Lecture Week 5 Flashcards
What is the purpose of assessment?
Assessment is only useful to the extent that it informs treatment.
What are some risks of spending too much time on assessment in early contacts?
Places client in passive role, awaiting expert judgment; What good is gathering data if client doesn’t come back?
When does treatment start?
Treatment starts from first contact.
What is the purpose of screening?
Meant to detect the possible presence of a problem and need for further evaluation.
What does an over-inclusive screening try to avoid?
False positive and false negative results.
What determines the frequency of false positives and negatives in screening?
The test’s ‘cutoff point’ – threshold at which the test says yes or no.
What is the balance issue in screening?
Lower false negative rate means accepting more false positives; better to over-identify than miss something important.
Define Sensitivity in screening.
Ability to accurately detect true positives and not make false negatives.
Define Specificity in screening.
Accuracy in not making false positive errors.
What is the purpose of a screening test cutoff point?
To offer the right balance between sensitivity and specificity.
What should a screening measure be?
Fairly quick and simple, fairly sensitive, reasonably specific.
What are the guidelines for administering screening?
Give clear instructions, provide assurance of privacy and confidentiality, explain routine procedure, listen to concerns, answer questions honestly.
What clinical question is used for alcohol screening for men?
How many times in the past year have you had five or more drinks in a day?
What clinical question is used for alcohol screening for women?
How many times in the past year have you had four or more drinks in a day?
What is the Rapid Alcohol Problems Screen (RAPS 4)?
A screening tool based on Remorse, Amnesia, Performance, and Starter Drinking Behavior in the past year.
What are two widely used alcohol screening tests?
Michigan Alcohol Screening Test (MAST) and Alcohol Use Disorder Identification Test (AUDIT).
What are the characteristics of the MAST?
Reasonably good track record but can have a high false positive rate due to ‘have you ever’ questions.
What is the AUDIT?
Alcohol Use Disorders Identification Test, developed by WHO, validated cross-culturally, and assesses drinking amount, dependence symptoms, personal and social problems.
What biological markers indicate recent heavy drinking?
GGTP and CDT.
What is the purpose of evaluation?
To understand the nature and causes of an individual’s situation and consider possible routes to change.
What are the four components of a multidimensional evaluation?
Nature and severity of substance use, motivation for change, client’s strengths and resources, functional analysis.
What is the purpose of functional analysis in substance use evaluation?
To assess the roles or functions substance abuse plays in life by evaluating Antecedents, Behaviors, and Consequences (ABCs).
What is the most common assessment approach for diagnosis?
Diagnostic interview, such as the Structured Clinical Interview for DSM (SCID).
What are the four phases of treatment?
Palliative care, stabilization, rehabilitation, maintenance.
What is the goal of palliative care in addiction treatment?
Keep person in contact with systems of care, reduce risks, increase motivation for change, facilitate access to further treatment.
What is the goal of rehabilitation?
Change prior substance use through problem identification, goal setting, and implementing a change plan.
What are the stages of change in the Transtheoretical Model?
Precontemplation, contemplation, preparation, action, maintenance.
What is the ARMS model for setting goals?
Achievable, Rewarding, Measurable, Specific.
What is Stepped Care?
Offering the least intensive level of care likely to help, moving to more intensive treatment if needed.
What are the common factors in successful treatment?
Empathic listening, hope and optimism, treating clients with respect, promoting hope, self-efficacy, and motivation.
