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MI fosters motivation by exploring ambivalence, highlighting discrepancies, and supporting autonomy. CBT (Option B) focuses on cognitive skills. REBT (Option C) challenges irrational beliefs. Aversion therapy (Option D) uses punishment. MI is particularly effective in early stages of treatment when clients are ambivalent about change.

The PHQ-9 is a validated depression screening tool frequently used in SUD settings. AUDIT (Option B), DAST (Option C), and CAGE (Option D) screen for substance use, not depression. Using PHQ-9 ensures integrated assessment of co-occurring disorders, guiding appropriate referrals.

A subpoena is not the same as a court order. Counselors should consult legal/agency counsel, assert confidentiality, and release records only as required. Immediate release (Option A) risks over-disclosure. Ignoring (Option C) risks legal penalties. Summarizing (Option D) without authority is noncompliant. Careful handling protects client rights and counselor liability.

Naltrexone is an opioid antagonist that reduces alcohol’s rewarding effects and blocks opioids. Acamprosate (Option B) stabilizes glutamate. Disulfiram (Option C) causes aversion. Methadone (Option D) is an agonist for opioid use disorder. Naltrexone is effective for both alcohol and opioid relapse prevention when adherence is maintained.

Contingency management (CM) applies behavioral principles, providing tangible rewards for drug-free urine screens or session attendance. Research shows CM is effective for stimulants, opioids, and alcohol. Psychoanalysis (Option B) lacks reinforcement. Gestalt (Option C) focuses on awareness, not reinforcement. Narrative (Option D) emphasizes meaning-making. CM is highly evidence-based, especially when combined with motivational interviewing or CBT.