NCAC/CADC II Exam – Substance Abuse
Counseling Study Guide and Practice Questions.
SECTION 1: ADDICTION COUNSELING & TREATMENT PLANNING (Questions 1–18)
Q1: A client presents for an initial intake and reports drinking 6–8 beers daily for
the past 3 years. Which screening tool is most appropriate to assess alcohol use
severity?
A. DAST-10
B. CAGE-AID
C. AUDIT
D. SASSI
Correct Answer: C
Rationale: Correct because the AUDIT (Alcohol Use Disorders Identification Test)
is a 10-item validated instrument specifically designed to identify hazardous and
harmful alcohol use, with a score of 8 or higher indicating problematic drinking.
Per standard addiction counseling practice, the AUDIT is the gold-standard
screening tool for alcohol use severity.
Q2: During a comprehensive biopsychosocial assessment, a counselor must
evaluate which of the following domains to determine ASAM Dimension 3
(Emotional, Behavioral, or Cognitive Conditions and Complications)?
A. Blood alcohol level and liver function tests
B. Current psychiatric symptoms, trauma history, and cognitive functioning
C. Family income and employment status
D. Availability of sober housing in the community
Correct Answer: B
Rationale: Correct because ASAM Dimension 3 specifically addresses emotional,
behavioral, and cognitive conditions, requiring assessment of psychiatric
symptoms, trauma history, and cognitive status. Standard addiction counseling
practice requires thorough evaluation of mental health comorbidities for accurate
level-of-care placement.
,Q3: A 28-year-old client meets 5 of the 11 DSM-5-TR criteria for alcohol use
disorder. What is the correct severity classification?
A. Mild
B. Moderate
C. Severe
D. In Remission
Correct Answer: B
Rationale: Correct because DSM-5-TR specifies that meeting 4–5 criteria indicates
moderate substance use disorder severity. Per DSM-5-TR criteria, mild is 2–3
criteria, moderate is 4–5 criteria, and severe is 6 or more criteria.
Q4: According to the Transtheoretical Model, a client who states, "I know I have a
problem, and I am thinking about making a change within the next 6 months" is in
which stage of change?
A. Precontemplation
B. Contemplation
C. Preparation
D. Action
Correct Answer: B
Rationale: Correct because the contemplation stage is characterized by
awareness of the problem and consideration of change without a firm
commitment or specific plan. Per the Transtheoretical Model, this stage involves
ambivalence and weighing the pros and cons of change.
Q5: A counselor is developing a treatment plan for a client with opioid use
disorder. Which element is required for a properly structured treatment plan
objective?
A. A broad statement of the client's overall recovery vision
B. A specific, measurable, achievable, realistic, and time-framed behavioral target
,C. A list of all possible interventions the counselor might use
D. A narrative summary of the client's life history
Correct Answer: B
Rationale: Correct because treatment plan objectives must be SMART—specific,
measurable, achievable, realistic, and time-framed—to facilitate progress
monitoring and outcome evaluation. Standard addiction counseling practice
requires concrete behavioral targets for effective treatment planning.
Q6: Using ASAM Patient Placement Criteria, a client with severe alcohol
withdrawal risk, unstable medical conditions, and a history of delirium tremens
should be placed at which level of care?
A. Level 0.5: Early Intervention
B. Level I: Outpatient Services
C. Level III.7: Medically Monitored Intensive Inpatient
D. Level IV: Medically Managed Intensive Inpatient
Correct Answer: D
Rationale: Correct because ASAM Level IV provides medically managed intensive
inpatient care for clients with severe biomedical conditions and acute intoxication
or withdrawal requiring 24-hour medical management. Per ASAM criteria, delirium
tremens and unstable medical conditions necessitate the highest level of care.
Q7: A client with stimulant use disorder is being referred to a community
resource for employment assistance. This activity represents which core function
of addiction counseling?
A. Screening
B. Assessment
C. Case Management
D. Crisis Intervention
Correct Answer: C
Rationale: Correct because case management involves coordinating care, making
referrals, and linking clients to appropriate community resources including
, vocational services. Standard addiction counseling practice requires active
coordination of services to address social determinants of recovery.
Q8: A counselor is using the SBIRT model during a routine primary care visit.
What does the "B" in SBIRT represent?
A. Brief Assessment
B. Brief Intervention
C. Brief Referral
D. Brief Screening
Correct Answer: B
Rationale: Correct because SBIRT stands for Screening, Brief Intervention, and
Referral to Treatment. Per SAMHSA guidelines, the brief intervention component
involves providing feedback, advice, and motivation for behavior change using
motivational interviewing techniques.
Q9: A client in early recovery reports feeling overwhelmed by cravings and asks
for help developing a plan. The counselor should prioritize which intervention?
A. Immediate referral to a higher level of care
B. Collaborative development of a relapse prevention plan with coping strategies
C. Prescribing anti-craving medication
D. Recommending immediate family confrontation
Correct Answer: B
Rationale: Correct because relapse prevention planning is a core component of
addiction treatment that empowers clients with coping skills, identifies triggers,
and establishes a structured plan for managing high-risk situations. Standard
addiction counseling practice emphasizes client-centered, collaborative planning.
Q10: A client has been abstinent from alcohol for 4 months and no longer meets
any DSM-5-TR criteria for alcohol use disorder. What is the appropriate diagnostic
specifier?
