ADC Exam 6 Top Questions and answers, 52 Questions. graded A+, Verified.

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ADC Exam 6 Top Questions and answers, 52 Questions. graded A+, Verified. 1. What do studies indicate about lesbian, gay, bisexual, and transgender (LGBT) individuals? a. They are more likely to ... abuse alcohol and drugs than the general population. b. They are similar to the general population in their use of alcohol and drugs. c. They are more likely to use drugs but not more likely to use alcohol than others. d. They are less likely to abuse alcohol and drugs than the general population. - ✔✔-A: They are more likely to abuse alcohol and drugs than the general population. Because many research instruments do not ask about sexual orientation, very little reliable information is available on substance abuse among lesbian, gay, or bisexual (LGB) individuals. However, research does indicate that lesbian, gay, bisexual, and transsexual (LGBT) individuals use alcohol and drugs more often than the general population. They are also more likely than the general population to persist in drinking heavily into later life and less likely to stop using drugs. On average, members of the LGBT community also use more kinds of drugs, including those that more profoundly impair judgment, such as amyl nitrite (poppers), Ecstasy, ketamine (Special K), and gamma hydroxybutyrate. These drugs are frequently used at parties and raves, during and after which increased risky sexual behavior may lead to human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) or hepatitis infections. Cultural groups differ in how they view their LGBT members. In Hispanic culture, matters of sexual orientation tend not to be discussed openly. LGB members of minority groups often find themselves targets of discrimination within their minority culture and of racism in the general culture. 2. What does the term cultural brokering refer to? a. Immigration and naturalization assistance b. Financial managers for ethnic and racial minorities c. Housing services for ethnic and racial minorities d. Liaison work between cultures to meet needs - ✔✔-D: Liaison work between cultures to meet needs. The culture brokering approach was conceived to mediate the difficult gap between the needs of foreign-born people and the U.S. health care system. This model can also help clients with disabilities and impairments. Almost one-sixth of all U.S. citizens have some functional disability. Of these, more than 30 percent live below the poverty line, and most expend considerable financial resources on their disabilityrelated needs. The combination of depression, frequent pain, employment difficulties, and functional limitations leaves the cognitively and physically disabled vulnerable to substance abuse. Yet, research reveals, they are less likely to receive effective treatment than those without any disability. Further, many disabled (and other) individuals struggling with addiction have unidentified learning disabilities that can impair successful treatment. Even individuals with the same disability may differ in their functional capabilities and limits. Consequently, treatment providers must carefully assess these clients and tailor treatments to meet their unique needs. 3. How do the rates of heavy alcohol use among youth ages twelve to seventeen in rural areas compare? a. Double the rates in metropolitan areas b. Slightly higher than the rates in metropolitan areas c. About the same as the rates in metropolitan areas d. Half the rates found in metropolitan areas - ✔✔-A: Double the rates in metropolitan areas. The rate of alcohol use among adults over the age twenty-five is lower in rural areas than that found in metropolitan areas. However, youth between the ages of twelve and seventeen have rates of heavy alcohol use that are almost double those in metropolitan areas. Further, rates of alcohol use and alcoholism among women in rural areas are higher than rates among women in metropolitan areas. Even so, at least one study reveals that individuals living in urban settings were treated for substance abuse more than twice as often as those living in a rural setting. It was concluded that the stigma of substance abuse treatment and the availability of treatment combined to substantially limit the treatment rate. Given that 20 percent of the U.S. population lives outside of metropolitan areas, understanding the unique needs of rural populations is important. 4. Although homeless individuals are more likely to receive detoxification services than people not homeless, what percentage will receive full treatment for their alcohol or substance abuse problems? a. 15 percent b. 25 percent c. 35 percent d. 45 percent - ✔✔-B: 25 percent. In other words, 75 percent will not receive proper treatment. Although the homeless receive detox services more than three times as often as people who are not homeless (45 percent vs. 14 percent), this is likely due to unexpected hospitalizations, psychiatric facility transitioning, and vagrancy and drug possession arrests that result in an involuntary detox and loose medical supervision. Of the approximately six hundred thousand homeless at any given time, about 41 percent are white, 40 percent are African-American, 11 percent are Hispanic, and 8 percent are Native American—disproportionate minority representation. The homeless may be: (1) transient—temporarily with others and at high risk of suddenly being on the street; (2) recently displaced—due to eviction or other financial problems (potentially due to substance abuse; or (3) chronically homeless—often with severe substance use and mental disorders, they are difficult to draw into treatment and are in need of creative outreach and programming initiatives. 