Certified Clinical Trauma Specialist-A (CCTSA) Trauma and Addiction (NEW)

Welcome to your Certified Clinical Trauma Specialist-A (CCTSA) Trauma and Addiction (2020)

Why is the ACEs study so important?

a. Strong predictors of success later in life

b. Strong predictors of trauma

c. Strong predictors of later social functioning, well- being, health risks, disease and death

d. Strong predictors of later health

Which of the following is essential for understanding trauma?

a. Negative emotions, thinking, and behaviors are normal body responses to stress

b. Trauma stems from episodic events that last throughout an individual’s lifetime

c. Emotions, thinking, and behaviors must be the focus in all trauma treatment

d. Individuals with trauma are damaged and must be repaired

Which of the following is NOT an example of Trauma Informed Care?

a. Asking an individual “What happened to you?”

b. Encouraging self-empowerment

c. Asking an individual “What’s wrong with you?"

d. Challenging behaviors are a way to adapt

When we talk about perceptual maturation, what does it require?

a. A sense of maturity in the way we look at things

b. A sense of perception

c. A sense of flexibility in the way we look at things

d. A sense of flexibility and perception

What can Vicarious Trauma also result in?

a. Therapist retraumatization

b. Client retraumatization in the event that the therapist experienced a similar traumatic event as them

c. Therapist retraumatization in the event that the therapist has endured their own trauma or traumatic event

d. Client retraumatization

Which of the following is a sure way to create distrust with a client?

a. By not being open with them

b. By not following up with them

c. By not having structure

d. By lying to them

The Anterior Cingulate of the Cortex is really the body’s _________________ .

a. Radar system

b. GPS Tracker

c. Eyes and Ears

d. Back up system

Which of the following best describes when Vicarious Trauma happens?

a. When helping professionals perspectives about the world alter due to the repeated exposure of other’s trauma

b. When helping professionals begin to look at the world around them differently due to the exposure of other’s trauma

c. When helping professionals’ self beliefs become deeply altered because of repeated exposure to the trauma of others

d. When helping professionals’ perspectives and beliefs about the world around them become deeply altered over time due to repeated exposure to the trauma of others

What happens when people are stuck in disregulation or the sympathetic system?

a. They stay stuck

b. They are pushed to engage in unhealthy risk behaviors

c. They become depressed

d. They begin to form unhealthy habits

The last Antibody is _________.

a. Self- Care

b. Caring for others

c. Taking care of your friends

d. Taking care of your coworkers too

When people are sympathetically charged, everything from the diaphragm up is ________________ and everything from the diaphragm below is ______________.

a. Stimulated, Suppressed

b. Speed up, Slowed down

c. Slowed down, Speed up

d. Suppressed, Stimulated

It is okay for people to have cravings, what is even more important is __________________.

a. That they don’t hide those cravings

b. That they don’t continue those cravings

c. That they don’t give in to their cravings

d. That they don’t talk about their cravings

According to SAMHSA, one of the Four R’s of an agency practicing trauma-informed care is that a program organization, or system ______________ the widespread impact of trauma and understand potential paths for recovery.

a. Repairs

b. Realizes

c. Re-triggers

d. Renews

Which of the following best describes what happens when people have experienced the input of cortisol and adrenaline?

a. Their blood circulation and breathing increases

b. Cortisol is released into the blood

c. There is a neurological shift in the brain that's taken place and they move from parasympathetic dominance, into sympathetic dominance

d. There is a neurological shift in the brain that’s taken place and the move from sympathetic dominance, into parasympathetic dominance

Which of the following is NOT one of SAMHSA’s Four R’s of Trauma-Informed Care?

a. Realizes

b. Recognizes

c. Renews

d. Responds

Which of the following best describes OAR?

a. It is a line where nurses and doctors answer questions regarding any drug

b. It is a free line, it is run 24/7 by nurses and pharmacists in order to answer questions that people might have regarding drugs

c. It is a line where nurses and pharmacists answer questions regarding opioids

d. It is a free line, it is run 24/7 by nurses and pharmacists in order to answer questions that people might have regarding opioids

