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Might as Well Face It, There's Addiction Among Your Clients: Treatment Planning - Test
by Cynthia Glidden-Tracey, Ph.D.

Course content © copyright 2008-2019 by Cynthia Glidden-Tracey, Ph.D.. All rights reserved.

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1. Which of the following is NOT one of the components of a collaborative treatment plan, as described in the course text? Help
A clear rationale for generating a plan
Goals both parties can agree are worth attempting
Objectives identifying meaningful steps toward the goal(s)
Methods dictated by the therapist
2. From a Motivational Interviewing perspective, a person is more likely to change a problem behavior when that person: Help
Resists participating in the development of the client's own treatment plan.
Voices in an interpersonal context a commitment to plan and implement change.
Relies on a therapist to give expert opinions that override the client's low motivation.
Follows instinct and spontaneous decisions without imposing structure or rationale.
3. Why should a therapist offer a client a rationale before launching into treatment planning? Help
Because it is required by most agencies for record keeping
To satisfy third party payers for reimbursement
To let the client know what to expect and how to participate
To inform clients of the therapist's authority to decide the course of treatment
4. The treatment planning process can be an intervention that contributes to progress in therapy in which of the following ways? Help
Collaborative planning invites the client's participation.
Treatment planning helps identify a focus of concern(s).
Treatment plans specify therapeutic goals and objectives.
All of the above
5. If a client resists formulation of a written treatment plan, the therapist should: Help
Insist that no further work can be done until the client is willing to discuss and sign a plan.
Listen carefully and develop a tentative plan that can be presented to the client at the next session.
Forego planning and talk about whatever the client wants to discuss.
Terminate the client and close the case file.
6. Which of the following therapists is most likely to effectively engage clients in collaborative treatment planning to address problematic or disordered substance use? Help
Those who are careful not to assert a format and decline to offer suggestions or interrupt a client
Those who offer numerous goals, objectives, and methods that have worked with other clients without unnecessary input or feedback from the current client
Those who develop self-knowledge and utilize professional consultation as needed to employ flexible structure in planning with clients
All of the above are likely to be equally effective strategies.
7. When the treatment goal is to increase a client's self-efficacy for changing alcohol or other drug use, the four objectives listed below can help improve the client's efficacy expectations. According to Bandura's social cognitive theory, which objective will have the strongest impact on clients' abilities to better regulate their own behaviors? Help
Choosing tasks with strong chances of client success
Learning to manage negative affect associated with treatment efforts
Learning from vicarious experiences, such as therapy or self-help groups
Persuading clients that they can and should change
8. Clients exhibiting substance use disorders often benefit from treatment goals and objectives planned to enhance their beliefs in their own ability to change their drinking or drugging behaviors. Their initial self-efficacy for change may be low because: Help
They continue using drugs or alcohol despite repeatedly trying to quit.
Substance use is a healthy strategy for coping with stress.
They have hope and realistic expectations for reaching their goals.
They take initiative and responsibility for making healthy choices.
9. A treatment plan to address a client's concerns about personal substance use incorporates performance objectives by: Help
Setting a condition requiring the client to abstain from all psychoactive substance use.
Encouraging the client to discuss and choose new behavioral tasks that are within the client's abilities.
Persuading clients to try new behaviors that they aren't sure they can or want to do.
All of the above.
10. Strong emotions like anxiety can reduce a client's confidence and self-efficacy toward changing excessive drinking or drug use. Methods recommended for helping a client better manage strong emotional arousal include: Help
Together identifying situations that trigger difficult emotions for the client.
Generating and practicing ways to cope with intense emotions without using psychoactive substances.
Reinforcing valid attempts and successful outcomes of identified alternative responses to difficult feelings.
All of the above.
11. Clients exhibiting substance use disorders can learn from vicarious experience of success in changing behavior by: Help
Talking to friends or family members who are current substance users.
Confronting their therapist about the therapist's substance use history.
Participating in group therapy or a self-help group on recovery from substance-related disorders.
Persuading their therapists to self-disclose personal biases about drugs and alcohol.
12. A therapist's verbal persuasion to change is most motivating when the: Help
Client is challenged to attempt a new task that the client has never before considered.
Client's emotional arousal is increased to promote greater anxiety.
Therapist expresses a sincere faith in the client's potential to change.
Client has some confidence in being able to achieve a task s/he is already considering.
13. Therapists who attempt to engage clients in change activities that are inconsistent with the client's current stage of readiness tend to: Help
Decrease the client's anxiety.
Carefully assess the client's stage of readiness for change.
Elicit client resistance in some form.
Encourage contemplative clients to prepare before taking action.
