Instructions: Print this exam worksheet. Return to the course page using the link below. Read the course material. Enter your answers on this worksheet. Return to the course page and click the link 'Take the Online Test.' Transfer your answers.
1. Research consistently demonstrates a strong connection between criminal activity and substance abuse. Each of the following is an accurate statement about this connection EXCEPT
A. Eighty-four percent of State prison inmates who were expected to be released in 1999 were involved with alcohol or illicit drugs at the time of their offense
B. 35 percent reported that they were under the influence when they committed their crime; and 16 percent indicated that they committed their offense for money to buy drugs
C. Data from the Arrestee Drug Abuse Monitoring program indicates that in 2000, 64 percent of male arrestees tested positive for at least one of five illicit drugs
D. 57 percent reported binge drinking in the 30 days prior to arrest, and 36 percent reported heavy drinking
2. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), substance abuse is a maladaptive pattern of substance use marked by recurrent and significant negative consequences related to the repeated use of substances, while substance dependence is defined as a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual is continuing use of the substance despite significant substance-related problems.
3. Information gathered during screening and assessment plays an important role in identifying offender needs and making appropriate referrals for services. However, in most cases a single screening is sufficient to place offenders in different levels of treatment services.
4. The goal of an assessment is to gather enough information about clients to describe how the treatment system can address their substance abuse problems and the impact of those problems. Which of the following falls under the Special Considerations Domain of the screening process?
A. General health and acute conditions
B. History of treatment and prior diagnosis
C. History of diagnosis of any personality disorder
D. History of abuse, including trauma experienced as a result of physical and sexual abuse
5. Accuracy of screening and assessment information is clearly dependent on the honesty of the offender, so it is critical to administer screening and assessment instruments in a way that encourages honest answers. Which of the following is an accurate statement regarding honesty and assessment?
A. Some factors that contribute to greater accuracy of responses include using historical information such as previous screening responses and past drug test results
B. It is best not to brief offenders in advance about who will have access to screening and assessment information because this tends to skew the results
C. Counselors and criminal justice professionals should clearly indicate their own role in the information gathering process and address myths regarding court-ordered or other mandated treatment and treatment program requirements
D. All of the above
6. Often times there will be a need to rescreen and reassess offenders with substance abuse issues. Which of the following is NOT a true statement about this reassessment?
A. Offenders who may fear the consequences of self-disclosing substance abuse problems in one setting may be more open to discussing their need for treatment at a later stage
B. While offenders’ motivation for treatment will not likely change over time, they may be more willing to participate in a program as they become more familiar with the setting
C. Reassessment may reflect a gradual process of uncovering reasons to quit substance use, and identifying strengths that can be built on during treatment
D. Previous information obtained may become outdated and may not include recent events that are relevant to treatment, such as relapse episodes, undetected mental disorders, or domestic violence
7. It is usually not recommended that screening be done as soon as the offender enters the criminal justice system, because it is always better to wait to provide a comprehensive assessment until the inmate is nearing the enrollment date for treatment services.
8. Drug testing is frequently used as a screening device in community-based and institutional settings, as drug testing serves both as a deterrent to use and as a strong incentive for offenders to remain abstinent.
9. Key areas addressed during substance abuse screening and assessment include all of the following EXCEPT:
A. Observable signs and symptoms of alcohol or drug use, signs of acute drug or alcohol intoxication and withdrawal effects, and drug tolerance effects
B. Negative consequences associated with substance abuse, the self-reported history of substance abuse, and recent patterns of use
C. Education and employment history, current support system, and religious or spiritual involvement
D. Family history of substance abuse, including current patterns of abuse by family members who have contact with the offender
10. One of the recommendations for screening in community and institutional settings is the administration of a 25-item instrument developed to screen for alcohol dependence symptoms. This assessment tool is known as the:
A. TCU Alcohol Screen
B. Simple Screening Instrument for Alcohol Abuse
C. Alcohol Dependence Screen
D. Alcohol Use Disorders Identification Test
11. A substantial percentage of those under criminal justice supervision have one or more co-occurring mental disorders in addition to their substance use disorder. Studies indicate that _____ percent of inmates had a major mental disorder, while ______ percent were under the influence of drugs or alcohol at the time of their offense.
A. 7-16; 49-65
B. 9-18; 47-63
C. 11-20; 45-61
D. 13-22; 43-59
12. Rates of trauma in men and women entering the criminal justice system are higher than are rates found in community samples. Which of the following is an accurate statement about trauma among offenders?
