What Would You Do?
A client asks you something during your internship and you don't know the answer. What do you do?
Best Practice: Be honest. Don't guess. Tell the client you'll find out and consult your supervisor.
A client needs help finding housing. Is this part of your role?
Yes. Case management and referrals are part of addiction counseling.
A client says, “I messed up. I used again.” What would you say?
Possible Response:
“Thank you for telling me. Let’s talk about what happened.”
Discussion prompt: What responses could make the client shut down?
You don’t understand an assignment your supervisor gives you. What do you do?
Appropriate Response:
Ask for clarification. It's better to ask questions than guess and make an avoidable mistake.
Discussion Prompt:
Why are interns sometimes afraid to ask questions?
A client says, “I know my drinking is causing problems, but I’m not ready to stop.” What stage of change are they likely in?
Contemplation. The client recognizes a problem but is not yet ready to make a change.
Discussion Prompt:
How would you work with this client without pushing them?
A client becomes upset during your conversation and starts crying. What do you do?
Best Practice:
Stay present, listen, acknowledge their feelings, and allow them space to talk. Don't rush to "fix" the situation.
A client asks, “Do you think I have bipolar disorder?” Can you diagnose them?
No. Recognize concerns, gather appropriate information, and refer or consult. Addiction counselors do not diagnose mental health disorders.
Discussion prompt: What can you say to the client?
A client says, “Everyone keeps telling me I need treatment, but I don’t think I have a problem.” What would you say?
Possible Response: “What concerns, if any, do you have about your substance use?”
Avoid arguing or trying to convince the client.
Your supervisor gives you constructive feedback you disagree with. What do you do?
Appropriate Response:
Listen, stay open, and ask questions. Use supervision to discuss your perspective and understand the feedback.
Discussion Prompt:
What’s the difference between explaining yourself and becoming defensive?
In Motivational Interviewing, what does OARS stand for?
Open-ended questions, Affirmations, Reflections, and Summaries.
Discussion Prompt:
Which OARS skill do you find easiest? Which is hardest?
You realize after meeting with a client that you may have said something incorrectly. What do you do?
Best Practice:
Don't hide the mistake. Consult your supervisor, determine whether it needs to be corrected, and learn from it.
Discussion prompt: Why might an intern be afraid to tell a supervisor they made a mistake?
A client asks if they should stop taking their prescribed medication. What is your role?
Explore their concerns and connect them with the prescriber. Do not give medical advice or tell them to stop medication.
Discussion prompt: How can you support the client without stepping outside your scope?
A client says, “You wouldn’t understand. You’ve never been through what I’ve been through.” What would you say?
Best Response:
“You’re right that I haven’t had your exact experience. I’d like to understand what it has been like for you.”
Discussion prompt: Why might saying “I know exactly how you feel” be a problem?
You notice a mistake in a client note after you submitted it. What do you do?
Appropriate Response:
Tell your supervisor and follow the agency’s procedure for correcting documentation. Don’t hide, delete, or improperly alter the record.
Discussion Prompt:
Why could trying to quietly fix the record create a bigger problem?
A client says, “I’ve been sober for 30 days, but nobody seems to notice how hard I’m trying.” Give a reflective response.
Possible Response:
“You’ve worked really hard for these 30 days, and it’s frustrating that others don’t seem to recognize that.”
Discussion Prompt:
How is a reflection different from giving advice?
A client tells you something that makes you uncomfortable, but you aren't sure whether it requires action. What do you do?
Best Practice:
Stay professional, don't react impulsively, and consult your supervisor. Clarify whether there are safety, reporting, ethical, or treatment concerns.
Discussion prompt: What would make this an issue you cannot simply keep to yourself?
A client says, “I don't want to live anymore.” Is this outside your role because you can't initiate a 5150?
No. Respond immediately, assess safety within your role and training, and involve the appropriate supervisor or crisis professional.
Discussion prompt: What's the difference between outside your scope and outside your responsibility?
A client says, “Just tell me what to do. Should I leave my partner or not?”
Possible Response:
“I can help you explore your options, but the decision is yours.”
Discussion prompt: Why shouldn't the counselor simply give advice?
You hear coworkers talking negatively about a client in the break room. What do you do?
Appropriate Response:
Don’t participate. Maintain professionalism and protect the client’s dignity and confidentiality. Seek supervision if the behavior raises concerns.
Discussion Prompt:
How could you handle this without creating unnecessary workplace conflict?
During group, one client talks constantly and others can’t participate. What should the facilitator do?
Appropriate Response:
Respectfully redirect the conversation and create space for other members to participate.
Discussion Prompt:
What could you actually say without embarrassing the client?
You strongly disagree with how your supervisor wants to handle a client situation. What do you do?
Best Practice:
Respectfully ask questions and explain your concern. Seek clarification and use supervision rather than ignoring the direction or arguing in front of the client.
Discussion prompt: What if you believe the supervisor's direction is unethical or could harm the client?
Your supervisor asks you to perform a task you believe is outside your scope. What do you do?
Speak up and seek clarification. Explain your concern and do not perform a service you are not qualified or authorized to provide.
Discussion prompt: What if you feel pressured because you're “just an intern”?
A client says, “Honestly, I don’t even want to be sober anymore.” What would you say first?
Possible Response: “Tell me more about what’s making you feel that way.”
Explore rather than judge, lecture, or immediately try to convince them.
Discussion prompt: What would you want to understand before deciding what to do next?
A staff member handles a client situation in a way that feels wrong, but you’re new and aren’t sure it was unethical. What do you do?
Appropriate Response:
Don’t ignore it or jump to conclusions. Focus on what you actually observed and consult your supervisor or the appropriate person.
Discussion Prompt:
What’s the difference between seeking consultation and gossiping about a coworker?
A client says, “I don’t have a problem. My probation officer is the only reason I’m here.” What counseling approach would be appropriate?
Appropriate Response:
Use Motivational Interviewing rather than arguing or confronting. Explore the client’s perspective and their own reasons for possible change.
Discussion Prompt:
What might happen if you respond, “If you didn’t have a problem, you wouldn’t be here”?