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| Question | Answer |
| Draw the model of assessment in substance use | |
| List the major screening tools designed to detect alcohol problems in the general population | Alcohol use disorders identification test (AUDIT) ASSIST (WHO for drug use) Michigan alcohol screening test (MAST) CAGE questionnaire Adolescent alcohol involvement scale Drug use screening inventory biological screening measures |
| What are the properties of the alcohol use disorders identification test (AUDIT) | • Developed by WHO to identify adults whose alcohol consumption has become hazardous or harmful to their health • Ten items with good psychometric properties • Assesses CURRENT as well as PAST use • Measures QUANTITY and PROBLEMS • Scores: - 8+ = hazardous drinking - 15+ = possible dependence |
| What is the purpose of screening instruments? | designed to detect substance use problems in the general population |
| If a problem is detected during screening what is the next step? | a more comprehensive evaluation (assessment) followed by a diagnosis and treatment plan OR a brief assessment leading to a comprehensive assessment or brief intervention, then comprehensive assessment, diagnosis, and treatment plan |
| What are the diagnostic tools and process that are applied once a substance-use problem has been identified? | Structured interviews semi-structured interviews clinical interviews (unstructured) Timeline follow back for pattern of use screen for depression/anxiety Mental state exam ABI screening ?neuropsych assessment |
| What are the core concepts in assessment of substance use? | Motivation to change assessing risk functional assessment skills and barriers to change |
| Why is motivation important in addiction? | Treatment of addiction is as successful as other chronic conditions e.g. diabetes, asthma (40-60%) Good outcomes depend on people staying in treatment, 50% exit after first contact Motivational Interviewing shown to enhance engagement and retention in treatment |
| How do you assess motivation? | Broadly: How ready is this person to make changes? How much have they planned it? What are they prepared to give up/endure for change? Target treatment based on stage of change; typically 5 stages: Pre-contemplative, Contemplative, Action, Maintenance, Relapse |
| What is the core principle of motivational interviewing? | Responsibility and capacity for change lie within the client, Therapist task is to create a set of conditions to enhance client’s intrinsic motivation for change and their natural helping relationships |
| How do you assess risk? | Broadly: Is the person at risk while using? If they stop? What are your duty of care and reporting requirements? • Health/medical risks: Seizures & death through withdrawal, liver failure, overdose, blood borne viruses, acquired brain injury, thiamine deficiency • Behaviour/mental state whilst intoxicated or during withdrawal: Suicide, assault, illegal activities, sexual activity • Psychosocial Context: Domestic Violence, Impacts on children, Gang associations |
| How do you assess functions of use? | Broadly: What does the person gain or avoid through their use? • In assessment consider a) Antecedents/triggers (“high risk situations”) and b) Consequences/maintaining factors • Look for internal changes e.g. Physiological state, psychological distress as well as external variables e.g. safety from DV, money, social status Dependency poly-substance use symptom management psychosocial context: status, safety, money, cultural norms |
| How do you assess coping skills/barriers to change | Broadly: If the person stops alcohol/drug use, what resources do they have to cope? How likely is relapse? Degree of support is a significant factor in treatment retention • Lack of alternative skills /behaviours: Social skills, frustration tolerance, relaxation, stress management, delaying gratification, problem solving • Lifestyle: presence of non-using peers, unemployment, exposure to alternative leisure activities, recovery environment (access to substances and level of support) |
| What is the timeline follow back method? | Attempts to obtain detailed drinking information via the use of memory aids 1. Calendar 2. Important dates 3. Significant periods of light or heavy days 4. Anchor points 5. Exaggeration technique |
| How do you implement the timeline follow back method? | With a calendar ask the client to mark off events on the calendar (birthdays, appointments, paydays, drug purchase, stressful situations etc.) Mark drug free periods on the calendar Mark typical use on the calendar Mark non-typical drug use days and amounts on the calendar Each day should have used/not used and how much |
| How does a substance use clinical interview differ from other clinical interviews? | Long interview Comprehensive risk assessment not sure?? watched the lecture, went through the slides, couldn't find anything! any suggestions would be welcomed :) |
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