A. Among female state prisoners, 30-70 percent report a history of emotional, physical, or sexual abuse
B. Female prison inmates are two times more likely to report a history of any abuse and four times more likely to report a history of sexual abuse in comparison to male inmates
C. Since most offenders are unwilling to talk frankly about their abuse and trauma experience to professionals, group treatment sessions where they can talk openly to other offenders are usually recommended
D. Despite high rates of physical and sexual abuse among offenders, screening and assessment in the criminal justice system has not historically addressed these issues, nor have treatment services been provided in jail, prison, or community settings
13. A number of criminogenic "risk factors" are often assessed in justice settings to determine eligibility for admission to substance abuse treatment programs and for community release, and these risk factors include gender and race, the diagnosis of a mental disorder, criminal history, family history, and the characteristics of the offender’s victims.
14. There are a variety of stressors that can lead to renewed substance use and risk for recidivism when offenders are released from custody or when their daily structure and level of supervision is reduced, but the single most important risk factor for criminal recidivism tends to be:
B. Antisocial attitudes
C. Prior history of crime and violence
15. Within different treatment settings in the criminal justice system, screening and assessment instruments and procedures are sometimes altered to address the unique needs of specific clinical populations, such as ethnic and cultural minorities, women, and offenders with co-occurring disorders. It is important to be aware of issues pertinent to special populations including each of the following EXCEPT:
A. Women respond differently to the screening process than men and they are more likely to have trauma-related problems, while men are more likely to have co-occurring mental disorders
B. Counselors should be aware of general cultural beliefs and expectations, and it may be necessary to modify screening and assessment instruments to be sensitive to cultural differences
C. Most substance abuse screening and assessment instruments were developed and tested in male populations, so those working with female offenders should carefully review screening and assessment instruments to examine whether they have included content that is relevant to female offenders
D. Specialized screening and assessment approaches are needed for offenders with co-occurring disorders to examine the relationship between these disorders and criminal behavior
16. A tiered screening and assessment approach should be developed in settings in which several types of treatment services are available, with an initial screening to detect those who have substance abuse problems, and a more intensive assessment to review specific treatment needs and risk levels so that the offender can be assigned to an appropriate level of treatment.
17. Treatment matching in the criminal justice system is most effective when there is a continuum of services ranging from low to high intensity, and when the continuum of treatment levels includes the major treatment categories of outpatient treatment, inpatient treatment, and:
A. Primary treatment
C. Post Treatment
D. Secondary Treatment
18. Outpatient treatment provides a broad range of services without overnight accommodation and includes nonintensive and intensive outpatient treatment, methadone treatment, and day treatment or partial hospitalization. Which of the following most correctly describes the services provided in intensive outpatient treatment?
A. It often addresses related psychiatric, emotional, and social issues, and offers a forum to explore issues such as the relationship between violence and mental disorders
B. It offers substance abuse treatment with professional assessment and treatment of more than 20 hours per week in a structured program
C. It is the most exhaustive of the outpatient treatment options and can be used for treating clients who demonstrate the greatest degree of dysfunction but who do not require inpatient or residential treatment
D. It includes substance abuse treatment with professional assessment and treatment from 9 to 20 hours per week in a structured program
19. Residential treatment options includes psychosocial care at the most intensive end and group living with no professional supervision at the least intensive end. A group home is a residential, transitional living situation without any specific treatment plan and minimal staff supervision, and it is sometimes known as a half-way house.
20. Coordination of substance abuse treatment matching within the criminal justice system can reduce the long-term costs of incarceration and other criminal justice functions only if adequate personnel and funding are available for case management. The optimal approach would be to assemble a team consisting of correctional/supervision and clinical staff to develop a triage and placement system and to assume responsibility for compiling and processing treatment matching information.
21. If a range of offender treatment options is available for substance abusers, placement in services usually is determined by all of the following factors EXCEPT:
A. Level of offender needs for substance abuse, mental health and other psychosocial or medical services, and employment
B. Risk for violent behavior within treatment setting
C. Offender motivation and readiness for treatment
D. Offender characteristics including cognitive and intellectual abilities, ability to read and write, and related abilities to communicate in individual and group settings and to withstand stress in highly intensive therapeutic communities
22. Evidence suggests that highly structured treatment approaches that use a directive, supportive, client-centered approach are more effective for offenders with pronounced substance abuse problems, in comparison to less structured treatment approaches that use a cognitive-behavioral treatment approach.
23. Assessments of offenders’ motivation for treatment and their current stage of change are useful in matching different types of treatment and developing treatment plans. Which of the following is an accurate statement about offender motivation and readiness for change?
A. Motivation for change occurs in predictable stages during the treatment and recovery process, and during the contemplation stage of change offenders have little awareness of substance abuse problems and have few intentions of changing their behavior
B. Movement through stages of change is a linear process, and offenders move through stages of change at their own pace before sustaining abstinence
C. For offenders who are in the early stages of change, placement in treatment that is too advanced and that does not address ambivalence regarding behavior change may lead to unsuccessful termination from treatment
D. All of the above
24. Mental disorder symptoms and impairment should be carefully considered in determining placement in substance abuse treatment services. The mental disorder diagnoses of inmates should be the central concern in triage and placement decisions.
