How to use this page

This page contains information on the sample exam you recently completed.  When you submitted your test responses, you received a feedback page that contained your test score.  An email will be sent you that contains exact information on the questions missed, along with suggestions from our staff.

The grade you received was a percentage.  For both the ICRC and NAADAC exams, you will need to obtain a test score of 70% or greater.  That would equate to a score of at least 35 out of 50 on this sample exam.

The sample exam will give you a good exposure to the credentialing exam and the types of questions typically asked.  Use this exam  to predict what you will need to prepare for. Your focus is to determine both

  1. The content of the questions and
  2. The type of memory/intellectual skills you will be asked to use.

Examples of these skills include:

·       Remembering specific facts.

·       Comparing, contrasting, and otherwise interpreting meaning in the information studied.

·       Applying principles and theories to solve problems (that may not have been covered explicitly in the materials).

·       Predicting possible outcomes given a set of variables.

·       Evaluating the usefulness of certain ideas, concepts, or methods for a given event or situation.

Rather than focus on the score you obtained, take the time to look at the questions.  If you missed a question, see if you can determine why.  Did you know what the question was asking?  Did you hurry in your response?  Was there a better selection that you overlooked?  Or was it a question that you knew nothing about?  In working with thousands of students who are preparing for their credentialing exams, we typically find that most already have a solid base of knowledge that would allow them to pass their exam.  Rarely do we discover someone who genuinely lacks the knowledge needed.  Rather, it is simple errors that often determine the difference between success and failure.  Here are some of the errors that occur:

  1. Didn't understand what the question was asking (is there a but, not, except, or something similar that changes the focus of the question?).
  2. Didn't read all five of the possible responses (both ICRC and NAADAC ask you to select the "best" response - this may mean that there are actually more than one correct answer, but one is the best).
  3. Mixed up the numbering of the question (actually put the answer for 33 in the blank for 34, etc.)
  4. Changed their mind on a response.  Many times a question later in the exam may make you think "gee, I should have answered that differently."  We tend to find that when someone feels they have answered a question correctly and then decides to "fix it" later, they typically change a correct answer for an incorrect one!
  5. Didn't know an answer so they left the response blank.  This is a cardinal sin - there is no additional penalty for missing a question, but if a question is left blank, it is automatically wrong.  When in doubt, guess.

If you discover that you missed a question due to a simple error in taking the exam, then remember this when you take your credentialing exam.  If you discover that you missed a question because you did not know the content, then take the time to study/review this information.

Go through the entire sample exam below, and note the content, ICRC Domain, or NAADAC Content.  See if you really did know the answer, or if you didn't know the material.  Also look for any additional tips that we've posted with each question - we've tried to highlight the need-to-know information for each test, and there are also some examples of some of the errors listed above to help illustrate our point.

Remember, if you have questions or need further feedback, don't hesitate to contact us by emailing us at

1.   ________ is the essential first step in determining the possible causes of addiction for the person and the most appropriate treatment modality for his or her needs.

Content Area: Assessment

ICRC Domain: Assessment / NAADAC Content: Theoretical Bases

  1. screening
  2. assessment 
  3. intake
  4. orientation
  5. treatment planning

This is a straight knowledge question - only one correct response.


2.   A client tells a counselor that she is unhappy with the way her treatment is progressing. The counselor should:

Content Area: Counseling

ICRC Domain: Counseling / NAADAC Content: Counseling Practice / NAADAC Content: Counseling Practice

  1. create new goals and objectives, and suggest alternate forms of therapy
  2. talk to the client about possible denial
  3. refer the client for more appropriate treatment
  4. draw up a new contract with the client
  5. discuss these concerns with the client and make necessary changes in treatment goals.

This is one of those "more than one correct" responses.  A, b, c, and d could be considered the right thing to do.  However, doing the "e" response would include all four of the others.


3.   A female client reports that she has some concerns about the relationship between her husband and her 14-year-old daughter from a previous marriage. She reports that her husband and daughter frequently argue, that her daughter refuses to take direction from her stepfather, and that her daughter regularly complains about her stepfather’s “faults” and describes how her biological father is better. The MOST relevant professional to whom a referral should be made is a:

Content Area: Referral

ICRC Domain: Case Management / NAADAC Content: Counseling Practice

  1. Social worker.
  2. Clinical psychologist.
  3. Licensed professional counselor.
  4. Marriage and family therapist.
  5. School psychologist.

While all of the other professionals may be helpful, there is no guarantee that they would have specific training in family issues.  By definition, a marriage and family therapist would.


