained return to previous levels or patterns of substance use.
Question 2: Self-efficacy in the context of Marlatt's relapse prevention model refers to:
- A client's comprehensive knowledge of substance pharmacology
- A therapist's confidence in delivering evidence-based treatment
- A client's belief in their capacity to cope with high-risk situations without using substances (Correct answer)
- A client's motivation to attend 12-step meetings consistently
Correct answer: A client's belief in their capacity to cope with high-risk situations without using substances
Bandura's concept of self-efficacy — applied by Marlatt — is the client's confidence that they can successfully handle specific high-risk situations without substances.
Question 3: Covert antecedents to relapse are best characterized as:
- Visible environmental triggers such as seeing drug paraphernalia
- Social invitations to events where substances will be available
- Peer pressure from friends or acquaintances who still use substances
- Internal states such as substance-related fantasies, rationalizations, and cravings (Correct answer)
Correct answer: Internal states such as substance-related fantasies, rationalizations, and cravings
Covert antecedents are hidden, internal precursors to relapse including thoughts, fantasies, and emotional states, in contrast to overt external environmental triggers.
Question 4: According to Marlatt, the primary mechanism by which lifestyle imbalance increases relapse risk is:
- An excess of obligations over pleasures generates chronic stress that substances may be sought to relieve (Correct answer)
- Imbalance limits access to formal treatment services and support groups
- Repeated failures reduce self-efficacy to the point where recovery seems impossible
- Imbalance decreases the time available for 12-step meeting attendance
Correct answer: An excess of obligations over pleasures generates chronic stress that substances may be sought to relieve
Marlatt's lifestyle balance concept holds that when obligations far outweigh pleasures, chronic stress accumulates and substances may be used as a perceived coping mechanism.
Question 5: A comprehensive relapse prevention plan should include all of the following EXCEPT:
- Identified personal high-risk situations and triggers
- A guarantee that the client will never use substances again (Correct answer)
- Early warning signs specific to the individual client
- Coping strategies and emergency support contacts
Correct answer: A guarantee that the client will never use substances again
Relapse prevention plans identify risks, warning signs, and coping strategies, but cannot guarantee abstinence — making such a promise establishes unrealistic and potentially harmful expectations.
Question 6: The primary clinical purpose of identifying early warning signs in a client's relapse prevention plan is:
- To create documentation of non-compliance for legal or insurance purposes
- To satisfy treatment program accreditation and regulatory requirements
- To provide a rationale for adjusting the client's medication regimen
- To enable timely intervention before the situation escalates to a full relapse (Correct answer)
Correct answer: To enable timely intervention before the situation escalates to a full relapse
Recognizing early warning signs allows both clients and counselors to intervene with coping strategies during the window before a lapse or full relapse develops.
Question 7: Family enabling behavior is addressed in relapse prevention primarily because:
- Family members share legal responsibility for the client's sobriety
- Insurance policies require documented family participation in treatment
- Enabling removes the natural consequences of substance use, undermining motivation for sustained recovery (Correct answer)
- Families must formally co-sign the client's relapse prevention plan
Correct answer: Enabling removes the natural consequences of substance use, undermining motivation for sustained recovery
Enabling shields clients from the consequences of substance use, thereby reducing the natural motivation to change and increasing the likelihood of continued use or relapse.
CADC Alcohol and Drug Counselor Relapse Prevention 2
In relapse prevention terminology, a 'lapse' is best defined as: