Addiction Treatment Self Reporting Screening Inventories
When assesing whether or not someone has a drug or alcohol problem treatment professionals are best to help to determine to what degree or if at all a person has a drug or alcohol dependence that deserves professional treatment. A helpful tool that is utilized is the self report inventory or screening.
An important distinction is that while "screening" is useful in assesment, a screen and an assesment are not the same. The difference is that a screen (such as a self-reporting inventory) is a brief process that identifies potential problems or high risk criteria, but does not neccesarily indicate a true addicted or alcoholic person and should not be relied on as a definitive answer to the question of whether or not a person is suffering from chemical dependency. The caution is that while a vital instrument in a comprehensive assesment, these inventories are not to be used in isolation from other assesment data that is gathered through interviews with the potential client, family and friends - all of which are best conducted by a qualified addictions counselor.
Another issue with self reporting inventories is that they are "self reporting". This opens the door for validity issues, wherin if a client has a strong denial system or is not reporting truthfully, a false result will be extracted from the assesment.
Despite the few drawbacks of Self Reporting Tests, they are still an invaluable tool in helping determine the existence of a drug or alcohol problem. There are currently three most commonly used inventories. The CAGE, the MAST and the SASSI.
This is perhaps the simplest and sometimes most debated screening instrument. The name is simply an acronym for four questions. The screen was originally used to determine alcohol problems, but may be modified to accomodate a range of substance abuse problems. The test was originally developed by Ewing and Rouse and as been a cornerstone in addiction assesment.
Responding affirmative to two or more questions will indicate an alcohol problem. The test was originally developed by Ewing and Rouse and as been a cornerstone in addiction assesment and can help open the door to further investigation by a certified addictions counselor or social worker.
The Michigan Alcohol Screening Test was developed as an easily administered and scorable 24 item test that can either be administered in written or oral form. Each question carries a score of either 0, 1, 2, or 5. "0" indicating a nondrinking response and "1, 2, and 5" indicating a drinking response. A score of 1 or 2 indicates a typical social or moderate drinker's response, while 5 is an indication of an alcoholic characteristic reply. While a social drinker might reveal one or two responses that carry a score of 5, the overall score is more revealing. An overall score of 0-4 would indicate a nonalcoholic drinker, while 5-6 would suggest an alcohol problem, 7-9 determines one alcoholic, 10-20 would point to a moderate alcoholic and 20 or more a severe alcohoic. However, the questions are so obviously designed around determining an alcohol problem, that false negatives are not uncommon. Later Jacobsen suggested a cutoff score of 12 as opposed to 7, which proved to yield a considerably lower rate of false positives; between 5 to 8% as opposed to 21 to 34% at a cutoff of 5. Still the false negatives were in the 7 to 12% range, which is still sufficiently high to prompt professionals to continue to rely on training and instinct over scores and formulas.
In surveying college populations Cooper and Robinson decried earlier screening inventories and hailed the SASSI, which made a considerable effort to do away with the short comings of earlier tools by overcoming the problem of strong denial systems in the typical chemically dependent person. Since that time, the SASSI is now in it's third revision by Glen Miller, the author of the inventory. The SASSI intends to scale the subtle attributes inherent in the substance abuser by asking questions seemingly unrelated to an addiction problem. The SASSI has found its way into treatment centers, college social workers offices, mental health hospitals, employee assistance programs and court-ordered substance abuse programs. The SASSI also is administered in both cases of adolescents and adults, with the adolescent version claiming a reading level of 5th grade. The test also receives markes for separating scoring for both male and female clients. Audiotape versions have also been developed for those with reading difficulties. However, the SASSI is not without it's critics, who point to a higher than claimed reading level. In the same breath, one of it's critics, Kerr, still upholds that the test does a good job in identifying chemically dependent persons, and is at the edge of efforts in giving psychometrically sound results in identifying chemically dependent persons.
As the above mentioned tools of the Treatment Professional are useful, it is important that a full assement be taken by a trained and qualified couselor. While most people have a very firm belief in what deems use, misuse and abuse, the lines are very clear and are best determined when a full client history can be taken. The sociological background, psychological makeup, educational and work history, family and marriage difficulties and medical issues all have to be taken into account and weighed carefully against specific criteria that determine the prevalance of a chemical dependency problem.
In many cases where all of these factors and histories can be documented and reviewed by a counselor, the need for screening inventories does not weigh as heavily, but in the short term can give the professional a good idea of whether a chemical dependency issue is at heart of the clients' problems.
If you or a loved one might think they have a chemical dependency, we provide pre-treatment assesments at no-cost and are available via online or phone consultations.
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