4.   A key factor for counselors to consider is that in a counseling relationship, the counselor has differential power. One of the best safeguards is:

Content Area: Professional Responsibility

ICRC Domain: Professional Responsibility/ NAADAC Content: Professional Issues

  1. To be alert to and understand the power relationship.
  2. To utilize the differential power to motivate the client.
  3. To realize the importance of this power in client interventions.
  4. To not become involved in a dating relationship until the client has completed treatment.
  5. To use differential power to get the client to try new behaviors.

D is an obviously wrong response (and unethical, too), but the other three may sound appropriate.  However, differential power has a place and purpose of use based on the client and their needs.  The "a" response is the best choice to answer the question.


5.   A pretreatment period is frequently the result of waiting lists or client reluctance to become fully engaged in primary treatment. What might be a danger of this pretreatment period?

Content Area: Case management

ICRC Domain: Case Management / NAADAC Content: Counseling Practice

  1. The pretreatment period may be when clients lose interest in treatment.
  2. A client may receive enough help so as not to need the services of the program or agency.
  3. Successful pretreatment may result in a client needing services that an agency doesn’t have, thus losing the potential admission.
  4. Typically, pretreatment services are not paid for by insurance services.
  5. There is really no danger with pretreatment - recovery will require much more programming than pretreatment can offer.

Losing a client's interest is the biggest concern we always face in the field.  Denial, delusion, "feeling better" are always good excuses not to get help.  Not being able to engage the client quickly and get them started is always a risk.


6.   According to Marlatt’s model of the relapse process, which of the following statements is not true?

Content Area: Relapse

ICRC Domain: Counseling / NAADAC Content: Counseling Practice

  1. Abstinence, not controlled use, must be the ultimate goal.
  2. Clients should be helped to recognize that one or more temporary lapses are likely to occur and are permitted.
  3. Clients should be taught skills for anticipating, avoiding, and coping with their personal high-risk situations.
  4. Clients should be taught constructive responses to cope with lapses when they do occur.
  5. Any positive expectations that clients have about drug use should be countered with reminders about the lows that follow the highs and about the long-term negative consequences of substance abuse.

This is a straight knowledge question.  If you haven't read up on Marlatt's model, this may be difficult.  It's OK to not make a perfect score on the credentialing exam!


7.   According to the DSM-IV, all of the following are criteria for psychoactive substance dependence EXCEPT:

Content Area: DSM

ICRC Domain: Assessment / NAADAC Content: Theoretical Bases; ICRC Domain: Education / NAADAC Content: Theoretical Bases

  1. Substance often taken in larger amounts than the person intended.
  2. Marked lack of initiative, interest or energy.
  3. Frequent intoxication when expected to fulfill major role obligations.
  4. One or more unsuccessful efforts to cut down substance use.
  5. Marked tolerance.

This is an example of a word that changes the focus.  The EXCEPT is what is being asked for.  Be sure you note such words and feel free to circle, underline, or mark the word in such a way as to help you seek out the correct response.


8.   Bob is a case manager in an intensive inpatient treatment facility.  He recently was assigned a client, Mary, who presents not only with alcoholism but has also been diagnosed with AIDS.  To assist Mary in her treatment and recovery needs, Bob would probably need to have knowledge of all of the following areas EXCEPT:

Content Area: Case management

ICRC Domain: Case Management / NAADAC Content: Counseling Practice

  1. AIDS epidemiology and transmission routes
  2. the disease's clinical progression
  3. new medication used in treatment regimens
  4. available social services for AIDS clients
  5. psychotherapeutic approaches to AIDS patients' grief and fear.

An "EXCEPT" again, but also this is a scope of practice type question.  You should know about AIDS, its progression, available social services, and counseling approaches (especially for grief and fear).  You would not be expected to know about medications - this is the domain of the physician.


9.   Case management is needed because services tend to be fragmented and inadequate to meet the needs of the substance-abusing population. This lack of coordinated services may result from all of the following factors EXCEPT:

Content Area: Case management

ICRC Domain: Case Management / NAADAC Content: Counseling Practice

  1. funding focused on single modalities rather than a continuum of care
  2. waiting lists caused by inadequate funding
  3. barriers between systems (e.g., mental health vs. substance abuse, criminal justice vs. mental health and substance abuse)
  4. eligibility/admission criteria that focus on special need clients
  5. lack of incentives for programs to work together

"Except" again.  The "d" response is the correct response because programs all tend to have special eligibility or admission criteria, or may offer services for special need clients.  This is not a problem in case management, but actually is an enhancement for continuum of case issues.


10.    Counselors rely heavily on the work of developmental theorists as they attempt to stimulate clients to initiate relevant growth. According to Erickson, one of the leaders in developmental theory, the task to be accomplished in adulthood is:

Content Area: Theory

ICRC Domain: Professional Responsibility/ NAADAC Content: Professional Issues

  1. Trust vs. Mistrust.
  2. Initiative vs. Guilt.
  3. Integrity vs. Despair.
  4. Identity vs. Role Confusion.
  5. Intimacy vs. Isolation.

