AADC Preparation Guide for North Carolina LCAS Candidates Study Guide

Apply it

A client has a positive alcohol screen during intake but reports little detail about consequences. Explain the result, assess immediate risks, and obtain the symptom and functional history needed before assigning an alcohol use disorder diagnosis.

Apply it

A client stopped drinking this morning, has mild tremor, and recalls a seizure during a previous quit attempt. Arrange prompt medical withdrawal assessment rather than assuming that today's mild presentation establishes suitability for routine counseling alone.

Apply it

During intake, a client says they intend to take an available supply of pills after leaving. Stay with the client, activate the emergency evaluation process, and address access to the pills while arranging a safe handoff.

Apply it

A client meets five distinct alcohol use disorder criteria during the past year. Classify the disorder as moderate, while separately assessing withdrawal risk, medical complications, and treatment needs rather than deriving those decisions from severity alone.

Apply it

A client reports panic attacks beginning years before stimulant use and continuing during a lengthy period without stimulants. Explore an independent anxiety condition alongside stimulant effects and coordinate assessment rather than attributing every episode to intoxication.

Apply it

A patient taking prescribed opioids as directed experiences withdrawal after a missed dose but denies impaired control or functional consequences. Assess the full diagnostic pattern and coordinate medical care rather than diagnosing opioid use disorder from withdrawal alone.

Apply it

An assessment item uses an idiom unfamiliar to a client who speaks another primary language. Obtain appropriate language assistance, clarify the intended meaning, and consider whether the measure is suitable before interpreting the response as evidence of impairment.

Apply it

A hospitalized client with confusion cannot answer symptom questions reliably. Notify the medical team that the self-report withdrawal score is unreliable and support assessment using suitable objective observations and medical evaluation rather than mechanically following the total.

Apply it

A mandated client gives one-word answers and expects punishment. Explain what information is collected and shared, acknowledge the client's concerns, and ask what would make today's meeting useful before returning to the required assessment areas.

Apply it

A client's drinking increased after job loss, insomnia, and separation, while a supportive sibling remains involved. Link these factors in the formulation and explore sleep care, practical assistance, and chosen support alongside alcohol treatment needs.

Apply it

A client requests medication after an overdose but previously stopped treatment because transportation failed. Record the prior response, current substance exposure, preferences, and access barriers, then arrange a prescribing assessment that addresses those practical obstacles.

Apply it

A client has modest withdrawal symptoms but lives alone, lacks transportation, and cannot reliably attend monitoring. Include these limitations in the medical placement discussion instead of choosing ambulatory management solely because the current symptom score is low.

Apply it

A client rejects the phrase alcohol use disorder but acknowledges repeated unsuccessful efforts to cut down. Explain the specific findings and available options, invite their perspective, and check understanding before negotiating the next assessment or treatment step.

Apply it

A client misses addiction visits during depressive episodes and stops psychiatric care after drinking. With appropriate permission, coordinate a shared plan addressing mood, substance use, medication follow-up, and engagement barriers instead of cycling between disconnected services.

Apply it

A client wants to handle cravings better. Together, specify practicing one chosen coping skill on four evenings before the next visit and recording what happened, then check whether the client feels confident that the step is manageable.

Apply it

A client wants psychiatric care but has missed two appointments because the bus route ends before the clinic. Explore an accessible location or appointment format and coordinate scheduling assistance rather than repeating the same referral instructions.

Apply it

A client benefits from medication but feels uncomfortable in a particular mutual-help group. Explore alternative peer communities, individual counseling, and other preferred supports while preserving medication access and discussing how each option serves the client's goals.

Apply it

After returning to alcohol use, a client identifies evening isolation and an unrealistic attendance schedule. Reassess safety, retain effective daytime coping strategies, and negotiate accessible evening support and a revised attendance plan with a clear follow-up date.

Apply it

A counselor learns that a referred client never received an appointment confirmation. Contact the service with permission, clarify the scheduling failure, help arrange the visit, and later verify attendance and the recommendations relevant to ongoing care.

Apply it

A hospitalized client receiving buprenorphine expects discharge tomorrow but has no follow-up appointment. Alert the care team, help confirm ongoing prescribing arrangements, and address pharmacy and transportation access before the client leaves the hospital without a continuation plan.