25. Often times treatment involvement within the criminal justice system is based primarily on a conviction or plea to a drug-related offense, and although the number and type of substance related charges is sometimes a fairly good indicator of substance abuse and related problems, a better indicator would likely be:
A. Presence of intoxicants in blood or urine at the time of arrest
B. Positive results based on multiple assessment criteria
C. The diagnosis of a DSM-IV-TR substance use or dependence disorder
D. None of the above
26. An important area to assess in developing a treatment plan is the presence and impact of psychological and emotional problems, particularly those that are not the direct result of substance abuse. At the same time it is critical to be aware that the early stages of recovery are often marked by increases in depression and anxiety, due, in part, to residual effects of substance withdrawal and also to the individual’s recognition of consequences related to his substance abuse, including incarceration or other restrictions to his liberty.
27. In developing treatment plans for substance involved offenders, it is important to assess the relationship between criminal attitudes/behaviors and drug and alcohol abuse. Three sources of criminal behavior that are closely associated with drug use can be identified as procriminal values, procriminal associates, and psychopathy. Which of the following is a true statement about these sources?
A. Examples of procriminal values include intolerance for personal distress and unwillingness to accept responsibility for behaviors that adversely affect others
B. Procriminal associates most often develop from "criminal thinking" and procriminal values or from relationships formed during incarceration or involvement in criminal justice programming
C. Psychopathy is distinguished from both procriminal values and procriminal associates in that it is most often conceptualized as a personality trait with primarily biological underpinnings
D. All of the above
28. One approach to treatment planning in juvenile justice and adult criminal justice settings is one in which assessment begins by determining what interests or inspires the client and by identifying those things in which the client has a sense of pride, while still maintaining necessary emphasis on accountability and responsibility. This is known as a ______________ approach.
D. None of the above
29. For criminal justice clients who will not remain long in a jail setting, linkages to the appropriate community services are an essential part the treatment plan. The longer the jail detention, the more important these links become, especially if a client needs a range of services, including educational, vocational, legal, medical, and mental health.
30. Substance abuse counselors working with criminal justice clients are likely to face a host of challenges, including encountering a client who is in need of detoxification services. Offenders who experience withdrawal without medical attention are at risk for serious health consequences, and the authors identify each of the following symptoms of substance abuse withdrawal EXCEPT:
A. Incessant talking, rapid eye movement, and paranoia
B. Anxiety, restlessness, and irritability
C. Profuse sweating, muscle jerks, and constant blinking
D. Depression, crying fits, and disorientation
31. Dealing with anger and hostility with criminal justice clients is much like dealing with anger and hostility with other clients, although they are more likely to use anger as a manipulative coping strategy and less likely to be able to separate anger from other feelings. Each of the following is an accurate statement about anger and hostility and these clients EXCEPT:
A. Clients may use anger for a variety of reasons including to deflect attention from other issues or to keep others off-balance
B. Problems with expressed anger relate to an inability to express other feelings, and interventions involve teaching criminal justice clients to recognize their affective states
C. Clients need to be able to identify feelings and realize that feelings equal thinking and behavior
D. For a surprising number of offenders, feeling states initially consist of "angry" and "others", so they need to learn to begin to recognize frustration, hurt, loneliness, fear, and other emotions
32. As offenders move through the criminal justice system, important elements in their identity can change. In prison, some people learn a new identity based on the prison culture in which they are involved, and this is known as a:
A. Prosocial identity
B. Criminal Identity
C. Community identity
D. Offender Identity
33. Offenders new to the criminal justice system, particularly first-time offenders who have recently lost much of their social standing, may struggle with guilt and shame. In some cases these feelings are realistic and may facilitate treatment, but in other cases they may be exaggerated and interfere with substance abuse treatment until they are adequately processed.
34. While it is not always easy, the creation of a therapeutic alliance is very important when working in criminal justice settings. All of the following are true statements about these relationships EXCEPT:
A. The ability to create this alliance and its relative importance varies according to staff ability, experience, and training
B. The alliance may be most critical in residential programs, especially if clients are engaged in outpatient treatment programs
C. In a prison or jail setting, it helps to include corrections staff as part of the treatment team, but clients should be told if this is going to part of the therapeutic alliance
D. Corrections officers can become too involved in the treatment process and become overly distraught over treatment failures, so roles need to be clearly defined
35. In a study of offenders on probation, three client background factors that are associated with treatment outcomes were examined to see if they had an effect on establishing a therapeutic relationship. The factor that was most associated with a positive therapeutic relationship and engagement in treatment was:
A. Recognition of the existence of a substance abuse problem
B. The degree of peer deviance in the client’s social network
C. Past and current family dysfunction
D. None of the above
36. Peer support and feedback is especially important in criminal justice settings because peers using a group treatment modality have the capacity to give more immediate feedback for positive steps to change and for negative thinking and behavior. Additionally, using peer support and feedback also serves to prepare incarcerated criminal justice clients for using peer support organizations in the community.
37. Spiritual approaches have been used in combination with substance abuse treatment services and can provide powerful tools for some to achieve sustained abstinence. Which statement below most accurately describes these spiritual practices?
A. Spiritual practices are defined as those that involve the formal practice of a system of beliefs
B. To provide inmates in jails and prisons with opportunities for spiritual growth, programs should promote religions of all persuasions
C. Clients should be encouraged to connect with the religious or spiritual tradition with which they associate most closely and to think about how that tradition can help them understand their own lives and what may be missing in them
D. All of the above
38. There is no denying that the ethnic and cultural composition of offender populations is quite different from that of society as a whole. Which of the following most accurately demonstrates this notion?
A. A recent study showed that African Americans represented 29.2 percent of the jail population, 34.1 percent of the prison population, 31 percent of those on parole, and 25 percent of those on probation, while they represented only 11 percent of the U.S. population
B. Hispanics/Latinos of any race, are also somewhat overrepresented, representing 17.4 percent of the jail population and 14.0 percent of the prison population but only 15.3 percent of the U.S. populatio
C. Caucasians are underrepresented at each stage of the criminal justice process, making up only 43.6 percent of the jail population, 35 percent of the prison population, 40 percent of those on parole, and 56 percent of probationers, but 77.1 percent of the U.S. population
D. None of the above
39. About 60 percent of women in State prisons used drugs in the month prior to the offense for which they were convicted, and about half of these women admitted to daily drug use. In addition, more female inmates than males were under the influence of drugs and/or alcohol at the time the crime was committed.
40. The percentage of women in the criminal justice system has increased in the past decade, and many issues create greater problems for women than for men offenders including each of the following EXCEPT:
A. Compared to their male counterparts, female inmates are more likely to have mental disorders, to have been physically or sexually abused, and to be HIV positive
B. The most common mental disorders that incarcerated women have are serious depression and anxiety disorders, and 14 percent had posttraumatic stress disorder and nearly 22 percent had at least one major depressive episode in the 6 months before entering jail
C. Few substance abuse treatment programs have been developed specifically for female offenders, and many of the programs that do exist are based on treatment models developed for male offenders, although women are more likely to complete a treatment program designed specifically for women
D. Histories of abuse are of particular concern for female offenders and can have a significant impact on treatment, although one difficulty with addressing these issues with women who are incarcerated is that immediate ongoing counseling is not always possible
41. Male offenders often are very concerned about the welfare of their children, and many male offenders feel inadequate when dealing with their children and have never had any instruction or assistance in how to be a good father. Parenting classes can be very helpful for incarcerated fathers, and one study showed that compared to others that did not take the class, participating fathers tended to more accepting of their children, have less stress about parenting, and:
A. Perceive fewer problems with their children
B. Maintain better contact with their children
C. Be more emotionally connected with their children
D. All of the above
42. Within prison culture, violence is an everyday part of life and inmates may resort to violence in order to protect themselves. Each of the following is a true statement about violence in prison settings EXCEPT:
A. Many offenders react with violence because they have never developed the social and coping skills necessary to react to problems in more positive ways
B. The prison culture reinforces violent behavior, and individuals who are incarcerated without a history of violence quickly learn its value in jail or prison
C. A number of programs have been developed to help offenders stop violent behaviors, and many use variations on cognitive-behavioral therapy and ask offenders to look at their "criminal thinking" and the ways in which it leads them to commit violent crimes
D. Anger management groups are a useful intervention with this population and they are often the most practical since they can be provided as stand-alone treatment options for violent offenders
43. Evidence suggests that people with cognitive disabilities are disproportionately involved in the criminal justice system, and nearly one half of inmates in state prisons and one third of those in federal prisons report having a physical or cognitive disability.
44. Age is a factor associated with positive treatment outcomes, and the older one is the more likely one is to stay in treatment, complete treatment, and have positive outcomes following treatment. However, characteristics typical of this population that complicate treatment include each of the following EXCEPT:
A. The tendency to be assertive, which may be interpreted as being aggressive and therefore hinder treatment
B. Lifelong patterns of criminal behavior that cannot easily be altered
C. The likelihood of a physical condition presenting as an emotional problem
D. Rigid habits and a slow response to directions
45. While there is a great deal of stigma associated with mental disorders even within the culture of prisons and jails, substance abuse does not carry the same degree of stigma in correctional institutions as it does in the outside community.