A. Early Remission
Counseling Study Guide and Practice Questions.
SECTION 1: ADDICTION COUNSELING & TREATMENT PLANNING (Questions 1–18)
Q1: A client presents for an initial intake and reports drinking 6–8 beers daily for
the past 3 years. Which screening tool is most appropriate to assess alcohol use
severity?
A. DAST-10
B. CAGE-AID
C. AUDIT
D. SASSI
Correct Answer: C
Rationale: Correct because the AUDIT (Alcohol Use Disorders Identification Test)
is a 10-item validated instrument specifically designed to identify hazardous and
harmful alcohol use, with a score of 8 or higher indicating problematic drinking.
Per standard addiction counseling practice, the AUDIT is the gold-standard
screening tool for alcohol use severity.
Q2: During a comprehensive biopsychosocial assessment, a counselor must
evaluate which of the following domains to determine ASAM Dimension 3
(Emotional, Behavioral, or Cognitive Conditions and Complications)?
A. Blood alcohol level and liver function tests
B. Current psychiatric symptoms, trauma history, and cognitive functioning
C. Family income and employment status
D. Availability of sober housing in the community
Correct Answer: B
Rationale: Correct because ASAM Dimension 3 specifically addresses emotional,
behavioral, and cognitive conditions, requiring assessment of psychiatric
symptoms, trauma history, and cognitive status. Standard addiction counseling
practice requires thorough evaluation of mental health comorbidities for accurate
level-of-care placement.
,Q3: A 28-year-old client meets 5 of the 11 DSM-5-TR criteria for alcohol use
disorder. What is the correct severity classification?
A. Mild
B. Moderate
C. Severe
D. In Remission
Correct Answer: B
Rationale: Correct because DSM-5-TR specifies that meeting 4–5 criteria indicates
moderate substance use disorder severity. Per DSM-5-TR criteria, mild is 2–3
criteria, moderate is 4–5 criteria, and severe is 6 or more criteria.
Q4: According to the Transtheoretical Model, a client who states, "I know I have a
problem, and I am thinking about making a change within the next 6 months" is in
which stage of change?
A. Precontemplation
B. Contemplation
C. Preparation
D. Action
Correct Answer: B
Rationale: Correct because the contemplation stage is characterized by
awareness of the problem and consideration of change without a firm
commitment or specific plan. Per the Transtheoretical Model, this stage involves
ambivalence and weighing the pros and cons of change.
Q5: A counselor is developing a treatment plan for a client with opioid use
disorder. Which element is required for a properly structured treatment plan
objective?
A. A broad statement of the client's overall recovery vision
B. A specific, measurable, achievable, realistic, and time-framed behavioral target
,C. A list of all possible interventions the counselor might use
D. A narrative summary of the client's life history
Correct Answer: B
Rationale: Correct because treatment plan objectives must be SMART—specific,
measurable, achievable, realistic, and time-framed—to facilitate progress
monitoring and outcome evaluation. Standard addiction counseling practice
requires concrete behavioral targets for effective treatment planning.
Q6: Using ASAM Patient Placement Criteria, a client with severe alcohol
withdrawal risk, unstable medical conditions, and a history of delirium tremens
should be placed at which level of care?
A. Level 0.5: Early Intervention
B. Level I: Outpatient Services
C. Level III.7: Medically Monitored Intensive Inpatient
D. Level IV: Medically Managed Intensive Inpatient
Correct Answer: D
Rationale: Correct because ASAM Level IV provides medically managed intensive
inpatient care for clients with severe biomedical conditions and acute intoxication
or withdrawal requiring 24-hour medical management. Per ASAM criteria, delirium
tremens and unstable medical conditions necessitate the highest level of care.
Q7: A client with stimulant use disorder is being referred to a community
resource for employment assistance. This activity represents which core function
of addiction counseling?
A. Screening
B. Assessment
C. Case Management
D. Crisis Intervention
Correct Answer: C
Rationale: Correct because case management involves coordinating care, making
referrals, and linking clients to appropriate community resources including
, vocational services. Standard addiction counseling practice requires active
coordination of services to address social determinants of recovery.
Q8: A counselor is using the SBIRT model during a routine primary care visit.
What does the "B" in SBIRT represent?
A. Brief Assessment
B. Brief Intervention
C. Brief Referral
D. Brief Screening
Correct Answer: B
Rationale: Correct because SBIRT stands for Screening, Brief Intervention, and
Referral to Treatment. Per SAMHSA guidelines, the brief intervention component
involves providing feedback, advice, and motivation for behavior change using
motivational interviewing techniques.
Q9: A client in early recovery reports feeling overwhelmed by cravings and asks
for help developing a plan. The counselor should prioritize which intervention?
A. Immediate referral to a higher level of care
B. Collaborative development of a relapse prevention plan with coping strategies
C. Prescribing anti-craving medication
D. Recommending immediate family confrontation
Correct Answer: B
Rationale: Correct because relapse prevention planning is a core component of
addiction treatment that empowers clients with coping skills, identifies triggers,
and establishes a structured plan for managing high-risk situations. Standard
addiction counseling practice emphasizes client-centered, collaborative planning.
Q10: A client has been abstinent from alcohol for 4 months and no longer meets
any DSM-5-TR criteria for alcohol use disorder. What is the appropriate diagnostic
specifier?
A. Early Remission