Apply it

A client lacks stable housing but has a trusted aunt, strong cooking skills, and interest in volunteering. Explore safe housing assistance while building a practical plan that uses those relationships and skills to strengthen daily stability.

Apply it

A client welcomes a sibling's involvement but fears a controlling partner. Explore the sibling's possible role and obtain appropriate permission, while assessing relationship safety and avoiding an automatic joint session with the partner simply because they live together.

Apply it

A client misses morning treatment because they wait in a food distribution line at the same time. Discuss food access and scheduling together, then identify a feasible arrangement rather than interpreting attendance in isolation from the unmet need.

Apply it

A client wants employment assistance but also reports symptoms suggesting dangerous withdrawal. Arrange medical assessment first, explain the reason, and preserve employment as an agreed priority once immediate safety has been addressed through an appropriate care plan.

Apply it

A counselor consults about recurrent panic symptoms during recovery. Document the reason for consultation, authorized information shared, the consultant's recommendations, the agreed referral steps, and who will check completion at the next contact with the client.

Apply it

After completing intensive treatment, a client feels isolated and wants meaningful work. Identify an accessible vocational service and a preferred community activity, agree on an initial contact, and review whether these connections improve daily structure and satisfaction.

Apply it

A client says every session becomes a lecture about meetings they do not want to attend. Ask what felt unhelpful, acknowledge the repeated mismatch, and agree on alternative tasks connected to the client's stated recovery priorities.

Apply it

A client says drinking helps them relax but threatens their relationship. Reflect that alcohol offers relief and that protecting the relationship matters deeply, then pause so the client can explore the tension in their own words.

Apply it

After one episode of use, a client thinks all recovery progress is ruined. Examine the evidence, identify skills that remain intact, and develop a balanced statement that supports contacting treatment and reviewing the circumstances of the episode.

Apply it

A stimulant treatment program provides a planned incentive immediately after a verified target is achieved. The counselor explains the rules consistently and pairs the program with coping-skills work so reinforcement and broader skill development support the same goals.

Apply it

A client reports severe sudden withdrawal after taking buprenorphine soon after a full agonist opioid. Explain the possible displacement mechanism and arrange medical assessment, then support a clinician-directed initiation plan rather than recommending unsupervised timing or dose changes.

Apply it

A group participant becomes unresponsive with very slow breathing after leaving the restroom. Activate emergency services, administer available naloxone, and provide indicated resuscitation support while another staff member guides responders to the room and stays available for assistance.

Apply it

A client believes disulfiram will let them drink without enjoying it. Explain that alcohol can instead trigger a hazardous reaction, check understanding, and connect the client with the prescriber to review suitability and exposure precautions before starting treatment.

Apply it

A client says they want clearer mornings and have already avoided drinking before work twice. Reflect the valued benefit and successful steps, then ask what made those mornings possible and how the client might repeat them.

Apply it

A client uses stimulants during lonely weekends. Work on an accessible recreation plan, supportive contacts, and employment goals that the client values, while examining how these activities can replace the social and emotional rewards previously associated with use.

Apply it

A client repeatedly drinks after receiving critical work messages. Map the message, thoughts of failure, anxiety, drinking, immediate relief, and next-day conflict, then select one earlier point where a different response could interrupt the recurring sequence.

Apply it

A client assumes every opioid use disorder medication blocks receptors in the same way. Explain the agonist, partial agonist, and antagonist distinctions, then ask which practical concerns and prior experiences should be included in the prescribing discussion.

Apply it

A client taking a prescribed benzodiazepine reports drinking alcohol and occasionally using opioids. Explain the breathing risk, assess current impairment and safety, and coordinate prompt medical review without instructing the client to abruptly stop the benzodiazepine.

Apply it

After explaining an overdose-response plan, ask the client to describe what they would do first if a friend were unresponsive and breathing slowly. Clarify missed steps and invite another explanation using the client's own words and sequence.

Apply it

A client becomes visibly overwhelmed when asked for detailed assault memories during addiction intake. Pause, offer grounding and choice, clarify what information is necessary now, and discuss appropriately trained trauma services without requiring disclosure to continue receiving care.