Straight "theory" question.  Need to be sure you've reviewed basics of all of the major theorists like Erickson, Rogers, Adler, etc.


11.    Drug use by adolescents is:

Content Area: Education

ICRC Domain: Education / NAADAC Content: Theoretical Bases

  1. not affected by parental drug use
  2. not affected by peer drug use
  3. most affected by parental drug use
  4. most affected by peer drug use
  5. equally affected by parental and peer drug use

Many resources on adolescent needs and issues focus on the peer group as being one of the most influential things with regards to adolescent drug using behavior.


12.    During the intake, a counselor can expect to address all of the following issues EXCEPT:

Content Area: Intake

ICRC Domain: Counseling / NAADAC Content: Counseling Practice

  1. a client’s fears and denial
  2. confidentiality
  3. information gathering 
  4. preliminary identification of client goals
  5. treatment planning

This is a core function question.  When answering core function question, make sure you know their definitions.  Treatment planning does not occur in the intake process, but all of the others do.

13.   Effective case management for persons in need of multiple services requires:

Content Area: Case management

ICRC Domain: Case Management / NAADAC Content: Counseling Practice

  1. Monitoring, feedback, and evaluation of services.
  2. Frequent face-to-face contact with the client.
  3. Collaboration with family members.
  4. Consent for full disclosure of information among all service providers.
  5. Careful matching with appropriate 12-step groups.

Key words here are "multiple services" - that makes "b", "c", and "e" incorrect.  "D" may sound like a good answer, but full disclosure is not needed to monitor or evaluate services.


14.    In determining whether a chemically dependent patient should be treated in an inpatient or outpatient program, all of the following should be considered except:

Content Area: Assessment

ICRC Domain: Assessment / NAADAC Content: Theoretical Bases

  1. whether the patient has a history of sobriety during the last several years
  2. whether the patient believes he can succeed in an outpatient program
  3. whether the patient has family support for sobriety
  4. whether the patient has a history of failed treatment on an outpatient or inpatient basis
  5. whether the patient’s job and family are likely to give him another chance if this treatment fails  

Again, it's the "EXCEPT" that determines the response.  All four of the other responses do help determine placement.  Consequences of failure are not a determining factor.


15.    Long-term effects of alcoholism may include:

Content Area: Pharmacology

ICRC Domain: Education / NAADAC Content: Theoretical Bases

  1. confusion
  2. cerebral atrophy and cardiovascular damage
  3. marked uncoordination
  4. depressed reflexes

  5. ataxia

All five responses are correct responses - they all occur in late stage alcoholism.  However, the "b" response is the why for the other four, making it the "best" response.


16.    It is crucial for the case manager to be aware of what may inhibit minorities' participation in the substance abuse treatment continuum.  Suppose that you are a case manager, working in an outpatient program with a Somali client.  AA is an integral part of your program, yet you are aware of the fact that while "accepting one's powerlessness" is a central tenet of 12-Step self-help programs, members of oppressed groups may not accept it, given their own societal powerlessness.   What would be the best thing to do in such a case?

Content Area: Case management, Cultural

ICRC Domain: Case Management / NAADAC Content: Counseling Practice

  1. Ask the client to participate, never-the-less, and suggest he simply “do his best” when dealing with the issue of powerlessness.
  2. Let the client know that participation in AA is mandatory, and that if he doesn’t participate, he could be discharged for “noncompliance.”
  3. Be sensitive to such cultural differences and seek out other recovery resources that are relevant to the individual's values.
  4. Seek out another Somali who is in a local AA group and ask the he or she sponsor your client.
  5. Do nothing.  The client can continue to participate in the AA group even if he doesn’t accept his powerlessness.

Need to know two things for this question - cultural needs and 12 Step programming.  This is a difficult issue that happens with great frequency today.  Having cultural knowledge is critical, but so is knowing the use and limitations of 12 Step programs.  There are alternatives today for self help - a counselor needs to be aware of them and use them in appropriate situations.


17.    It is important to understand clients and their expectations for counseling. Clients coming in for treatment carry with them both helpful and harmful expectations. Which of the following is a harmful client expectation?

Content Area: Professional Responsibility

ICRC Domain: Professional Responsibility/ NAADAC Content: Professional Issues

  1. “This counselor is a stranger, but maybe I can learn to trust her.”
  2. “My counselor will direct me to do what I need to do, and everything will be OK”
  3. “My counselor will be a resource that I can use to resolve my problems.”
  4. “The counselor’s main concern and responsibility is to help me achieve my goals and objectives.”
  5. “The counselor and I can have a relationship in which we are both equally responsible.”

