TEXAS LICENSED CHEMICAL DEPENDENCY
COUNSELOR LICENSING EXAM ACTUAL
2026 VERIFIED QUESTIONS WITH ANSWERS
COMPREHENSIVE & RATIONALE|INSTANT
DOWNLOAD
1. A 32-year-old client with severe alcohol use disorder states, "I only
drink because my job is stressful. If I had a different job, I wouldn't
need alcohol." According to motivational interviewing principles,
which response by the counselor is most appropriate?
A. "Your job is not the real issue; alcohol is your problem."
B. "Tell me more about how stress and drinking are connected for you."
C. "You should resign from your job immediately."
D. "Stress does not cause addiction."
Answer: B
Rationale: Motivational Interviewing (MI) emphasizes empathy,
reflective listening, and exploration rather than confrontation. The
counselor encourages the client to explore the relationship between
stress and substance use while maintaining autonomy. The other
responses are judgmental, directive, or dismissive.
2. Which neurotransmitter is most directly associated with the brain's
reward pathway and reinforces addictive behaviors?
A. Serotonin
B. Dopamine
C. Acetylcholine
D. Histamine
Answer: B
1
,Rationale: Dopamine plays the central role in the mesolimbic reward
pathway, especially between the ventral tegmental area (VTA) and
nucleus accumbens. Drugs of abuse increase dopamine release,
reinforcing repeated use.
3. A client in the precontemplation stage says, "I don't think
marijuana has caused any problems in my life." Which
intervention is MOST appropriate?
A. Develop a relapse prevention plan.
B. Increase awareness of discrepancies between behavior and goals.
C. Require abstinence immediately.
D. Focus exclusively on coping skills.
Answer: B
Rationale: Individuals in precontemplation do not recognize their
substance use as problematic. The counselor's goal is to raise awareness
using motivational techniques rather than pushing immediate behavior
change.
4. Which DSM-5 criterion is NOT included in diagnosing a substance
use disorder?
A. Craving
B. Tolerance
C. Withdrawal
D. Criminal behavior
Answer: D
Rationale: DSM-5 no longer includes legal problems as a diagnostic
criterion. Craving, tolerance, withdrawal, impaired control, risky use,
and social impairment are among the 11 diagnostic criteria.
2
, 5. During an intake assessment, which information should receive the
HIGHEST priority?
A. Educational history
B. Immediate risk of overdose or suicide
C. Recreational interests
D. Favorite hobbies
Answer: B
Rationale: Safety always takes precedence. Assessing suicidal ideation,
homicidal ideation, overdose risk, severe withdrawal, and medical
emergencies is essential before completing less urgent portions of the
assessment.
6. Which withdrawal syndrome represents the greatest immediate
medical emergency?
A. Cannabis withdrawal
B. Nicotine withdrawal
C. Alcohol withdrawal with delirium tremens
D. Caffeine withdrawal
Answer: C
Rationale: Delirium tremens can include seizures, hallucinations, severe
autonomic instability, and death if untreated. Alcohol withdrawal
requires careful medical monitoring.
7. Which screening tool is specifically designed to identify
problematic alcohol use?
3
, A. PHQ-9
B. GAD-7
C. AUDIT
D. MMSE
Answer: C
Rationale: The Alcohol Use Disorders Identification Test (AUDIT) is a
validated screening instrument developed by the World Health
Organization to identify hazardous and harmful alcohol use.
8. Which counseling skill BEST demonstrates reflective listening?
A. Interrupting to provide advice
B. Repeating the client's statement while adding meaning
C. Asking multiple questions rapidly
D. Giving lectures
Answer: B
Rationale: Reflective listening involves accurately restating and
expanding on client statements to demonstrate understanding and
encourage deeper exploration.
9. Which opioid overdose symptom requires immediate emergency
intervention?
