Two Phases of an Evaluation
What actions must a AP take during a screening?
MAST
Michigan Alcohol Screening Test, 22 y/n questions, 0-2 no alcohol problem, 3-5 early middle problem drinkers, 6 or more are problem drinkers.
DAST
Drug Abuse Screening Test, non-alcoholic counterpart to MAST.
ASI
Addiction Severity Index, used if DAST/MAST are +, assesses medical, employment/support, drug use, alcohol use, legal status, family/social status, and psychiatric status.
SASSI-4
Substance Abuse Subtle Screening Inventory, for discovering the truth, produce profiles for tx planning, and understand the client. 15-minutes.
ASAM
American Society of Addiction Medicine, a placement instrument to help make referrals.
6 Dimensions of the ASAM
ASI Problem Severity Index
Assigned based on the client’s use in the past 30 days. Ex: how much money have you spent on substances?
Two Phases of a Formal Intake
Other aspects of intake
-Review screening results
-Determine severity of use
-determine presence of co-occurring disorder
-Is the participation of family members appropriate?
What is the purpose of a clinical assessment?
Obtain relevant info useful for formulating a diagnosis.
Biopsychosocial-Spiritual Assessment
An integrative, holistic, comprehensive assessment used to collect info on client’s background and hx by examining the influence of biological, psychological, social, and spiritual factors.
Objectives of a Clinical Assessment
How much do genetics and the interaction of genetic factors account for a person’s risk of addiction?
50%
Wernicke-Korsakoff Syndrome
Neurological difficulties associated with long-term substance misuse.
The mental status exam
Guides tx planning by exploring a client’s level of functioning in speech, behavior, perception, appearance, mood, insight, and cognitive factors.
Social Factors
Any aspect of the client’s thoughts and behaviors as they occur in the context of their social environment.
Relapse
When a client returns to substance misuse after a period of stopping.
Stages of Relapse
Relapse Prevention Plan
Identifies triggers for use/abuse, list of tools and coping mechanisms, support systems, and support group.
Situational Confidence Questionnaire
Assesses cause of relapse including personal states and situational confidence (degree of self-assurance in resisting tempting situations.)
On average, how many patients relapse within their first year of recovery?
40-80%
Abstinence Violation Effect
No intermediate response to a lapse.