Key word is "harmful."  The other four responses are all "helpful" making "b" the only choice.


18.    Joe is a 27-year old addict who has begun counseling, but has not yet been able to give up using drugs.  During one session, he tells his counselor that he is beginning to feel that "it is useless to try to stop," and that "sometimes life is not worth living."  The counselor is concerned that Joe could be suicidal.  The counselor should:

Content Area: Crisis Management

ICRC Domain: Assessment / NAADAC Content: Theoretical Bases

  1. assess Joe's potential for suicide without directly asking him about suicide plans, but assess his high-risk factors
  2. assess Joe's potential for suicide by asking him about his intent, and evaluating high risk factors
  3. determine if Joe has a gun or other weapon
  4. initiate hospitalization procedures
  5. list all the reasons he has for living

Dealing with suicidal behavior can never be danced around.  Asking direct questions about intent and looking for high risk factors like having the means and opportunity to carry through with suicidal behavior is always the direction to take.  "C" does address the high risk factor, but just having a gun is not an issue unless Joe also says "I'm going to shot myself in the head," or something similar.


19.   One of the counselor’s tasks is to guide the client in relating and communicating in specific terms, rather than in general or abstract terms. That characteristic or ability is called:

Content Area: Individual Counseling

ICRC Domain: Counseling / NAADAC Content: Counseling Practice

  1. Confrontation.
  2. Immediacy.
  3. Potency.
  4. Concreteness.
  5. Clarification.

This is a Basic Counseling 101 question.  Straight definition of concreteness.  Be sure to know all of the definitions for basic counseling skills like this.


20.    One of the earliest models for case management services in the criminal justice system was created in 1972, when the White House launched a demonstration program known as:

Content Area: Case management

ICRC Domain: Case Management / NAADAC Content: Counseling Practice

  1. Treatment Alternatives to Street Crime (TASC)
  2. Treatment Approaches for Criminal Offenders (TACO)
  3. Treatment Resources for Chronic Repeat Offenders (TRCRO)
  4. Helping Services for the Criminal Element (HSCE)
  5. Project for Drug and Alcohol Offenses (PDAO)

This is a history type question that would require you to have ready this somewhere.  Not an easy one to get unless you have.


21.    Ralph is a recovering alcoholic.  He as been sober for several months, and has managed to find gainful employment and re-establish family relationships.  He is in a twelve-step program as well as individual counseling.  One day, he arrives to a counseling session quite upset.  He reveals that he had a "slip" and drank a beer at a party.  He did not get drunk, but feels terribly remorseful and has promised himself that he will not do it again.   Which of the following is most true?

Content Area: Individual counseling, Relapse

ICRC Domain: Counseling / NAADAC Content: Counseling Practice

  1. This constitutes a relapse, and Ralph may need to begin the recovery process all over again.
  2. Ralph should be reassured that this behavior is permissible as long as he did not lose control and become drunk.
  3. The counselor should talk to Ralph about the implications of dangerous situations like this, but assure him that it is possible to continue his recovery process.
  4. Ralph should avoid friends who serve alcohol
  5. Although Ralph did have a relapse, recovery should be easier the second time around.

Many theories and approaches to relapse talk about slips and their implications.  All agree that while not desired, slips can and do occur.  They should not impede future recovery and are especially beneficial if we look at the reasons behind the use.


22.    Record keeping is an important part of the counseling process.  Which of the following best reflects the type of information which should be kept in a client’s record?

Content Area: Record Keeping

ICRC Domain: Counseling / NAADAC Content: Counseling Practice

  1. the name of an attending physician, referrals made, diagnostic procedures used
  2. names of family members, emergency numbers, DSM-IV diagnosis
  3. personal notes, insurance information, treatment notes
  4. information about consultations, diagnosis, treatment, prognosis, and progress
  5. this depends upon the procedures adhered to by the counselor and the agency

Again, a "best" response question.  The "d" response would cover all of the other things listed in some why, shape, or format.


23.    The agency you work for wants you to lead a group for dually diagnosed clients. You have no training in this area. You should:

Content Area: Professional Responsibility

ICRC Domain: Professional Responsibility/ NAADAC Content: Professional Issues

  1. Lead the group to increase your skills.
  2. Lead the group but tell the clients you are new to this area.
  3. Get help from another staff member who knows the issues of dual diagnosis to co-facilitate the group.
  4. Inform your supervisor you do not have the qualifications to lead the group.
  5. Research the topic of dually diagnosed clients and attend training on the topic before leading the group.