A. Increased appetite
B. Pinpoint pupils with respiratory depression
C. Elevated blood pressure
D. Hyperactivity
Answer: B
4
COUNSELOR LICENSING EXAM ACTUAL
2026 VERIFIED QUESTIONS WITH ANSWERS
COMPREHENSIVE & RATIONALE|INSTANT
DOWNLOAD
1. A 32-year-old client with severe alcohol use disorder states, "I only
drink because my job is stressful. If I had a different job, I wouldn't
need alcohol." According to motivational interviewing principles,
which response by the counselor is most appropriate?
A. "Your job is not the real issue; alcohol is your problem."
B. "Tell me more about how stress and drinking are connected for you."
C. "You should resign from your job immediately."
D. "Stress does not cause addiction."
Answer: B
Rationale: Motivational Interviewing (MI) emphasizes empathy,
reflective listening, and exploration rather than confrontation. The
counselor encourages the client to explore the relationship between
stress and substance use while maintaining autonomy. The other
responses are judgmental, directive, or dismissive.
2. Which neurotransmitter is most directly associated with the brain's
reward pathway and reinforces addictive behaviors?
A. Serotonin
B. Dopamine
C. Acetylcholine
D. Histamine
Answer: B
1
,Rationale: Dopamine plays the central role in the mesolimbic reward
pathway, especially between the ventral tegmental area (VTA) and
nucleus accumbens. Drugs of abuse increase dopamine release,
reinforcing repeated use.
3. A client in the precontemplation stage says, "I don't think
marijuana has caused any problems in my life." Which
intervention is MOST appropriate?
A. Develop a relapse prevention plan.
B. Increase awareness of discrepancies between behavior and goals.
C. Require abstinence immediately.
D. Focus exclusively on coping skills.
Answer: B
Rationale: Individuals in precontemplation do not recognize their
substance use as problematic. The counselor's goal is to raise awareness
using motivational techniques rather than pushing immediate behavior
change.
4. Which DSM-5 criterion is NOT included in diagnosing a substance
use disorder?
A. Craving
B. Tolerance
C. Withdrawal
D. Criminal behavior
Answer: D
Rationale: DSM-5 no longer includes legal problems as a diagnostic
criterion. Craving, tolerance, withdrawal, impaired control, risky use,
and social impairment are among the 11 diagnostic criteria.
2
, 5. During an intake assessment, which information should receive the
HIGHEST priority?
A. Educational history
B. Immediate risk of overdose or suicide
C. Recreational interests
D. Favorite hobbies
Answer: B
Rationale: Safety always takes precedence. Assessing suicidal ideation,
homicidal ideation, overdose risk, severe withdrawal, and medical
emergencies is essential before completing less urgent portions of the
assessment.
6. Which withdrawal syndrome represents the greatest immediate
medical emergency?
A. Cannabis withdrawal
B. Nicotine withdrawal
C. Alcohol withdrawal with delirium tremens
D. Caffeine withdrawal
Answer: C
Rationale: Delirium tremens can include seizures, hallucinations, severe
autonomic instability, and death if untreated. Alcohol withdrawal
requires careful medical monitoring.
7. Which screening tool is specifically designed to identify
problematic alcohol use?
3
, A. PHQ-9
B. GAD-7
C. AUDIT
D. MMSE
Answer: C
Rationale: The Alcohol Use Disorders Identification Test (AUDIT) is a
validated screening instrument developed by the World Health
Organization to identify hazardous and harmful alcohol use.
8. Which counseling skill BEST demonstrates reflective listening?
A. Interrupting to provide advice
B. Repeating the client's statement while adding meaning
C. Asking multiple questions rapidly
D. Giving lectures
Answer: B
Rationale: Reflective listening involves accurately restating and
expanding on client statements to demonstrate understanding and
encourage deeper exploration.
9. Which opioid overdose symptom requires immediate emergency
intervention?
A. Increased appetite
B. Pinpoint pupils with respiratory depression
C. Elevated blood pressure
D. Hyperactivity
Answer: B
4