46. Substance abuse often is associated with criminal or antisocial lifestyle and is highly correlated with antisocial personality disorder (ASPD). According to the Diagnostic and Statistical Manual of Mental Disorders, in order to be diagnosed with ASPD, a person needs to demonstrate, after the age of 15, three or more of the associated traits, including each of the following EXCEPT:
A. Deceitfulness, as indicated by repeated lying, uses of aliases, or conning others for personal profit or pleasure
B. Affective instability due to marked reactivity of mood
C. Impulsivity or failure to plan ahead
D. Lack of remorse, as indicated by being indifferent or rationalizing having hurt, mistreated, or stolen from another
47. HIV, AIDS, and tuberculosis are more prevalent among inmates than in the general population. The federal prison system undertakes random HIV testing of inmates for data collection purposes, and all inmates are tested on release; otherwise inmates are tested only if there is a clinical indication that they may be HIV-positive or if they request testing.
48. There is a high prevalence of substance abuse among those incarcerated for rape or sexual assault. Which of the following is an accurate statement about sex offenders and substance abuse?
A. Self reports from sex offenders reveal that 18 percent admitted they were under the influence of alcohol alone when they committed their crime, another 12 percent acknowledged using both alcohol and drugs, and an additional 7 percent reported they had been using drugs alone
B. One study showed that 37 percent of those arrested for sex offenses tested positive for drugs at the time of arrest, indicating that self-report numbers considerably underestimate the pervasiveness of substance abuse among this population
C. While the high prevalence of substance abuse among sexual offenders is clear, solid information about the relationship between substance abuse and sexual offending is not readily available
D. Sexual offenses committed while intoxicated, such as date rape, are indicators of serious impulse control and are likely to be habitual occurrences
49. Mental health and substance use disorders can mask or imitate each other, so accurate diagnosis of these disorders requires skilled screening and assessment. It is best to have separate assessments for each disorder in order to facilitate accurate diagnosis.
50. Data evaluating arrests made in the United States indicated that in one year, out of the over 13.5 million arrests, 83.7 percent of arrestees were aged 18 or older, while 46.3 percent of arrestees were under the age of 25, and 76.8 percent of the arrestees were male.
51. From a substance abuse treatment perspective, arrest and the related crisis may have a positive outcome. Each of the following is an accurate illustration of this EXCEPT:
A. Arrest can be a significant event in a person’s life, and for offenders whose arrest was related to their substance abuse, the event might make it difficult for the person to deny substance abuse problems
B. Arrest offers the opportunity for the individual to voluntarily choose to enter substance abuse treatment
C. Representatives from both the criminal justice and substance abuse treatment systems can view arrest as an important point from which to establish linkages, engage the defendant in interventions, and promote collaboration between the systems
D. An arresting officer has the authority to transfer individuals to substance abuse treatment rather than to the criminal justice system, as protected under civil rights law and due process, which is often the first step toward sobriety
52. Once a guilty verdict has been determined, sentencing guidelines based on fixed criteria are considered before imposing the penalty. However, these guidelines allow for a significant amount of flexibility based on defendant-specific factors such as substance use or mental disorders.
53. Throughout the United States, drug courts and other diversion programs hold considerable promise for engaging and retaining offenders who are involved with drugs in treatment and related services. Treatment through drug courts usually consists of three or four phases that include orientation and drug education, treatment, aftercare and transition, and
A. Modifications of drug testing and interventions
B. Monitoring and evaluating of program goals
C. Relapse prevention and educational/vocational services
D. None of the above
54. People with some types of mental disorder are more frequently jailed than sent to hospitals, and many of those with substance abuse issues and co-occurring disorders do not respond well to traditional community interventions because their problems are too complex.
55. Practitioners and institutions such as the National Association of Drug Court Professionals and the U.S. Department of Justice are discussing the potential benefits of widespread use of Driving Under the Influence (DUI) courts. Although arrests for DUI have been on the decline since 1987, serious, habitual abusers of alcohol remain largely unaffected by stiff criminal penalties and public awareness campaigns to stop drunk driving, so practitioners believe that DUI courts may be a more effective alternative.
56. A number of intervention strategies and treatment components can be adapted to assist offenders in the pretrial setting. Which of the following most accurately describes these treatment options?
