IC&RC ADC (IC&RC Addiction Professional Exams) cheat sheet

Screening briefly determines whether a substance use problem may exist and whether further evaluation is needed; assessment is a comprehensive process that establishes diagnosis, severity, and treatment needs.

DSM-5 substance use disorder requires at least 2 of 11 criteria within a 12-month period: 2–3 criteria = mild, 4–5 = moderate, and 6 or more = severe.

ASAM criteria use six dimensions: withdrawal risk, biomedical conditions, psychiatric and cognitive conditions, readiness to change, relapse potential, and recovery environment.

Common screening cutoffs: CAGE score of 2 or more is significant; AUDIT score of 8 or more generally indicates hazardous alcohol use; DAST-10 score of 3 or more suggests moderate drug-related problems.

Stages of change are precontemplation, contemplation, preparation, action, and maintenance, with relapse as a possible return to an earlier stage; interventions are matched to the current stage.

Motivational interviewing core skills are summarized by OARS: open-ended questions, affirmations, reflections, and summaries.

Alcohol and benzodiazepine withdrawal can cause seizures, delirium tremens, and death and require medical management; opioid withdrawal is rarely life-threatening.

Confrontational counseling approaches are associated with increased dropout; MI-consistent reflective listening is preferred for engagement.

Use qualified interpreters rather than family members when language barriers exist, and screen in the client's preferred language when possible.

A treatment plan includes problem statements, client-centered goals, measurable objectives, specific interventions, responsible persons, target dates, and methods for evaluating progress.

Goals are broad desired outcomes; objectives are specific, measurable, achievable, relevant, and time-bound steps toward each goal.

ASAM level-of-care placement matches the six assessment dimensions to the least restrictive level of care that can safely meet the client's needs.

Under 42 CFR Part 2, most disclosures require written consent identifying the program, recipient, client, purpose, information to be disclosed, expiration, and right to revoke.

A warm handoff links the client directly to the referral provider through a live introduction or joint contact and increases the likelihood of referral follow-through.

A valid release of information specifies the client, recipient, purpose, information covered, expiration date, and client signature and must satisfy applicable federal and state law.

Treatment plans are living documents that are reviewed and updated when the client's needs, goals, or level of care change.

Continuing care planning identifies post-treatment supports, relapse prevention needs, and follow-up appointments before discharge.

Referral follow-up should be documented, including whether contact was made, whether services began, and any barriers encountered.

Cognitive behavioral counseling identifies cognitive distortions, challenges them, and replaces them with more balanced thoughts that reduce craving and substance use.

The motivational interviewing spirit consists of partnership, acceptance, compassion, and evocation; the righting reflex is avoided because it can increase client resistance.

Motivational interviewing proceeds through engaging, focusing, evoking, and planning processes, used flexibly rather than as rigid sequential steps.

Contingency management provides tangible, verifiable rewards for objective evidence of abstinence or treatment attendance and has strong support for stimulant use disorders.

Relapse prevention identifies high-risk situations, triggers, and coping skills; a lapse is a single return to use, whereas relapse is a return to a problematic pattern.

Common group stages are forming, storming, norming, performing, and adjourning; leadership adjusts for safety, conflict, cohesion, productivity, and termination.

Integrated treatment addresses substance use and mental health disorders together in the same setting rather than requiring one disorder to be treated before the other.

Suicide risk assessment directly evaluates intent, plan, means, and protective factors, followed by agency protocol, emergency evaluation when needed, and documentation.

Informed consent covers the nature of services, risks, benefits, alternatives, confidentiality limits, fees, and the right to withdraw and is an ongoing process rather than only a signature.

Common confidentiality exceptions include imminent danger to self or others, suspected child or elder abuse, court orders, and medical emergencies; specific duties vary by state law.

42 CFR Part 2 is generally more stringent than HIPAA for substance use disorder records and requires written consent for most disclosures.

Counselors avoid dual relationships that could impair objectivity or exploit clients; unavoidable situations require documentation, consultation, boundary setting, and monitoring for harm.

Scope of practice defines the services a counselor is trained and legally authorized to provide; clients are referred when needs exceed the counselor's competence or licensure.

Mandated reporting laws require counselors to report suspected child abuse, elder abuse, or dependent adult abuse to designated authorities, often within a specified time frame.

Clinical records should be timely, objective, accurate, and sufficient to justify services; errors are corrected with dated addenda rather than alteration or deletion of original entries.

A boundary crossing is a minor deviation from usual professional practice that can be managed; a boundary violation exploits or harms the client and is never acceptable.

Counselors use supervision and consultation when facing ethical dilemmas, high-risk situations, or issues outside their expertise.