Illinois CADC Exam 2023 Questions with Verified Answers

Understanding Addiction and Recovery - ANSWER-Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by a diminished recognition of significant problems with one's behaviors. (ASAM: American Society of Addiction Medicine) Factors that Influence Addiction - ANSWER-Genetic, Home & Family, Peer & School; Early Use; Method of Administration; Fundamental changes in the Brain. Theories of Causation - ANSWER-Moral Model; Disease Model (E.M. Jellinek 1960); Genetic Model; Cultural Model; Blended Model. Substance Use Disorders (SUDs) - ANSWER-Exist along a continuum. Drugs of Abuse - ANSWER-Alcohol is the most frequently abused substance. Drugs obtained through prescriptions or stolen from pharmacies is a serious problem. Alcohol - ANSWER-Alcohol is classified as a sedative-hypnotic, thus a central nervous system depressant. Alcohol has eights stages of effect: sub-clinical, euphoria, excitement; excitement (2); excitement/confusion; confusion/stupor;coma and death Catholic University of America 2011) Alcohol - ANSWER-While it is trues that men are more likely to drink alcohol and in greater amounts, women have a higher risk of developing problems from alcohol consumption. This is because women generally have less water than men's bodies. Because alcohol mixes with body water, a given amount of alcohol is less diluted in a woman's body than in a man's. Women become more impaired by alcohol's effects and are more susceptible to alcohol-related organ damage. Cannabis (Marijuana) - ANSWER-Contrary to popular belief, marijuana is addictive. Prescription Drugs - ANSWER-Past year abuse of prescription pain killers now ranks second-only behind marijuana- as the nations's most prevalent drug problem. The classes of prescription drugs most commonly abused: - ANSWER-Opioid pain relievers such as Vicodin or Oxycontin; stimulants for treating ADHD such as Adderall, Concerta or Ritalin and Cental Nervous System depressants for relieving anxiety such as Valium and Xanax. Prescription Drugs - ANSWER-More people die from overdoses of prescription opioids than from all other drugs combined, including heroine and cocaine (Centers for Disease Control, 2011). Withdrawal from Drugs of Abuse - ANSWER-Central to the role of nearly all drugs taht are commonly abused to prodeuce euphoria is the nucleus accumbens, the brain's "pleasure center". Withdrawal from Drugs of Abuse - ANSWER-Attempting to give up a benzodiazepine or alcohol dependency can result in seizures and worse if not carried out properly. Recovery - ANSWER-Recovery is a process of change whereby individual's improve their health and wellness, to live a self-directed life, and strive to reach their full potential (SAMHSA, 2014) A New Recovery Paradigm - ANSWER-There has been a shift in traditional clinical practice toward new priorities of supporting the client in working toward self-defined goals and taking responsibility for their own life. The new recovery movement affirms the very real potential for permanent, personal resolution of behavioral health problems. Recovery-Oriented Systems of Care - ANSWER-ROSCs are a model of sustained recovery management (RM). The RM model wraps traditional interventions in a continuum of recovery support services spanning the pre-recovery, recovery initiation and stabilization, and recovery maintenance stages of problem resolution. Distinctive is the model's emphasis on post-treatment monitoring and support; long term, stage-appropriate recovery education; peer- based recovery coaching; assertive linkage to communities of recovery; and when needed, early re-intervention (White, 2006). CSAT - ANSWER-Center for Substance Abuse Treatment SAMHSA - ANSWER-Substance Abuse and Mental Health Services Recovery and Recovery-Oriented Systems of Care - ANSWER-Important to make the destiction between Recovery and ROSC. Recovery - ANSWER-Process of change whereby individuals improve their health and wellness. ROSC - ANSWER-Partnering with people in recovery from mental health and SUD to guide the behavioral health system and promote individual, program and system-level approaches that foster health and resilience; increase permanent housing, employment, education and other necessary supports; and reduce barriers to social inclusion. Four Major Dimensions in an effective ROSC - ANSWER-Health (disease management);Home;Purpose; Community. Clinical Evaluation - ANSWER-Effectively assessing a person's alcohol and/or drug misuse is critical to preventing or early intervention in addiction - can be through outreach, screening, or assessment. Engaging the client in treatment - ANSWER-Making a respectful, non-judgmental connection with client is key to engagement. Goals of the Initial Interview - ANSWER-(1) Establish trust, rapport and effective communication with the client. (2)facilitating the client's UNDERSTANDING OF THE RATIONALE, PURPOSE, AND PROCEDURES ASSOCIATED WITH THE SCREENING AND ASSESSMENT PROCESS. (3) Exploring the client's problems and expectations; and (4) determining whether further assessment is needed. The Interview Climate - ANSWER-Factors include Stigma, Expectations, Likableness, First Impression, Professional Manner, Environment. Communication Techniques (reflecting, clarifying, focusing, summarizing) - ANSWER-Active Listening is an intentional