A. During the pretrial stage, a brief intervention can determine if treatment is necessary, and can provide feedback to the individual about personal risk or impairment, place responsibility to change on the individual, and offer advice and empowerment to the individual
B. Some pretrial treatment programs use behavioral contracts with clients that describe precisely what is required of them, and although there is no evidence that they can reduce relapse and improve retention in treatment, they can offer rewards or incentives for specific behaviors
C. Sobering stations are used to monitor the behavior of arrestees in the pretrial setting and of probationers and parolees under community supervision, and they provide closer supervision than twice-a-week drug testing, but are less restrictive than residential treatment
D. None of the above
57. Judges and prosecutors have seen that a system of accountability is necessary to encourage participation in treatment and to gain public acceptance of treatment in lieu of punishment. ____________ are used to ensure that offenders swiftly experience real consequences of their actions.
A. Strict penalties
B. Coercive measures
D. All of the above
58. In a pretrial setting, some offenders may sign up for treatment when they don’t genuinely have a drug or alcohol problem because they hope to avoid harsher sentencing and improve chances for leniency in the criminal justice system. For this reason, it is important that treatment counselors assess collateral evidence of a substance use disorder.
59. Counselors tend to believe that putting an individual into treatment is of primary importance during the pretrial period; however, they should be sensitive to the fact that although treatment is critically important, it is not always the client’s most pressing priority. Each of the following is a true statement about other considerations that counselors must take into account during this time EXCEPT:
A. Counselors should prioritize case management services to include the most pressing client needs, such as food, clothing, shelter, medical treatment and detoxification if needed
B. The client’s due-process rights can affect the counselor’s role in the pretrial setting, so counselors should only discuss the factors of the ongoing criminal case that are pertinent to treatment
C. The counselor should inform the client at the outset that at some point it may be necessary to report to the court or pretrial supervision staff, and be clear about this process, its requirements, and his or her role in relation to the community supervision agency
D. Sometimes the presumption of innocence is difficult for counselors because for individuals to participate in drug treatment, they must first admit to having a drug problem, and when the crime is possession of drugs, counselors often have a difficult time presuming innocence
60. The authors suggest strategies to optimize the timing and sequence of treatment services for offenders with substance abuse issues, and these include moving offenders into treatment as soon as possible, providing services to increase the motivation for engagement in treatment, using brief interventions when appropriate, and addressing the offender’s _________.
D. All of the above
61. An effective diversion program called The Brooklyn Drug Treatment Alternative to Prison program was established to divert nonviolent felony offenders with one or more prior felony convictions and a documented history of drug abuse into treatment. Defendants accepted into the therapeutic community are exposed to rigid structure, rules, timetables, and goals, and have their sentences deferred while undergoing 15-24 months of rigorous, intensive drug treatment. A 5-year study indicated that ___ percent of the participants had completed the program, and after 2 years, program graduates were ___ percent less likely to return to prison.
A. 58: 81
B. 53; 87
C. 49; 90
D. 45; 94
62. More research is needed to determine the economic costs and benefits of treatment interventions at the pretrial stage, but intensive and long-term programs that target first time or low-risk offenders and limited nonintensive interventions for chronic serious offenders are likely to be cost-effective.
63. Jails, often called detention centers, house diverse groups of people detained for a wide variety of reasons, including those who have allegedly violated probation, parole, or bail conditions, inmates awaiting transfer to state, federal, or other local authorities, those who are in various stages of the adjudication process, and those sentenced to short-term incarceration. Several recent trends have led to changes in the jail population, including all of the following EXCEPT:
A. Significantly reduced funding for the mental health care system has led to an increase in the number of multiproblem inmates
B. Jails house growing numbers of individuals who have been displaced from traditional societal "safety nets" such as state hospitals
C. Enactment of harsher sentencing laws for drug offenses has led to increases in the number of minority inmates, while the increase in the number of drug treatment and diversion programs has led to a decrease in the number of female inmates
D. By necessity, jails have enlarged the scope of their mission to serve as community gatekeepers in identifying and addressing a range of psychosocial problems, such as HIV/AIDS, domestic violence, educational deficits, homelessness, mental illness, and substance use disorders
64. According to 2002 data, approximately ___ percent of jail inmates had not received a GED or graduated from high school, ___ percent of jail inmates were not working at all at the time of their arrest and only ___ percent were employed full time.
A. 32; 23; 48.3
B. 36; 25; 51.1
C. 40; 27; 54.8
D. 44; 29; 57.4
65. Jails maintain a classification-based system that is typically based on security needs and bed/space availability, which may or may not coincide with an inmate’s needs, and many small, rural, or older jails in particular have environments and structures that are not conducive to treatment.
66. For substance abusing offenders in jail settings, treatment intensity and duration are increased with length of stay, as is the scope of topics that can be addressed. The authors describe three levels of treatment including brief, short, and long term. Which of the following interventions occurs during phase two of treatment?
