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Substance Use Disorders and Child Maltreatment

Chapter One-Purpose and Overview

1. Statistics indicate that more than ___________ children in the United States live with at least one parent who abused or was dependent on alcohol or an illicit drug during the past year.

A. 12 million

B. 10 million

C. 8 million

D. 6 million

2. Abused and neglected children from families affected by substance abuse are more likely to be placed in foster care and to remain there longer than maltreated children from families not affected by substance abuse.

A. True

B. False

Chapter Two-The Continuum of Alcohol and Drug Use

3. Substance abuse is a pattern of substance use that lends to significant impairment or distress,reflected by one or more of the following factors EXCEPT:

A. Failure to fulfill major role obligations at work, school, or home

B. Trouble with the law or interpersonal or social problems

C. Continued use in spite of physical hazards

D. Repeated acts of violence demonstrated while under the influence

Characteristics of Addiction

4. The National Institute on drug abuse has defined addiction as a chronic disease like heart disease, hypertension, and diabetes, but studies have shown alcohol and drug abuse treatment is significantly less effective as treatments required for these other chronic diseases.

A. True

B. False

5. Some research has demonstrated a biological and genetic predisposition to addiction with scientists estimating that genetic factors account for 40-60 percent of an individual's risk of addiction.

A. True

B. False

Negative Consequences of Substance Use Disorders

6. Which of the following is NOT one of the categories that negative consequences from substance use, abuse, and dependence generally fall into?

A. Social manifestations

B. Loss of behavioral control

C. Phychophysical withdrawal

D. Role maladaptation

7. Marijuana use is associated with having a burning or stinging sensation in the mouth or throat, respiratory problems and an increased likelihood of cancer in the throat and lungs.

A. True

B. False

Methamphetamine Use and Its Impact on Children

8. Methamphetamine use has significantly impacted the child welfare population, and in a survey by the National Association of Counties, 49 percent of the CPS officials reported that methamphetamine use had increased the difficulty of family reunification.

A. True

B. False

Chapter Three-The Impact On Prenatal Development

9. Identifying the effects of drugs and alcohol on fetuses has posed challenges for researchers, and securing accurate information regarding the use of illicit drugs from pregnant women or women who have given birth has proven to be very difficult.

A. True

B. False

Childhood Behavior and Characteristics Associated with FAS, ARND and ARBD

10. Children age 5-7 with Fetal Alcohol Syndrome (FAS), or ARND and ARBD may exhibit which of the following characteristics?

A. Difficulty remembering rules of games

B. Lack of remorse in breaking rules

C. Overwhelmed with new situations and interactions with other children

D. Become depressed and exhibit other behavior problems

11. The use of marijuana and cocaine during pregnancy has been linked to growth retardation, developmental disorders, and hypersensitivity to touch.

A. True

B. False

Children Abuse as a Precursor to Substance Use Disorders

12. One study found that women with a history of childhood physical or sexual abuse were nearly ___ times more likely to use street drugs and more than ___ times likely to abuse alcohol as women who were not maltreated.

A. 3; 4

B. 6; 3

C. 4; 5

D. 5; 2

Chapter Four- Screening

13. CPS caseworkers can use screening as a part of their standard home visits or family assessments, in order to determine whether a family member requires further evaluation for SUDs.

A. True

B. False

Sample Screening Instruments For Substance Use Disorders

14. The screening instrument that assesses whether or not the person has neglected responsibilities, become preoccupied with substance use, or is using substances to relieve emotional discomfort is:

A. The CAGE Questionnaire


C. Drug Abuse Screening Test (DAST)

D. Adult Substance Use Survey (ASUS)


15. SUD assessments should include various aspects of family living, such as housing, health issues, child behavior problems, and ________________.

A. Interpersonal dynamics

B. History of interventions

C. Environmental stressors

D. Family strengths

Key Points for Making Referrals and For Using Assessments

16. A good assessment should address each of the following family and parenting issues EXCEPT:

A. How substance use affects the client's ability

B. The level of care of intervention that would be most appropriate for this individual to address the current level of substance use

C. The parents' willingness to participate in parenting classes and family therapy

D. What should be required of the parent in order to demonstrate the ability to rear the child safety in light of a problematic use of substances.

Decision Tree for Child Welfare Cases Involving Caregiver Substance Use Disorders

17. If a caregiver is willing to commit to a SUD treatment and to change his or her lifestyle, the CPS worker should ensure that the child is in a safe environment and refer the caregiver to treatment while addressing parenting issues and family stability.

A. True

B. False

Chapter Five-The Goal of Treatment

18. People with SUDs often have poor coping and communication skills, and have learned to be manipulative or dishonest in order to obtain substances or hide their addiction.

