NCAC I & II EXAM STUDY NOTES
❖ PART 1
❖ Counseling practice
➢ Types of Treatment Modalities for SUD
■ Detoxification
● Medically assisted withdrawal
● 2-14 days
■ Inpatient
● Full time, around the clock care
● Required to attend 12-step or similar support group
■ Intensive Outpatient Program (IOP)
● Up to 12 weeks
● Structured activities 9-20 hours per day
● Comprehensive services with minimal disruption to normal schedule
■ Outpatient
● Least intensive
● Weekly or biweekly group or individual
● SUD and comorbid psych or mental disorders
➢ Screening to determine if client meets criteria
■ Two phases
■ Determine if they meet criteria for SUD
■ Review confidentiality, fees, scope of practice, scheduling, etc
➢ Tools for Substance Abuse
■ Michigan Alcohol Screening Test
● 1971
● 25 yes/no questions
● Now 22 questions
◆ Scoring:
➢ 0-2=no issue
➢ 3-5=early to middle problem drinkers
➢ 6 or more=problem drinkers
● Accurate to a .05 level of confidence
■ Drug Abuse Screening Test
● Nonalcoholic version of the Michigan test
● If addiction is present with either test, then use the Addiction Severity Index (ASI)
[180 questions] to determine areas that the addiction has been most invasive
◆ Medical
◆ Legal
◆ Familial
◆ Social
◆ Employment
◆ Psychological
◆ Psychiatric
■ Substance Abuse Subtle Screening Inventory (SASSI-4)
● 1988
● Help identify covert users
● 15 minutes to complete
● Paper or computer
● High accuracy
➢ Dimensions of ASAM Multidimensional Assessment
■ Client meets criteria→schedule appointment
■ If not→utilize ASAM to find appropriate referrals
■ ASAM 6 dimensions
● Acute Intoxication and withdrawal
● Biomedical conditions and complications
, ● Cognitive, behavioral, and emotional conditions
● Readiness to change
● Relapse, continued use, or continued problem potential
● Recovery environment
➢ Addiction Severity Index (ASI)
■ 1980
■ Standardized assessment to collect information of several aspects of the client’s
substance use
■ Help to develop treatment plan
■ 7 functional assessment domains
● Medical status
● Employment and support
● Drug use
● Alcohol use
● Legal Status
● Family/social status
● Psychiatric status
■ A problem severity index is assigned based on substance use in the last 30 days
➢ Formal Intake Process
■ Two phases
● Administrative
◆ Consents, explanation of services, ROIs
● Comprehensive biopsychosocial assessment
◆ All aspects of SUD impacts
➢ Initial Clinical Assessments
■ Gather information to formulate a diagnosis
■ Gather complete picture of
● Substance use
● Coping skills
● Treatment needs
● Recovery tools
■ Objectives
● Framework for treatment interventions
● Determine appropriate level of care
● Identifying strengths, supports, and contextual factors
● Form therapeutic alliance
● Assessing motivation for change
➢ Biopsychosocial Assessments
■ Collaborative, strengths-based, holistic approach to the diagnosis of SUD
■ Factors
● Age
● Medical history
● Co-occurring disorders
● Genetics
● Culture
● Socioeconomic status
● Environmental conditions
❖ Ongoing Treatment Planning
➢ Biopsychosocial
■ Biological
■ Psychological
■ Social
■ Spiritual
➢ Biological (dimension 1 and 2)
■ Genetics
■ Environmental (epigenetics)
, ● Accounts for nearly half of a person’s risk of addiction
■ Physical symptoms
■ Family history
■ Factors
● Prescribed medications
● Sleep disturbances
● Intellectual functioning
● How the substance is chemically processed
● Prenatal care
● Age or developmental level
● Diet and exercise
● Gender
■ Neurological difficulties with long-term use
● Wernicke-Korsakoff syndrome “wet brain”
➢ Psychological (dimension 3 and 4)
■ Speech, behavior, appearance, perception, mood, insight, and cognitive factors
■ Factors
● Subjective level of distress
● Decision making
● Psychological trauma
● Perception of condition
● Emotional dysregulation
● Suicidal or homicidal ideation
● Coping skills
● Depression and anxiety
● Executive functioning
● Low self-esteem
● Positive and negative outcomes of SUD
➢ Social (dimension 3, 5, and 6)
■ Factors
● Interpersonal relationships
● Sexual and intimate relationships
● Coworkers
● Peers
● Disconnection
● Socioeconomic status
● Community attitudes
● Living situation
● Legal
● Military status
➢ Cultural
■ Factors
● Race
● Ethnicity
● Sexual orientation
● Gender identity
● Language spoken
● Homelessness
● Cultural norms
● Acculturative stress
● Access to healthcare
● Marginalized status
➢ Religious or Spiritual
■ Support in faith-based community is helpful for people dealing with SUD
➢ Individualized Treatment Plans
■ Give sessions focus, direction, and purpose