5. Homeless individuals are particularly susceptible to substance abuse due to the stress and hopelessness of their current situation. What are the three most common substances of abuse among this population? a. Alcohol, crack cocaine, and marijuana b. Alcohol, opioids, and marijuana c. Alcohol, opioids, and crack cocaine d. Alcohol, marijuana, and inhalants - ✔✔-C: Alcohol, opioids, and crack cocaine. Alcohol is the primary substance of abuse for 50 percent of the homeless admitted to treatment, with 18 percent abusing opioids (pain meds, heroin, etc.) and 17 percent abusing crack cocaine. Nearly one-quarter of the homeless (23 percent) have co-occurring disorders, while 20 percent of those not homeless also suffer with a co-occurring disorder. Recommendations for retaining homeless clients in treatment include: (1) meet their survival needs (food, clothing, warmth, and safe shelter) in addition to treatment and extensive continuing care; (2) optimally, early intensive treatment (clients attending 4.1 days per week have better outcomes than those attending fewer days); and (3) case management, which is needed to: (1) arrange safe and drug-free housing (which powerfully influences recovery, especially if housing is contingent on abstinence), (2) coordinate psychiatric and medical care, and (3) locate vocational training or education to help individuals become self-sufficient. The Alcohol Severity Index, the Alcohol Dependence Scale, and the personal history form have all been deemed valid and reliable screening tools for this population, especially when interviewed in a protected setting, with factual questions based on a recent time period. 6. What is the case management model that seeks to identify clients' needs and assist clients in obtaining access various identified resources known as? a. Brokerage or Generalist Model b. Program of Assertive Community Treatment Model c. Strengths-Based Perspective d. Clinical or Rehabilitation Model - ✔✔-A: Brokerage or Generalist Model. This approach endeavors to evaluate and determine clients' needs in order to help them access specific resources. Client contacts are minimal, and planning is brief, as the goal is prompt and accurate referral without establishing an intensive, long-term relationship. Consequently, there is little to no monitoring or proactive advocacy. Because of this, the Brokerage or Generalist model is not always ideal, yet the limited relationship allows for cost-effective rendering of services to a greater numbers of clients. This approach works best when treatment and social services are well integrated, thus limiting the need for advocacy and monitoring. The optimal client is not economically deprived, has otherwise adequate resources, and is not in late-stage addiction. Smaller agencies that offer narrowly defined services may benefit most from this model. In some situations, case managers may also serve as educators, offering sessions on substance abuse and related high-risk behaviors. 7. Which is the ONLY case management model that specifically addresses making contact with clients in their homes and other natural settings? a. Clinical or Rehabilitation Model b. Strengths-Based Perspective c. Program of Assertive Community Treatment Model d. Brokerage or Generalist Model - ✔✔-C: Program of Assertive Community Treatment Model. Developed as a mental health treatment model, key elements of PACT include: (1) meeting clients in homes and other natural settings; (2) addressing practical daily problems; (3) advocating assertively; (4) limiting caseloads to ensure effectiveness; (5) regular client-case manager contacts; (6) caseloads shared by a team; and (7) long-term client services. First adapted for use with chronic alcoholics, the model deviated from a typical approach in two ways: (1) case managers used an enforced contact strategy to meet clients at home and in the field, and (2) the focus was on alleviating suffering rather than requiring a pledge of total abstinence. An adaptation of PACT, the Assertive Community Treatment (ACT) model is used to provide direct counseling and the skills needed to succeed in a community setting. Case managers provide crisis intervention, family consultation, and group facilitation—teaching about human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), work skills, and relapse prevention. As opposed to PACT, the ACT model is time limited, and extended abstinence and treatment completion is expected. ACT can be implemented alone or in concert with a therapeutic community. 