From what perspective do you talk about dealing with addiction?

a. That it is tied to the sympathetic system

b. That it is tied to the parasympathetic system

c. That it is tied to the trauma

d. That it is tied to the trauma and parasympathetic system

What happens when our Anterior Cingulate of the Cortex becomes activated?

a. Broadens our focus

b. Narrows our focus

c. Perception focuses

d. Perception narrows

How the ASAM works is, one dimension indicates whether a person needs residential treatment, which dimensions are these?

a. 2 or 4

b. 1 or 2

c. 3 or 4

d. 4 or 6

When we regulate our body as the first step, what are we doing?

a. Relaxing our body

b. Creating an environment that is safe

c. Releasing tension

d. Driving out stress

When the hot system is activated, __________________.

a. Hearing ability reduces

b. Attention span reduces

c. Moral reasoning increase

d. Language ability reduces

Which of the following are you only able to do if you are relaxed?

a. Be open & honest

b. Be nice & kind

c. Be funny & entertaining

d. Be available & listen

There are considerations to think about when working with people who are not only experiencing trauma but helping them ____________________.

a. Through anything else they need

b. Overcome their addiction

c. Overcome something

d. Through personal issues

A relaxed body cannot be ______________.

a. Dysregulated

b. Distrubed

c. Traumatized

d. Triggered

When can we think outside the box?

a. When we are integrating the executive functioning and survival component

b. When we are using our survival components

c. When we are using our parasympathetic system

d. When we are integrating the executive functioning and parasympathetic system

What is someone who is in determination or preparation doing/saying?

a. “I don’t have a problem”

b. "I have a problem & I am ready to get better”

c. “I have a problem & I want help”

d. “I have a problem; I just don’t know what to do”

Out of the Four Essential Interventions, which one is the most important?

a. The person of the caregiver/staff is to create an environment that feels safe for the resident from the first to the last contact

b. The caregiver/staff regulate the resident while with them

c. The person of the caregiver/staff must self- regulate their own threat/stress response system

d. Help the resident regulate self when not with the caregiver/staff

How many more times are you likely to be an alcoholic with 3 ACEs, opposed to having no ACEs.

a. 10

b. 6

c. 2

d. 50

What are the three R’s?

a. Revenge, Regret, Remorse

b. Release, Relax, and Restore

c. Reduce and Recycle

d. Rage, Rejection, and Resentful

As a trauma sensitive and informed organization, staff, and the people they serve must feel physically, emotionally, and psychologically __________________.

a. Stable

b. Informed

c. Congruent

d. Safe

The purpose of the ____________________ is to maintain homeostasis and balance in the body.

a. Parasympathetic System

b. Sympathetic System

c. Central Nervous System

d. Peripheral Nervous System

Which of the following illnesses do people with 4 ACEs not have an increased risk for?

a. Suicide

b. Obesity

c. Heart disease

d. Heart attack

Which of the following best describes what happens when you try to put additional demands on someone?

a. You’re going to make them struggle more

b. They are going to remain in their same state of mind

c. They are going to try to resist

d. You’re going to help them remain in that system

The ____________________ is the most primitive portion of the brain, focusing on survival.

a. Parasympathetic System

b. Sympathetic System

c. Central Nervous System

d. Peripheral Nervous System

When you make comments like, “I really want to hear what you have to say to me”, it lets that person know _______________.

a. I really want to hear what you have to say

b. I am attuned into what you want to tell me

c. I care about what you have to say

d. I don’t care about what you want to say

Which of the following is a therapist risk of Vicarious Trauma?

a. Poor self-care

b. Healthy eating

c. Healthy self-care

d. Non- Stressful personal life

Which of the following best describes precontemplation?

a. When a person has no insight, has no clue, that they have even a need to change the way they drink or use substances

b. Clueless people

c. When a person is totally unaware of their surroundings

d. Someone that doesn’t know they need to change their addictions

Out of the following, what can addiction eventually lead to?

