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SIT AOD Work Group Screening and Assessment Definitions

Introduction:

The State Interagency Team (SIT) Alcohol and Other Drug (AOD) Work Group was charged with strengthening services for children, youth, and families where there is a nexus between AOD use and child safety, education, workforce readiness and success, maternal/child health, and mental health. A non-scientific survey was conducted by Work Group members to ascertain whether or not AOD screening took place within their service system and, if so, what was effective and what was ineffective in their screening process. The Work Group’s recommendations were endorsed by the SIT Leadership on August 24, 2007.

Survey Summary Recommendation:

Develop common AOD screening and assessment definitions to improve communication and evaluation.

AOD Screening:

AOD screening is a formal process to determine whether an individual warrants further attention to address their AOD use. The purpose of the screening process does not necessarily identify the type or seriousness of the problem, nor does it identify an involved diagnosis. The purpose is to determine whether further AOD assessment is warranted.

The goal of screening individuals for AOD use is to identify potential candidates for AOD services as early as possible to reduce their risk of significant substance-related problems. Early intervention offers the best alternative for interrupting the cycles of AOD problems and addiction.

Training to Perform AOD Screening:

AOD Screening can be done by most staff in any system with a minimum of specialty training. Training strategies can vary based on the needs of the client population. Training for AOD screening can be included in routine trainings and ongoing staff development. This orientation should be done system wide, so that everyone involved knows the importance of screening, the screening decisions, and what screening decisions mean. Screening should be a fairly "seamless" process. That is, screeners should be fully integrated into the process and not be seen as adjuncts to the overall process. The degree to which screening is integrated with other processing activities will determine its success in the system. Used appropriately, screening can provide important information and contribute to effective care.

Use of Validated and Standardized Tools:

AOD screening should be done with validated (tested) instruments. Commonly used validated screening instruments are:

  • Substance Abuse Subtle Screening Inventory (SASSI)
  • Drug Abuse Screening Test (DAST)
  • CAGE Questionnaire
  • Alcohol Use Disorders Identification Test (AUDIT)
  • Michigan Alcohol Screening Test (MAST)
  • Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST)

The screening instruments chosen should be used across the system, which is called standardized screening. It should be noted that there are specialized tools for adolescents and seniors. Be sure to select a screening tool that is appropriate for the age and culture of the individual.

If the screening indicates a potential problem with AOD use, the individual should receive a brief intervention and be referred to an AOD treatment professional for a complete assessment.

For more information and where to find AOD screening instruments, please visit the following website:

http://lib.adai.washington.edu/instruments/

AOD Assessment:

A basic AOD assessment consists of gathering key social history information and engaging in a process with the individual that enables the counselor to understand the individual’s readiness for change, problem areas, and the presence of substance abuse disorders, disabilities, and strengths. An assessment typically involves a clinical examination of the functioning and well-being of the individual through a number of tests, which include both written and oral exercises.

The AOD assessment process reduces false positive screening results. Once the positive results are confirmed, the assessment determines the severity of the AOD problem and helps illuminate other issues that may be connected to the substance use disorder. The information gained in the AOD assessment will be used to help determine the appropriate level of care for the individual.