Deck 27: The Assessment of Suspected Substance Use Disorders

Question 1

In contrast to the screening phase, during the assessment phase the individual conducting the assessment is attempting to

A) assign responsibility for the individual's substance use disorder on to those who hurt the client emotionally.
B) identify the severity of the client's SUD.
C) identify socioeconomic forces that contributed to the development of the client's SUD.
D) develop a time sequence for the victimization of the substance abusing individual.

Answer 1

identify the severity of the client's SUD.

Question 2

One major disadvantage of paper-and-pencil screening instruments is that they are

A) expensive and labor intensive.
B) inexpensive but labor intensive.
C) vulnerable to attempts at deception.
D) more threatening to the client than face-to-face interviews.

Answer 2

vulnerable to attempts at deception.

Question 3

The core of the assessment process is

A) having the client complete the SASSI.
B) asking the CAGE questions.
C) a clinical interview.
D) performing the TWEAK.

Answer 3

a clinical interview.

Question 4

Jerry is a substance abuse counselor working with a client, Ned. Through completing a thorough assessment, Jerry has discovered that Ned has developed tolerance to cocaine, is preoccupied with using cocaine, has come to work high on cocaine, and continues to use cocaine despite his desire to quit, often to ward off symptoms of withdrawal. Based on this information, Jerry

A) has sufficient information to diagnosis Ned with a SUD.
B) should perform a drug test on Ned.
C) should perform the DAST screening on Ned.
D) should immediately get Ned into inpatient drug treatment.

Question 5

According to your text, which of the following is NOT one of the roles the assessment process plays?

A) Forms the foundation of the rehabilitation process
B) Helps put the drug abuser in jail
C) Helps identify those individuals who require professional assistance with their SUDs
D) Helps identify the proper level of treatment for an individual with a SUD

Question 6

What additional information should Jerry, from the question above, gather about his client, Ned?

A) Where Ned gets his cocaine
B) The current level of cocaine in Ned's system
C) Ned's motivation for seeking an assessment
D) All of these answers

Question 7

Which of the following is an example of collateral information that may be important to collect during a client assessment?

A) Information from family members
B) Past treatment records
C) Court documents
D) All of these answers

Question 8

The term addiction

A) is clearly defined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders.
B) is still not clearly defined.
C) is applied only to substance use disorders.
D) automatically indicates the need for rehabilitation.

Question 9

The Alcohol Use Disorders Identification Test (AUDIT) is effective in identifying people with an alcohol use disorder.

A) 70 percent
B) 100 percent
C) 50 percent
D) 90 percent

Question 10

A score of 5 points on the DAST would

A) be below the cut-off score necessary to suggest a substance use disorder on this instrument.
B) be sufficiently high to suggest a substance use disorder on this instrument.
C) suggest substance abuse, but not substance dependence.
D) reflect extreme denial on this instrument since a score of "5" has been engineered to be a lie detection score suggestive of attempts at deception.

Question 11

One drawback of the AUDIT is that it

A) was normed on a representative sample of individuals only in the United States.
B) is relatively insensitive to active drinkers over the age of 65.
C) tends to have a high number of "false positive" cases in persons over the age of 65.
D) was designed mainly to be used to screen individuals over the age of 65.

Question 12

A business owner calls you about an employee who failed a worksite urine drug toxicology test. The person is addicted to drugs and the employer wants them to be sent to a rehabilitation center. Your response would be

A) to help them find a rehabilitation center close to where the employee lives.
B) to assume the employee is addicted.
C) to suggest the need for a complete substance use assessment.
D) refer the individual to an outpatient drug and alcohol counselor you know.

Question 13

The CAGE tends to be best for identifying the following subgroup of people

A) women who are binge drinkers.
B) illicit drug abusers.
C) men who are not binge drinkers.
D) adolescents who also abuse illicit drugs.

Question 14

One of the problems of the SASSI-3 is that it

A) provides a detailed list of substances the individual has abused in the past.
B) does not identify binge drinking in young adult males.
C) does not identify which substances are possibly being abused.
D) focuses more on drugs of abuse rather than alcohol use disorders.

