Scientific Principles
25%of exam
Screening + Assessment
20%of exam
Treatment + Referral
30%of exam
Ethics + Legal
25%of exam
BoundariesConfidentialityDocumentationSupervisionRights
Quick Facts
- Exam
- IC&RC ADC
- Credential
- Alcohol Drug Counselor
- Questions
- 150 total
- Scored
- 125 scored
- Pretest
- 25 unscored
- Time
- 3 hours
- Pass
- Scaled 500/800
- Blueprint
- November 2022
Tolerance vs Dependence
Tolerance
- Needs more
- Reduced effect
- Dose adaptation
Dependence
- Withdrawal risk
- Body adaptation
- Stopping symptoms
Dose vs withdrawal
Addiction Brain
- Reward pathway
- Reinforcement circuit
- Dopamine
- Reward neurotransmitter
- Tolerance
- Needs more
- Dependence
- Withdrawal adaptation
- Craving
- Compulsive urge
- Cross-tolerance
- Class overlap
- Disease model
- Chronic brain disorder
Substances
- Alcohol
- Depressant
- Benzodiazepines
- Sedative-hypnotics
- Opioids
- Analgesic euphoria
- Stimulants
- Increased activation
- Cannabis
- THC effects
- Hallucinogens
- Perception changes
- Inhalants
- Volatile toxins
Withdrawal + Overdose
- Alcohol withdrawal
- Seizure risk
- Opioid withdrawal
- Flu-like distress
- Sedative withdrawal
- Medical risk
- Stimulant crash
- Depression fatigue
- Overdose
- Life threat
- Naloxone
- Opioid reversal
- Detox referral
- Safety first
Co-occurring
- Depression
- Mood symptoms
- Anxiety
- Fear arousal
- PTSD
- Trauma response
- Psychosis
- Reality impairment
- Medical conditions
- Health complications
- Trauma
- Risk amplifier
- Integrated care
- Treat together
ASAM Six
Six dimensions choose placement.
IntoxicationBiomedicalEmotionalReadinessRelapseEnvironment
Screening vs Assessment
Screening
- Brief flag
- Risk indicator
- Triage next
Assessment
- Deeper picture
- Diagnosis support
- Plan care
Flag vs formulate
Assessment Picker
- Need alcohol screen→AUDIT
- Quick alcohol flag→CAGE
- Need drug screen→DAST-10
- Broad severity→ASI
- Diagnose SUD→DSM(Criteria)
- Choose care level→ASAM(Placement)
- Immediate danger→Safety plan
- Ambivalence present→MI(Engage)
Screening Tools
- CAGE
- Alcohol screen
- AUDIT
- Alcohol risk
- DAST-10
- Drug screen
- ASI
- Problem severity
- ACE
- Trauma exposure
- SASSI
- SUD indicators
- Urine test
- Recent use
Assessment Core
- Interviewing
- Structured conversation
- Collateral
- Outside information
- Biopsychosocial
- Whole-person history
- DSM
- Diagnostic criteria
- Severity
- Mild moderate severe
- Readiness
- Change motivation
- Safety
- Immediate needs
Placement
- ASAM
- Placement framework
- Intoxication
- Acute risk
- Biomedical
- Medical needs
- Emotional
- Mental health
- Readiness
- Engagement level
- Relapse risk
- Continued use
- Recovery environment
- Support context
OARS
MI rows with OARS.
Open questionsAffirmReflectSummarize
Goal vs Objective
Goal
- Broad outcome
- Client direction
- Longer range
Objective
- Measurable step
- Specific target
- Track progress
Outcome vs measure
Treatment Picker
- Low readiness→MI(Engagement)
- Distorted thoughts→CBT
- Skill deficits→Psychoeducation
- Opioid disorder→MAT referral
- Family impact→Family referral
- Peer support→Mutual aid
- Crisis event→De-escalation
- Care ending→Discharge plan
Counseling Skills
- OARS
- MI micro-skills
- Reflection
- Meaning mirror
- Reframing
- New perspective
- Clarification
- Check meaning
- Affirmation
- Strength spotlight
- Rapport
- Working alliance
- De-escalation
- Crisis calming
Plan GOI
Plans move goal to intervention.
GoalObjectiveIntervention
Treatment Plans
- Problem
- Priority need
- Goal
- Broad outcome
- Objective
- Measurable step
- Intervention
- Counselor action
- Relapse prevention
- Risk plan
- Coping skill
- Safer response
- Update
- Revise plan
Groups + Recovery
- Group process
- Member interaction
- Cohesion
- Group bond
- Curriculum
- Structured content
- MAT
- Medication support
- Mutual aid
- Peer support
- Holistic care
- Whole health
- Discharge plan
- Next care
Ethics BCS
Boundaries, consent, supervision protect clients.
BoundariesConsentSupervision
Confidentiality vs Privilege
Confidentiality
- Ethical duty
- Protect information
- Applies broadly
Privilege
- Legal protection
- Court context
- Jurisdiction varies
Duty vs evidence
Ethics Picker
- Outside competence→Refer/consult
- Boundary concern→Supervision
- Record request→Consent check
- Child abuse→Report
- Serious threat→Duty response
- Client complaint→Grievance process
Ethics + Legal
- Confidentiality
- Protect records
- 42 CFR Part 2
- SUD privacy
- Informed consent
- Client agreement
- Mandated reporting
- Required disclosure
- Duty to warn
- Serious threat
- Scope
- Practice limits
- Grievance
- Complaint process
Consultation vs Supervision
Consultation
- Specialized advice
- Peer input
- Case question
Supervision
- Formal oversight
- Accountability
- Development focus
Advice vs oversight
Professional Practice
- Boundaries
- Role limits
- Dual relationship
- Role conflict
- Self-disclosure
- Client benefit
- Consultation
- Expert input
- Supervision
- Practice oversight
- Documentation
- Clinical record
- Cultural humility
- Responsive care
Common Traps
Scaled Score Trap
500 scaled ≠ Not percent correct
Pretest Trap
25 unscored ≠ Not identified
Screening Trap
Screen flags ≠ Assessment decides
Ethics Trap
Consult early ≠ Do not improvise
Referral Trap
Outside scope ≠ Refer/consult
Treatment Trap
Objectives measurable ≠ Goals broad
Last Minute
- 1.Know 25/20/30/25 weights
- 2.150 total; 125 scored
- 3.Passing score is 500 scaled
- 4.Screening first; assessment deep
- 5.ASAM guides placement
- 6.MI resolves ambivalence
- 7.Objectives must be measurable
- 8.Confidentiality has exceptions
- 9.Scope limits require referral
- 10.Answer every question
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