A. True

B. False

19. Treatment has been shown to be cost-effective and to reduce costs in such areas as crime, health care and:

A. Incarceration

B. Unemployment

C. Law enforcement fees

D. None of the above


20. The immediate goals of detoxification programs include each of the following EXCEPT:

A. To provide a safe withdrawal from the substance of dependence and enable individuals to become alcohol-or drug free

B. To provide withdrawal that protects people's dignity

C. To prepare individuals for ongoing alcohol and drug abuse treatment

D. To begin the process of addressing the psychological social and behavior problems associated with addiction

Treatment Considerations

21. Involuntary or mandated treatment is generally not as effective as voluntary treatment because an individual must want to change.

A. True

B. False

22. The treatment approach that incorporates some elements of cognitive-behavioral therapy, but focuses on increasing and maintaining the participant's desire to change is:

A. Motivational enhancement treatment

B. Contingency management

C. Therapeutic community

D. Evidence-based reinforcement treatment

23. Trauma informed treatment services focus on trauma and its impact on SUDs and recovery and then goes a step further to address the impact of the specific trauma on the lives of participants.

A. True

B. False

Gender-Sensitive Treatment: Women

24. Compared to men, a greater number of women who enter treatment have a history of physical or sexual abuse and are more than likely than men to have co-occurring mental health problems.

A. True

B. False

Chapter Six-Family Assessment and Case Planning

25. During the family assessment, the caseworker engages the family in a process designed to gain a greater understanding of family strengths,_________, and  resources so that children are safe and the risk of maltreatment is reduced.

A. Support

B. Needs

C. History

D. Patterns

North Carolina Family Assessment Scale

26. This assessment scale uses the family interactions domain to to address the physical, emotional, and relational functioning of the children in the family.

A. True

B. False

Stages of Change and the CPS Caseworker's Tasks

27. The conscious decision to change and identifying the motivation to change occurs in the action stage of change.

A. True

B. False

Using Motivational Interviewing

28. Which of the following in NOT one of the four general principals of motivational interviewing?

A. Ambivalence about substance use is normal and is an obstacle in recovery

B. Ambivalence can be overcome by working with the client's motivations and values

C. The relationship between the caseworker or treatment provider and the client should be collaborative with each participant bringing his own expertise

D. Aggressive confrontation should be used when necessary

Supporting Children of Parents With Substance Use Disorders

29. The three C's to helping children deal with issues associated with a parent's SUD are, "You did not cause it", "You cannot cure it", and:

A. "Your parents still care about you"

B. "You cannot cover it up"

C. "You cannot control it"

D. "You cannot carry the burden"

Chapter Seven-Areas of Similarity

30. CPS and SUD treatment agencies often overlap in programmatic goals, the characteristics of the families served, management challenges, and new demands regarding outcomes.

A. True

B. False

Areas of Difference

31. CPS and SUD systems operate under different laws and regulations, and funding for the two systems comes from different sources.

A. True

B. False

Chapter EIght-Setting the Stage

32. Collaboration between CPS and SUD treatment agencies builds on the individual strengths of each agency and family member, forging shared approaches that are more effective than an individual response.

A. True

B. False

Chapter Eight-Setting the Stage

33. In order to be effective, collaborative relationships should include trust, shared values, common goals, a common language, respect, commitment, and a desire to share ____________.

A. Decision-making

B. Risk taking

C. Accountability

D. All of the above

Collaboration At All Levels

34. State CPS and other officials can promote collaboration among agencies by establishing ongoing task forces, creating joint mission statements, preparing integrated funding, and requiring cross-training of staff.

A. True

B. False

35. Co-locating CPS agencies and SUD treatment providers on site helps demonstrate that agency officials consider cooperation and collaboration to be agency priorities.

A. True

B. False

Confidentiality and Information Sharing

36. The exemption from standard confidentiality requirements applies to initial reports of child abuse or neglect, as well as requests and subpoenas for additional information or records.

A. True

B. False


37. If subpoenaed to court to testify, an SUD treatment provider should first refuse, citing Federal regulations related to confidentiality, and only with a judge's subsequent court order that finds a just cause to ignore this law may a counselor testify without a client's written consent.

A. True

B. False

38. Federal law and regulations allows which of the following information to be shared between CPS caseworkers and SUD treatment personnel?

A. SUD screening information

B. SUD diagnosis and treatment information

C. Attendance in treatment programs

D. A treatment participant's relapse

39. SUD treatment providers may disclose information under a MOU without the patient's consent, if the MOU outlines how to share information and protect the confidentiality of individuals they serve.

A. True

B. False

40. When approached with care, confidentiality rules do not automatically limit communication, but rather set the context within which staff can share important information, and assure families that sensitive aspects of their lives will be protected.

A. True

B. False

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