1. Assessment

2. General Points re: Assessment 1. Screening is different than assessment. Identifies whether further attention is warranted. Appendix H Identifies whether further attention is warranted. Appendix H 2. Assessment identifies needs and guides treatment. 3. Assessment helps you get to know the client. 4. Assessment creates a holistic picture of the client.

3. Basic Components Engage the client Engage the client Psychosocial History Psychosocial History Mental Status Exam Mental Status Exam Strengths and wellness Strengths and wellness Sometimes questionnaires, e.g. MAST, Beck Depression Inventory, Mental Health Screening Form III, etc. Sometimes questionnaires, e.g. MAST, Beck Depression Inventory, Mental Health Screening Form III, etc. Safety – suicide, harm to others, domestic violence Safety – suicide, harm to others, domestic violence Trauma Trauma Culturally relevant Culturally relevant

4. Watch “Mary” Interview Observe Observe Thinking Thinking Behavior Behavior Emotion Emotion Avoid interpretation, drawing conclusions, making judgments Avoid interpretation, drawing conclusions, making judgments Write down what you see Write down what you see

5. Sources of information The client The client The client, later The client, later Collaterals: parents, partners, siblings, adult children Collaterals: parents, partners, siblings, adult children Previous records Previous records Parole/probation officer Parole/probation officer *Remember confidentiality laws!!!

6. Quiz topics 4 explanations for relationship between chem. Dep and mental disorder (secondary substance abuse, secondary psychiatric, common factor and bidirectional) 4 explanations for relationship between chem. Dep and mental disorder (secondary substance abuse, secondary psychiatric, common factor and bidirectional) Quadrants of care Quadrants of care What does DSM IV-TR stand for and what is it’s purpose What does DSM IV-TR stand for and what is it’s purpose Multiaxial system – 5 axes Multiaxial system – 5 axes Difference between assessment and screening Difference between assessment and screening Sources of information for assessment Sources of information for assessment Components of assessment Components of assessment

7. 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

8. Case discussion 1. Read the scenario 2. Identify sx. Do NOT draw conclusions…just list emotions, behaviors, cognitive process or content that seems like a sx. 3. Create a timeline of past and current sx. 4. Include psychosocial stressors on timeline. 5. Which of the “rules” might be relevant?

9. Stage of Change Assessment What changes does Bill need to make? What changes does Bill need to make? Drinking Drinking Social life Social life Working Working Counseling Counseling What stage is he at for each (pg. 94) What stage is he at for each (pg. 94)

10. Emotional, Behavioral or Cognitive Conditions and Complications American Society of Addiction Medicine (ASAM) Dimension 3 (of 6) American Society of Addiction Medicine (ASAM) Dimension 3 (of 6) Areas of risk that need to be assessed: Areas of risk that need to be assessed: Dangerousness/lethality Dangerousness/lethality Interference with addiction recovery efforts. Interference with addiction recovery efforts. Social functioning Social functioning Ability for self-care Ability for self-care Course of illness-what is this person’s pattern of sx Course of illness-what is this person’s pattern of sx

11. Treatment Matching – Figure 4-3, pg. 97 Small groups Small groups You will draw three slips of paper You will draw three slips of paper Review the sections you draw and discuss: Review the sections you draw and discuss: What do you know? What do you know? What further information would help you provide the best treatment match? What further information would help you provide the best treatment match?