A. Facilitating access to community services
B. Employment counseling
C. Reconnection with family and transition services
D. Social skills training
67. Motivational enhancement approaches help clients to address their ambivalence about involvement in substance abuse treatment, and to identify methods of dealing with this ambivalence. The goal of this process is to engage inmates in a discussion of the treatment process and their potential reasons for changing substance abuse behavior and to help inmates:
A. Develop their own rationale for changing this behavior
B. Acknowledge the benefits of choosing to discontinue use
C. Identify the barriers to continued abstinence
D. Overcome denial about their circumstances
68. Offenders who abuse substances are perhaps at their most vulnerable when they are making the transition back to the community, so the treatment system needs to plan for an inmate or detainee who is leaving the jail, and the community needs to be prepared to receive the individual.
69. Inmates learn about actions that can trigger their substance cravings and how cravings and urges are tied into relapse prevention. Each of the following is an accurate statement about relapse issues EXCEPT:
A. Offender group discussions should focus on what inmates may expect when returning to their families, and how some family members may not fully support their involvement in recovery
B. While in treatment, inmates can work on exercises to identify substance abuse triggers and review strategies to face, rather than avoid, the triggers that will likely be present upon release
C. Returning to live with family members who actively use substances or who condone substance use within the home creates additional high-risk situations for the offender, so counselors should assess the home situation and possibly examine alternative housing arrangements
D. Reunification with family members is often accompanied by stress related to the family’s distrust and anger over the offender’s past substance use, unresolved conflicts with the partner or spouse, or increased financial burdens, all of which can be triggers for relapse
70. During long term treatment, counselors use a structured approach to examine the offender’s family network and background in order to try to understand the family’s criminal and/or substance use history and how its members adapted over the years in an effort to maintain stability. This approach, known as ________________, helps people understand how and why substance abuse and other maladaptive behaviors exist in their family.
A. Family Charting
B. Family Mapping
C. Family Surveying
D. None of the above
71. The competing goals of the criminal justice and treatment systems can sometimes pose problems, though the systems share many of the same objectives. For example, while the treatment system focuses on behavior change and rehabilitation and the criminal justice system is concerned with the safety of inmates and personnel, shared goals between the two include public health and the safety of the community.
72. Because of scarce resources, many jails find that they must prioritize how to allocate treatment services for inmates with differing levels of treatment needs. Experts believe that the priority should be to focus the limited resources that they have on inmates with more traditional substance abuse treatment needs, rather than on those who require specialized care and high utilization of community services.
73. Some jail administrators resist using pharmacotherapy as part of treatment because they are philosophically opposed to administering medication to people with substance abuse problems. However, advantages to using medications when necessary with this population include all of the following EXCEPT:
A. They provide a human response to treating symptoms of withdrawal and addiction
B. They resolve or improve symptoms of mental illness and allow the dually diagnosed individual to focus on substance abuse issues
C. The use of prescription medications to treat specific issues teaches inmates the difference between appropriate use of necessary substances versus the abuse of unnecessary substances
D. Providing appropriate medications allows for continuous treatment from community to jail, and jail to community
74. A survey of metropolitan jail treatment programs indicates that many jails have several treatment phases and endorse more than one therapeutic orientation. More than half of the jail programs surveyed included 12-Step groups, relapse prevention programs, and:
A. Substance abuse educational groups
B. Anger management groups
C. Life skills and parenting groups
D. None of the above
75. Prisons differ from jails in that inmates generally are serving longer periods of time and the offenders have often committed serious or repeated crimes. Additionally, prisons are unique in that they are separated by function and inmate classification.
76. During 2003, the nation’s prison population grew 2.1 percent and by the end of that year, state and federal prisons in the United States housed a total of 1,470,045 inmates. Which of the following most accurately describes prison populations.
A. While the lifetime incidence of substance abuse or dependence disorders in the prison population is roughly 75 percent, in 2001, 28 percent of state prison inmates were incarcerated for drug-related offenses
B. As of 2003, 13 percent of State prison inmates were receiving some type of regular counseling or therapy from a trained professional, and studies report that 10 percent of all inmates in state prisons receive psychotropic medication
C. Although in recent years, the rate of HIV infection has decreased somewhat for the general prison population, the number of all State and Federal prison inmates with HIV infection is estimated to be nearly four times higher than that of the general population
D. Since 1995, the rate of incarceration of women in prisons has increased at a higher rate than that of men, and in 2003, the number of women in state or federal prisons increased by 5.4 percent, while the number of men in those institutions increased by 3 percent
77. Many male offenders have been perpetrators of domestic and/or sexual violence and/or have gotten into trouble because of fighting or assaults. Violence prevention groups may help participants explore thoughts, feelings, and behaviors that are often the underpinnings of violent behavior and sexual aggression, and these include issues such as a lack of empathy, narcissism, anger management problems, an overblown sense of entitlement, and:
A. Lack of effective thinking skills
B. Tendency to blame others for problems
C. Desire to justify maladaptive behavior
D. Lack of responsibility and accountability
78. The concept of camaraderie is perhaps the most central to understand the positive effects of self-help groups, as these groups empower members to use their personal strengths to enable others to feel less helpless and to encourage growth.