feedback loop wherein the counselor reflects, clarifies and summarizes what the client says in order to verify that they understand both the literal content and feelings being conveyed. Specific skills include: Reflecting (restating); Clarifying (rephrasing); Focusing (directing client's attention) and Summarizing. Motivational Interviewing (MI) - ANSWER-A style of interaction to facilitate change, began in substance abuse treatment in the early 1980's. It contrasts with the traditional confrontational style. MI is a client-centered approach that seeks to enhance and individual's motivation to change by exploring and resolving ambivalence. It has been framed as a "guiding" style of communication as compared to a more directive style. GAIN - ANSWER-Standardized Screening tool to obtain information about substance use. Assessment - ANSWER-A process for defining that nature of the problem, determining a diagnosis, developing specific treatment recommendations. Entry level counselors perform screening while assessment is performed by more experienced and credentialed staff. Assessment is an in-depth evaluation. Assessment Interview (Biopsychosocial) - ANSWER-Interviews with the person being assessed are more comprehensive than the brief interviews used for screening. In screening, information is focused on the self-report of the person seeking services, while in assessment interviews, a more thorough and systematic method of gathering information is used. Assessment Instruments - ANSWER-Include Standardized interviews, Structured Interviews, Self-administered tests. Standardized Interview - more credible than the structured interview for referrals, legal actions DCFS etc. - ANSWER-Differs from the Structured Interview in that it limits the interviewer to a prescribed style and list of questions. The interviewer is restricted from freely probing beyond conflicting or superficial answers, which is sometimes a disadvantage of this technique. An advantage is that this interview may be more credible than the structured interview. Structured Interview - ANSWER-A prescribed interview structure but the interviewer is free to ask probing or clarifying questions when clinically appropriate. Self-Administered Tests - ANSWER-A less threatening method of self-disclosure Risk Assessment - ANSWER-At both the screening and assessment stages, counselor must observe client to assess for signs of psychoactive substance toxicity, intoxication and withdrawal; aggression or danger to others; potential for self-inflicted harm or suicide; and coexisting mental health problems, Treatment Planning - ANSWER-An intentional carefully considered road map for treatment and recovery process. All of the information gathered throughout the assessment process is analyzed and interpreted in order to make decisions about client placement and approaches to treatment. Treatment planning is action-oriented and lays out a logical, goal-oriented strategy for making positive changes in a client's life. Treatment plans are developed once a diagnosis is confirmed, a placement recommendation has been made and the client has been admitted into an appropriate level of care. The level of care is determined based on the diagnosis of the problem and on the client's strengths and assets. Readiness to Change - ANSWER-Proschka and Diclemente 1984: Stages of Change Model. The five stages of change are pre-contemplation, contemplation, preparation, action and maintenance. Case Management - ANSWER-A collaborative process. it's primary purpose is to help individuals identify needed services, select the most appropriate services available in a given geographical area, facilitate linkage with services and promote continued retention in services by monitoring the individual's participation, co-ordinate the activities of multiple services when present and when necessary and advocate for continued participation (NASW 2012). Objectives include continuity of care, accessibility, accountability and efficiency. The core agency for a specific geographic area is responsible for developing contracts with providers for the delivery of specified services for case-managed clients. Memoranda of Understanding (MOU) - ANSWER-MOUs are a means to structure a relationship among agencies. More formal than "social service bartering". Counseling - ANSWER-A professional relationship that empowers diverse individuals, families and groups to accomplish mental health, wellness, education and career goals. Therapeutic Alliance - ANSWER-A key component of successful counseling. Has three components: (1) The relationship or bond between therapist and client (2)Consensus between counselor and client regarding the techniques/methods employed in treatment (3) Consensus between therapist and client regarding the goals of treatment. THE PRIMARY RESPONSIBILITY FOR DEVELOPING AND MAINTAINING THE RELATIONSHIP RESTS WITH THE COUNSELOR. It has been found that over 80% of the positive outcomes of treatment may be due to the therapeutic relationship (warmth, empathy, respect for client). Building Motivation for Treatment - ANSWER-Motivational Interviewing as a style of interaction to facilitate change, began in SUD treatment in the early 1980's. MI was truly an innovation in SUD because it created a shift in the underlying philosophy of care and used a set of specific techniques