- Mental Health
Screening and Assessment Tools for Substance Abuse Counselors
There are numerous tools available for screening an individual in order to determine if substance use disorders are present. The manner in which the screening is done varies and some of the assessments are located online such as the Michigan Alcoholism Screening Test (MAST), the Drug Abuse Screening Test (DAST-20), and the CAGE Questionnaire. Other significant tools are the Substance Abuse Subtle Screening Inventory (SASSI-3 and SASSI-A2) and the Alcohol Use Inventory (AUI). With understanding, compassion, knowledge and beneficial assessment tools; it is highly possible for a therapist to assist and treat an addicted individual if the person is willing and ready.
The Michigan Alcoholism Screening assessment was created in 1971 by M. L. Seizer (Stevens & Smith, 2013). The MAST is one of the most researched assessment tools and it has proven to be reliable since it successfully identifies 95% of alcoholics that have taken the self-administered 22 question online test (Stevens & Smith, 2013). While the MAST is used to diagnose alcoholism, it can be adapted to test adults and adolescents for other substance use (Stevens & Smith, 2013). In a counseling setting, the therapist could use the MAST during assessment on a client that is not forthcoming about alcohol use. For instance, the client has lost his job, his wife and his children due to drinking but is unwilling to admit to drinking. The therapist could have him self-report and if he scored four points the therapist would know that alcoholism is present (Stevens & Smith, 2013). The score would not only show alcoholism but the client’s willingness to change, and based on this; the therapist and client could form an effective treatment plan.
The Drug Abuse Screening Test (DAST-20) was derived from the MAST and consists of 20 questions which are found online in a self-report manner. The DAST-20 tests the individual for various drug use behaviors (Stevens & Smith, 2013). Once the client takes the test, the website will calculate the answers by using the sum of all answers. If the client scores highly, it is indicative that the individual is dependent (Steven & Smith, 2013). The test can be adapted to test for other substances and is beneficial for cataloging various areas of users (Stevens & Smith, 2013). When counseling a potential user, a clinician could have the client self-report and the results would show possible dependency as well as polydrug use, which will allow the therapist to determine any withdrawal potential. The questions are written in a manner that will allow the therapist to learn if the client is ready to make changes, and from this point a treatment plan can be adapted.
An easily accessible, short online test for adult alcohol users is the CAGE Questionnaire. The tool consists of four questions regarding the client’s history of cutting down any alcohol intake, annoyance regarding criticism of use, guilt regarding drinking behavior, and drinking upon waking to cut down on anxiety due to withdrawal (eye-openers) (Steven & Smith, 2013). A therapist could use CAGE to see if a user is ready to quit, suffers from guilt, or in denial. For instance, a 19 year old woman answers yes to feeling a need to quit, being criticized, and guilt because she feels like an embarrassment to her family; the clinician would see that the client has a problem and that she is ready to quit and there is a chance of withdrawal and treatment can begin.
The Substance Abuse Subtle Screening Inventory (SASSI-3 and SASSI-A2) have been tested and modified for sixteen years, consist of 52 true/false questions which seem unrelated to substance use, and 26 questions that allow the client to self-report any negative aspects of use (Steven & Smith, 2013). SASSI-3 (adults) and SASSI-A2 (adolescents) are accessible only by trained therapists and are excellent tools to use if the client is reluctant to answer truthfully; these tests are resistant to faking and do not allow the client to give the answer that is “correct” (Steven & Smith, 2013). The clinician can use this test to identify abuse patterns that are often hidden in other tests due to minimalizing and denial (Steven & Smith, 2013). For instance, if an adolescent client is hiding his use, it would be ideal for the clinician to use SASSI-A2 in order to bring his use out, as well as spotting his readiness to change.
The Alcohol Use Inventory (AUI) assessment is a, “hierarchically organized set of self-report scales (Steve & Smith, 2013)” that provide the therapist a base for diagnosing issues that come with alcohol use. The test is protected and consists of 228 multiple choice questions which can be administered to individuals sixteen years in age and over (Steve & Smith, 2013). The test is available as a pencil and paper test or electronic, but not available online. AUI is a beneficial tool because it allows the therapist to see any underlying issues that the client might have. In a clinical setting a clinician could use this assessment in a semi-structured interview to see if a client addicted to alcohol has any psychological issues that are not currently treated. If a therapist were doing an assessment for a patient who has a history of sexual abuse through childhood into adolescents and the patient drinks a “box of wine” per day, including eye-openers, the clinician could use this test to see if there are other issues that the client is not dealing with and form an effective treatment plan that can treat the alcohol use and other issues. The AUI could also show the clinician if the client has a potential for withdrawal and if she is ready to change.
The tools available to clinicians and clients are easy to use and very valuable; the majority of which are online and self-reporting such as the MAST, DAST-20, and the CAGE Questionnaire. Other tools, such as the SASSI-3, SASSI –A2, and AUI, are effective in finding substance use and allowing the clinician to effectively treat the client. With understanding, compassion, knowledge and beneficial tools; it is highly possible for a therapist to assist and treat an addicted individual if the person is willing and ready.
Stevens, P. & Smith, R.L. (2013). Substance Abuse Counseling: Theory and Practice. Upper Saddle River, NJ. Pearson Education Inc.