79. Therapeutic communities which are offshoots of the mental health and self-help approaches, are among the most successful in-prison treatment programs and are preferable for the placement of offenders who are assessed as substance dependent. Goals of these therapeutic communities include all of the following EXCEPT:
A. Decline in or abstinence from substance use
B. Cessation of criminal behavior
C. Employment and/or school enrollment
D. Use of a positive peer culture to foster change
80. Although there is some variation in the structure of prison-based therapeutic communities, most are a minimum of 9 months in duration, and there is evidence that these programs may provide their best results for those whose residency extends from 12 to 24 months.
81. In recent years, the number of inmates in State and Federal prisons aged 55 and older has increased dramatically, and between 1995 and 2003 that number has increased approximately ___ percent.
82. In 1990, the Amity prison therapeutic community at the R.J. Donovan Correctional Facility in San Diego, Ca., a medium security facility, began to accept offenders who were under life sentences as counselors in its substance abuse treatment program and it remains one of a handful of programs in the country to do so. Each of the following is an accurate statement about this program EXCEPT:
A. Lifers were accepted as members of the counseling staff because they could provide stability to the program and ensure its continuity
B. The program is selective about who can participate and all counselors have to be graduates of the program, complete a 1-year internship, and must be individuals who have the respect of their peers and demonstrate high levels of motivation
C. They are available to program participants 24 hours a day, unlike staff from outside the prison, and can have a vital role in keeping a community alive and helping to hold its members responsible for their behavior
D. Because these are individuals who have considerable respect in the prison community, they are able to help keep participants in the program safe and out of situations that can cause them trouble
83. Parolees and probationers often share a history of drug or alcohol use. Studies indicate that approximately two thirds of probationers can be characterized as alcohol or drug involved offenders, while almost 74 percent of released state prisoners have had drug and/or alcohol issues.
84. Parolees and probationers receive similar services in community supervision, and the authors believe that several treatment services can reasonably be provided for people under community supervision, and these include all of the following EXCEPT:
A. Reintegration with family members and social support
B. Attention to basic needs
C. Crisis Intervention
D. Case Management
85. Prisoners released into the community face a sometimes bewildering transition, and a successful transition from offender to citizen often depends on successful treatment. Which of the following most accurately describes this group of offenders and their needs?
A. Studies estimate that nearly 90 percent of prisoners returning to the community are released on parole under conditional release
B. Ancillary services are needed before and after release to prepare the offender for the return to family, employment, and the community.and these include drug-free housing or other living arrangements, employment, family support, transportation, education, and primary health care
C. Community aftercare is the crucial function that links the offender with appropriate resources, tracks progress, reports information to supervisors, and monitors conditions imposed by the supervising agency
D. All of the above
86. Compared to parolees, probationers are less likely to have spent extended time in a correctional facility, and their ties to the community are relatively intact, which are usually benefits in substance abuse treatment.
87. There are historic differences between the criminal justice and public health systems that influence the nature and quality of services provided at both the program and policy levels. Which of the following is NOT an accurate statement about these differences?
A. A basic difference is the primary focuses of the two fields, as it is the responsibility of the criminal justice system is to protect the public safety, while the substance abuse treatment system’s focus is on restoring individuals to productive lives and minimizing the consequences of alcohol and drug dependence
B. Offenders are sometimes viewed as less deserving competitors for scarce substance abuse treatment services compared to nonoffending citizens
C. The two systems sometimes operate at cross-purposes, with punishment as the primary goal and treatment secondary for the criminal justice system
D. Because the missions of public health departments and correctional agencies are not complementary, treatment programs tend not address the additional needs of criminal justice client
88. Federal, state, and local policies have a tremendous effect on the quality and availability of substance abuse treatment for offenders, as do policies and procedures within individual programs, and information management is the key to identifying treatment needs and to providing treatment and related services more effectively.
89. Research and evaluation is a critical dimension of substance abuse treatment programs in the criminal justice system. The examining of inmate behavior, staff functioning and physical properties are all part of which type of evaluation?
D. None of the above
90. Another critical area in substance abuse program development within the criminal justice setting is that of program costs, including determining how to allocate funds within a program and for understanding the relationship between costs and outcomes. A cost benefit analysis looks at the relationship between program costs and program effectiveness, based on patient outcome.
Copyright © 2013 Quantum Units Education
Visit us at QuantumUnitsEd.com!