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IR&RC Addiction Counselor Exam > Domain I - Screening, Assessment, and Engagement > Flashcards

Domain I - Screening, Assessment, and Engagement Flashcards

1
Q

What is critical to early intervention or prevention of addiction?

A

Effective assessment of drug or alcohol use

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2
Q

What 3 skills are essential during clinical evaluation?

A

1) Establishing rapport; 2) creating a welcome atmosphere; and 3) assists in motivating and engaging the client

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3
Q

How does the initial screener/counselor need to be perceived?

A

Respectful, non-judgmental and attentive

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4
Q

What does engagement mean?

A

Making a connection between client and counselor

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5
Q

What is the first goal of the initial interview?

A

Establishing trust, rapport, and effective communication with the client

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6
Q

What is the second goal of the initial interview?

A

Facilitating the client’s understanding of the screening and assessment process.

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7
Q

What is the third goal of the initial interview?

A

Exploring the client’s problems and expectations

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8
Q

What is the fourth goal of the initial interview?

A

Determining whether further assessment is necessary

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9
Q

What is the first step in creating an effective relationship with client and counselor?

A

Make them feel comfortable

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10
Q

What are the 3 key elements in the drug recognition process?

A

1) Identify that individual’s physical responses deviate from the norm; 2) Ruling out a non-drug reason for deviations; and 3) Use diagnostic procedures to determine categories of drugs to cause impairments

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11
Q

How does stigma affect the interview climate?

A

May be reluctant to participate in screening interview

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12
Q

How can stigma be overcome in the interview climate?

A

Acknowledge the negative feelings about the stigma

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13
Q

How do expectations affect the interview climate?

A

Expectations may influence the client’s behavior and motivation.

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14
Q

How can the effect of expectations be managed in the initial interview climate?

A

Help set positive expectations

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15
Q

How does likability affect the initial interview?

A

Some clients have better relationship/social skills than others. This makes them more likely to be open than others.

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16
Q

How does the initial impression affect the initial interview?

A

Clients are more likely to disclose with someone they had a positive first impression with.

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17
Q

How does a counselor’s professional manner affect the initial interview?

A

Client’s want to be taken seriously; the counselor’s professionalism conveys this.

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18
Q

How does the environment affect the initial interview?

A

Sets the stage for the mood during the interview

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19
Q

What is rapport?

A

A sense of having connection with the other person.

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20
Q

How is rapport established?

A

Active listening; credibility/dependability; and respect and responsiveness.

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21
Q

How does the counselor’s emotions affect rapport?

A

Management of feelings towards the client is necessary for good rapport.

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22
Q

How effect does the counselor’s supportive words have on a client?

A

Build’s self-esteem and encourages the client.

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23
Q

What can the counselor do to show support?

A

Reinforce, sustain, and encourage appropriate expression of emotions.

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24
Q

How should a counselor use reassurance?

A

Use it only when appropriate. (IE don’t tell someone everything is going to be if it is not)

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25
Q

What is empathy?

A

Understanding the shared feelings and hope that something can be done about a situation.

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26
Q

What is sympathy?

A

Does not share feelings and conveys hopelessness.

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27
Q

What is acceptance in regards to the helping relationship?

A

A counselor conveys acceptance of a client despite any negative things they may have done.

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28
Q

What are the three basic components of information gathering?

A

Listening, questioning, and observing

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29
Q

What is active listening?

A

An intentional feedback loop between the counselor and the client

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30
Q

What are the specific components of active listening?

A

Reflecting, clarifying, focusing, and summarizing?

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31
Q

What does reflecting entail in active listening?

A

verbally restating the content of what the client has said.

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32
Q

What does clarifying entail in active listening?

A

Rephrasing what the client has said to improve understanding

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33
Q

What does focusing entail in active listening?

A

Helping to direct the client’s attention to a single topic

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34
Q

What does summarizing entail in active listening?

A

putting together key ideas and feelings into a brief statement

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35
Q

What is the function of questioning?

A

Using questions for clarification in order to understand the client, to motivate the client to pursue a specific topic and to help clarify his thoughts.

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36
Q

What is the benefit of open ended questions?

A

Client can’t answer with a yes or no and encourages client to express feelings and convey information.

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37
Q

What type of question should be avoided?

A

Why?

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38
Q

What is the benefit of observation?

A

Observe non-verbal information

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39
Q

What sort of things are reflected in non-verbal information?

A

state of mind, body image, self concept, or culture

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40
Q

What is motivational interviewing?

A

A style of interaction to facilitate change

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41
Q

When was motivational interviewing first used in substance abuse treatment?

A

1980s

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42
Q

What type of approach is Motivational Interviewing?

A

Person centered

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43
Q

How does motivational interviewing work?

A

Exploring and resolving ambivalence

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44
Q

What is a screening?

A

The process by which the counselor, client, and collateral review the current situation, symptoms, and other information.