8. What is the case management approach that focuses on helping clients assert direct and personal control in the search for resources? a. Program of Assertive Community Treatment Model b. Clinical or Rehabilitation model c. Brokerage or Generalist Model d. Strengths-Based Perspective - ✔✔-D: Strengths-Based Perspective. This approach was developed to assist those with persistent mental illness to transition from institutional care to independent living. Two foundational principles are: (1) assisting clients in assuming direct control over their own search for resources (e.g., transportation, housing, employment, etc.), and (2) drawing upon clients' strengths in the acquisition of resources. This model focuses on informal helping networks (rather than institutional networks), supported through the client-case manager relationship. To achieve goals, the case manager maintains an active client outreach. The strengths case management perspective is used with substance abusers for three reasons: (1) case management facilitates client responsibility in finding and accessing resources needed for an enduring recovery; (2) the advocacy component counters the belief that substance abusers are morally deficient or in denial and thus unworthy of support; and (3) the emphasis on client strengths, assets, and abilities counterbalances treatment models that emphasize pathology and disease. Advocacy and client-driven goal planning can at times cause stress between the case manager and other members of a treatment team, but the approach clearly leads to improved client outcomes. 9. What is the case management model that integrates therapeutic and resource acquisition activities known as? a. Strengths-Based Perspective b. Clinical or Rehabilitation Model c. Brokerage or Generalist model d. Program of Assertive Community Treatment Model - ✔✔-B: Clinical or Rehabilitation Model. The case management clinical or rehabilitation approaches integrate clinical therapy and resource activities together. Both needs are met by the case manager rather than separate providers. Researchers have posited that it is not feasible or functional to divide these two activities for an extended time. To this end, the Clinical or Rehabilitation model merges these two activities by training case managers to see beyond solely environmental issues to other client-focused needs. To this end, the case manager is positioned to provide psychotherapeutic services, offer family therapy, and teach essential skills in a variety of areas, including relapse prevention, and so on. Beyond the usual repertoire of case management functions (assessment, planning, linkage, monitoring, and advocacy [per the Joint Commission on Accreditation of Healthcare Organizations] or assessing, arranging, coordinating, monitoring, evaluating, and advocacy [per the National Association of Social Workers]), the case manager should also address issues of transference, countertransference, client internalizations of observations, theories of ego functioning, and so on. In this way the client's needs can be met in a more holistic and integrated fashion, which should lead to enhanced outcomes. 10. Among the numerous principles that are essential to effective case management, how is the principle of advocacy BEST described? a. Taking the client's side in situations of conflict b. Ensuring the client understands institutional rules c. Helping an institution to meet a client's desires d. Advocating for the client's best interests - ✔✔-D: Advocating for the client's best interests. The case manager's advocacy role is to identify and secure a client's best interests. This is involves a dual responsibility—advocating for a client's genuine needs to be met and holding clients accountable when necessary. There are times when an institution is overlooking its responsibilities or even failing to meet those duties ascribed to it by contract, law, or legislative policy, and so on. In such situations, the case manager must advocate for the services that should be provided to the client, even if it requires confronting the institution or agency. In like manner, there are times when a client is failing to meet responsibilities and must be held accountable. At such times, it may be necessary for the case manager to advocate for sanctions, reporting, or other exclusions in order to ensure the client recognizes the neglected responsibilities, compliance, or performances that are required. 11. How are the clinical, evaluative, and administrative activities that link clients with treatment, community services, and other resources needed to carry out a treatment plan MOST comprehensively referred to? a. Case management b. Client advocacy c. Service coordination d. Resource linkage - ✔✔-C: Service coordination. Both case management and client advocacy are subsets of service coordination, and resource linkage is one of the direct activities involved in each of these endeavors. Service coordination provides an action framework by which a client is enabled to achieve the specific goals identified in a treatment plan. It requires collaborative efforts not only between a case manager or counselor and a client but also with significant others as well as liaison activities with available agencies, service providers, managed care systems, and other community resources. Fundamental to service coordination is ongoing evaluation of client needs and treatment progress as well as resource referrals and advocacy as needed. The coordination and integration of treatment activities shared among various providers is a central feature of service coordination. 