Screening and Assessment
Tools
By
TLPI
Presented by Mark Panasiewicz
Why are Screenings/Assessments
Important
Screenings/Assessments
The aim of screening is to identify as many potential or actual
substance abusers as early in their use or abuse history as
possible. Furthermore it is important to try and establish a history
of abuse and whether or not co-occurring disorders are present.
It is important so that appropriate interventions can be provided
and more importantly the proper treatment can occur.
A good intake involves two parts:
1. Screening- where individuals are screened to identify the
potential presence of an alcohol or drug-related problem.
2. The assessment stage takes the process a step further and
confirms the existence of a problem, identifies the nature of the
problem(s), and suggests appropriate avenues of treatment.
Often a screening can be completed by a line staff. Assessments
vary with degree of difficulty and can require a trained
professional but some of the simpler assessments can be
completed by line staff and are also very reliable.
Cage and Cage Aid
The CAGE (Cut down, Annoyed Guilt , Eye Opener) or CAGE-
AID should be preceded by these two questions:
1. Do you drink alcohol?
2. Have you ever experimented with drugs?
If the patient has experimented with drugs, ask the CAGE-AID
questions. If the patient only drinks
alcohol, ask the CAGE questions.
CAGE and CAGE-AID Questions
1. In the last three months, have you felt you should cut down or stop
drinking or using drugs?
2. In the last three months, has anyone annoyed you or gotten on your
nerves by telling you to cut down
or stop drinking or using drugs?
3. In the last three months, have you felt guilty or bad about how much
you drink or use drugs?
4. In the last three months, have you been waking up wanting to have
an alcoholic drink or use drugs?
Each affirmative response earns one point. One point indicates a
possible problem. Two points
indicate a probable problem.
What factors should be considered when deciding on the
most appropriate instrument?
Ease of use
Expertise and time required of staff to administer and score test
Possibility of bias (cultural or administrative)
Validity (does it measure what it is intended to measure?) and
reliability (do re-tests yield identical results?)
What factors should be considered when deciding on the
most appropriate instrument?
Credibility of test among academic and treatment professionals
(reliability)
Motivation level and verbal and reading skills required of persons
to be assessed
Average cost per test
Reliability vs. Validity
Validity
Validity is the extent to which a test measures what it claims to
measure. It is vital for a test to be valid in order for the results to
be accurately applied and interpreted.
Reliability
Reliability is the degree to which an assessment tool produces
stable and consistent results.
A test is considered reliable if we get the same result repeatedly.
For example, if a test is designed to measure a trait (such
as jealousy), then each time the test is administered to a subject,
the results should be approximately the same.
Substance abusers are poor historians,
everything changes with a drug screen.
Faking good Faking Bad
Screening, Brief Intervention and Referral to Treatment
(SBIRT)
(SBIRT) can help professionals determine whether someone uses
alcohol and/or drugs in unhealthy ways. Its components are:
Screening - Short, well-tested questionnaire identifies risk (such
as the ASSIST, the CRAFFT, the AUDIT, the DAST, etc.)
Brief Intervention - Short, structured conversations that feature
feedback and options for change
Referral - For in-depth assessment and/or diagnosis and/or
treatment, if needed
ASI (Addiction Severity Index): 1-800-553-6874
SASSI II (Substance Abuse Subtle Screening Inventory) 1-800-726-0526
SUDDS-IV (Substance Abuse Disorder Diagnostic Schedule):: 1-800-755-6299
MAST (Michigan Alcohol screening test):1-800-272-8464
Examples of assessment instruments that have been used effectively with juveniles are:
T-ASI (Teen addictions Severity Index): 1-800-553-6847
SASSI II for Adolescents (Substance Abuse Subtle Screening Inventory): 1-800-726-
0526
PEI (Personal Experience Inventory): 1-800-222-2670
CFARS (Children’s Functional Assessment Rating Scale): [email protected]
Web Resources
http://www.alcoholscreening.org/Screening/Page07.aspx online
self Alcohol Screening
http://www.utexas.edu/research/cswr/nida/instrumentListing.html
Loads of alcohol/drug assesments
http://pubs.niaaa.nih.gov/publications/arh28-2/78-79.htm
Cage and T-AGE National Institute of Alcohol abuse
http://www.integration.samhsa.gov/clinical-
practice/sbirt/adolescent_screening,_brieft_intervention_and_refer
ral_to_treatment_for_alcohol.pdf
Adolesent Screening/Assessment
http://www.integration.samhsa.gov/clinical-
practice/sbirt/screening-page#manuals
SAMSA good screenings.
For More Information . . .
TLPI believes in providing resources
free of charge, or at minimal cost,
whenever possible.
Visit www.tlpi.org
or
contact:
Lauren Van Schilfgaarde,
[email protected]