This goes to the issue of scope of practice.  Ethically, a counselor should not be delivering services in areas which they have no skill or training.  While "c" sounds like a good answer, the first duty would be to inform the supervisor - he or she may decide to have a skilled staff member co-facilitate, but that's their call, not yours.


24.    The association between drugs and crime can be made in which of the following ways?

Content Area: Criminal Justice

ICRC Domain: Education / NAADAC Content: Theoretical Bases

  1. The criminal act of manufacturing or selling illegal drugs is undertaken for the extreme profits that can be made.
  2. Some addicted persons engage in income-generating crimes to support their drug use habits. This includes crimes such as robbery, shoplifting, burglary, and prostitution.
  3. The mind-set that allows a person to commit criminal behavior is the same mind-set associated with dependent use of alcohol and other drugs.
  4. A and B are correct. 
  5. A and C are correct.

Here's the first example of an "a and b" or similar response.  ICRC tends to shy away from such responses, but they have been found in both ICRC's and NAADAC's exams.  Don't assume that just because you see this choice (or the famous "all of the above") that the choice would be "d' or "e."  Make sure you read the responses and decide based on what they contain.  In this case, the criminal mind-set does not determine addiction or use behavior, making "c" wrong. 


25.   The CAGE test is a simple assessment that is administered to individuals with a drinking problem.  The questions on this test refer to:

Content Area: Assessment, Screening

ICRC Domain: Assessment / NAADAC Content: Theoretical Bases

  1. cutting down on drinking, feeling annoyed and guilty, and dealing with hangovers
  2. craving a drink, drinking alone, feeling guilty, and employment difficulties
  3. client perceptions, guilt, and “eye-openers"
  4. a self-administered screening test
  5. making a distinction between problem drinkers and alcoholics

CAGE is a quite common screening tool that spells out four questions based on the C, A, G, and E.  Cutting down, being annoyed by questions, feeling guilty, and the "eye-opener" are what they stand for.


26.  The focus of intervention in the criminal justice system is first to do which of the following?

Content Area: Criminal Justice

ICRC Domain: Education / NAADAC Content: Theoretical Bases

  1. Protect the health, safety, and welfare of the public.
  2. Rehabilitate offenders.
  3. Use the threat of incarceration as a motivator to change.
  4. Keep the chronic, chemically dependent person off the streets.
  5. Punish the offender for their behavior.

A basic criminal justice type question.  With both ICRC and NAADAC, they tend to have a small handful of questions from information areas that have become mainstream - meaning that they've been around for at least 2 years or more.  Right now, criminal justice, especially Therapeutic Communities, seem to be the newest information.  That doesn't mean you need to take the time to study this (if you haven't already).  There will not be enough questions in such an area to determine whether or not you pass the exam.


27.   The initial stage of crisis intervention involves:

Content Area: Crisis Management

ICRC Domain: Counseling / NAADAC Content: Counseling Practice

  1. discussing the client’s plans for the future
  2. helping the client adapt
  3. determining the problem
  4. determining a solution
  5. contacting the appropriate referral agency

Another example of all of the responses being technically correct.  But in this case, one thing has to happen first before anything else can.  Determining the problem helps to do all of the other things.


28.    The measurement of progress toward treatment plan goals is best assessed by:

Content Area: Treatment Planning

ICRC Domain: Counseling / NAADAC Content: Counseling Practice

  1. Reviewing documentation in progress notes.
  2. Consulting with the client’s significant others.
  3. Referring the client to a professional outside your agency for an objective review.
  4. Asking the client to write a personal evaluation of his/her own progress.
  5. Comparing the client’s progress to another client’s progress.

This could also be a case management question.  Think about how we document progress in treatment.  It's the progress notes that tie the treatment plan to the programming we perform.  Makes this the only viable response.


29.   The PRIMARY purpose of a professional code of ethics is to:

Content Area: Ethics

ICRC Domain: Professional Responsibility/ NAADAC Content: Professional Issues

  1. Serve as a guide in helping clients while behaving in a fair way to colleagues.
  2. Strengthen the appearance of professionalism among addiction counselors.
  3. Clarify the difference between acceptable and unacceptable client behavior.
  4. Provide legal recourse and concrete consequences for unethical behavior.
  5. Ensure that disadvantaged people receive services without discrimination.

This comes both from NAADAC's ethical guidelines, but also from LeClair Bissell's book on ethics.  Should know this, and should have a good handle on ethics in general - expect 4-5 questions specific to this area.


30.   The PRIMARY purpose of professional standards of practice is to:

Content Area: Professional Responsibility

ICRC Domain: Professional Responsibility/ NAADAC Content: Professional Issues

  1. Provide recognition of demonstrated competency in addictions counseling.
  2. Ensure that each client receives equal treatment regardless of ability to pay.
  3. Help programs qualify for Medicaid and other third-party reimbursement.
  4. Allow unlicensed counselors to work in licensed facilities.
  5. Provide guidelines to counselors for developing treatment plans.