14. Treatment methods based on Motivational Interviewing strategies establish interpersonal conditions for the therapy relationship that communicate: Help
The necessary imposition of the therapist's expert opinion.
The therapist's intentions to respect the client's perspective.
Arguments against the client's continuing drug or alcohol use.
The client's responsibility for achieving insight into the causes of his or her disordered substance use.
15. The transtheoretical model of the stages of change emphasizes that most personal change requires: Help
16. When the treatment goal is to increase insight into the implications of the client's substance use and the client denies that his or her substance use is a problem, an appropriate treatment objective would be to: Help
Determine whether there is a problem to be addressed.
Prepare the client to undertake a course of action to reduce drinking or drug use.
Change the rewards and punishments the client associates with substance use.
Weigh options to help resolve the problems identified by other people with respect the client's substance use.
17. In response to an admitted problem with frequent drinking to the point of blackouts, Jen's objective is to decide whether or not she wants to change her typical pattern of alcohol consumption, which she says is "wicked fun." Which of the following methods would you as a therapist recommend for Jen, a client in the contemplation stage of change? Help
Refrain from alcohol use as a condition for continuing therapy.
Engage in self-forgiveness for past mistakes.
Role-play how to avoid people and situations that trigger cravings to use alcohol or other drugs.
Generate and weigh options to clarify goals and possible strategies.
18. As clients in the preparation stage ready themselves to take action, their commitment to resolve problems may conflict at times with continuing urges to use alcohol or other drugs. Thus therapists at this point should be skilled at dealing with client: Help
19. Changing substance use behavior in the action stage of change involves a plan that specifies behavioral criteria of change. From a classical conditioning perspective, action objectives aim to sever the connection between: Help
A signal that substances are available and the behavioral response the client makes to that signal.
An abstract strategy and concrete tasks that meet criteria for change.
Emotional reactions and behavioral responses to drugs or alcohol.
The client's substance use and the rewards or punishments that follow it.
20. In the action stage of change, which of the following methods can be utilized to help clients control exposure to stimuli (such as certain music, beer posters, or drug pipes) that the client wishes to avoid because those stimuli trigger urges and cravings to resume substance use? Help
Generating and brainstorming possible options for future behavior
Identifying specific events that will confront the client with triggering stimuli
Articulating and practicing steps clients can take to minimize exposure
Both 2 and 3
21. For substance users, making choices to avoid alcohol and other drugs and to seek other types of rewards instead is a challenge that must be faced. Using an operant conditioning approach, treatment methods can help modify the patterns of reinforcement for the client's behavior. The method that involves applying meaningful rewards for behaviors that are incompatible with substance use is called: Help
Contingency management.
Commitment to taking action.
22. Efforts to modify the consequences of the client's behaviors work better if the therapist: Help
Avoids discussion of rewards the client experiences from using drugs or alcohol.
Focuses solely on raising client awareness of detrimental consequences of substance use.
Acknowledges the benefits as well as the costs the client associates with substance use.
Rules out the possibility of mixed motivations the client may experience.
23. Although he tries to avoid situations with cues reminding him of alcohol, Ron can't help noticing bar ads on campus and beer commercials on TV. He needs methods for resisting urges stimulated by such cues to help him meet his treatment goal of abstinence from drinking. When stimuli that trigger thoughts of drinking or using drugs cannot be eliminated from the client's environment, "re-evaluation" can be incorporated into the client's treatment plan to help identify maladaptive thoughts, such as Ron's beliefs that urges to drink are compulsory, and to: Help
Replace them with messages Ron can give himself about being willing and able to resist the temptation triggered by the ads.
Provide tokens or vouchers that reward Ron for watching beer commercials during sporting events.
Turn off the TV or leave the room any time Ron is confronted with a cue that reminds him of drinking.
Evaluate whether he is actually capable of controlling his environment to limit exposure to alcohol related cues and stimuli.
24. Clients are presumed to be in a better position to participate effectively in their own therapy if the: Help
Therapist insists on the client's complete abstinence for the duration of therapy.
Client has little knowledge of how therapy works or what to expect.
Therapist provides psychoeducation about the nature of therapy.
Therapist keeps her or his methods mysterious.
25. The therapist educates the client about confidentiality so that: Help
Protection of confidentiality can be emphasized to facilitate trust.
The limitations of therapeutic confidentiality are understood and accepted by the client.
Questions the client might have about confidentiality and disclosure can be discussed and clarified.
All of the above
26. Psychoeducation about the abstinence expectation for coming to therapy sessions "clean and sober" involves the therapist explaining reasons to the client and being receptive to the client's reaction. A rationale for expecting abstinence from drugs and alcohol at least for the day of the session is that the: Help
Therapist does not want to have to smell the bad breath of a client who has used drugs, alcohol or cigarettes right before the session.