❖ PART 1
❖ Counseling practice
➢ Types of Treatment Modalities for SUD
■ Detoxification
● Medically assisted withdrawal
● 2-14 days
■ Inpatient
● Full time, around the clock care
● Required to attend 12-step or similar support group
■ Intensive Outpatient Program (IOP)
● Up to 12 weeks
● Structured activities 9-20 hours per day
● Comprehensive services with minimal disruption to normal schedule
■ Outpatient
● Least intensive
● Weekly or biweekly group or individual
● SUD and comorbid psych or mental disorders
➢ Screening to determine if client meets criteria
■ Two phases
■ Determine if they meet criteria for SUD
■ Review confidentiality, fees, scope of practice, scheduling, etc
➢ Tools for Substance Abuse
■ Michigan Alcohol Screening Test
● 1971
● 25 yes/no questions
● Now 22 questions
◆ Scoring:
➢ 0-2=no issue
➢ 3-5=early to middle problem drinkers
➢ 6 or more=problem drinkers
● Accurate to a .05 level of confidence
■ Drug Abuse Screening Test
● Nonalcoholic version of the Michigan test
● If addiction is present with either test, then use the Addiction Severity Index (ASI)
[180 questions] to determine areas that the addiction has been most invasive
◆ Medical
◆ Legal
◆ Familial
◆ Social
◆ Employment
◆ Psychological
◆ Psychiatric
■ Substance Abuse Subtle Screening Inventory (SASSI-4)
● 1988
● Help identify covert users
● 15 minutes to complete
● Paper or computer
● High accuracy
➢ Dimensions of ASAM Multidimensional Assessment
■ Client meets criteria→schedule appointment
■ If not→utilize ASAM to find appropriate referrals
■ ASAM 6 dimensions
● Acute Intoxication and withdrawal
● Biomedical conditions and complications
, ● Cognitive, behavioral, and emotional conditions
● Readiness to change
● Relapse, continued use, or continued problem potential
● Recovery environment
➢ Addiction Severity Index (ASI)
■ 1980
■ Standardized assessment to collect information of several aspects of the client’s
substance use
■ Help to develop treatment plan
■ 7 functional assessment domains
● Medical status
● Employment and support
● Drug use
● Alcohol use
● Legal Status
● Family/social status
● Psychiatric status
■ A problem severity index is assigned based on substance use in the last 30 days
➢ Formal Intake Process
■ Two phases
● Administrative
◆ Consents, explanation of services, ROIs
● Comprehensive biopsychosocial assessment
◆ All aspects of SUD impacts
➢ Initial Clinical Assessments
■ Gather information to formulate a diagnosis
■ Gather complete picture of
● Substance use
● Coping skills
● Treatment needs
● Recovery tools
■ Objectives
● Framework for treatment interventions
● Determine appropriate level of care
● Identifying strengths, supports, and contextual factors
● Form therapeutic alliance
● Assessing motivation for change
➢ Biopsychosocial Assessments
■ Collaborative, strengths-based, holistic approach to the diagnosis of SUD
■ Factors
● Age
● Medical history
● Co-occurring disorders
● Genetics
● Culture
● Socioeconomic status
● Environmental conditions
❖ Ongoing Treatment Planning
➢ Biopsychosocial
■ Biological
■ Psychological
■ Social
■ Spiritual
➢ Biological (dimension 1 and 2)
■ Genetics
■ Environmental (epigenetics)
, ● Accounts for nearly half of a person’s risk of addiction
■ Physical symptoms
■ Family history
■ Factors
● Prescribed medications
● Sleep disturbances
● Intellectual functioning
● How the substance is chemically processed
● Prenatal care
● Age or developmental level
● Diet and exercise
● Gender
■ Neurological difficulties with long-term use
● Wernicke-Korsakoff syndrome “wet brain”
➢ Psychological (dimension 3 and 4)
■ Speech, behavior, appearance, perception, mood, insight, and cognitive factors
■ Factors
● Subjective level of distress
● Decision making
● Psychological trauma
● Perception of condition
● Emotional dysregulation
● Suicidal or homicidal ideation
● Coping skills
● Depression and anxiety
● Executive functioning
● Low self-esteem
● Positive and negative outcomes of SUD
➢ Social (dimension 3, 5, and 6)
■ Factors
● Interpersonal relationships
● Sexual and intimate relationships
● Coworkers
● Peers
● Disconnection
● Socioeconomic status
● Community attitudes
● Living situation
● Legal
● Military status
➢ Cultural
■ Factors
● Race
● Ethnicity
● Sexual orientation
● Gender identity
● Language spoken
● Homelessness
● Cultural norms
● Acculturative stress
● Access to healthcare
● Marginalized status
➢ Religious or Spiritual
■ Support in faith-based community is helpful for people dealing with SUD
➢ Individualized Treatment Plans
■ Give sessions focus, direction, and purpose
