writing-center-style-apa-7th-edition-template-without-abstract (17)
docx
keyboard_arrow_up
School
Grand Canyon University *
*We aren’t endorsed by this school
Course
500
Subject
Arts Humanities
Date
Jan 9, 2024
Type
docx
Pages
8
Uploaded by DeaconLoris3344
Assessment and Diagnosis for Substance Abuse and Addiction
Nick Salvesen
College of Humanities and Social Sciences, Grand Canyon University
CNL501: Substance Use Disorders and Addiction
Mark Brana
11.1.23
1
Assessment and Diagnosis for Substance Abuse and Addiction
This paper provides an overview of the process of screening, assessment, and treatment
planning for clients with addictive disorders. It includes definitions and description of these
processes, and the criteria according to the Diagnostic and Statistical Manual of Mental
Disorders (DSM-5) for diagnosis. Additionally, the paper reviews commonly used substance use
disorder assessment tools, and provides their benefits and limitations.
Definition of Screening, Assessment, and Treatment Plan
Screening, assessment, and treatment planning are important aspects of the clinical process
for individuals with addictive disorders. These processes aim to identify, evaluate, diagnose, and
develop effective treatment strategies for individuals struggling with substance use. Essential
components of the intake process include, and are not limited to, screening, patient assessment,
and treatment planning (Capuzzi & Stauffer, 2015).
Screening is the first step in identifying individuals who may be at risk for substance use.
It is a brief process that helps to determine if further assessment is needed. Screening tools, such
as questionnaires, are administered to detect signs and symptoms of substance use disorders.
While screening does not always provide a concrete diagnosis, it helps to understand and identify
individuals who should undergo a more comprehensive assessment.
Assessment is a more in-depth evaluation of the client's substance use and contributing
factors. It involves an examination of the client’s history, as well as their behaviors. Assessment
typically includes questionnaires, interviews, and observations. The goal is to diagnose the
severity of substance use, as well as identifying contributing factors such as mental health
disorders, and or trauma that may exacerbate the substance use concerns.
2
Diagnosing Clients for Addictive Disorders
Identifying, assessing, and diagnosing clients for addictive disorders is a process that requires
careful consideration of various factors. This process consists of identifying individuals who may
be at risk for addictive disorders, assessing the client’s history with substance use, and forming a
diagnosis for the client.
The initial step involves identifying individuals who may be at risk for, or already have
addictive disorders. This can be done through various means, including self-referral, referral
from family or friends, healthcare professionals, or legal authorities. Screening tools, such as the
Alcohol Use Disorders Identification Test (AUDIT) or the Drug Abuse Screening Test (DAST),
can be used to determine whether further assessment is necessary (McNeely & Adam, 2020).
Assessment of the client follows the initial step of identifying risk factors. Assessment
includes a comprehensive evaluation of the client's history, current substance use, and any
associated problems. Protocol for proper assessment of a client may come in the form of
administering assessment tools and questionnaires, conducting clinical interviews, and gathering
additional information that may be pertinent to the client.
The final step in the process is forming a diagnosis. According to the DSM-5, substance use
disorders should be classified through various methodologies. The client should be given a
diagnosis, pertinent to their substance, such as alcohol or opioid use. The extent of the addiction
or usage should be classified by severity of addiction or usage (mild, moderate, or severe).
3
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
Considerations for Choosing an Appropriate Assessment Tool
When selecting an assessment tool for clients with addictive disorders, counselors must
consider factors such as the tool's validity, reliability, and cultural sensitivity. Additionally, it's
essential to select tools that align with the client's substance use (Abuse, 2023). For example, if a
client primarily abuses alcohol, it would be more appropriate to use an alcohol-specific
assessment tool like AUDIT.
In addition to validity of the tool used, reliability of the tool should be considered. The
reliability of the tool ensures that the outcome cannot be influenced by additional factors.
Cultural sensitivity of the assessment tool ensures that the cultural background of the client is
taken into consideration to ensure the client’s understanding of the assessment. An example of
this would be providing a translator if a client’s primary language is something other than the
counselor’s native language. The final consideration for assessment is the clinical utility and
efficacy of the tool being used. Factors to consider regarding clinical utility include time of the
assessment, time constraints, and efficacy of the tool.