Apply it

Following assessment of nonimminent suicide risk, a client identifies escalating isolation as a warning sign. Develop concrete coping steps, reachable contacts, crisis services, and a feasible means-safety arrangement, then check that the client can locate and explain the plan.

Apply it

A group can describe assertiveness but struggles when friends offer substances. Model a brief refusal, let members rehearse realistic scenarios, provide specific feedback, and ask each participant where they will practice the skill before the next meeting.

Apply it

A client asks whether medication means they are not truly recovering. Explore their understanding, ask permission to explain treatment options, provide concise information, and invite their reaction before discussing whether a prescribing consultation fits their goals.

Apply it

A client notices a craving after an argument. Guide brief observation of bodily sensations and breathing without acting on the urge, then help the client choose a safe next action and review how the experience changed over time.

Apply it

A client who has completed withdrawal asks whether acamprosate will make drinking cause flushing and nausea. Explain its abstinence-maintenance role and distinguish it from disulfiram, then use teach-back and refer medical suitability questions to the prescribing clinician.

Apply it

A Part 2 program receives an ordinary care-coordination request for a counselor's separately maintained session analysis under a general treatment consent. No enumerated exception applies. Obtain separate counseling-note consent before disclosure. A qualifying use in the program's own supervised training follows a different rule because it is an enumerated exception.

Apply it

A counselor notices they assume employed clients have fewer substance-related problems. Review whether assessments have been equally thorough, seek supervision, and return to diagnostic evidence and functional impact rather than employment status when forming conclusions or recommending care.

Apply it

A client requests specialized trauma processing from a counselor trained only in general addiction care. Discuss the competence boundary, offer appropriate stabilization within existing skills, and arrange qualified consultation or referral without abruptly abandoning the client's ongoing treatment needs.

Apply it

A supervisor asks a counselor to document a full session after the client left within minutes. Record the actual contact and services, decline the inaccurate entry, and use appropriate consultation or reporting channels to address the instruction.

Apply it

A study compares a voluntary recovery program with usual care, but participants in the new program have much more stable housing. Before endorsing the program as superior, examine whether design or analysis addressed housing and other baseline differences.

Apply it

A client joins a video session from a relative's home in another town. Confirm the current address and emergency arrangements before proceeding, and review how to reconnect or obtain local help if the connection drops during a crisis.

Apply it

A counselor directly learns that a colleague falsified client service records. Preserve factual information, consider ongoing client harm, and follow the Board's applicable reporting requirements rather than agreeing to remain silent in exchange for a private promise.

Apply it

A client offers an expensive watch after asking for extra private contact. Decline the watch respectfully under the monetary prohibition, discuss its meaning and the contact boundary, and seek consultation about the relationship implications. Consultation supports care planning rather than permission to accept the prohibited gift.

Apply it

A Part 2 program receives a lawyer's request to use treatment records against a client, accompanied only by a general treatment consent. Do not assume that consent authorizes the use; obtain appropriate review of specific consent or court authorization.

Apply it

After a client misses two visits, document the dates, contact attempts, and the client's explanation that transportation failed. Record any clinical interpretation separately rather than labeling the client manipulative or stating an unverified intention to avoid treatment.

Apply it

A client signs an intake form but believes everything discussed will be shared with their employer. Pause to explain actual disclosure rules and any authorization, invite questions, and check understanding before relying on the form as evidence of informed consent.

Apply it

A study reports excellent outcomes among program completers, but half the intervention group lacks follow-up compared with few controls. Examine missing-data patterns and analyses before accepting the apparent advantage as evidence that the intervention improves outcomes.

Apply it

A probation-referred client assumes every session detail is automatically sent to the officer. Explain the actual reporting arrangement, relevant authorization or legal basis, and confidentiality limits, then verify understanding before beginning sensitive discussion about substance use and family relationships.

Apply it

A new supervisee is assigned a complex intervention without defined evaluation criteria. Clarify competencies, observation methods, review dates, and support needs before proceeding, and adjust the assignment if the available supervision cannot support safe practice at the supervisee's level.

Apply it

A counselor considers sending a client's treatment summary through a personal social-media account because it is convenient. Use the organization's authorized process, verify the recipient and disclosure permission, and document the exchange according to applicable record practices.