Clinical Evaluation Strategies: Screening & Assessment Techniques
School
San Diego City College**We aren't endorsed by this school
Course
AODS 156
Subject
Psychology
Date
Dec 11, 2024
Pages
25
Uploaded by AdmiralIce15808
Chapter 6PRACTICE DIMENSION I:CLINICAL EVALUATIONELEMENTS: SCREENING & ASSESSMENTContributor: Lori PhelpsLori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 20156-1
Competency 24Establish rapport, including management of a crisis situation and determination of need for additional professional assistance.Strategies for Establishing RapportConsider stages of Change80% of substance abusers are currently in pre-contemplation or contemplationOffer relevant information in a supportive and empathetic mannerLori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-2
Raising the TopicOpening SessionsEstablish rapport and trustExplore events that precipitated treatment entryCommend clients for comingMotivationalApproachLori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-3
Establish Rapport and Trust•First to ask the client for permission to address the topic of change•Shows respect for client’s autonomy•Explain how you and/or your program operate•Try not to overwhelm•Explain assessments•Confidentiality•Let client do most of the talking (feelings and hopes)Lori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-4
5 Principles of Motivational Interviewing (Miller & Rollnick)1.Express empathy through reflective listening.2.Develop discrepancy between clients’ goals or values and their current behavior.3.Avoid argument and direct confrontation.4.Adjust to client resistance rather than opposing it directly.5.Support self-efficacy and optimism.Lori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-5
Competency 25Gather data systematically from the client and other available collateral sources, using screening instruments and other methods that are sensitive to age, developmental level, culture, and gender. At a minimum, data should include current and historic substance use; health, mental health, and substance-related treatment histories; mental and functional statuses; and current social, environmental, and/or economic constraints.Lori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-6
Element: ScreeningA process by which the counselor, the client, and available significant others review the current situation, symptoms, and other available information to determine the most appropriate initial course of action, given the client’s needs and characteristics and the available resources within the community (CSAT, 2006a, p. 39)Lori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-7
Competencies 26-2726. Screen for psychoactive substance toxicity, intoxication, and withdrawal symptoms; aggression or danger to others; potential for self-inflicted harm or suicide; and co-occurring mental disorders27. Assist the client in identifying the effect of substance use on his or her current life problems and the effects of continued harmful use or abuseLori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-8
Integration of Treatment for CODNational Survey on Drug Use and Health (NSDUH) 2009only 7.4 percent of people with co-occurring disorders receive treatment for both substance use disorders (SUDs) and mental illness (MI). People with co-occurring disorders are far more likely to get treatment for MI than for SUDs.People with severe mental illness (SMI) are more likely than those with mild MI to have an SUDLori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-9
ScreeningA formal process of testing to determine whether a client does or does not warrant further attentionThe screening process for COD seeks to answer a Yes or No question: Does the substance abuse (or mental health) client being screened show signs of a possible mental health (or substance abuse) problem?Lori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-10
Screening for CODDoes not necessarily identify what kind of problem the person might have or how serious it might beDetermines whether or not further assessment is warrantedCan be conducted by counselors using their basic counseling skills. Seldom any legal or professional restraints on who can be trained to conduct a screening.Lori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-11
Suicide AssessmentSuicide is a leading cause of death among people who abuse alcohol and drugs (Wilcox, Conner, & Caine, 2004). Individuals treated for alcohol abuse or dependence [SUD] are at about 10 times greater risk to eventually die by suicide (than general population)people who inject drugs are at about 14 times greater risk for eventual suicideIndividuals with substance use disorders are also at elevated risk for suicidal ideation and suicide attemptsLori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-12
GATE: Procedures for Substance Abuse Counselors•For Suicide Assessment•Gather information Access supervisionTake responsible action Extend the action •Document all actions you take•what information you obtained•when and what actions were taken•how you followed upLori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-13
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Sample Screening Questions•Introducing the topic •I have a few questions to ask you about suicidal thoughts and behaviors. •Screening for suicidal thoughts •Have you ever thought about carrying out suicide? •Screening for suicide attempts •Have you ever tried to take your own life? Lori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-15
Element: Assessment•An ongoing process through which the counselor collaborates with the client and others to gather and interpret information necessary for planning treatment and evaluating client progress.6-16©Rob Marmion/Shutterstock.com
Competency 3333. Select and use a comprehensive assessment process that is sensitive to age, gender, racial, and ethnic culture, and disabilities that includes but is not limited to:•History of alcohol and drug use•Physical health, mental health, and addiction treatment histories•Family issues•Work history and career issues•History of criminality•Psychological, emotional, and worldview concerns . . . continued6-17
Competency 33 cont’d•Current status of physical health, mental health, and substance use•Spiritual concerns of the client•Education and basic life skills•Socioeconomic characteristics, lifestyle, and current legal status•Use of community resources•Treatment readiness•Level of cognitive and behavioral functioningLori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-18
Competencies 34-3634: Analyze and interpret the data to determine treatment recommendations35: Seek appropriate supervision and consultation36: Document assessment findings and treatment recommendationsLori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-19
Basic Assessment1.Screening is a process for evaluating the possible presence of a particular problem2.Assessment is a process for defining the nature of that problem and developing specific treatment recommendations for addressing the problemLori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 20
Lori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-21
Internet ResourcesProject CORK:http://www.projectcork.org/clinical_tools/index.htmlSubstance Use Screening & Assessment Instruments Database:http://lib.adai.washington.edu/instruments/Lori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-22
VIDEOS/WEBCASTSAlcohol and Drug Use Screening, Intervention, and Referral: Changing the Nation’s Approach to Comprehensive Healthcare http://store.samhsa.gov/product/Alcohol-and-Drug-Use-Screening-Intervention-and-Referral-Changing-the-Nation-s-Approach-to-Comprehensive-Healthcare-DVD-/DVD183Introduction to Screening, Brief Interventions, & Referral to Treatment (SBIRT)http://vimeo.com/24133647Lori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-23
Exercises/ActivitiesProject CORK: http://www.projectcork.org/clinical_tools/index.html6-24AUDIT(Alcohol Use Disorder Identification Test) MAST(Michigan Alcoholism Screening Test)AUDIT-C (Consumption)MAST-G (Geriatric)AUDIT-PC (Primary Care)Brief MASTCAGEShort MASTCRAFFT Short MAST-GDAST (Drug Abuse Screening Test)T-AceFagerstrom Test for Nicotine Dependence Trauma IndexTWEAK
Exercises/ActivitiesSimple Screening Instrument for Substance Abuse (SSI-SA) pp. 123-126Mental Health Screening Form-III (pp. 127-128)Lori L. PhelpsCalifornia Association for Alcohol/Drug Educators, 2015 6-25