Screening and Assessment Instruments Screening efforts for any health care probl

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Screening and Assessment Instruments

Screening efforts for any health care problem can be undertaken at various levels. They can be applied routinely to everyone, or they can be targeted, administered only to those in higher-risk groups. Broad-based screening efforts, meaning routine use of a screening tool in a range of settings, is desirable when the condition is common.

The substance abuse field is increasingly using standardized instruments to promote treatment planning as well as to provide a yardstick for measuring treatment effectiveness. The most widely used tool for both of these purposes is the Addiction Severity Index (ASI).

Mental Status and Psychosocial History, Dual Diagnosis and Stages

The mental status examination is a tool used by mental health professionals to guide observation and to assist the interviewer in gathering essential data about mental functioning. There are many psychosocial treatment approaches. Were you to wonder which particular treatment would be best for a particular individual, you would not be alone. A number of large studies have been conducted to examine this very question.

Understanding the relationship between alcohol or other drug use and mood, thoughts, or behavior is one of the most challenging and essential components of anyone’s work in the substance abuse field. Dual diagnosis is an individual with a substance use disorder plus another mental illness. There is at best evidence that clients do better when clinicians match their clinical approach to the client’s “stage.” It is said to ignore a commonly recognized phenomenon—that individuals often change seemingly quite suddenly.

Assess the serious consequences when there is a failure to treat.

Discuss two screening tests that are effective in identifying those with a high likelihood of having an alcohol problem. Then which of the two would you prefer, explain why.

Compare and contrast the following screening instruments: AUDIT, CAGE, TWEAK, short MAST

Compare and contrast the following assessment instruments: ASI and SASSI

Three aspects of mental functioning are standard parts of a mental status examination: mood and affect, thought processes, and cognitive functioning. Discuss each aspect and how it relates to the alcohol-dependent.

Psychological problems are not the cause of alcohol disorders per se. However, in remembering that message, don’t lose sight of the fact that an individual may have both an alcohol problem and another psychiatric condition. Analyze two other types of psychiatric conditions that an alcoholic-dependent may exhibit.

Explanation / Answer

Failure to treat which is often a culmination of misdiagnosis or comorbid impact of a disorder leads to deteriorated state of an individual. In cases of substance abuse where withdrawal symptoms can be devastating and immediate intervention is needed to support the individual through the process of inculcating change is tedious and needs close supervison. Failure to treat may lead to going back to giving in to the addiction or damage to the liver in case of alcohol intolerance. It may even be to the extent of life threatening. AUDIT is a good screening tool for identifying alcohol concerns in individuals since it is a brief, and easily measurable rating scale based tool. Another screening tool is FAST (Fast alcohol screening test) since it is reliable and less time consuming.

CAGE is a 4 question instrument that is used usually in clinical settings to identify children having alcohol problems. Its sensitivity ranges from 61 to 100%. This was a test which was done on known and identified alcoholics primarily white males initially whereas AUDIT is an identification tool right from its origination. TWEAK, however is a more women sensitive tool and aims at identifying women with alcohol problems. AUDIT and TWEAK tend to have more sensitivity of results than CAGE or short MAST. Certain cultural differences between the screening tools is also established including sensitivity of the AUDIT and TWEAK was not seen to differ significantly between African-American and Caucasian men. For women, however, the AUDIT was more sensitive among African-Americans (71 percent), whereas the TWEAK was more sensitive among Caucasians. SASSI is a bried self reported inventory available in separate versions for adults and adolescents. Addiction severity index (ASI) on the other hand is a semi structured interview protocol designed to aim at understanding the entire life of a client to check for qalcohol dependence symtoms. It is usually used by state agencies and treatment providers and it is a standardised tool that covers multiple dimensions of alcohol dependence.

Mood and affect, thought processes and cognitive functioning, all play a crucial role in relating to alcohol dependence. Mood and affect of the inidividual may be socially or situation-inappropriate in many ways. This means that distortions are likely to occue in a person who is heavily alcohol dependent. Laughing bizarrely or out of context may be one example. Other than that, dstortions in thoughts may also be noticeable since the intellectual functioning of alcohol dependent individuals is likely to be slower than that of 'normal' ones. This is due to the eventual slowing down of brain neuron cells due to the repeated consumption of alcohol. The instant 'high' received after alcohol consumption becomes a prolonged manner of operation when the body becomes alcohol dependent. Comorbid conditions that an alcoholic may have could be signs and symptoms or full blown depression. An alcoholic does realise that he is addicted and needs to withdraw- however the dependence on the substance leads to the continuation of her/his fate. This repeated juggling between attempting not to consume and yet giving up may lead to depression. Another psychiatric condition could be that of anxiety. A generalised anxiety may especially be seen in individuals undergoing withdrawal sympoms. They may even end up feeling or believing that they would die if they don't consume alcohol right away.

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