12. How is the individual who is responsible to carry out the clinical monitoring and collaborative client assessments, evaluations, referrals, treatment coordination, and goodness-of-fit appraisals of the treatment plan to client goals and objectives BEST known as? a. Case manager b. Service coordinator c. Therapist d. Administrator - ✔✔-A: Case manager. This individual is the one most comprehensively responsible to evaluate, track, and coordinate the broad array of resources and services that a client is receiving in the treatment process. A service coordinator may assume some of these roles but is less involved in the clinical assessment and evaluation processes. A counselor or therapist may be very involved in clinical evaluations and assessments but would not typically be as involved in service coordination. Finally, an administrator looks after the management of a program or agency and thus would not typically be involved in frontline client evaluations and assessments or referrals and service coordination. Case management, however, addresses: assessment and evaluation (client capacity, progress and readiness, as well as agency, program, and resource availability and effectiveness), service coordination, referrals and referral network management, monitoring, tracking, problem solving, advocating, negotiating, offering liaison services, and arranging and carrying out the resource needs of a treatment plan. 13. A program or agency at times may require outside services to continue functioning properly. When an outside official or agency provides services solely to maintain the function and viability of a treating agency or program, confidentiality is maintained when service providers sign a a. Contractual Agreement for Limited Services (CALS). b. Qualified Service Organization Agreement (QSOA). c. Confidentiality and Privacy Service Agreement (CPSA). d. Consent and Disclosure Limitations Contract (CDLC). - ✔✔-B: Qualified Service Organization Agreement (QSOA). The use of a Qualified Service Organization Agreement (QSOA) is only indicated when an outside official or agency is providing services directly to a treatment program or agency itself. Any disclosure under the auspices of a QSOA is strictly limited to that information necessary for the service provider to ensure that the program or agency is able to function effectively. In turn, the QSOA stipulates that the service provider (i.e., the official or the contracted agency) is legally bound to resist any judicial proceedings seeking client information outside federal confidentiality standards and to maintain these same confidentiality standards in managing, processing, storing, and releasing any client information. In this way, the service provider is properly informed of relevant information to offer advice, consultations, and administrative insights necessary for the program or agency to efficiently and effectively carry out its necessary functions. 14. 114. What is a brief, but comprehensively integrated public health approach to early substance abuse intervention and treatment known as? a. Treatment, Brief Intervention, Referral, and Screening (TBIRS) b. Brief Intervention, Screening, Referral, and Treatment (BISRT) c. Referral, Screening, Brief Intervention, and Treatment (RSBIT) d. Screening, Brief Intervention, and Referral to Treatment (SBIRT) - ✔✔-114. D: The Screening, Brief Intervention, and Referral to Treatment (SBIRT) public health approach is designed for use in hospital emergency departments, trauma centers, primary care clinics, and other health care settings. The goal is to identify diagnosable substance abuse disorders as well as those at-risk for developing a disorder before serious consequences develop. Each key component has a specific function toward this end: (1) screening—identifying and rapidly assessing substance use severity and determining the appropriate treatment level needed; (2) brief intervention—enhancing clients' awareness and insights regarding substance abuse consequences as well as motivating the client toward behavioral change; (3) referral to treatment—linking clients to specialized substance abuse treatment options as assessment indicates is needed and appropriate. 15. 115. What is the key feature that differentiates a substance abuse counselor who merely practices in the field from one who succeeds in changing clients' lives? a. The knowledge of addiction issues b. The ability to be empathetic c. The skill to set clear boundaries d. The capacity to firmly confront - ✔✔-115. B: The ability to work with genuine compassion for clients is the first essential feature of successful counseling, provided appropriate boundaries are also maintained. Skills, knowledge, and information specific to the client's situation and needs are essential but are substantially ineffective if not managed with compassion and care. The renowned psychologist Carl Rogers taught that every individual has a positive, trustworthy center if this psychological core can be accessed. Connecting with this center taps into an individual's resourcefulness and capability for self-understanding and positive self-direction. To this end, he promoted three keys: (1) congruence (genuineness); (2) unconditional positive regard (caring concern and compassion); and (3) accurate, empathetic understanding (the ability to meaningfully assume the client's subjective perspective). Using these tools, clients can be reached and motivated toward positive change. 16. 