Credentialing demonstrates competency, whether it's certification or licensure.


31.   The tendency of the family to try and maintain balance is called:

Content Area: Family Counseling

ICRC Domain: Counseling / NAADAC Content: Counseling Practice

  1. equilibrium
  2. stability
  3. homeostasis
  4. accommodation
  5. harmony

Balance is the keyword - homeostasis means balance.


32.   The therapeutic reasoning for self-disclosure in group counseling is to:

Content Area: Group Counseling

ICRC Domain: Counseling / NAADAC Content: Counseling Practice

  1. Provide the group members with insight into the counselor’s background.
  2. Convince group members that the counselor has more life experiences than they do.
  3. Provide a means by which the counselor can also benefit from the group process.
  4. Demonstrate how to react when other group members disclose personal information.
  5. Facilitate the growth of the group by relating to client or group issues.

Self-disclosure should only be done when it helps the group move forward.  It is not self-serving, and is not used to show that the counselor is "just like me."


33.   Therapeutic communities differ from Synanon because:

Content Area: Therapeutic Communities

ICRC Domain: Education / NAADAC Content: Theoretical Bases

  1. these communities are based on individual psychotherapy rather than group encounter
  2. these communities rely on professional psychologists rather than former addicts or abusers
  3. these communities try to return clients to society
  4. these communities keep the patients busy rather than engaging in contemplative thought
  5. Synanon caters only to rich patients and these other communities treat everyone regardless of economic level

Again, a specific knowledge question that you may or may not have studied.


34.    There are many benefits of having a group that is highly cohesive. One possible risk, however, is the development of a process known as “groupthink.”  “Groupthink” entails all of the following EXCEPT:

Content Area: Group Counseling

ICRC Domain: Counseling / NAADAC Content: Counseling Practice

  1. suspension of critical thinking
  2. suppression of valid personal objections to a group decision
  3. group decisions that are more risky and extreme than those that would ordinarily be made by an individual
  4. illusions of invulnerability and superior morality
  5. obstruction of individual growth

This is a very specific question, but there is a way to get the right answer.  Think about the word "groupthink" - what does it mean to you?  Doesn't it suggest that the group need would outweigh the need of the individual?  Doesn't that suspend critical thinking?  Wouldn't the group dynamic keep others from objecting?  Don't groups tend to think that their viewpoint is right, superior?  Don't groups tend to suppress individual growth, especially if it threatens the strength of the group?  Wouldn't risky or extreme viewpoints be ignored or not allowed to happen?  By thinking about the word, and weeding out the response, "c" becomes the clear choice.


35.    There are several psychological and sociological differences between male and female alcohol abusers. Which of the following best describes one of those differences?

Content Area: Pharmacology, Special Populations

ICRC Domain: Education / NAADAC Content: Theoretical Bases

  1. Women more often than men will cite a traumatic event that precipitated their drinking.
  2. Female alcoholics are more likely to be sociopathic and male alcoholics are more likely to have affective problems.
  3. Female alcoholics are less frequently characterized as feeling depressed and guilty than male alcoholics.
  4. Women move more slowly from the early stages to the later stages of abusive drinking than men.
  5. Women appear to do more social drinking with friends at country clubs and home parties.

"B," "c," "d," and "e" are all just the opposite of what we know about women alcohol abusers. 


36.    When a client discloses suicidal thoughts, the counselor’s first step is to:

Content Area: Crisis Intervention

ICRC Domain: Assessment / NAADAC Content: Theoretical Bases

  1. Identify alternative courses of action.
  2. Offer emotional support.
  3. Contact emergency personnel.
  4. Assess degree of risk.
  5. Contract for safety.

Oops - didn't we already have a question like this?  Look back at #27 - very similar.  It does sometimes happen, and is a classic example of where suddenly "the light goes on."  If you are like most people, you'll set out to find the similar question to see if you answer them both the same way.  This can be anxiety inducing, and can also waste valuable time.  Don't worry about it - if you get this one right, you probably answered the other one right, too. 


37.   When assessing the signs and symptoms of alcohol withdrawal, all of the following may be noted EXCEPT:

Content Area: Assessment

ICRC Domain: Assessment / NAADAC Content: Theoretical Bases

  1. Restlessness, irritability, anxiety, agitation.
  2. Tremor, elevated heart rate, increased blood pressure.
  3. Decreased sensitivity to sounds, oversensitivity to tactile sensations.
  4. Hallucinations (auditory, visual, or tactile).
  5. Decreased appetite, nausea, and vomiting.

