CARN Counseling and Therapeutic Modalities 2 — Questions and Answers
Question 1: Which stage of the Transtheoretical Model is characterized by a patient acknowledging a problem but not yet committed to change within the next 6 months?
- Precontemplation
- Contemplation (Correct answer)
- Preparation
- Action
Correct answer: Contemplation
In the contemplation stage, individuals recognize their problem and are thinking about change but have not committed to taking action in the near future.
Question 2: A CARN uses Contingency Management (CM) with a patient in alcohol recovery. Which core mechanism drives this intervention?
- Insight into unconscious conflicts
- Operant conditioning through positive reinforcement (Correct answer)
- Challenging cognitive distortions
- Developing mindfulness awareness
Correct answer: Operant conditioning through positive reinforcement
Contingency Management is based on operant conditioning, providing tangible rewards (e.g., vouchers) to reinforce abstinence or treatment participation.
Question 3: During a group therapy session for opioid use disorder, a patient says, 'I'm not as bad as the others here.' Which defense mechanism is this?
- Rationalization
- Projection
- Minimization via social comparison (Correct answer)
- Denial
Correct answer: Minimization via social comparison
Comparing oneself favorably to others to minimize one's own problem is a form of minimization through downward social comparison.
Question 4: What is the primary goal of Seeking Safety, an evidence-based intervention used with patients who have co-occurring PTSD and substance use disorder?
- Trauma processing through exposure techniques
- Teaching coping skills and establishing safety without requiring trauma narration (Correct answer)
- Reducing medication dependence
- Developing 12-step program engagement
Correct answer: Teaching coping skills and establishing safety without requiring trauma narration
Seeking Safety focuses on present-focused coping skills and establishing safety without requiring patients to discuss trauma details.
Question 5: A nurse implementing Brief Strategic Family Therapy (BSFT) with an adolescent's family would MOST focus on:
- The adolescent's peer relationships exclusively
- Identifying and restructuring maladaptive family interaction patterns (Correct answer)
- Medication adherence education
- Individual CBT for the adolescent
Correct answer: Identifying and restructuring maladaptive family interaction patterns
BSFT targets maladaptive family interaction patterns that are believed to maintain the adolescent's substance use behavior.
Question 6: Which element distinguishes Dialectical Behavior Therapy (DBT) from standard CBT when treating patients with addiction and emotional dysregulation?
- DBT excludes behavioral techniques
- DBT incorporates radical acceptance and distress tolerance skills (Correct answer)
- DBT focuses solely on medication management
- DBT avoids group therapy formats
Correct answer: DBT incorporates radical acceptance and distress tolerance skills
DBT adds dialectical philosophy, emphasizing the balance between acceptance and change, including skills like radical acceptance and distress tolerance not central to standard CBT.
Question 7: When using the FRAMES approach in brief intervention for alcohol misuse, what does the letter 'M' represent?
- Monitoring alcohol intake
- Menu of change options (Correct answer)
- Motivational enhancement
- Medical feedback
Correct answer: Menu of change options
In FRAMES, 'M' stands for Menu, meaning offering a range of strategies and options for the patient to choose from to reduce drinking.
CARN Counseling and Therapeutic Modalities 2
Which stage of the Transtheoretical Model is characterized by a patient acknowledging a problem but not yet committed to change within the next 6 months?