116. A great deal is communicated nonverbally in the counseling process. How much communication does nonverbal body language account for, according to research? a. 10 percent b. 25 percent c. 50 percent d. 75 percent - ✔✔-116. C: The pioneering University of California, Los Angeles (UCLA) nonverbal communication researcher Albert Mehrabian has revealed that approximately 50 percent of all communication is exchanged nonverbally in the form of body language. According to Mehrabian, there are three fundamental elements in faceto-face communication: (1) the actual words used; (2) the tone of voice used; and (3) nonverbal behaviors (e.g. facial expression, body posture, gestures, etc.). If the nonverbal elements are incongruent, the behavior and tonality tend to be seen as more genuine than any words expressed. Given the importance of genuine compassion and empathy in the therapeutic process, body language is particularly important. To optimize nonverbal communication, the counselor should be seated two to four feet from the client, with no intervening barrier (e.g., a desk), leaning forward, legs and arms uncrossed, hands open, nodding to communications expressed, and making direct eye contact (if cultural permits it). The client's body movements (including micromovements, such as nostril flaring or quivering chin) should be noted and responded to appropriately. 17. 117. During the intake process, it is important for clients to sign an informed consent form. Of the following, what is the MOST significant reason for signing this form? a. To acquaint clients with program rules, regulations, and boundaries b. To ensure full compliance with program accreditation standards c. To better develop a meaningful treatment plan d. To ensure client commitment to and readiness for treatment - ✔✔-117. A: Individuals with a history of substance abuse often come out of families, relationships, and environments with few if any boundaries or rules. Further, due to long-standing issues of shame and embarrassment over substance abuse, clients are often overly sensitive to feelings of critique and failure. Consequently, it is particularly important for clients to become aware of the rules, regulations, and boundaries of treatment program participation in advance. In this way, clients need not be surprised when redirected to existing boundaries and standards of conduct. In turn, this consistency creates an environment that feels more stable, predictable, and safe from the clients' perspective, which is important as they work to muster and maintain the motivation to make important changes in their lives. The program's informed consent process also leads naturally into identifying and establishing the early treatment goals needed to motivate, shape, and monitor clients' success. 18. 118. The Substance Abuse and Mental Health Services Administration (SAMHSA) maintains a national registry known as NREPP. What does this acronym refer to? a. National Registry of Examinations for Psychological Practices b. National Registry of Excellence in Program Practicum c. National Registry of Evidence-Based Programs and Practices d. National Registry of Examiners for Program Procedures - ✔✔-118. C: The Substance Abuse and Mental Health Services Administration (SAMHSA) maintains the National Registry of Evidence-Based Programs and Practices (NREPP), which is a database of evidence-supported approaches to substance abuse counseling. The goal is to make available those theories, strategies, programs, and practices that have been proven effective in the treatment of substance abuse disorders. The database includes approaches such as twelve-step facilitation therapy, cognitive-behavioral therapy (CBT), and motivational interviewing (MI), among others. The database offers evaluations, recommendations, and suggestions to optimize the effectiveness of the various programs reviewed. The database is readily accessible via the Internet, and counselors should become familiar with the various programs, techniques, theories, and approaches offered to ensure optimal practices and program outcome effectiveness. 19. 119. It is important to determine a client's readiness for change at the outset of treatment. From among the following, what is the BEST indicator of readiness? a. A client's statement of his or her readiness for change b. The client and family's level of emotional and physical pain c. The client and family's admission that there is a substance abuse problem d. A client's changes in finances required to continue the substance abuse - ✔✔-119. B: There are many things that offer indication of readiness for change. Clients having hit bottom and families that have reached a breaking point are often poised for change. A skilled counselor can sometimes create a false bottom by breaking through denial using a pointed but caring presentation of reality in such a way as to motivate change. Engaging the family in the recovery process is often as important as engaging the client in recovery. Families have to deal with their own emotional pain and shame and learn how to make choices from the perspective of whether or not each choice will help or hinder the recovery of their loved one. Learning to avoid enabling patterns is also crucial, along with family referrals to support groups and literature sources that will ensure understanding and enduring commitment to the recovery process. 20. 120. Significant substance abuse can arrest personal progress and growth in many ways. How will emotional and other normal developmental stages MOST likely be affected? a. They will progress more slowly due to significant substance abuse. b. They will progress more rapidly due to significant substance abuse. c. They will be largely skipped due [Show More]

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