to engender engagement and empowerment of the persons seeking help for substance use problems. Earlier style used confrontation as an intervention. Five principles for MI - ANSWER-Open-ended questions; Listen reflectively; Summarize; Affirm; Elicit self-motivational statements. The "spirit" of MI is based on 4 key elements: - ANSWER-(1)Partnership/Collaboration: Work in collaboration and avoid the "expert" role. (2)Acceptance/Autonomy:Respecting the client's autonomy, potentials, strengths and perspectives (3)Compassion: Keeping the client's best interests in mind. (4)Evocation: The best ideas come from the client: "You have what you needs and together we will find it". Setting Expectations - ANSWER-Educate the client regarding the structure, expectations and limitations of the counseling process. Personal Dimensions that characterize facilitative relationships are: - ANSWER-Empathy: ability to understand how another person sees and interprets and experience, Genuineness: the ability to be fully oneself and express this to others, Respect, counselor believes that the client has the ability to make it in life, the right to make his or her own decisions, Self-Disclosure: the ability to disclose information about oneself (thoughts and feelings); Warmth: convey care; Immediacy: focus on the :here and now: relationship with another person; Concreteness: the ability to identify specific problems and steps necessary to correct them; Cultural Sensitivity: cultural competence requiring ongoing training and self-evaluation of counselor. Active Listening - ANSWER-Clear listening. New counselors tend to think while listening and is not accurately hearing what the person is saying. Important to listen without judging. Reflecting: summarizing and repeating client's thoughts and feelings in a simple and clear manner. Asking open-ended questions, requiring clients to explore the reasons they think, feel and act the way they do. Use effective body language (sit with legs and arms uncrossed, lean forward and make eye contact. Watch for non-verbal cues. Listen and watch carefully. Process of SUD Treatment: Models of Treatment - ANSWER-Medical model: Views addiction as a chronic and progressive disease. Emphasis on physical causes and genetic factors. Spiritual Model: Largely because of AA and 12 step fellowships - Cocaine Anonymous, Narcotics Anonymous and Al-Anon. Spiritual models give less weight to causation and emphasize the importance of the spiritual path to recovery. Recognizing a higher power beyond one-self, asking for healing of character, maintaining communication withe the Higher Power through prayer and meditation and seeking to conform one's life to its will. Twelve step programs are not "wholly self-help but rather "Higer Power-help" programs. Psychological model - psycopathology can be treated behaviorally or psychoanalytically oriented dynamic therapies. Change process shifts from internal (intrapsychic) to external (behavioral, interpersonal). Sociocultural model: substance related problems are seen as occurring in interactive relations with families, groups, and communities, alterations in policies, laws and norms as part of the change process. Composite Biopsychosocial-Spiritual Model: recognizes the importance of many interacting influences. Perspectives on SUD Treatment - ANSWER-Scientifically based approaches to SUD treatment can include behavioral therapy (counseling, cognitive, psychotherapy), medications or their combination. Behavioral therapies offer people strategies for coping with their drug cravings, teaching them ways to avoid drugs and prevent relapse, help them deal with relapse if it occurs. Case management and referral to other medical, psychological and social services are crucial components of treatment for many clients. No single treatment is appropriate for all individuals. Counseling strategies and individual progress - ANSWER-Good outcomes: Participation for less than 90 days is of limited or no effectiveness. For methadone maintenance, 12 months is the minimum. For opiate-addicted individuals, methadone maintenance treatment can last years. Many individuals have multiple episodes of treatment, often with a cumulative impact. Recovery support services are complementary to, and supportive of treatment rather than antithetical or a replacement for treatment. Clinical and Recovery Support Services - ANSWER-advocacy, housing support, linkage to legal and child welfare services, employment readiness, education support and remediation, family programs, child development education, parenting education, life skills, community and recovery support services. Self-Help Approaches - ANSWER-Formal Treatment organizations incorporate 12-step groups into their treatment regimen and recommend them for ongoing recovery support following the conclusion of treatment. The key to recovery is turning one's life and will over to a personally meaningful "higher power" such as God or Spirit. An extremely valuable aid to recovery as a social support network outside of the treatment program, and teaches skills needed to recover and helps clients take responsibility for their recovery. Alcoholics Anonymous - ANSWER-Began in 1935 as a fellowship for those who wanted to stop drinking. Bill W. a stockbroker and Dr. Bob, a surgeon were the original two members. The main p