CARN Recovery and Relapse Prevention 1 — Questions and Answers
Question 1: According to ASAM's definition, which statement best describes recovery from addiction?
- Complete lifelong abstinence from all mood-altering substances
- A process of change through which individuals improve health, wellness, and self-direction (Correct answer)
- Successful completion of a 28-day inpatient rehabilitation program
- Achieving one consecutive year of sobriety verified by drug testing
Correct answer: A process of change through which individuals improve health, wellness, and self-direction
ASAM defines recovery as a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential — not merely abstinence.
Question 2: Which relapse prevention model identifies high-risk situations, coping responses, and self-efficacy as its core components?
- Prochaska's Transtheoretical Model
- Gorski's CENAPS Model
- Marlatt's Cognitive-Behavioral Model (Correct answer)
- Miller's Motivational Enhancement Model
Correct answer: Marlatt's Cognitive-Behavioral Model
Marlatt's Cognitive-Behavioral Model identifies high-risk situations, the individual's coping response, and self-efficacy as the key determinants of whether relapse occurs.
Question 3: A patient in recovery identifies 'people, places, and things' associated with past drug use as things to avoid. This concept is best described as:
- Negative reinforcement patterns
- Environmental cue conditioning (Correct answer)
- Emotional dysregulation triggers
- Cognitive distortions about use
Correct answer: Environmental cue conditioning
Environmental cues become conditioned stimuli through repeated pairing with substance use, capable of triggering cravings even years into recovery via classical conditioning.
Question 4: Which of the following is a relapse WARNING SIGN rather than an external trigger?
- Passing a bar where the patient used to drink
- Smelling alcohol at a family gathering
- Increased social isolation and withdrawal from support (Correct answer)
- Seeing friends who continue to use substances
Correct answer: Increased social isolation and withdrawal from support
Warning signs like social isolation and attitude changes are internal behavioral/emotional shifts that precede relapse, distinguishable from external environmental triggers.
Question 5: In Marlatt's relapse prevention model, 'seemingly irrelevant decisions' (SIDs) refers to:
- Minor relapses that do not significantly impact overall recovery
- Small choices that cumulatively set up high-risk relapse situations (Correct answer)
- Decisions made while under the influence of substances
- Life decisions unrelated to substance use
Correct answer: Small choices that cumulatively set up high-risk relapse situations
SIDs are small, apparently innocent choices (e.g., driving past a dealer's house 'by accident') that gradually increase proximity to relapse situations.
Question 6: A nurse explains to a patient that a 'lapse' differs from a 'relapse' in that:
- A lapse is a single brief episode of use, while relapse is a return to prior problematic use patterns (Correct answer)
- A lapse is planned, while relapse is always unplanned
- A lapse involves only alcohol, while relapse involves illicit substances
- A lapse requires hospitalization, while relapse can be managed outpatient
Correct answer: A lapse is a single brief episode of use, while relapse is a return to prior problematic use patterns
A lapse is a single, brief episode of substance use, whereas relapse denotes a full return to the previous pattern of problematic use.
Question 7: Which statement accurately reflects the evidence base for peer support in recovery?
- Only 12-Step programs (AA/NA) have significant evidence for long-term outcomes
- Only SMART Recovery has randomized controlled trial support
- Both 12-Step programs and SMART Recovery have evidence supporting effectiveness (Correct answer)
- Neither mutual aid approach has sufficient evidence to recommend
Correct answer: Both 12-Step programs and SMART Recovery have evidence supporting effectiveness
Both 12-Step facilitation and SMART Recovery have supporting evidence, and patients should be offered multiple options based on personal preference and needs.
