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Exam Number : NCAC-I
Exam Name : National Certified Addiction Counselor, Level I
Vendor Name : NCC-AP
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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 assessment.
- 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 assessment 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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