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Assessment skills are important because substance abuse counselors should be able to understand the basics of current diagnostic assessment tools and instruments. A competent LCDC should be capable of writing appropriate and professional descriptions of behaviors in regards to addictions. In order to gather relevant information about the client’s substance abuse history, counselors need to practice effective interviewing techniques; the interviews should include the client and other sources of information about the client, such as family members, friends, and coworkers.
A substance abuse counselor should be able to use these skills and explain to the client why and how the assessment takes place. In doing so, the client would have a better understanding of his/her own treatment process.
One of the most important things to remember about a client’s assessment is confidentiality. The assessment is the first opportunity for both the client and the counselor to interact with each other, therefore, confidentiality and professional work ethics should begin here.
Screening and assessment are two different tools. Screening is a process by which we can identify a potential problem with the client’s alcohol and other drug (AOD) use. This tool allows us to determine whether a client is eligible for a particular treatment program.
Assessment is a tool used to confirm the existence of a problem. This allows counselors to identify the nature of the problem and therefore suggest options for treatment. During the assessment process we can identify the client’s strengths and weaknesses, and his/her needs in order to develop an appropriate treatment plan.
Assessment instruments must be reliable and valid. Reliability means that consistent results are obtained under consistent conditions. Reliable assessment instrument provide consistent results when the assessment is repeated under consistent conditions.
Validity is the degree to which a test really measures what we want to measure, and not something else.
Nota bene: Reliability does not imply validity.
Contributor: Yvette McBride Thomas
Assessment—the procedures and processes of collecting information and measures of human behavior outside of test data .
- Can be obtained “through a variety of formal and informal techniques including standardized tests, diagnostic interviews, projective personality measures, questionnaires, mental status examinations, checklists, behavioral observation, and reports by significant others (medical, educational, social, legal, etc.)”
- The concept of assessment emphasizes the humanness of counseling…a total picture of the person being evaluated.
- “The term assessment is being used increasingly to refer to the intensive study of an individual, leading to recommendations for action in solving a particular problem.”
- The goal of the assessment process is a comprehensive evaluation of individuals, usually in the present.
- Often it includes a formulation of a treatment plan that will result in positive and predictable outcomes.
- Ways to conduct assessments include:
- Structured clinical interviews
- DSM-IV-TR (2000)—Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, published by the American Psychiatric Association (APA)
- Mental Status Exam (MSE) is being “increasingly used by counselors in work settings requiring assessment, diagnosis, and treatment of mental disorders”
- Overall, assessment is crucial because it allows counselors not only to determine what a client’s problem is but to learn the client’s orientation to problem solving.
Resource: Gladding, S.T. (2011). Counseling: A comprehensive profession (7th ed.). Upper Saddle, NJ: Pearson-Merrill.
While screening is used to determine whether a client is eligible for admission into a particular program, assessment is an ongoing process to evaluate the treatment plan the client’s progress in treatment.
There are different assessment tools and we must select the one that is more appropriate, based on age, gender, racial and ethnic background, and disabilities.
Assessment tools include:
- History of alcohol and drug use
- Physical and mental health
- Addiction treatment histories
- Family issues
- Work issues
- History of criminality
- Psychological and emotional issues
- Current physical and mental health, and substance use/abuse issues
- Education and basic life skills
- Socioeconomic situation and lifestyle
- Current legal status
- Use of community resources
- Level of readiness for treatment
- Level of cognitive and behavioral functioning
When selecting and administering assessment instruments, we need to know which are the current validated instruments and protocols (remember validity and reliability); we also need to take into consideration the limitations of both the assessment instruments and the counselor’s training and education. Our responsibility is to use these instruments appropriately, so we must recognized when we need assistance from a supervisor (remember: consultation with other professionals).
Extra training, and therefore commitment, is required in order to learn how to analyze and interpret assessment results. In order to determine treatment recommendations, treatment plan modifications, and whether somethings are working better that others, we must be knowledgeable about:
- Scoring methods for assessment instruments
- How to analyze and interpret results
- Available treatment options
Remember that we want that our client participates actively in the treatment process, so we must introduce and explain the purpose of ongoing evaluations.
Finally, we need to keep in mind our agency’s protocols and procedures; appropriate terminology and abbreviations (avoid jargon!); legal implications of actions and documentation; and how to maintain client’s confidentiality (always important in everything we do).
Assessment is the procedure used to identify and evaluate client’s strengths, weaknesses, problems and needs. This information is necessary in order to develop a treatment plan.
- Gather information from the client regarding history of alcohol and other drug abuse.
- Use appropriate interviewing techniques.
- Obtain and corroborate information from significant collateral sources in regards to client’s alcohol and drug abuse and psychosocial history, through the use of appropriate methods and procedures.
- Identify appropriate assessment tools.
- Explain assessment rationale to client.
- Develop a diagnostic evaluation of the client’s substance abuse and co-occurring disorders based on the results of all assessments. The goal is to provide an integrated approach to treatment based on client’s strengths, weaknesses, problems and needs.
Miller, Geri. “Learning the Language of Addiction Counseling.” 2nd ed.