Early Recovery Choices
Jamie finishes IOP and feels emotionally better but still has cravings. Which choice best supports long-term sobriety?
A. Trusting feelings and reducing support
B. Keeping the same routine and supports for now
C. Waiting to see if cravings go away
D. Focusing on motivation instead of structure
✅ Correct: B
Why: Feelings improve before the brain fully stabilizes. Keeping structure during this phase reduces relapse risk while cravings naturally fluctuate.
A client has strong cravings during stress but does not use.
What best explains this?
A. Cravings no longer matter
B. Willpower alone is working
C. Coping skills are interrupting behavior
D. Stress will soon disappear
✅ Correct: C
Why: Cravings can exist without use when coping strategies interrupt the automatic response.
A client has a lapse and immediately tells their counselor. What does this most improve?
A. Confidence
B. Chance of quick recovery
C. Self-esteem
D. Motivation
✅ Correct: B
Why: Early disclosure allows fast intervention and reduces the chance of a lapse becoming a full relapse.
A client has friends but none know about their recovery. What is the biggest vulnerability?
A. Loneliness
B. Lack of accountability
C. Poor communication
D. Low self-esteem
✅ Correct: B
Why: Support that isn’t recovery-informed cannot provide accountability or intervene during risk moments.
A client has been sober for several months, feels stable, and starts skipping recovery routines because “life is busy.” Which factor most increases relapse risk here?
A. Increased responsibility
B. Reduced cravings
C. Gradual loss of structure
D. Overconfidence
✅ Correct: C
Why: Structure fades quietly, and relapse risk often rises before cravings return.
Alex says, “I don’t feel confident I can stay sober.” What most increases Alex’s odds long-term?
A. Gaining confidence before making changes
B. Avoiding all stress until confidence improves
C. Continuing recovery behaviors despite doubt
D. Waiting until motivation feels stronger
✅ Correct: C
Why: Recovery success is linked to behavior, not confidence. Acting despite doubt builds confidence over time.
After an argument, one client isolates; another reaches out. Which response best supports long-term sobriety?
A. Isolation to cool down
B. Distracting alone
C. Reaching out for support
D. Ignoring the feeling
✅ Correct: C
Why: Reaching out reduces isolation, lowers stress, and adds accountability—key protective factors in recovery.
A client lapses, feels ashamed, and stops attending groups. What most increases relapse risk?
A. Cravings
B. Shame and secrecy
C. Lack of education
D. Bad intentions
✅ Correct: B
Why: Shame drives isolation, which removes accountability and support—two key relapse-prevention factors.
A client chooses support people who challenge them. Why is this protective?
A. It increases pressure
B. It prevents cravings
C. It promotes accountability
D. It reduces stress
✅ Correct: C
Why: Accountability helps interrupt denial and reinforces recovery-aligned choices.
A client is doing well but avoids talking about recovery with new friends. What is the biggest vulnerability?
A. Fear of judgment
B. Social anxiety
C. Lack of accountability
D. Poor communication skills
✅ Correct: C
Why: Recovery kept private limits support during high-risk moments.
Chris understands why they use but hasn’t changed their daily schedule.
What is the biggest risk factor here?
A. Lack of insight
B. Poor intentions
C. No behavioral change
D. Lack of intelligence about addiction
✅ Correct: C
Why: Insight alone does not interrupt habits. Without behavior and routine changes, old patterns are likely to return.
A client did not use but felt overwhelmed and exhausted coping. What does this suggest?\
A. Recovery is failing
B. Coping strategies need strengthening
C. Cravings are harmless
D. They should push harder
✅ Correct: B
Why: White-knuckling increases burnout. Sustainable recovery requires coping skills that reduce strain, not just prevent use.
Two clients relapse once. One adjusts their plan; the other gives up. Who has better long-term outcomes?
A. The one who stayed sober longer
B. The one who feels worse
C. The one who adjusts and re-engages
D. The one who avoids triggers
✅ Correct: C
Why: Flexibility and re-engagement predict sustained recovery more than avoiding mistakes.
A client returns to the same environment and routines post-treatment. What risk factor is present?
A. Poor motivation
B. Environmental cues tied to use
C. Lack of intelligence
D. Overconfidence
✅ Correct: B
Why: Environmental cues activate conditioned habits and cravings even with good intentions.
A client says, “I don’t have cravings, so I don’t need a plan.” What is the primary risk in this belief?
A. Lack of motivation
B. Ignoring early warning signs
C. Over-reliance on willpower
D. Denial
✅ Correct: B
Why: Relapse often begins with subtle warning signs, not cravings.
Taylor avoids all triggers and uncomfortable situations. Which outcome is most likely long-term?
A. Permanent protection from relapse
B. Increased coping skills
C. Difficulty managing unexpected stress
D. Reduced need for support
✅ Correct: C
Why: Avoidance prevents learning coping skills. Real-world stress is unavoidable, and lack of practice increases relapse vulnerability.
A client follows their routine even when emotionally dysregulated. What recovery factor is strongest here?
A. Positive emotions
B. Insight
C. Behavioral consistency
D. High motivation
✅ Correct: C
Why: Consistent behavior stabilizes the nervous system and supports recovery even when emotions fluctuate.
A client says, “Relapse means treatment didn’t work.” What risk does this belief create?
A. Reduced motivation
B. Increased shame and drop-out
C. Loss of insight
D. Poor memory
✅ Correct: B
Why: This belief increases self-blame and disengagement rather than problem-solving.
A client builds a predictable but boring routine. What benefit does this provide?
A. Emotional excitement
B. Reduced stress and decision fatigue
C. Fewer cravings
D. Faster recovery
✅ Correct: B
Why: Predictability lowers nervous system load and reduces impulsive decision-making.
A client replaces substances with excessive work, exercise, or relationships. What recovery concern does this raise?
A. Poor time management
B. Avoidance of emotional regulation
C. Lack of discipline
D. Too much ambition
✅ Correct: B
Why: Substituting compulsive behaviors can maintain the same avoidance patterns.
Sam says, “Once probation ends, I won’t need as much recovery support.” What is the biggest concern?
A. Sam lacks motivation
B. Sam doesn’t understand addiction
C. Support is tied only to external pressure
D. Sam is being dishonest
✅ Correct: C
Why: Recovery maintained only by external pressure often weakens once that pressure is removed.
Evenings and weekends are unplanned and difficult. What most increases relapse risk?
A. Lack of insight
B. Boredom
C. Unstructured time
D. Too much freedom
✅ Correct: C
Why: Unstructured time increases exposure to triggers, stress, and impulsive decision-making.
A client views relapse as information, not failure.What does this predict?
A. Fewer cravings
B. Higher flexibility and resilience
C. No future lapses
D. Faster recovery
✅ Correct: B
Why: Learning-oriented thinking supports adjustment and persistence over time.
A client relies on only one support person. What risk does this increase?
A. Emotional dependence
B. Burnout
C. Limited backup if support fails
D. Conflict
✅ Correct: C
Why: A narrow support system increases vulnerability if that person becomes unavailable.
A client says, “I’ll ask for help if things get really bad.” What is the risk in this plan?
A. Dependence on others
B. Waiting until crisis
C. Lack of insight
D. Fear of vulnerability
✅ Correct: B
Why: Waiting until crisis reduces available options and increases impulsive decisions.