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45
Q

What is the first step in addressing substance use?

A

Screening

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46
Q

What is the screening’s role in determining treatment?

A

Screening determines whether further intervention is needed and what level of care.

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47
Q

What is the goal of screening?

A

Identify individuals with substance use or related service needs.

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48
Q

What is the role of screening in the general public?

A

Determine the presence or absence of a substance use disorder.

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49
Q

What is the role of screening in client’s already at risk?

A

Determine severity of the problem and need for comprehensive assessment.

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50
Q

What sort of information gathering tools are used during screening?

A

Screening instruments, lab tests, clinical interviews, and personal contact.

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51
Q

What factors affect a screening?

A

Circumstances regarding contact, demeanor and behavior, signs of intoxication, physical signs of drug use or self-harm, and information offered spontaneously.

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52
Q

What are the guidelines for a successful screening?

A

Conducted on persons at risk in a variety of symptoms; collaboration among agencies; sensitive to individual differences; brief; and gather information from multiple sources.

53
Q

What are examples of standardized screening instruments?

A

CAGE, GAIN-SI, and Michigan Alcohol Screening Test (MAST)

54
Q

What settings are standardized screening instruments often used?

A

doctor’s office, ERs, and community health settings.

55
Q

What things do standardized screening instruments evaluate?

A

Frequency and intensity of drug/ETOH use.

56
Q

What question are screenings designed to answer?

A

Is it likely there is a substance use problem present and is additional screening needed?

57
Q

How can observations assist the screening/assessment process?

A

Observe family members, clinicians, teachers, law enforcement, and others in their interactions with the client.

58
Q

What is common during screenings which negatively impacts outcomes?

A

Denial and minimization

59
Q

When are clients less likely to use denial?

A

When the atmosphere is non-threatening.

60
Q

How can fear of prosecution or other sanctions be overcome?

A

Assurances of confidentiality

61
Q

What is the purpose of assessment?

A

Defining the nature of the problem, determining a diagnosis, and developing treatment recommendations.

62
Q

Who typically performs screenings?

A

Entry level counselors, child welfare, and public health.

63
Q

Who is typically responsible for assessments?

A

Experienced and credentialed staff.

64
Q

What information does assessment look at?

A

Historical and situational factors contributing to onset of use; patterns of use; signs and symptoms of SUD; and consequences of use.

65
Q

In addition to substance use disorders, what else does the assessment look for?

A

Co-occurring disorders; interpersonal, physical, or spiritual problems; financial and legal difficulties; and other issues affecting addiction.

66
Q

How are co-occurring disorders best treated?

A

With integrated treatment.

67
Q

How can the counselor fully motivate and engage the client in assessment and treatment process?

A

By using a client centered approach.

68
Q

What does the initial assessment lead to?

A

Recommendations for treatment and treatment planning.

69
Q

How often should assessment be completed?

A

On an ongoing basis.

70
Q

What should the counselor watch for and document during treatment?

A

Changes in client status and response to treatment.

71
Q

What tools are used during assessment?

A

Standardized interventions, structured interviews, and self-administered tests.

72
Q

What two factors should guide the tests that are selected for assessment?

A

Reliability and validity

73
Q

What is validity?

A

The test acutely measures what it intends to measure.

74
Q

What is reliability?

A

The test produces stable results.

75
Q

What is the benefit of using multiple sources of information during assessment?

A

Obtain relevant and related information to establish eligibility and appropriateness and to facilitate the assessment process.

76
Q

What other sources are useful in triangulating data during assessment?

A

Collateral, written reports and records from schools, employers, criminal justice, and previous treatments.

77
Q

What is necessary to contact collateral for additional information?

A

Written Release of information/consent

78
Q

Why is it necessary to use multiple sources of information during assessment?

A

Avoid minimization and exaggeration.

79
Q

What should assessors consider when obtaining information from collateral?

A

Validity of information vs client report.

80
Q

What is the benefit of using previous treatment records?

A

It is generally the most objective source.

81
Q

What is the difficulty of using previous treatment records and other service records?

A

May be out-of-date or no longer acurate

82
Q

How is the assessment interview different from a screening interview?

A

Assessment is generally more in depth and more systematic than the screening

83
Q

What is the benefit of an interview during assessment?

A

Assessment adds to available information obtained by other sources; helps confirm archival records; helps develop a positive and trusting relationship between client and counselor

84
Q

Who, besides the client, might a counselor with to interview during assessment?

A

Family members, teachers,employers and other significant individuals

85
Q

What is the assessment frequently referred to at many agencies?

A

Biopsychosocial assessment

86
Q

What is a structured interview?

A

An assessment with a prescribed outline, but allows the interviewer to ask probing questions when necessary

87
Q

What is a benefit of self-administered tests?

A

Requires little skill among staff

88
Q

What is required of the client’s during self-administered tests?

A

Motivation and ability to read.