Question 15

You are an addictions counselor in private practice. You have referred a client to an intensive treatment program based on his history of binge drinking, as a person with an alcohol dependence problem. The client's pastor calls to challenge your recommendation on the grounds that the individual in question had a low score on the Michigan Alcoholism Screening Test (MAST). Your best response would be

A) the pastor has no right to become involved in a substance use assessment.
B) the MAST is relatively insensitive to binge drinking patterns.
C) the client probably has been honest with the pastor about his or her drinking pattern, so the pastor's concerns are well placed.
D) the pastor should complete a separate, comprehensive, substance use assessment.

Question 16

The assessor, while functioning as a "gatekeeper" for the admissions process

A) must identify which insurance company benefit package will pay for treatment.
B) gathers the information to justify treatment.
C) essentially operates on the assumption that everybody has a SUD until proven otherwise.
D) works as an extension of the law enforcement agencies, helping to identify those likely to drive under the influence of chemicals in the future.

Question 17

According to your text, the two-question screening instrument designed by Brown, et. al., is

A) at best able to identify only 75 percent of substance abusers.
B) able to identify substance abusers with 95 percent accuracy if the client answers honestly.
C) avoids the problem of confusion over binge substance use and addiction.
D) identifies those people who have a compulsion to use chemicals.

Question 18

It is important to diagnosis an individual based on the results of their SUDs screening.

Question 19

A person who has been found to have a "dirty" urine toxicology test for the first time has a substance addiction.

A) possibly
B) definitely
C) cannot possibly (since it is only their first time)
D) and has a high blood alcohol level

Question 20

Which of the following is important historical information to compile during a client assessment?

A) Educational and vocational history
B) Legal history
C) Military history
D) All of these answers

Question 21

Select two standardized tests discussed in your text and describe their characteristics.

Question 22

The MacAndrew Alcohol Scale of the Minnesota Multiphasic Personality Inventory could best be described as

A) being a useful, if rather lengthy, screening tool.
B) best able to identify personality patterns commonly associated with substance use disorders.
C) being 95 percent accurate in its ability to identify persons with a SUD if they answer the questions honestly.
D) identifying introverted persons as having a greater chance of having a SUD.

Question 23

Describe the various roles the process of assessment plays regarding SUDs.

Question 24

One other factor the assessor should attempt to identify is

A) client's motivation for seeking treatment services.
B) whether financial windfall was a motivating factor.
C) second degree relatives who might also have a SUD.
D) who supplies alcohol or drugs to the client.

Question 25

When inquiring about the client's medical history, it is important to inquire about

A) the name of the physician prescribing a medication for the client.
B) the name of the pharmacy where the client's prescriptions are filled.
C) the number of physicians prescribing a medication for the client.
D) the effects of the prescribed chemicals on the client.

Question 26

A client presents after conviction for his second "drunk driving" conviction. During the assessment process he also reveals he had a disciplinary action while in the military for driving a vehicle on base while intoxicated. This would

A) be counted as a third "drunk driving" conviction, although it did not appear on his civilian driving record.
B) not be counted as a "drunk driving" conviction since he was on base and it did not appear on his civilian record.
C) be dismissed as evidence of a substance use disorder since everybody knows that people in the military drink more than civilians of the same age.
D) be included as evidence of a "drunk driving" only if it involved the same chemical that was involved in their civilian convictions.

Question 27

A urine toxicology test reveals that a client has THC in his or her urine. This is proof that the client

A) used marijuana on one occasion in the days before the urine test.
B) is addicted to marijuana.
C) is a heavy substance abuser who is in denial.
D) has engaged in active deception to avoid family members knowing about their marijuana abuse.

Question 28

A client reports spending "only $100" a week on alcohol, but becomes indignant when you report that this is over $5,000 a year for alcohol. This is an example of

A) disengagement.
B) denial.
C) attempt to rationalize.
D) mindfulness.

Question 29

What are the types of "response sets" that might distort the assessor's opinions of the client's SUD? What are ways
to mitigate these?

Question 30

Although there is no standardized format, discuss some of the common elements found in better assessment
processes.

Question 31

Discuss the advantages and disadvantages of paper­and­pencil screening instruments.

Question 32

An important rule for assessing and diagnosing an individual is to always assume deception unless proven otherwise.

Question 33

One way for many substance abusers to avoid having their substance use interfere with their vocational activities is to be

A) only an on-call worker.
B) an employee of a small company.
C) self-employed.
D) not part of the work force.