A counselor notices that a client with a trauma history frequently minimizes the severity of their substance use during sessions but has tested positive on three consecutive urine drug screens. Applying trauma-informed principles, the counselor should FIRST:

A client in an outpatient group begins sharing a detailed account of his recent substance use in a way that seems to glamorize the experience and visibly engages other members who appear excited. The counselor’s BEST response is to:

A counselor incorporates mindfulness-based relapse prevention (MBRP) into a client’s aftercare plan. The CENTRAL skill that MBRP adds beyond standard relapse prevention is:

An electronic health record system automatically logs the date and time of each entry and the author’s name. A counselor changes a note’s timestamp to make it appear the note was written on the date of service rather than four days later. This action constitutes:

Based on a shared client’s vague, indirect disclosures, a counselor suspects a colleague is abusing that client. The client begs the counselor not to report and insists the allegations are minor. The counselor should:

A client discloses that their spouse sometimes physically disciplines their 10-year-old stepchild in ways the client describes as a little harsh. The client asks the counselor to keep this between them. The counselor should:

Social learning theory, as applied to substance use disorders, predicts that a client who grew up watching a parent use alcohol to manage stress is most at risk for which specific pattern?

Which brain region is most responsible for the impaired decision-making and poor impulse control commonly observed in individuals with moderate to severe substance use disorder?

Fetal alcohol spectrum disorders (FASDs) occur because ethanol crosses the placenta and interferes with fetal development. Which mechanism accounts for the most serious neurological effects?

A client who recently immigrated discloses symptoms that overlap with both trauma responses and substance withdrawal. The counselor suspects that acculturation stress may be a contributing factor. Which assessment strategy is most appropriate?

During an assessment, a counselor notices that a client enthusiastically endorses wanting to change but has taken no concrete steps over the past three months. This pattern is MOST consistent with which clinical observation?

A client in a mandated treatment program says, ‘I’m only here because the judge made me come. I don’t have a drug problem.’ Which approach BEST reflects evidence-based practice for assessing and engaging this client’s motivation?

A client who has been abstinent for 14 months reports increasing isolation, missed meetings, and feeling “numb” about recovery. The counselor recognizes these as warning signs of:

A client in outpatient treatment discloses that she stopped taking her prescribed medication for a mood disorder because she cannot afford the refills. The counselor’s FIRST priority in the case management role should be to:

A counselor is using Acceptance and Commitment Therapy with a client who has a stimulant use disorder and significant shame about their past behavior. Which process is most directly targeted when the counselor helps the client observe their thoughts about shame without fusing with them or acting on them?

When a client begins to argue against the counselor’s suggestions about reducing substance use, the response most consistent with motivational interviewing is to: