Studying for the LCSW or MFT Exam? Let's take a look at Substance Use, Abuse & Dependence

By Bethany Vanderbilt on February 29, 2012

It's Hot Topics Tuesday and this week we're looking at substance abuse.  Regardless of what setting you work in or the population that you work with, you will come across clients who are dealing with the ill effects of substance use, abuse or dependence.


Here’s how it might come up in a test item:

Sample Question:

A social worker meets with a couple seeking treatment due to an increase in tension and arguments.  During the assessment, the wife reports that she has been on Oxycontin since having back surgery a year ago.  When the social worker asks follow up questions, the wife admits that she has been taking more than the prescribed dose and that she gets “sick” if she misses a dose.  What should the social worker do FIRST?

A. Explore how the wife’s medication use is affecting the couple’s relationship

B. Teach the couple communication skills to manage arguments more effectively

C. Complete a comprehensive assessment of the couple’s overall functioning

D. Refer the wife for a substance abuse assessment

  First, some clinical definitions: Substance Abuse A maladaptive pattern of using certain drugs, alcohol, medications, and toxins despite their adverse consequences. Substance Dependence Continued use; craving; and other cognitive, behavioral, and physiological symptoms that occur through the use of certain drugs, alcohol, medications, and toxins. Some symptoms include being preoccupied about the substance; taking greater amounts than intended; making persistent efforts to control its use; reducing occupational and social activities; and continually using the substance despite recognizing that it is causing recurrent physical, psychological, or social problems. Tolerance and withdrawal are essential.   Oxycontin, along with morphine, heroin, codeine and many others, are all under the category of Opiods.  Symptoms of Opiod Intoxication include: papillary constriction (or in extreme overdose cases, dilation), drowsiness or coma, slurred speech, and impairment in attention or memory.  Symptoms of Opiod Withdrawal include: dysphoric mood, nausea or vomiting, muscle aches, lacrimation or rhinorrhea (runny eyes or nose), papillary dilation,, diarrhea, yawning, fever, and insomnia.  It is essential, in cases where a client is exhibiting signs or symptoms of substance abuse or dependence, to facilitate a substance abuse assessment and treatment before further mental health treatment is initiated.  In most cases, this will mean a referral to a clinician specializing in the assessment and treatment of substance-related disorders.  


The best answer choice is, in this case, D, since the client is reporting problems in her relationship, use of a substance, and possible symptoms of withdrawal.  A, B, and C might all be part of a viable treatment plan, but only after the substance abuse issue is addressed.   Like what you see on our blog?  Check out the “LCSW Exam Prep” and “MFT Exam Prep” tabs on our website.  Our on-demand workshops and study materials are comprehensive, clear and, above all, USEFUL.  We want to help you pass your exam…with confidence!  

Coming up next week: Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence

Think our straightforward, sensible approach could help you PASS your social work or MFT exam? If you're preparing for a social work exam, check out our Social Work Study Materials. If you're preparing for an MFT exam, check out our MFT Study Materials. Learn more about our offerings at The Therapist Development Center.

Looking for more practice questions and some study tips? Check out our new Social Work Exam Study Guide:

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