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

Screening is a brief, low-burden procedure to flag probable problems and decide whether fuller assessment is warranted; it is not diagnostic.

The AUDIT-C uses 3 items (consumption frequency, typical quantity, heavy episodic use) and is scored 0-12; on the full AUDIT, cutoffs of 8+ (men) and 7+ (women) suggest hazardous drinking.

The CAGE has 4 yes/no items (Cut down, Annoyed, Guilty, Eye-opener); 2 or more positive answers indicates a need for further evaluation.

The DAST-10 score is the count of positive items; 1-2 indicates low level, 3-5 moderate, 6-8 substantial, and 9-10 severe level of problems related to drug use.

DSM-5-TR substance use disorder requires at least 2 of 11 criteria within a 12-month period; severity is mild (2-3), moderate (4-5), or severe (6 or more).

Withdrawal delirium, hallucinations with intact reality testing, and withdrawal seizures are specifiers for alcohol withdrawal, not separate diagnoses.

Under 42 CFR Part 2, a substance use disorder record may be disclosed only with the patient's written consent meeting specified content requirements, or under a narrow enumerated exception such as a medical emergency.

Screening tools are not interchangeable across languages and cultures; translated instruments should be validated in the target population before scores are interpreted.

Engagement is supported by motivational interviewing's relational components (empathy, affirmation) and technical components (evoking change talk, rolling with resistance).

The ASAM Criteria dimension framework has six dimensions: intoxication/withdrawal risk, biomedical conditions, psychiatric/cognitive conditions, readiness to change, relapse/continued-use potential, and recovery environment.

Level of care placement is determined by the highest severity across the six dimensions, not by an average or by the primary substance alone.

A treatment plan element is written as a problem statement, measurable goal, specific objective, and intervention with a target date; objectives must be observable and time-bound.

Goals are the client's broad aims; objectives are the discrete, measurable steps that demonstrate progress toward a goal.

Treatment plan reviews are required at intervals set by the program and by payer rules, and whenever there is a significant change in status, such as a new diagnosis or a relapse.

Referral decisions must account for the client's legal status, insurance or funding, transportation, childcare, and language needs; an unmet practical barrier is a placement failure.

Release of information must specify the recipient, purpose, information covered, expiration date, and the client's right to revoke in writing.

Co-occurring disorders are treated as the expectation rather than the exception; integrated treatment is the evidence-based default over sequential or parallel care.

Case consultation with other providers requires consent and should be documented with date, participants, information shared, and decisions made.

Motivational interviewing's four processes in order are engaging, focusing, evoking, and planning; planning is not required for every encounter.

Change talk is client speech favoring change (desire, ability, reasons, need, commitment, activation, taking steps); sustain talk favors the status quo.

The decisional balance exercise weighs perceived benefits and costs of using and of changing; it is a tool for building discrepancy, not a persuasion script.

Cognitive restructuring targets the interpretation between an event and an emotional response; the counselor tests the evidence for and against the automatic thought.

Refusal skills training uses rehearsal and role-play of specific, assertive responses to offers of substances, including a plan for high-risk social situations.

Relapse prevention distinguishes a lapse (a single return to use) from a relapse (a return to the previous pattern); framing a lapse as a lapse reduces the abstinence violation effect.

Contingency management delivers tangible, verifiable reinforcers for objectively confirmed abstinence or treatment attendance; it is not the same as token economy in residential settings.

Group counseling requires screening for fit; clients in acute withdrawal, active psychosis, or with a history of aggressive behavior in groups may need individual care first.

Trauma-informed counseling assumes a high prevalence of trauma, prioritizes safety and choice, and avoids coercive or confrontational techniques.

Confidentiality in substance use disorder treatment is governed by 42 CFR Part 2, which is more restrictive than HIPAA for records identifying a client as a patient in a federally assisted program.

Informed consent requires capacity, disclosure of risks and alternatives, freedom from coercion, and the client's comprehension of what is being consented to.

Dual relationships should be avoided when they risk impaired judgment, exploitation, or harm; when unavoidable, they require disclosure, consultation, and documentation.

The duty to warn or protect (Tarasoff) varies by jurisdiction and is triggered by a credible threat of serious harm to an identifiable person.

Mandatory reporting duties typically cover suspected child abuse or neglect, and in many jurisdictions elder or dependent adult abuse; the counselor's statutory role overrides client requests for silence.

Scope of practice is defined by state licensure law and the counselor's training; performing assessments or diagnoses outside that scope is a violation even if the counselor has the knowledge.

Boundary crossings are minor and may be clinically useful (for example, attending a client's graduation); boundary violations are harmful and exploit the client's vulnerability.

Documentation should be objective, behavioral, and contemporaneous; opinions should be labeled as such, and late entries should be marked as late with the actual date of the note.

Supervision and consultation are the standard response to ethical dilemmas; a counselor should not resolve an ambiguous ethical conflict alone.

Case management functions include outreach, screening, assessment, service planning, linkage, monitoring, advocacy, and discharge planning.

Warm handoffs, where the referring counselor directly connects the client to the receiving provider, reduce attrition compared with passive referrals.

Marlatt's relapse prevention model identifies high-risk situations, coping skills, self-efficacy, outcome expectancies, and the abstinence violation effect as key determinants of relapse.

The abstinence violation effect is the cycle of guilt and self-blame after a lapse that increases the likelihood of a full relapse; cognitive reframing interrupts it.

Relapse is commonly described as a process with stages (emotional, mental, and physical relapse) rather than a single event, so early warning signs can be identified and addressed.

A relapse prevention plan specifies the client's triggers, early warning signs, coping strategies, support contacts, and an emergency step for imminent risk.

Levels of case management contact should be matched to acuity; higher-need clients require more frequent monitoring and, in some programs, assertive outreach.

Discharge planning begins at intake and should specify continuing care, medications, housing, and follow-up appointment dates.

Case managers document linkages and outcomes, not just referrals made, because an unmet referral is not a delivered service.