Screening and Assessment Flashcards
Two Phases of an Evaluation
- Screening the client to determine if they meet the criteria for SUD
- If they meet the criteria, then specific assessments are carried out.
What actions must a AP take during a screening?
- Review confidentiality & it’s limitations.
- Obtain informed consent.
- Outline fees, correspondence with 3rd parties, scope of practice, appt scheduling, criteria for placement, and counselor’s theoretical orientation.
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
- Acute intoxication and withdrawal
- Biomedical conditions and complications
- Cognitive, behavioral, and emotional conditions
- Readiness to change
- Relapse, continued use, or continued problem potential
- Recovery environment.
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
- Administrative
- Comprehensive biopsychosocial assessment
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
- Framework for tx interventions
- Level of care
- Identify client’s strengths and supports.
- Form therapeutic alliance
- Assess motivation to change.
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
- Emotional Relapse
- Mental Relapse
- Physical 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.
Covert Antecedents
Temperament, emotional conditions, and relationship factors. Interpersonal and intrapersonal states.
Decision Grid
For the problem of immediate gratification, considers time frames when listing the pros and cons of substance abuse.
Cognitive therapy
Replacing negative thought patterns with positive self-talk.
Motivational Enhancement Therapy
Uses role-playing to teach client how to communicate goals and feelings.
ACA Code of Ethics 2014
When clients disclose they have a communicable and life threatening disease, counselors may be justified in disclosing info to 3rd parties if parties are at risk of contracting the disease.
How is HIV transmitted?
Intravenously, sexually, and perinatally.
What percentage of individuals with HIV report using drugs intravenously?
10%
In 2018, what percentage of biseuxal and gay men accounted for new cases of HIV?
70%
What race has the highest infection rate of HIV?
African American males followed by Hispanic males.
HBV
Hepatitis B virus, bloodborne pathogen transferrable thru blood, semen, and other bodily fluids.
What can HBV lead to?
Cirrhosis of the liver or liver cancer.
How can you prevent HBV?
-Vaccine
-Don’t share razors or toothbrushes with those infected
-Use pre-or post exposure prophylaxis (latex gloves, etc.)
HCV
Hepatitis C, bloodborne pathogen most commonly transmitted through sharing needles with an infected person.
What gender is more at risk for catching HCV?
Men
National Harm Reduction Coalition
Established principles to minimize the consequences for PWUD, their families, and their communities.
8 Harm Reduction Principles of National Harm Reduction Coalition
- Compassionate, therapeutic care
- Complex and multi-faceted phenomenon
- Policies aligned with reducing morbidity
- Services that reduce stigma
- Engage in public policy
- Rights of PWUD to be their own agents of change
- Understand how trauma, oppression, racism affect engagement in tx
- Acknowledge acute risks and tragic consequences
Clinical Documentation
Provides chronological account of client’s episode of care. Must be clear, concise, and objective.
How often should an AP conduct progress reviews?
3 months, and for long-term goals every six months.
Progress notes
Included in client’s record and provide the counselor’s account of each clinical interaction. Must be objective and nonbiased.
Individual Progress Notes
Detail client’s progress towards tx goals, tx interventions, response to interventions, and post-session plan.
Multidisciplinary/interdisciplinary teams
Consist of professionals who use their expertise to establish an integrated approach to client care.
What info does a counselor need to provide to a referral agency?
- Reason for referral
- client’s case conceptualization
- treatment needs
- current progress twds tx goals.
Premature or unexpected termination
Occurs when the client or counselor unilaterally chooses to end treatment.
How many days prior to ending service should you send a letter?
10 days
Continuing Care Plan
Offshoot of tx plan, provides direction and focus to post-discharge goals and objectives. Summary of tx conditions, findings identified during tx, primary and secondary diagnosis, response to interventions, and med directions.
What is the primary goal of client, family, and community education?
Prevention
Primary Prevention
Aims at preventing disease before it occurs.
Secondary Prevention
Involves screening to identify those at risk for - or in the early stages of disease so long-term consequences can be avoided.
Tertiary Prevention
Treating those already diagnosed with the disease to minimize complications.
MAKKS Assessment
Multicultural Awareness Knowledge and Skills Survey