Alcohol, being a depressant drug, does cause a decreased sensitivity to sound (hearing is typically impaired), but deadens nerve endings, causing a loss of tactile sensations.  In withdrawal, however, these effects are generally reversed and magnified.  That would mean an increased sensitivity to sound and oversensitivity to tactile sensations.


38.   When conducting an assessment, what is the counselor’s primary focus?

Content Area: Assessment

ICRC Domain: Assessment / NAADAC Content: Theoretical Bases

  1. identifying the client’s problems and needs, strengths and weaknesses
  2. explaining the rules of the program
  3. having the client sign Release of Information forms
  4. confronting the client’s denial
  5. exploring treatment options

The definition of assessment.  Again, make sure you know your core function definitions - they will help greatly when answering questions.


39.    Which of the following is the BEST indicator that an individual is physically dependent upon alcohol or another drugs?

Content Area: Assessment

ICRC Domain: Assessment / NAADAC Content: Theoretical Bases

  1. the amount consumed daily
  2. the length in years of heavy drinking or drug use
  3. presence of withdrawal symptoms
  4. the frequency of memory blackouts
  5. presence or absence of tolerance

Though not all drugs have withdrawal symptoms, it is still the best true indicator of physical dependence.  Amount of use and length of time used don't determine addiction.  Blackouts can occur when abusing or misusing alcohol or other drugs.  Tolerance is also a natural phenomenon that even develops with social drinkers.


40.    Which of the following statements about dysfunctional families is true?

Content Area: Family Counseling

ICRC Domain: Counseling / NAADAC Content: Counseling Practice

  1. The family cannot get well until the dependent person seeks help.
  2. The children in a dysfunctional family can be protected from the problems cause by chemical dependency.
  3. The divorce rate in dysfunctional families is highest after recovery has been initiated.
  4. All of the above statements are true.
  5. None of the above statements are true.

Here's that "all" and "none" response, but neither is correct.  The "a" and "b" responses are both common myths - the family can get well in spite of the dependent person not seeking help, and children are always impacted, even with the spouse or other family members try to protect them.  The sad reality is that indeed, the divorce rate tends to be highest after recovery has been initiated.  This is when the family sees a person they've never experience before, or at least for a long time.  They may not like the recovering person any better than when they were using.


41.   Before beginning treatment a counselor must:

Content Area: Screening

ICRC Domain: Assessment / NAADAC Content: Counseling Practice

  1. establish rapport
  2. reassure the client and reduce anxiety
  3. make a formal diagnosis
  4. identify the problem
  5. make appropriate referrals

Five good answers, but only one is best.  Again, think about the core functions and how the unfold.  You screen a client, do an assessment, make a diagnosis, and refer to treatment.  When you screen, you see if there is even a problem to be concerned about.  No rapport is needed, you don't always need to reassure the client and reduce anxiety.


42.    Which statement MOST accurately describes the relationship between Alcoholics Anonymous and the professional treatment community?

Content Area: Recovery/Self-Help

ICRC Domain: Professional Responsibility / NAADAC Content: Professional Issues

  1. AA policy clearly states that recovery can often be frustrated by contact with professionals.
  2. AA has made no statements for or against the professional treatment community.
  3. There are inherent conflicts between AA and the professional treatment community which are unlikely to be resolved.
  4. A partnership between AA and the professional community was repeatedly emphasized by the founders of AA.
  5. For the most part, the professional treatment community has been skeptical of the AA program because it is not scientific.

This is a history question that relates to AA.  Expect to see 3-4 questions about self-help on the exam.


43.    Which term refers to a client’s projecting past emotional feelings and/or attitudes onto the counselor?

Content Area: Counseling

ICRC Domain: Counseling / NAADAC Content: Counseling Practice

  1. Transference
  2. Countertransference
  3. Reaction formation
  4. Transaction
  5. Sublimation

Know your defense mechanisms.  There tends to be some questions from this area.  This is the definition for transference.


44.    While taking an alcohol drug history, which of the following is a good clue to alcohol dependency?

Content Area: Assessment

ICRC Domain: Assessment / NAADAC Content: Theoretical Bases

  1. depression and lethargy
  2. continued use despite experiencing problems that result from drinking
  3. recurring incidents of driving under the influence
  4. occasional binges
  5. increased tolerance, and withdrawal symptoms when abstinence is attempted

Straight from the work of E.M. Jellinek.  The V-chart is still one of the greatest single tools used for evaluating dependence and the stage at which a client enters care.


45.    You have assessed your client and determined that he is a problem drinker. He insists that the reason he drinks is because of his wife’s behavior. Your initial objective should be to help him:

Content Area: Assessment

ICRC Domain: Counseling / NAADAC Content: Counseling Practice

  1. Take responsibility for his behavior.
  2. Learn about surrender.
  3. Get his wife into counseling with him.
  4. Develop a more positive perception of himself.
  5. Effect a behavioral intervention.

