CADC Certified Alcohol and Drug Counselor Certification Exam
| Complete Practice Questions, Verified Answers & Detailed
Rationales (2026/2027)
QUESTION 1
According to the Transtheoretical Model of Change, a client who is
aware that a problem exists but has not yet made a commitment to
take action is in which stage?
A. Precontemplation
B. Contemplation
C. Preparation
D. Action
Correct Answer: B. Contemplation
Detailed Rationale: In the Contemplation stage, individuals recognize
their behavior is problematic and are weighing the pros and cons of
changing, but they have not yet made a firm commitment to act.
Precontemplation is when the client does not yet recognize a problem.
QUESTION 2
When a counselor experiences feelings toward a client that are actually
rooted in the counselor’s own past experiences or unresolved issues,
this is known as:
A. Transference
B. Projection
,C. Countertransference
D. Rationalization
Correct Answer: C. Countertransference
Detailed Rationale: Countertransference occurs when the therapist
displaces feelings, attitudes, or desires onto the client. Transference is
the reverse—when the client projects feelings onto the counselor.
QUESTION 3
Which federal regulation specifically governs the confidentiality of
substance use disorder patient records in federally assisted programs?
A. HIPAA Privacy Rule
B. 42 CFR Part 2
C. The Affordable Care Act
D. Title IX
Correct Answer: B. 42 CFR Part 2
Detailed Rationale: 42 CFR Part 2 provides stricter confidentiality
protections for substance use disorder patient records than general
medical records under HIPAA, requiring specific written consent for
most disclosures.
QUESTION 4
The ASAM (American Society of Addiction Medicine) Criteria utilizes a
multidimensional assessment approach. Which dimension assesses
"Biomedical Conditions and Complications"?
A. Dimension 1
,B. Dimension 2
C. Dimension 3
D. Dimension 4
Correct Answer: B. Dimension 2
Detailed Rationale: ASAM Dimension 1 is Acute
Intoxication/Withdrawal Potential; Dimension 2 is Biomedical
Conditions and Complications; Dimension 3 is Emotional, Behavioral, or
Cognitive Conditions; Dimension 4 is Readiness to Change.
QUESTION 5
In Motivational Interviewing, what does the acronym OARS stand for in
terms of core communication skills?
A. Observation, Assessment, Reflection, Summarizing
B. Open-ended questions, Affirmations, Reflections, Summaries
C. Objective, Analysis, Rapport, Strategy
D. Open communication, Active listening, Reframing, Support
Correct Answer: B. Open-ended questions, Affirmations, Reflections,
Summaries
Detailed Rationale: OARS is the foundational micro-skill set used in
Motivational Interviewing to build rapport, elicit change talk, and
reinforce the client's autonomy.
QUESTION 6
When treating a client with co-occurring disorders, what is the primary
goal of "integrated treatment"?
, A. To treat the mental health disorder first, then the addiction.
B. To treat the addiction first, then the mental health disorder.
C. To address both the substance use and mental health disorders
simultaneously in a coordinated manner.
D. To refer the client to two separate providers who do not
communicate.
Correct Answer: C. To address both the substance use and mental
health disorders simultaneously in a coordinated manner.
Detailed Rationale: Integrated treatment recognizes that substance use
and mental health disorders are often intertwined. Treating them
simultaneously with a coordinated team improves outcomes and
reduces the risk of relapse.
QUESTION 7
Which of the following is considered a primary cognitive distortion
often targeted in Cognitive Behavioral Therapy (CBT)?
A. Active listening
B. Catastrophizing
C. Empathy
D. Urge surfing
Correct Answer: B. Catastrophizing
Detailed Rationale: Catastrophizing is a cognitive distortion where the
client assumes the worst-case scenario will happen. CBT aims to identify
and restructure such negative thought patterns.
| Complete Practice Questions, Verified Answers & Detailed
Rationales (2026/2027)
QUESTION 1
According to the Transtheoretical Model of Change, a client who is
aware that a problem exists but has not yet made a commitment to
take action is in which stage?
A. Precontemplation
B. Contemplation
C. Preparation
D. Action
Correct Answer: B. Contemplation
Detailed Rationale: In the Contemplation stage, individuals recognize
their behavior is problematic and are weighing the pros and cons of
changing, but they have not yet made a firm commitment to act.
Precontemplation is when the client does not yet recognize a problem.
QUESTION 2
When a counselor experiences feelings toward a client that are actually
rooted in the counselor’s own past experiences or unresolved issues,
this is known as:
A. Transference
B. Projection
,C. Countertransference
D. Rationalization
Correct Answer: C. Countertransference
Detailed Rationale: Countertransference occurs when the therapist
displaces feelings, attitudes, or desires onto the client. Transference is
the reverse—when the client projects feelings onto the counselor.
QUESTION 3
Which federal regulation specifically governs the confidentiality of
substance use disorder patient records in federally assisted programs?
A. HIPAA Privacy Rule
B. 42 CFR Part 2
C. The Affordable Care Act
D. Title IX
Correct Answer: B. 42 CFR Part 2
Detailed Rationale: 42 CFR Part 2 provides stricter confidentiality
protections for substance use disorder patient records than general
medical records under HIPAA, requiring specific written consent for
most disclosures.
QUESTION 4
The ASAM (American Society of Addiction Medicine) Criteria utilizes a
multidimensional assessment approach. Which dimension assesses
"Biomedical Conditions and Complications"?
A. Dimension 1
,B. Dimension 2
C. Dimension 3
D. Dimension 4
Correct Answer: B. Dimension 2
Detailed Rationale: ASAM Dimension 1 is Acute
Intoxication/Withdrawal Potential; Dimension 2 is Biomedical
Conditions and Complications; Dimension 3 is Emotional, Behavioral, or
Cognitive Conditions; Dimension 4 is Readiness to Change.
QUESTION 5
In Motivational Interviewing, what does the acronym OARS stand for in
terms of core communication skills?
A. Observation, Assessment, Reflection, Summarizing
B. Open-ended questions, Affirmations, Reflections, Summaries
C. Objective, Analysis, Rapport, Strategy
D. Open communication, Active listening, Reframing, Support
Correct Answer: B. Open-ended questions, Affirmations, Reflections,
Summaries
Detailed Rationale: OARS is the foundational micro-skill set used in
Motivational Interviewing to build rapport, elicit change talk, and
reinforce the client's autonomy.
QUESTION 6
When treating a client with co-occurring disorders, what is the primary
goal of "integrated treatment"?
, A. To treat the mental health disorder first, then the addiction.
B. To treat the addiction first, then the mental health disorder.
C. To address both the substance use and mental health disorders
simultaneously in a coordinated manner.
D. To refer the client to two separate providers who do not
communicate.
Correct Answer: C. To address both the substance use and mental
health disorders simultaneously in a coordinated manner.
Detailed Rationale: Integrated treatment recognizes that substance use
and mental health disorders are often intertwined. Treating them
simultaneously with a coordinated team improves outcomes and
reduces the risk of relapse.
QUESTION 7
Which of the following is considered a primary cognitive distortion
often targeted in Cognitive Behavioral Therapy (CBT)?
A. Active listening
B. Catastrophizing
C. Empathy
D. Urge surfing
Correct Answer: B. Catastrophizing
Detailed Rationale: Catastrophizing is a cognitive distortion where the
client assumes the worst-case scenario will happen. CBT aims to identify
and restructure such negative thought patterns.