a. Worse addictions

b. More addictions

c. A lowered IQ

d. Disability or premature death

Behavioral symptoms result from the over-use of the ________________ response system coupled with the body’s effort to heal.

a. Lax

b. Threat/stress

c. Balancing

d. Mitigating/adaptation

From the 1990s to 2013, there has been almost _______ people who have died from overdoses nationally.

a. 1,500,000

b. 200,000

c. 400,000

d. 150

We want to find ways that when we work with individuals, were not _______________ but we are lifting them up and encouraging them.

a. Lying to them

b. Letting them down

c. Discouraging them

d. Bringing them down

When someone is in fight or flight mode, what might you see?

a. Someone that is trying to fight

b. Someone trying to avoid the situation

c. Impairment with anger & impulse control

d. Impairment with self control

When someone has an active addiction it is neither ___________ or ______________ .

a. Deliberate, on purpose

b. On purpose, intended

c. Deliberate, planned

d. Intended, planned

When we calm our environments, we have greater success at __________________.

a. Talking with people

b. Calming ourselves

c. Calming children

d. Calming people

Which of the following would be an intrusion symptom?

a. Recurrent mood swings

b. Recurrent distressing relationships

c. Recurrent, involuntary, and intrusive distressing memories of the traumatic events

d. Recurrent depressed actions

Which of the following best describes what Mitigating creates?

a. Whining behaviors

b. Distance oriented responses of adults raised in adverse environments

c. Abandonment movements

d. Positive oriented responses of adults raised in adverse environments

Where is Moral awareness located?

a. Sympathetic system

b. Nervous system

c. Parasympathetic system

D. Circulatory system

What do you typically see when talking about irritable behavior or angry outbursts?

a. People who are using fight or flight components as a way to protect themselves

b. People who are in the parasympathetic system, who are using fight or flight components as a way to protect themselves

c. People who are in the sympathetic system, who are using fight or flight components as a way to protect themselves

d. People who are loud and expressing themselves through fight or flight responses

When a person has little self evaluation or insight, it should tell us that the _______________.

a. Person is not self aware

b. Person has been through trauma

c. Stress threat response system is activated

d. Stress level is high

Out of the following, what best encourages the healing process from pain, stress, and fear?

a. Focusing on the factors that caused the pain, stress, and fear for the one in recovery

b. Focusing on their competence and the value they have as the one in recovery

c. Creating a safe environment for the one in recovery

d. Forming a positive and healthy relationship with the one in recovery

What creates Stability?

a. The state of being stable

b. When the brain is well linked, with differential parts working together

c. Balance of the mind

d. Enduring nature

The ability to develop and maintain relationships, is talked about in which system?

a. Parasympathetic system

b. Sympathetic system

c. Nervous system

d. Integumentary system

What happens as we become increasingly dysregulated?

a. We become less- reflective and look for an object of blame

b. We become more assertive

c. We distance ourselves

d. We begin to blame ourselves

What does OAR stand for?

a. Opioid Assistance Resources

b. Opioid Assistance Referral

c. Opioid Awareness Resources

d. Opioid Awareness Referral

Which of the following is not a therapist factor?

a. Adhering to the code of ethics

b. Attitude

c. Self- Awareness

d. Competence

Which of the following can be altered by toxic stress caused by the ACE’s?

a. Healthy development of a child

b. Healthy brain development

c. Healthy coping skills

d. Healthy habits

It is estimated that nearly ____________ Arizona children have more than five ACEs.

a. 75,000

b. 100,000

c. 60,000

d. 70,000

People with ____ ACEs, 1 in 16 smokes.

a. 0

b. 3

c. 1

d. 10

Which of the following best describes the ACC?

a. Impacts the relevancy process

b. Helps our body radar system

c. Creates competition

d. An active relevancy system that is individualized based on one’s history

Your Relevancy System only pays attention to _________________ .

a. What is going on in that moment

b. What is in front of you

c. What is relevant to society

d. To what is of value to you

It is important that we continue to build ________________ in terms of learning.

