Free Master Addiction Counselor Practice Test

1. Which one of the following is true of the Three Stage Model of drug use sequencing:

a. Progression from one drug to another is always seen
b. Individual drug use always escalates to "harder" drugs
c. Initiation to marijuana tends to occur in the second stage
d. Heroin use typically precedes cocaine use

2. The term "adaptive consequences" refers to:

a. Behavioral enhancements that preserve family dysfunction
b. Family responses to any violation of family rules
c. Punishment for stepping out of a family role
d. Rewards for adherence to family norms

3. According to Jung, the role of an archetype is to:

a. Funnel information into the collective unconscious mind
b. Mediate overwhelming aspects of perception
c. Attach to key memories in the personal unconscious
d. Facilitate communication with the unconscious mind

4. Phenomenology is best described as:

a. The role that prominent life events play in shaping the psyche
b. A person's subjective reality and experience as a human being
c. The study of the meaning of life
d. The branch of psychology dealing with interrelationships

5. To successfully work with a client, Alfred Adler felt that his or her life challenges could be studied most meaningfully from the perspective of:

a. Intrapsychic conflicts
b. Social context
c. Future goals and aspirations
d. Biological predispositions

6. The second of Talbott & Crosby's seven key components of effective recovery contracts is:

a. Leverage
b. Short time frame
c. Releases of information
d. Presenting the contract

7. In coping-skills training, the FAN model (Kern & Lennon, 1994) refers to:

a. Feeling + action = new feeling
b. Frequency + activity = new behavior
c. Fear + anxiety = new stressor
d. Frustration + anger = new response

8. A model that helps explain how individuals get into trouble with drugs is known as:

a. The "drug, set, setting" model
b. The "drug, setting, set" model
c. The "set, drug, setting" model
d. The "setting, set, drug" model

9. Two primary ethical texts in the field of addiction counseling and ethics (Bissell & Royce, 1987; and White & Popovits, 2001) reveal how many zones of vulnerability in addiction counseling practice?

a. 9
b. 7
c. 5
d. 3

10. All of the following acronyms identify brief alcohol screening instruments except one:

a. CAGE
b. DAST
c. AUDIT
d. MAST

Answers and Explanations

1. C: Initiation to marijuana tends to occur in the second stage. Researchers have identified a prototypical sequence in the trajectory of substance initiation and use. In Stage One, legal substances (alcohol and tobacco) are initiated; in Stage Two marijuana is initiated; and in Stage Three cocaine and then heroin are initiated. Although tobacco use may lead directly to marijuana use, alcohol tends to be an intermediate step. Likewise, cocaine tends to precede heroin use. Other pathways are possible, such as marijuana leading to hallucinogenic substance abuse, or alcohol directly to prescription drug use, etc. The concept of gateway drugs is an oversimplification, as clear causation is not evident. Certainly, delaying drug use onset is highly significant for fewer problems, as drug use may be avoided altogether, and the younger one starts, the more difficult the problems experienced later tend to become.

2. A: Behavioral enhancements that preserve family dysfunction. Researchers noted that couples were often more relaxed and communicative when the alcoholic partner was drinking as opposed to when abstaining. Thus, the behavioral patterns associated with substance abuse can sometimes offer positive reinforcements (i.e., adaptive consequences) that sustain and perpetuate the problematic behavior regardless of other causative factors. Bowen (1974) has noted that problematic nuclear family symptoms are often expressed in three areas: 1) marital conflict, 2) spousal dysfunction (e.g., substance abuse), and 3) projection onto one or more children (i.e., the "family projection process"). The children who receive projections become "symptom bearers" and are referred to as "identified patients," who serve to express the entire family's pain. Individual differentiation is often low in substance-abusing families, where personal needs are sacrificed to protect the family system. Both projection and low differentiation patterns lead to intergenerational transmission of problems such as addictions, etc.

3. D: Facilitate communication with the unconscious mind. Jung sought to enable both counselor and client to communicate with the unconscious mind. To this end, Jung used archetypes (universal concepts, behaviors, emotions, and psychic perceptions shared by all humans) to process and interpret insights via "guiding messages" obtained from the unconscious mind in therapy. Jung sought to identify numerous core archetypes in folklore, myths, and art to serve as a universal bridge of commonality by which to explore the unconscious mind. Common archetypes include: 1) Shadow archetypes-aspects of the self in the conscious mind that the client avoids acknowledging or does not like. 2) Persona archetypes-the adaptive bridges between the conscious and unconscious inner self, allowing for idiosyncratic responses to similar situations. 3) Animus and anima-respectively, the personification of male tendencies in a woman's psyche and female tendencies in a man's psyche. 4) The self-that which defines life's meaning within each human being and allows for greatness in every individual.

4. B: A person's subjective reality and experience as a human being. In moving beyond the conscious mind, Jung primarily used dream analysis in his psychoanalytic approach, tracking various archetypes that would appear and then interpreting them to increase insight into a client's motivations and behaviors. While dream analysis is a highly specialized field, there are five core themes that are useful to addiction counseling: 1) Relationships-men and women are more alike than they are different. 2) Spirituality-a "higher power" is very individualized, and Jung felt that spirituality was necessary to make a person complete. 3) Midlife crisis-the need to find personal acceptance in issues such as marriage, spirituality, money, career, and changing health. 4) Death-Jung believed in life as a journey that continued after death, and clients had to reconcile themselves to death to fully live. 5) Individualism instinct-the drive to define oneself and find one's place in the world.

