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Assessment. General Points re: Assessment. Screening is different than assessment. Identifies whether further attention is warranted. Appendix H Assessment identifies needs and guides treatment. Assessment helps you get to know the client.
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General Points re: Assessment • Screening is different than assessment. • Identifies whether further attention is warranted. Appendix H • Assessment identifies needs and guides treatment. • Assessment helps you get to know the client. • Assessment creates a holistic picture of the client.
Basic Components • Engage the client • Psychosocial History • Mental Status Exam • Strengths and wellness • Sometimes questionnaires, e.g. MAST, Beck Depression Inventory, Mental Health Screening Form III, etc. • Safety – suicide, harm to others, domestic violence • Trauma • Culturally relevant
Watch “Mary” Interview • Observe • Thinking • Behavior • Emotion • Avoid interpretation, drawing conclusions, making judgments • Write down what you see
Sources of information • The client • The client, later • Collaterals: parents, partners, siblings, adult children • Previous records • Parole/probation officer *Remember confidentiality laws!!!
Quiz topics • 4 explanations for relationship between chem. Dep and mental disorder (secondary substance abuse, secondary psychiatric, common factor and bidirectional) • Quadrants of care • What does DSM IV-TR stand for and what is it’s purpose • Multiaxial system – 5 axes • Difference between assessment and screening • Sources of information for assessment • Components of assessment
Rules for distinguishing substance-related from psychiatric sx ***History of symptom (sx) onset ***Quality of sx ***What happens over 4 week period of abstinence? *Family history (hx) of m.h. or cd? *Tx hx? *Response to medication
Case discussion • Read the scenario • Identify sx. Do NOT draw conclusions…just list emotions, behaviors, cognitive process or content that seems like a sx. • Create a timeline of past and current sx. • Include psychosocial stressors on timeline. • Which of the “rules” might be relevant?
Stage of Change Assessment • What changes does Bill need to make? • Drinking • Social life • Working • Counseling • What stage is he at for each (pg. 94)
Emotional, Behavioral or Cognitive Conditions and Complications • American Society of Addiction Medicine (ASAM) Dimension 3 (of 6) • Areas of risk that need to be assessed: • Dangerousness/lethality • Interference with addiction recovery efforts. • Social functioning • Ability for self-care • Course of illness-what is this person’s pattern of sx
Treatment Matching – Figure 4-3, pg. 97 • Small groups • You will draw three slips of paper • Review the sections you draw and discuss: • What do you know? • What further information would help you provide the best treatment match?