a. Healthy relationships

b. Daily resources

c. A sense curiosity

d. Goals

All those 3 therapist factors are important in terms of ____________.

a. Looking at the variables that might increase the client’s risk of retraumatization

b. Looking at the things that might affect the client’s health

c. Building a stronger relationship with a client

d. Creating trust with a client

Which of the following does clinically managed not mean?

a. Your dealing with high intensity cases

b. Your dealing with people with multiple dimensions

c. Your dealing with people that have been in the legal system

d. Your dealing with simple cases

Since addiction short circuits part of the brain, what does your memory look at?

a. Always the good things

b. Always the bad things

c. The good and the bad

d. Everything

Which of the following best defines Duality of Awareness?

a. Someone that can control their awareness of their trauma

b. Mature state awareness & being

c. Mature state of consciousness

d. Someone that can talk about their trauma and not be retraumatized by it

____________________ is the body’s reaction to Sympathetic System dominance that has occurred continuously or repeatedly creating change in the Central Nervous System.

a. Stress

b. Sleep

c. Fear

d. Trauma

Those who are caught in contemplation, ask themselves which question?

a. “Should I ask for help?”

b. “I wonder if I may have a problem?”

c. “Am I getting worse?”

d. “Am I a bad person?”

Which of the following behaviors is not a biological behavior in the sympathetic system?

a. Addiction

b. Self- injury

c. Suicidality

d. Fatigue

When is it important to use the Subjective Units of Distress Scale (SUDS)?

a. When you work with people that have been traumatized

b. When you work with people that struggle with dysregulation

c. When you have clients that suffer from a lot of distress

d. When you have clients that have gone through a lot

Instead of validating clients, ______________________.

a. Read their body language

b. Think through and utilize subtexting

c. Pay attention to their subtexting

d. Think thoroughly and pay attention to their body language

What kind of thinking, from a scientific purpose, has the potential to help a person regulate their body?

a. “Anything is possible”

b. “Sticks and stones can break my bones, but words will never hurt me”

c. “The grass is always greener on the other side”

d. “Kill people with kindness”

ACE’s sometimes referred to as toxic stress or ________________.

a. Toxic habits

b. Recent trauma

c. Childhood trauma

d. Toxic relationships

Practicing Trauma-Informed Care validates the humanity of the individual and recognizes behaviors as symptoms of ______________________.

a. Biology and Communication

b. Emotions and Thinking

c. Product of poor self-regulation

d. Bad behavior

Why is it still important for those who are independently certified, to consult with people and to have a system of friends or professionals?

a. So they can call them out in a friendly or professional manner

b. So they can call them out when they see them becoming lax in their practice

c. So they can call them out if the see them becoming unprofessional

d. So they have someone that isn’t scared to call them out

What two things do we look at, when talking about ACEs?

a. Impacts of chronic medical conditions and chronic mental health conditions in adulthood

b. Impacts of trauma

c. Impacts of chronic mental health and physical conditions

d. Impacts of chronic medical conditions

How would you see a person as precontemplative?

a. They have no awareness of their surroundings

b. They have no insight, no clue to the dangers that is happening

c. They have idea what is currently happening

d. They don’t want to know about anything happening

Which of the following best describes why it is important to develop a tolerance for pain?

a. Because your body will always experience pain while growing

b. Because this line of work is very hard

c. Because everyone experiences pain

d. Because your going to experience pain as you do this line of work

Which of the following would you not see if someone has spent their life primarily in their sympathetic nervous system?

a. A lot of consistent self reflection or evaluation of the self

b. Rigid black and white thinking

c. Overly negative memories

d. No ability to really orient to the future

What opportunity happens when someone lapses?

a. They can learn from their mistakes

b. A setback, in which they can learn from

c. It becomes a teachable moment

d. It becomes a punishing moment

What is someone in the sympathetic system, not be able to see?

a. The effect they are having on other people

b. Significant problems with their behavior

c. The problems their actions are causing

d. The dysregulated state they are in