5. B: Social context. After breaking with Freud, Adler established a theory of "individual psychology"-a cognitive-behavioral, goal-directed, holistic, and phenomenological approach. He saw all people as Mitmenschen (equal fellows) laboring to fit into society (i.e., the social interest). Consequently, a client's life challenges and motivations could only be fully understood within the context of social interactions, especially as related to family of origin-centered around five potential family positions: oldest, second of only two, middle, youngest, and only. Understanding the role of the family in positively or negatively shaping the client's development and model of the world is crucial. Individual psychology seeks to produce profound "self-actualizing" insights (i.e., "ah-ha" moments) that will engage the internally driven need that all have for self-determination and life mastery, and thereby achieve healthy lifestyle choices. By this process, clients move from discouragement (potentially leading to addictive behaviors, etc.) to encouragement on Adler's "road to becoming."

6. C: Releases of information. Behavioral contracts are intended to reinforce positive behaviors and monitor progress, and thereby increase the likelihood of successful recovery. Talbott & Crosby (2001) provide seven key components of effective recovery contracts: 1) presenting the contract-requires a compassionate and serious overture, ideally with a significant other and/or program personnel present; 2) releases of information-allowing contact with significant others, family, coworkers, and other relevant individuals who can aid in monitoring and reporting; 3) leverage-from detailed behavioral expectations and meaningful consequences (program discharge, marital and/or employment reporting, etc.); 4) client support system-needed people to support change should agree to be involved; 5) short time frame-start small to boost client confidence (e.g., quarterly review, over a five-year period, etc.); 6) contract review-informally (ongoing) and formally (no less than every six months); and 7) relapse ("slip") clause-warning-sign education and immediate response plan to avoid full-blown relapse. If poorly designed, clients may attempt to sabotage a plan.

7. A: Feeling + action = new feeling. Coping-skills training recognizes that substance abuse is rooted in the need to cope with moods, stressors, feelings, etc. The FAN model teaches clients to cope through positive alternate actions. The pyramid model of emotional well-being (Scott, Kern, & Coombs, 2001) recognizes that all feelings (at the apex of the pyramid) stem from four fundamental corners: biochemistry, environment, thinking, and behavior. Changing biochemistry is the goal of substance abuse, yet feeling states can also be altered by changes in the other corners. Feelings identification is essential (e.g., "How am I feeling now?" exercises hourly), after which resultant emotions must be explored, from which new options and strategies can emerge. Counselors introduce new options-exercise, socialization, new thinking patterns, etc.-and teach the ABCs of rational emotive therapy-beliefs (B), about activating events (A), can trigger consequent feelings/actions (C). However, disputing unproductive beliefs (D), can produce positive effects (E). Through homework and monitoring, client progress is made and tracked.

8. A: The "drug, set, setting" model. The drug portion of the model recognizes that the unique chemistry of a drug and its effects are important elements in the addiction development process. In addition, the route of administration also affects the experience-the faster the effects accrue, the more compelling they are; this explains why smoking cocaine is a larger problem that snorting it. The level of illegality of a drug results in very poor quality control and the harm that can result. The set element in the model refers to the interaction of personality with the drug, and some personalities are more prone to experimentation, needs, and/or intoxication of various kinds. The setting is the where of drug use-at parties vs alone, etc.-can influence the kinds of drugs used, the safety (or lack of it), and the context of the individual's life and community relationships.

9. B: The seven zones of vulnerability are: 1) personal conduct; 2) business conduct; 3) nonclinical professional conduct; 4) conduct with clients and families; 5) peer relationship conduct; 6) conduct related to safety threats; and 7) ethics in the course of special roles and functions (e.g., training, research, prevention, etc.). Three steps to ethical analysis are: 1) Who is expected to benefit and who may be harmed? 2) What cultural or universally accepted values may apply? 3) What existing codes, laws, regulations, policies, and/or standard practices apply? The National Association of Alcohol and Drug Abuse Counselors (NAADAC) Code of Ethics offers 12 principles: 1) nondiscrimination, 2) responsibility (including integrity and objectivity), 3) competence, 4) legal and moral standards, 5) public statements, 6) credit in publication, 7) client welfare, 8) confidentiality/privacy, 9) proper client relationships, 10) proper interprofessional relationships, 11) remuneration, and 12) societal obligations.

10. B: DAST. DAST refers to the "drug abuse screening test," which has 20 "yes/no," unweighted questions (maximum score = 20). A more in-depth substance abuse screening instrument is the Substance Abuse Problem Checklist (SAPC). It involves more than 300 questions in eight categories (treatment motivation, health, personality, social relationships, employment, use/misuse of leisure time, religious/spiritual perspectives, and legal problems). CAGE is a very brief (four-question) alcohol-problem screening instrument. AUDIT (Alcohol Use Disorders Identification Test) consists of 10 questions. MAST (Michigan Alcoholism Screening Test) offers 24 "yes/no," weighted questions regarding alcohol use, with a total possible score of 53 and a cutoff of 20 (above which indicates severe alcoholism). Another instrument, the Alcohol Use Inventory (AUI), offers multiple-choice options from which various scales can be derived. It explores alcohol use, key consequences of drinking, and individual awareness of an alcohol problem.

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Last Updated: 03/01/2017


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