2024 Edition

Addiction Counselor Practice Test

Try this free addiction counselor practice test to see what's on a licensing or certification exam for counselors who work with substance addiction. 

Most states require that an addiction counselor be certified or licensed.  Organizations such as the National Board for Certified Counselors (NBCC) and the National Certification Commission for Addiction Professionals (NCC AP) provide education and certification opportunities. To become a certified addiction counselor, a candidate has to pass an exam. The NCC AP offers different levels of certification such as National Certified Addiction Counselor I and II and Master Addiction Counselor (MAC).  The NBCC offers certification as a Masters Addition Counselor. Addiction counselor exams cover such subjects as screening, assessment and engagement, treatment planning, collaboration and referral, case management, individual and group counseling and professional responsibility.

Screening, Assessment and Engagement

1. All of the following are questions on the CAGE questionnaire EXCEPT?
2. According to the DSM-5, which symptom is not included in the criteria for an alcohol use disorder?
3. Lee is coming into the clinic for a substance use assessment. He reports using Xanax occasionally, but is unsure if he has a problem. During the course of the assessment, you learn that when he first started taking Xanax he used about one pill at a time. He reports that he is now taking three pills during each use because "one just doesn't do it for me anymore." You also learn that he decided he wanted to stop using Xanax altogether, but that he "keeps going back to it." He denied any other issues related to Xanax. When assessing the severity of Lee's Xanax use, what severity specifier would be most appropriate?
4. The following substances are all stimulants, except:
5. The CAGE-AID is a screening tool containing four yes/no items. How many questions need to be answered "yes" to be considered a positive screen?
6. Angela is attending a substance use assessment in hopes to be admitted to a residential program same day. During her assessment, she completes a drug screening including a breathalyzer and a drug panel. She does not appear significantly intoxicated, but she blows a .38 BAC. What is the next appropriate step?
7. Which of the following drugs would be present on a Urine Drug Screen (UDS) 5 days after use?
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8. Joseph comes into your office for an intake assessment required by his Probation Officer. Joseph is reluctant to discuss his opiate use. However, he is compliant because he knows that the results of the intake would be reported to his PO. He shared that he is on probation as a result of being arrested for stealing. Joseph explained that he was stealing to support his heroin use and has continued to use since his arrest. Joseph began using Oxycodone recreationally at age 17 which progressed to daily use soon after. Joseph began using heroin approximately 8 months later due to the cost difference. Joseph has used to avoid withdrawal symptoms. He recently began to share needles and noted that he is aware of the health risk that this behavior poses. Joseph's family began distancing themselves from him when he continued using heroin after being arrested.

With the information provided, how would you diagnose Joseph?
9. Susan was referred for an Alcohol Assessment by her Primary Care Physician. She scored a 17 on the AUDIT assessment. Which risk zone and action recommendation would be the most appropriate?
10. Which option correctly represents the Stages of Change Model?

Treatment Planning, Collaboration and Referral

11. A 67 year old female, Mary, attends an intake assessment with you on Monday. You diagnosis her with Alcohol Use Disorder, Severe and Bipolar I. You gave her a treatment schedule to engage her in group sessions along with a referral for a doctor on staff to assess for medications. Mary lives alone and has limited mobility due to severe arthritis. Mary misses her group session on Wednesday. As her primary clinician, you call her to follow up regarding her absence. While on the phone, it becomes apparent that she is inebriated and she reported falling down stairs and is struggling to get up. You encourage her to call 911, however she refuses.

Which would be the best course of action to present to your supervisor?
12. All of the following are indicators that a person would be appropriate for inpatient treatment except:
13. You are working with Abby as her substance abuse counselor. Abby reports ongoing issues with alcohol. She also reports nightmares, flashbacks, and significant distress when reminded of a sexual assault from the past. Which of the following referrals would you consider?
14. Of the following substances of abuse, which would be indicated for a possible Medicated-Assisted Treatment (MAT) referral?
15. Treatment plan objectives should be:
16. Your client has requested that you collaborate with their mental health practitioner while they are in outpatient substance use treatment. You review and have them sign a release of information. You have attempted to contact the provider over the course of the last two weeks via phone and email, but you have not heard anything back. What is the best course of action to take next?
17. Thomas is currently engaged in group and individual counseling with you and has a diagnosis of Alcohol Use Disorder, Severe and ADHD. Thomas has a positive Urine Drug Screen for stimulants and reported that he is currently prescribed stimulants for his ADHD by Dr. Smith.

Which of the following actions would not be appropriate for you to do?
18. Treatment plans should be updated_________.
19. Sara is currently engaged in group and individual sessions with you. A current goal is to receive the Vivitrol injection to aid in her abstinence from opiate use. As her counselor, how can you best support her?
20. Who should be involved in developing the treatment plan?
21. Mary just completed her intake session with you. Her use of alcohol has had a significant negative impact on her life. Consequences of her use were discord with her husband, missing her children's soccer games, daily use of alcohol and decreased productivity at work. Which consequence should be addressed first?

