Summary: Assessment Review for the Addiction Counselor Certification Exam Dr. Dawn-Elise Snipes, PhD, LPC-MHSP Podcast Host: Counselor Toolbox and Addiction Counselor Exam Review 12 Assessment Steps ~ Engage ~ Get authorizations and gather information from collateral sources ~ Screen for co-occurring disorders ~ Determine the severity of mental and SUDs ~ Determine appropriate level of care ~ Determine diagnoses ~ Determine disability and functional impairment ~ Identify strengths and supports ~ Identify cultural and linguistic needs and supports ~ Identify additional problem areas (medical, housing, education…) ~ Determine readiness for change ~ Plan treatment Assessment ~ Screening determines the possible presence. ~ Assessment ~ Is an ongoing process ~ Determines the nature and severity ~ Develops specific treatment recommendations ~ Surveys client strengths and resources for addressing “life problems.” (wrap-around) ~ Substance Abuse Assessment Foci ~ Historical and situational factors contributing to or triggering use ~ Patterns of use ~ Common signs and symptoms ~ Consequences of use Assessment ~ Examines the context(s) in which the disorder(s) manifest ~ Explores reciprocal interactions of… ~ Family/marital life ~ Social support/interpersonal functioning ~ Physical health needs ~ Spirituality ~ Employment ~ Financial issues ~ Legal issues ~ Other issues which may impact treatment (transportation, childcare) Assessment ~ Explores reciprocal interactions cont… ~ Gender, cultural, linguistic issues ~ Readiness for change ~ Relapse risk ~ Recovery support ~ Special life circumstances (single parent) ~ Medical conditions ~ Client centered—respecting ~ The client’s perceptions of his problems ~ Goals he wishes to accomplish ~ Strengths he has Assessment Instruments ~ Forms ~ Standardized interviews ~ Limits interviewer to a script ~ Requires limited training ~ Collects the same information on all clients ~ Structured interviews ~ Probing questions can be asked ~ Requires additional training/knowledge ~ Self-administered tests/questionnaires ~ Require some motivation and reading ability on the client’s part ~ Standardized instruments have: ~ Reliability ~ Validity information Assessments ~ Sources of information (with written consent) ~ Personal reports ~ Family ~ Other professionals/prior treatment experiences ~ May be the most objective resource ~ Employment history ~ Criminal records ~ Drug tests ~ Collateral information gathered should be confirmed to the extent possible ~ Accurate assessment requires the coherent integration of multiple sources of information to avoid under- or over-estimation of the problem. Drug Testing in SUD Treatment ~ Drug testing is ~ Part of the initial assessment ~ Used to identify drugs to make most appropriate treatment recommendations ~ Screen to prevent adverse effects of prescribed medications ~ Component of the treatment plan ~ Way to monitor use of substance and compliance with medications ~ Method to assess efficacy of treatment ~ Method to document abstinence for legal matters, disability, custody etc. ~ Drug testing cannot replace an assessment to diagnose a substance use disorder. Drug Testing in SUD Treatment ~ Drug Testing ~ Can accurately reveal drugs in the system ~ Time frame for detection is limited ~ Dependable for identifying frequent users ~ Less accurate for infrequent or binge users Types of Drug Tests ~ Breathalizer (hours) ~ Urine (up to a month) ~ On-site ~ Gas chromatograph ~ Can produce false positives ~ Saliva (past day) ~ Sweat and hair ~ drug use patterns over periods of time ~ Cannot discriminate between recent and past drug use ~ Not able to identify use within past 3-8 days ~ Blood Risk Assessment ~ One of the most important functions at both screening and assessment ~ Presence of any risk warning signs ~ Requires immediate referral (detox, CST, ER) ~ Screening and assessment are inappropriate ~ Assess for: ~ Intoxication ~ Substance toxicity ~ Withdrawal ~ Aggression/dan