89
Q

To what grade level are most self-administered tests written?

A

Fourth or fifth

90
Q

When are self-administered tests especially helpful?

A

When the client has difficulty talking about himself

91
Q

Why are self-administered tests most helpful with clients who can’t talk about themselves?

A

It is indirect and less threatening

92
Q

What benefit do self-administered tests have in regards to reliability?

A

The tests are less biased because they are not subject to interpretation

93
Q

What factors must the counselor keep In mind regarding assessment tools?

A

Their reliability and validity and the limitations of the tools

94
Q

What must be true of individuals using assessment tools?

A

They must be fully trained, credentialed, and supervised.

95
Q

What effect do cultural factors have on selection of interviews?

A

Need to consider sequencing of questions, vocabulary, and sensitivity to revealing certain aspects of information.

96
Q

What is important to consider when selecting a translator to use with clients who do not speak English?

A

Competency of the translator in both languages, and translator’s knowledge of clinical terminology and slang regarding drugs and drug abuse.

97
Q

What can be useful for conducting assessment with cultures which do not encourage outward expression?

A

A group or family interview.

98
Q

What is the function of a risk assessment during the screening and assessment process?

A

Ensure the client is not experiencing symptoms of toxicity, intoxication, or withdrawal; assess for danger/aggression towards others; assess for risk of self-harm/suicide; and assess for mental health concerns.

99
Q

According to the AFSP, what percentage of suicides involve alcohol?

A

30 %

100
Q

What percentage of people with alcohol dependence die by suicide?

A

7%

101
Q

What percentage of people who die by suicide have a diagnosable disorder?

A

90 %

102
Q

What percentage of people who die by suicide have struggled with MDD?

A

60%

103
Q

What percentage of alcoholics with co-occurring depression die by suicide?

A

75%

104
Q

According to the American Psychiatric Association, what are 3 major areas of suicide assessment?

A

Current presentation of suicidality; history; and risk management.

105
Q

What is the benefit of using drug testing?

A

Assist in evaluation and ongoing monitoring.

106
Q

What types of drug testing are available?

A

breath analysis; urine; saliva; sweat; blood; and hair

107
Q

Why are breathalyzers most commonly used?

A

They are readily available, convenient, and inexpensive.

108
Q

Over what period of time can urine tests assess for drug use?

A

Ranges from 1 week to 1 month, depending on the drug.

109
Q

Over what period of time do saliva tests assess for drug use?

A

The past day

110
Q

What is the benefit of sweat tests?

A

Assesses cumulative drug use over time.

111
Q

What is the benefit of blood tests vs the drawback?

A

They are accurate and reliable, but invasive and costly.

112
Q

What is the benefit of using hair tests?

A

Looks for drug use over a period of 2-4 months and more sensitive than saliva or urine tests

113
Q

What is the most widely used, cost effective, and well-researched test for detecting drugs?

A

Urine tests

114
Q

What is the drawback of using hair testing?

A

Does not detect use within the last 8 days and not good for long-term monitoring due to inability to discriminate between previous vs more recent use.

115
Q

How are sweat tests performed?

A

A piece of gauze is attached to individual with a tamper proof seal and sweat is collected over a weeks time.

116
Q

What sort of drugs can create a false positive in urine tests?

A

decongestants; prescribed amphetamines; poppy seeds

117
Q

When should a client be referred to another agency?

A

When the client’s needs lie outside the agency’s ability to provide service.

118
Q

What are important factors to assess when looking at co-occurring disorders?

A

chronicity, severity, disability, and the degree of impairment of functioning.

119
Q

How do alcohol and drugs affect mental health problems?

A

They may mimic symptoms, disguise symptoms, or exacerbate symptoms.

120
Q

What is the benefit of using DSM to describe disorders?

A

Describe to other professionals who are familiar with the DSM

121
Q

According to the DSM, what are the two major types of SUDs?

A

Substance use disorder and substance induced disorders

122
Q

How are substance induced disorders different from co-occurring disorders?

A

Symptoms are independent from co-occurring disorders and caused only by the substances.

123
Q

How many levels of care are there for substance use treatment?

A

Five

124
Q

What is ASAM treatment level 0.5?

A

Early Intervention

125
Q

What is ASAM treatment level 1?

A

Outpatient Treatment

126
Q

What is ASAM treatment level 2?

A

Intensive Outpatient/Partial Hospitalization

127
Q

What is ASAM treatment level 3?

A

Residential/Inpatient treatment

128
Q

What is ASAM treatment level 4?

A

Medically managed intensive inpatient treatment.

129
Q

What are the 6 dimensions used to determine ASAM level of care?

A

acute intoxication/withdrawal potential; biomedical conditions and complications; emotional, behavioral, or cognitive conditions and complications; readiness to change; relapse continued use or continued problem potential; and recovery/living environment.

IR&RC Addiction Counselor Exam (6 decks)

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