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1. The significant growth in the justice system has resulted from changes in drug laws and law enforcement practices and from the absence of public services for people who have mental or substance use disorders, who are homeless, and who are impoverished.
A. True
B. False
2. Studies indicate that _____ of justice involved individuals who have severe mental disorders also have co-occurring substance use disorders.
A. 60 - 87%
B. 24 - 34%
C. 17 - 34%
D. 10 - 15%
3. People with CODs often engage in drug use to alleviate symptoms associated with serious mental disorders, including:
A. Depression
B. Anxiety
C. Paranoia
D. All of the above
4. Participants in correction-based treatment programs for CODs often show positive treatment outcomes, including lower dropout rates in comparison to community treatment programs.
A. True
B. False
5. Mixing people who have more predatory characterological disorders in specialized CODs programs with others who have significant impairment related to bipolar disorders, depression, or psychosis may be problematic for which reason?
A. People with pronounced characterological disorders may be at higher risk for criminal recidivism, and it is contraindicated to combine offenders who are at significantly different risk levels in treatment and supervision services.
B. People with more severe impairment related to CODs are frequently victimized while in the justice system and may be more vulnerable to emotional and physical abuse when placed with offenders who are at higher criminal risk levels.
C. People with more severe impairment related to their mental or learning disorders require distinctive interventions, including medication management, basic life skills training, crisis stabilization, and intensive case management.
D. All of the above.
6. An important new criterion for substance use disorders is _____, reflecting factors surrounding the intensity of desire for ongoing substance use.
A. Dependence
B. Legal difficulties from drug use
C. Cravings
D. All of the above
7. As a result of the intertwined nature of mental and substance use disorders among people in the justice system, it is critically important to:
A. Determine if mental health symptoms appeared after engaging in substance use.
B. Assess whether engaging in substance use was motivated by attempts to alleviate symptoms of mental disorders.
C. Investigate the presence of mental health symptoms following periods of abstinence to help determine if there is a causal relationship between the mental and substance use disorders.
D. All of the above.
8. In some justice settings, identification of CODs is aided by parallel screening and assessment activities for mental and substance use disorders, as this approach often leads to detection of CODs and other related issues, information sharing, enhanced communication regarding overlapping areas of interest, development of integrated services goals that address both mental health and substance use issues.
A. True
B. False
9. Opportunities to train responders in the identification of the signs and symptoms of mental and substance use disorders and to more quickly resolve crisis situations have more operational value than adding extensive screening procedures.
A. True
B. False
10. Jails are required to conduct at least basic screening for all of the following, except:
A. Suicide
B. Criminal risk
C. Mental health
D. Substance use
11. Planning for reentry should begin at:
A. Initial detention
B. First appearance court
C. Jail booking
D. Dispositional court
12. Which of the following describes the role of screening?
A. It is implemented when there is a need for more detailed information to help place people in a specific level of care or type of service.
B. It addresses immediate needs for services.
C. It informs treatment planning or case planning.
D. It examines a range of long-term needs and factors that may affect engagement and retention in services, such as housing, vocational and educational needs, transportation, family and social supports, motivation for treatment, and history of involvement in behavioral health services.
13. Assessment for CODs is a brief, routine process designed to identify indicators, or “red flags,” for the presence of mental health, substance use, or other issues that reflect an individual’s need for treatment and for alternative types of supervision or placement in housing or institutional settings.
A. True
B. False
14. Assessment in the criminal justice setting should be conducted by individuals who:
A. Are knowledgeable about the dynamics of criminal behavior.
B. Understand the pathways and interactions between criminal behavior and clinical pathology related to substance use and mental disorders.
