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NCAC-I exam Format | NCAC-I Course Contents | NCAC-I Course Outline | NCAC-I exam Syllabus | NCAC-I exam Objectives

Total Questions: 150

Scored Questions: 130

Unscored (Pretest) Questions: 20 (used for future exam development)

Time Allotted: 3 hours (180 minutes) to complete the exam.

Passing Score: 70% (exact scaled score may vary slightly based on psychometric analysis).

Exam Format: Multiple-choice questions (single best answer).

Administered via computer-based testing (CBT) at Pearson VUE test centers or through online proctoring.



- Orientation to the Treatment Process (14%)

- Assessment (23%)

- Ongoing Treatment Planning and Implementation (25%)

- Addiction Counseling Practices and Skills (21%)

- Professional Practices (17%)



- Orientation to the Treatment Process

- Screening: Determining client eligibility and appropriateness for treatment programs.

- Intake: Collecting comprehensive client information to inform treatment planning.

- Orientation: Educating clients about treatment processes- expectations- and program rules.

- Client Engagement: Building rapport and motivating clients to participate in treatment.

- Initial Case Management: Coordinating referrals and ensuring clients are connected to appropriate services.



- Screening Tools: Standardized instruments (e.g.- AUDIT- DAST) used to identify substance use severity.

- Intake Assessment: Comprehensive data collection- including medical- psychological- and social history.

- Orientation Process: Explanation of confidentiality- program rules- and client rights.

- Motivational Interviewing: A counseling approach to enhance client readiness for change.

- Referral: Directing clients to specialized services (e.g.- medical detox- mental health support).

- Confidentiality: Legal and ethical standards (e.g.- HIPAA- 42 CFR Part 2) protecting client information.



- Assessment

- Clinical Assessment: Gathering data on substance use history- mental health- and psychosocial factors.

- Diagnostic Criteria: Applying diagnostic tools (e.g.- DSM-5) for substance use disorders (SUDs).

- Risk Assessment: Evaluating risks such as suicide- self-harm- or relapse potential.

- Co-occurring Disorders: Identifying mental health or medical conditions alongside SUDs.

- Cultural Competence: Assessing clients with sensitivity to cultural- social- and demographic factors.



- DSM-5: Diagnostic and Statistical Manual of Mental Disorders- 5th Edition- for diagnosing SUDs.

- ASAM Criteria: American Society of Addiction Medicine criteria for determining treatment levels.

- Biopsychosocial Assessment: Holistic evaluation of biological- psychological- and social factors.

- Co-occurring Disorders: Simultaneous presence of SUDs and mental health disorders (e.g.- depression- PTSD).

- Risk Assessment: Tools like the Columbia-Suicide Severity Rating Scale (C-SSRS).

- Cultural Competence: Understanding diverse cultural backgrounds to inform exam.

- Standardized Instruments: Tools like the Addiction Severity Index (ASI) or CAGE questionnaire.



- Ongoing Treatment Planning and Implementation

- Treatment Planning: Creating individualized- goal-oriented plans based on exam data.

- Evidence-Based Practices: Implementing interventions supported by research.

- Progress Monitoring: Evaluating client progress and adjusting treatment plans as needed.

- Relapse Prevention: Strategies to help clients maintain sobriety and manage triggers.

- Case Management: Coordinating care with other professionals or agencies.



- Individualized Treatment Plan (ITP): A tailored plan outlining client goals and interventions.

- SMART Goals: Specific- Measurable- Achievable- Relevant- Time-bound objectives.

- Evidence-Based Practices: Interventions like Cognitive Behavioral Therapy (CBT) or Contingency Management.

- Relapse Prevention Plan: Strategies such as coping skills- trigger identification- and support systems.

- Case Management: Coordination of services like housing- medical care- or vocational support.

- Continuum of Care: Levels of treatment (e.g.- detox- inpatient- outpatient) based on client needs.

- Motivational Enhancement Therapy (MET): A counseling approach to sustain motivation.



- Addiction Counseling Practices and Skills

- Counseling Techniques: Applying therapeutic approaches to address SUDs.

- Individual Counseling: One-on-one sessions to address personal recovery goals.

- Group Counseling: Facilitating group therapy to promote peer support and skill-building.

- Crisis Intervention: Managing acute situations like overdose or suicidal ideation.

- Client Education: Teaching clients about addiction- recovery- and coping strategies.



- Cognitive Behavioral Therapy (CBT): A therapy addressing dysfunctional thoughts and behaviors.

- Dialectical Behavior Therapy (DBT): A therapy focusing on emotional regulation and mindfulness.

- Motivational Interviewing (MI): A client-centered approach to elicit behavior change.

- Group Dynamics: Processes like cohesion- conflict- or peer support in group therapy.

- Crisis Intervention: Techniques like de-escalation or safety planning.

- Psychoeducation: Educating clients about addictions effects on the brain and body.

- Therapeutic Alliance: The collaborative relationship between counselor and client.



- Professional Practices

- Ethics: Adhering to professional standards and codes of conduct.

- Legal Responsibilities: Understanding laws related to SUD treatment (e.g.- confidentiality- mandatory reporting).

- Professional Development: Engaging in continuing education and supervision.

- Documentation: Maintaining accurate and compliant client records.

- Boundary Issues: Managing professional relationships with clients.



- NAADAC Code of Ethics: Guidelines for ethical practice in addiction counseling.

- 42 CFR Part 2: Federal regulation protecting confidentiality of SUD treatment records.

- HIPAA: Health Insurance Portability and Accountability Act for client privacy.

- Mandatory Reporting: Legal obligation to report abuse or harm (e.g.- child or elder abuse).

- Supervision: Guidance from a qualified professional to enhance counseling skills.

- Documentation: Records like progress notes- treatment plans- or discharge summaries.

- Dual Relationships: Avoiding inappropriate relationships with clients to maintain professionalism.

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