Denial, delusion, avoidance, blaming - all good reasons why addiction continues in spite of problems and difficulties.  Taking responsibility is a hallmark need in the field of recovery that has to happen in order to receive effective help.


46.    Your client has been advised by his sponsor to discontinue a needed antidepressant medication. You believe this advice to be premature and possibly harmful. What action should you take as a first step?

Content Area: Confidentiality

ICRC Domain: Counseling / NAADAC Content: Counseling Practice

  1. Obtain your client’s authorization and contact the sponsor to discuss the situation further.
  2. Encourage your client to ignore the sponsor’s advice and continue the medication.
  3. Encourage your client to look for another, more understanding sponsor.
  4. Have the client discontinue involvement in AA until antidepressant medication is no longer needed.
  5. Encourage your client to follow the sponsor’s advice.

Anytime you need to bring others into the care system, or anytime you need to share information about treatment, a release of information is needed.  Talking with the sponsor is critical to avoid conflict in the recovery process, but do it the right way by getting the release before the contact is made.


47.    A common error that counselors make when conducting an assessment is:

Content Area: Assessment

ICRC Domain: Assessment / NAADAC Content: Theoretical Bases

a. asking too many questions

b. moving too quickly from data collection to treatment planning

c. focusing on strengths and weaknesses

d. processing the data collected from the client

e. determining the clients level of denial  

The keyword is "error" - all of the responses but "b" are appropriate things to do in the assessment process.  Treatment planning doesn't occur at this stage, except for identification of immediate goals.  The formal treatment planning process happens after more assessment work is done, and in conjunction with the client and the other members of the treatment team.


The last three questions on this sample represent the new style of questions used for the last 13 questions of the actual IC&RC exam. 


48.   The most appropriate response to Jack given what he has shared with you in your office today would be to:

Crisis Intervention Core Function (Global Criteria 30 and 31)

  1. authorize an immediate extended pass for Jack to be with his wife and mother-in-law.

  2. encourage Jack to stay in treatment by exploring alternative ways for him to show support for his wife and mother-in-law.

  3. dismiss Jack Against Medical Advice and report his leaving to his work supervisor.

  4. urge Jack to stay in treatment at least until his group session in the afternoon to secure the opinions of his fellow patients on what he should do.

This “emergency” threatens to interfere with Jack’s treatment.  Counseling may assist him with exploring other options that can assist his wife and mother-in-law deal with this death without Jack’s help.  There are no assurances that Jack will even return, let alone continue treatment if he leaves at this time.


49.   Jack stays in treatment after talking to his wife’s mother and arranging for Nancy to travel to her mother’s home with her aunt, who will also assist in watching over their children.  The very next day, you receive a call from Jack’s work supervisor inquiring “how Jack is doing.”  You discover that Jack has not signed a release of information form allowing you to talk with his supervisor.  How do you respond to this call?

Professional Responsibility and Ethics (TAP 21, Competency 115)

  1.  you ask the supervisor for his phone number so you can call him back after you have talked with your supervisor.

  2. you tell the supervisor you can not share that information but urge him to call Jack’s wife for her opinion on Jack’s progress.

  3. you tell Jack’s supervisor that confidentially laws prevent you from telling him how Jack is doing, and hope Jack will not lose his job because of this.

  4. you take the supervisor’s number and speak with Jack, getting the needed release of information signed, allowing you to provide treatment updates to the supervisor.

Since you do not have written authorization to disclose any information to Jack’s supervisor, to do so would not only be an ethical violation, but would also violate federal law.


50.   Prior to his discharge from treatment, Jack’s wife refuses to participate in family programming, stating that she’s angry that Jack didn’t leave treatment to drive her to her parent’s home.  Which of the following alternatives would be your BEST response to this situation?:

Counseling Core Function (Global Criteria 22 and 26)

  1. You schedule an appointment with Jack’s wife with the intention of getting her to change her mind.

  2. You schedule an appointment with Jack to explore his feelings and help him develop a plan of action to deal with the situation.

  3. You schedule an appointment with a local marriage and family therapist for Jack and his wife after the completion of treatment.

  4. You urge Jack to find a good attorney for legal advice about divorcing his wife for lack of support.


Jack will need lots of support from you or other members of your treatment team to deal with his wife’s threats.  Individual counseling can assist him to develop a plan of action to deal with his feelings and interact with his wife in a way that hopefully will encourage them to seek marital counseling from a marriage and family therapist referral.  To simply set up an appointment with a marriage and family therapist is premature at this time.