Therapist believes that more productive work can be done when the client's emotions and cognitions are not compromised by the psychoactive substances.
Client is wrong to argue that being high or intoxicated is not a barrier to his or her functioning because that is a normal state of mind for the client.
Therapist will automatically terminate therapy with the client if the client ever shows up for a session under the influence of alcohol or other drugs.
27. In addition to coming to sessions "clean and sober," therapists convey a second minimum expectation to the client, asking clients to report honestly any substance use between sessions. The therapist asks the client each week about recent alcohol and drug use because it: Help
Helps get an accurate indication of the client's recent behavior.
Creates a context for straightforwardly discussing the topic.
Effectively shames the client into future abstinence.
Both 1 and 2
28. If a therapist has not established ground rules about abstinence and regular report of recent substance use: Help
The client will be more likely to openly reveal current substance use.
The therapist can easily inquire later if suspicions arise about client substance use that is inconsistent with treatment goals.
It can be quite awkward for the therapist to raise questions about client substance use later.
The client will not be surprised or put off if the therapist later asks if the client has been recently using drugs or alcohol.
29. Psychoeducation for clients about the effects of psychoactive substances on the brain emphasizes that drugs and alcohol: Help
Can modify normal functions of the brain in a manner that may disrupt thinking, emotion, and behavior.
Contribute to disorders only in persons who have an alcoholic or addicted parent.
Are never safe for human use, so total abstinence is required in all circumstances.
Are risky to use in the short term, but have few dangerous long-term consequences.
30. Clients may benefit from psychoeducation about possible harm that high levels of exposure to drugs and alcohol can inflict on the human body. These hazards include: Help
Embarrassing behavior in social situations.
Coming to therapy sessions under the influence of alcohol or other drugs.
Keeping an open mind about the pleasures of substance use.
Damaging the organs' abilities to rid the body of foreign chemicals.
31. Therapists can provide psychoeducation about how clients can move in the direction of beneficial change by inviting clients to: Help
Make passive rather than active choices about future behavior.
Create idealistic expectations about substance use disorder therapy and recovery.
Develop a plan and obtain support for rewarding success and accepting setbacks.
All of the above
32. Relapse prevention strategies involve both helping the client learn to avoid resumption of problematic alcohol or drug use and related behaviors, as well as: Help
Accepting that any future substance use indicates a failure of treatment.
Building skills for coping with high-risk situations and occasional lapses if they occur.
Continuing indefinitely in therapy with the realization that substance users cannot control their own behavior.
Dismissing memories of past disordered substance use since there is nothing to be learned from them.
33. Relapse prevention planning helps counter-condition persons who have decided to quit disordered use of substances by replacing old learned responses to drugs and alcohol with new and incompatible ones. Thus, as clients identify factors that have triggered their own urges and cravings to drink or use drugs, what does the therapist do? Help
Ensure that the client will not be further exposed to any factors or cues that trigger those urges and cravings to use substances.
Encourage clients to put themselves in risky situations, like attending a bar or party, that will test their resolve to prevent relapse.
Persuade the client to attend 30 Alcoholics Anonymous or Narcotics Anonymous groups over the next 30 days.
Help clients consider and practice new behavioral options in response to triggers, urges and cravings encountered in daily life.
34. Reframing self-defeating thoughts about reducing substance use and preventing relapse can include cognitive restructuring techniques like thought-stopping and thought-substitution, possibly with rhythmic repetition to reinforce alternative positive messages. Cognitive restructuring works best when the client: Help
Externalizes problems as outside of personal control.
Maintains ambivalence about whether personal substance use is actually problematic.
Believes the therapist understands and accepts the client's initial thoughts as well as personally meaningful alternatives they generate together.
Doubts the need or ability to change thoughts or actions regarding her or his own use of drugs or alcohol.
35. It is not unusual or unlikely for a client in therapy for substance-related disorders to experience an occasional relapse during the course of therapy and recovery. In such instances, it is most useful for the therapist and client together to: Help
Accept the possibility of relapse.
Deal with feelings about relapse.
Determine what can be learned from the relapse.
All of the above
36. Alice has shown progress in her ability to deflect relapse by developing new hobbies and engaging in new activities to replace her former habit of marijuana use. To expand Alice's relapse prevention skills, her therapist discusses with her: Help
The limitations of trusting that the recent changes she has made will be lasting or ultimately satisfying.
Ways to revise her treatment plan to reinforce steps she is already taking and clarify new priorities and next steps for implementation.
Termination of therapy so that Alice can have more time to pursue her hobbies and interests.
Testing the strength of her relapse prevention skills by resuming friendships with people with whom Alice used to smoke marijuana.



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