CASAC Relapse Prevention and Recovery Support 1 — Questions and Answers
Question 1: In Marlatt and Gordon's cognitive-behavioral model of relapse, what is the first step in the relapse process?
- A lapse to substance use
- An encounter with a high-risk situation (Correct answer)
- Loss of self-efficacy
- Negative emotional states only
Correct answer: An encounter with a high-risk situation
Marlatt and Gordon's model begins with exposure to a high-risk situation, which challenges the individual's coping skills and self-efficacy.
Question 2: According to relapse prevention theory, what is the 'abstinence violation effect' (AVE)?
- A legal consequence of violating probation terms
- The guilt and self-blame that follows a lapse and often leads to full relapse (Correct answer)
- A physical withdrawal symptom after stopping use
- A counselor's intervention when a client relapses
Correct answer: The guilt and self-blame that follows a lapse and often leads to full relapse
The AVE describes how a client who lapses may experience intense guilt and self-blame, leading them to abandon recovery efforts entirely.
Question 3: Which of the following is an example of an internal high-risk situation for relapse?
- Attending a party where alcohol is served
- Driving past a former drug dealer's house
- Experiencing negative emotions such as anger or loneliness (Correct answer)
- Receiving a job offer
Correct answer: Experiencing negative emotions such as anger or loneliness
Internal high-risk situations include negative emotional states, stress, and boredom — all of which can trigger cravings without external cues.
Question 4: The acronym HALT in relapse prevention reminds clients to check if they are:
- Happy, Angry, Lonely, Tired
- Hungry, Angry, Lonely, Tired (Correct answer)
- Hopeful, Anxious, Lethargic, Tense
- Hungry, Apathetic, Lethargic, Tense
Correct answer: Hungry, Angry, Lonely, Tired
HALT stands for Hungry, Angry, Lonely, Tired — four common vulnerability states that increase relapse risk.
Question 5: A client reports experiencing strong urges to use substances but has not used. The CASAC counselor should FIRST:
- Recommend immediate inpatient hospitalization
- Explore the triggers associated with the craving and review coping strategies (Correct answer)
- Discharge the client for being at high risk
- Contact the client's family without consent
Correct answer: Explore the triggers associated with the craving and review coping strategies
Exploring the triggers and reinforcing coping strategies is the appropriate clinical response to reported cravings, as it builds skills to manage future urges.
Question 6: Which technique involves a client imagining themselves 'surfing' a craving without acting on it?
- Systematic desensitization
- Urge surfing (Correct answer)
- Flooding
- Cognitive restructuring
Correct answer: Urge surfing
Urge surfing is a mindfulness-based technique where clients observe cravings like waves, allowing them to rise and fall without responding to them.
CASAC Relapse Prevention and Recovery Support 1
In Marlatt and Gordon's cognitive-behavioral model of relapse, what is the first step in the relapse process?