Case Management, Discharge and Continuing Care

22. At what phase of treatment does case management begin?
23. James was engaged in group and individual counseling in your outpatient program. He has maintained his sobriety and has found a medication regimen that helps him manage his depressive symptoms. James attends Alcoholic Anonymous four times per week and has been active in working the steps with his sponsor. Which of the following recommendations would be the least effective at his discharge?
24. Macy is in recovery from alcohol and heroin. Macy will complete treatment next week and is preparing for discharge. She expressed that she has interest in self-help groups, but is not interested in any groups that incorporate God or spiritual associations. Which would be the most appropriate recommendation for continuing care?
25. Of the following, which is an appropriate reason for discharge:
26. Jon attends your aftercare group once a week to support his abstinence from alcohol. During group, Jon shares that he has begun drinking alcohol occasionally. What is the best course of action to take?
27. Continuing care is:
28. Susan is being discharged as a result of continued relapses and inconsistent attendance for group therapy. Despite your best efforts, she is reluctant to agree with your recommendation for inpatient treatment. Which of the following would be the most appropriate course of action at the conclusion of her discharge session?
29. All of the following are models of case management except:
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30. All of the following are benefits of aftercare treatment except:
31. All case management approaches can be considered ______-_______.

Counseling (Individual and Group)

32. In Twelve-Step traditions, which step is "Came to believe a Power greater than ourselves could restore us to sanity?"
33. Which of the following is specific to Motivational Interviewing?
34. Which of the following is the best example of behavioral activation?
35. Using the stages of change model, which intervention would not be appropriate for someone who is in the contemplation stage of change regarding their substance use?
36. You work in an outpatient program with a team of addiction counselors, social workers, a nurse and a physician. You facilitate an intensive outpatient group in the mornings from 9am-12. Around 9:30 am you notice that Scott appears to be nodding off in the group. You also observe that group members have noticed him as well and appear uncomfortable. You are aware that Scott uses opiates and has been struggling to abstain from use. What is your best course of action?
37. Which of the following is not a consequence of glorifying drug use in a group session?
38. Which form of counseling has been shown to have the most benefit with addiction?
39. Which therapeutic approach is the most effective when working with a resistant client?
40. Matt is a heroin addict. Which group would be an appropriate suggestion for him?
41. You are facilitating a co-occurring mental health and substance abuse group. One of the group members, Sally, shares that she has been struggling with her depression symptoms and feels as though being sober is "too much". She noted that yesterday on her way home from work she was driving by a liquor store and stayed in the parking lot for approximately 35 minutes before calling her sponsor. Which approach are you least likely to use?

Professional and Ethical Responsibility

42. What is transference?
43. Mary is an 18 year old female who is currently engaged in outpatient treatment with you. She has been actively using cocaine and has reported continued discord with her mother. Mary has not signed a consent for her mother at this time. While in your office, you receive a phone call from her mother insisting to know the results from Mary's recent drug screens. Mary's mother stated that she believes her daughter is using cocaine based on her current behaviors and "attitude".

What is the most appropriate response?
44. Steven is a 15 year old male who was referred to treatment by his school counselor after he was observed impaired at school. Steven has been abusing Xanax and acknowledges use at school. He currently lives with his mother who has a legal prescription for Xanax which she does not keep in a locked location. Steven's mother is aware that this is her son's drug of choice and has decided to not keep her prescription in a secure location. Knowing that your client's drug of choice is not securely locked in the house, what would be the best course of action to discuss with your supervisor?
45. Sally and Joe have been married for 16 years and have a pattern of verbal and physical abuse when drinking. Both persons are engaged in treatment within your facility. You work with Joe and your colleague works with Sally individually. Joe informs you that he and Sally have been drinking every night to the point of blacking out. He explains that they often wake up in the living room and do not remember several hours of the evening before. You are aware that they have 2 children, ages 7 and 4 who live with them. You feel as though you need to do something regarding the children's safety.

Which of the following is the best option to discuss with your supervisor?
46. While working in an outpatient clinic, you recognize the name of a person you are supposed to conduct an intake assessment with at 2pm in the afternoon. You recognize the name because this person is friends with your brother. What is the best course of action?
47. You facilitate an after care group for clients who have successfully completed your inpatient program. This group is on an outpatient basis and occurs once per week. You are notified that a person who was engaged in the inpatient treatment at the same time as some of your aftercare patients has overdosed and died. How should you proceed?
48. Sky is your client and is enrolled in a residential program. She is on probation for a drug related offense. You currently have a release of information on file for her probation officer, Katie. You get a call from Sarah, stating that she is covering for Katie while Katie is on maternity leave and needs updated progress notes faxed to her. How should you respond?
49. You've been working with Chris for about three months and have a good therapeutic relationship. During your appointment on December 23rd, he brings you an origami crane as a Christmas gift. All of the following should be considered in your decision making, except:
50. You're a counselor working in an outpatient program. Your client finds your personal social media account and sends you a message regarding their treatment plan. Which of the following is the best course of action?