C. Both (A) and (B).
D. None of the above.
15. Goals of the CODs assessment process include all of the following, except:
A. Determination of need and prescribing appropriate medication.
B. History of previous mental health or substance use treatment(s) and response to treatment(s).
C. Family history of mental health or substance use disorders.
D. Development of diagnoses according to formal classification systems.
16. Which of the following types of information should be examined in assessing CODs within the justice system?
A. Juvenile and adult justice system history and current status.
B. Reasons for living.
C. Trauma exposure, including combat, non-combat, and general trauma.
D. All of the above.
17. Assessment of substance use should include:
A. Misuse of prescription drugs.
B. Reasons for substance use.
C. Periods of abstinence.
D. All of the above.
18. In the absence of specialized instruments to address both disorders, an integrated screening approach typically involves use of a combination of mental health and substance use instruments.
A. True
B. False
19. Integrated screening and assessment approaches are associated with more favorable outcomes among people in the justice system and in the community, and help to maximize the use of scarce treatment resources.
A. True
B. False
20. All of the following characteristics carry elevated risk for CODs, except for:
A. Female gender
B. Youthful offender status
C. Low educational achievement
D. History of unstable housing or homelessness
21. Related areas of functional ability include all of the following, except for:
A. Reading skills
B. Writing skills
C. Prosocial leisure skills
D. How the individual responds to confrontation or stress and manages unusual thoughts and impulses
22. Accuracy of information obtained during screening and assessment can be compromised by which of the following factors?
A. Incomplete, mislabeled, or misleading clinical or criminal justice records.
B. The transparent nature of screening and assessment instruments may lead to individuals providing false information.
C. Symptoms may be feigned or exaggerated if an offender believes this will lead to more favorable placement or disposition.
D. All of the above.
23. Screening and assessment of mental and substance use disorders in the justice system is most often based on self-report information, however, self-report information obtained from justice-involved individuals has been found to be invalid and not useful for treatment planning.
A. True
B. False
24. Strategies for maximizing the accuracy of self-report information include all of the following, except for:
A. Providing clear instructions regarding the screening and assessment process.
B. Asking about “typical” or “usual” substance use patterns rather than specifying a time frame related to past substance use.
C. Establishing rapport through use of motivational interviewing and other related techniques.
D. Carefully explaining the scope of and limits to confidentiality and the potential consequences for reporting mental health and substance use problems.
25. Observation by family members, friends, and direct care staff cannot provide information that is as accurate as data compiled from interviews or standardized instruments.
A. True
B. False
26. While the DSM-IV-TR and DSM-5 indicate that individuals should be abstinent for approximately _____ before an accurate mental health diagnosis can be provided, the precise length of the extended baseline for screening and assessment should be determined by the severity of the symptoms and the general health status.
A. 10 days
B. 4 weeks
C. 8 weeks
D. 3 months
27. The “Risk Principle” indicates that the intensity of services provided by CODs programs should be proportional to the risk of recidivism, and that the most intensive services should be reserved for the higher risk offenders.
A. True
B. False
28. The major criminogenic needs include all of the following, except for:
A. Antisocial attitudes, personality features, and friends and peers
B. Poor employment skills
C. Low self-esteem
D. Lack of prosocial leisure activities
29. The capability factor of the Suicide Risk Decision Tree framework is the acquired ability to engage in self-harm, which is influenced by all of the following, except:
A. Desire to feel pain
B. Fearlessness of death
C. Suicidal plans and preparations
D. Duration and intensity of suicidal ideation
30. Consequences of not screening for trauma include:
A. Inappropriate treatment referral
B. Dropout from treatment
C. Premature termination of treatment
D. All of the above
31. Given that two-thirds of incarcerated women are from cultural or ethnic minorities, screening and assessment approaches should be selected that are culturally valid and sensitive.
A. True
B. False
32. Motivation to engage in treatment is necessary to provide effective services for justice-involved individuals.
A. True
B. False
33. The purpose of motivational interviewing is to:
A. Normalize ambivalence towards change.
B. Develop discrepancy between the offenders’ current attitudes and behaviors and their values and goals.
C. Both (A) and (B).
D. None of the above.
34. Important cultural themes to consider during the assessment and treatment process include:
A. Religiosity and related beliefs and customs.
B. Independent versus interdependent cultural orientations.
C. Trust versus distrust of authority figures.
D. All of the above.
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