Overview of the Assessment Tool
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
(DSM-5), provides specific criteria for the diagnosis of substance use disorders. The criteria for
substance use disorders include 11 symptoms, and the severity of the disorder is determined by
the number of criteria met over a 12-month period. These criteria are organized into four
categories, impaired control, social impairment, risky use, and pharmacological criteria
(American Psychiatric Association, 2013).
4
Impaired control refers to the patient’s urge to use, and frequency of use. Typically,
clients who portray factors related to impaired control, have tried to stop usage previously, but
were unsuccessful in stopping or reducing usage
(Sripada, 2022). Social Impairment refers to the
degree of substance use. Typically, clients who exhibit signs of social impairment have had
responsibilities that they have been unable to fulfil due to their addiction.
Risky use is similar to
social impairment in that despite the risk associated with substance use, the client’s addiction
prevents the individual from stopping or reducing usage (American Psychiatric Association,
2013, p. 483).
The final step in this process requires the counselor to consider the tolerance or
pharmacological criteria associated with usage. Depending on the usage of the individual, and
tolerance built up over time, a counselor would categorize usage from mild, moderate to severe.
The tolerance and substance usage over time helps the clinician as they formulate a treatment
plan and consider any adverse effects that may transpire as a result, such as withdrawal. The
severity of the substance use disorder is categorized as mild (2-3 criteria), moderate (4-5
criteria), or severe (6 or more criteria) based on the number of criteria met.
Potential Problems When Relying Solely on DSM Criteria for Treatment Planning
The DSM-5 criteria provide valuable guidelines for diagnosing substance use disorders.
There are potential problems when relying solely on these criteria for treatment planning. Some
of these problems include and are not limited to, lack of individualization, comorbidity, and
stigmatization
(Chmielewski et al., 2015).
The DSM 5 is a valuable resource but does not meet the clients individual needs. Proper
treatment should include considering the clients’ needs and customizing a treatment plan
5
according to those needs. Comorbidity is an additional factor that the DMS 5 fails to recognize.
Often substance use, and addiction are triggered by a traumatic event and or mental disorder. The
DSM 5 is unable to identify any comorbidities that may be affecting the client.
The final aspect to consider is stigmatization of the client’s diagnosis. Often, clients may
feel overwhelmed with the amount of work required to stop the addiction and end up feeling
somewhat defeated with what may be a very serious diagnosis. It is important to empower the
client, and not let them focus on the stigma of their diagnosis. Encouragement should be
provided to the client to ensure they don’t get overwhelmed with what is being asked of them.
Commonly Used Substance Use Disorder Assessment Tools
There are a variety of commonly used assessment tools. In this paper we will examine
two
specific tools, the “Alcohol Use Disorders Identification Test” or (AUDIT). The benefits
associated with this assessment tool are primarily its validity as well as efficiency of the tool.
AUDIT’s have been widely used and are known to be relatively short in nature and practical to
understand
(de Meneses-Gaya et al., 2009). Limitation of this tool is that it is only used for
Alcohol related disorders. This tool also relies on the information a client provides, and at times
can fall subject to personal bias.
Drug Abuse Screening Test or (DAST-10) is another commonly used assessment tool and
is tailored to individuals battling drug use. The test is short and easy to administer and often
times provides valid and reliable information. Like AUDIT, the DAST-10, may be subject to
personal bias from the client, and may not properly depict the degree of substance use or
addiction
(Skinner & University, 1982).
6
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
In conclusion, screening, assessment, and treatment planning are essential steps in the
management of addictive disorders. While the DSM-5 provides a foundation for diagnosis, it is
important to consider individualization, and comorbidity when developing treatment plans.
Assessment tools like the AUDIT and DAST-10 have their benefits and limitations, and
combining multiple tools can lead to a more comprehensive understanding of a client's needs.
Ultimately, an effective treatment plan should be client-centered, evidence-based, and consider
the unique circumstances of each individual with an addictive disorder.
7
References
Abuse, N. I. on D. (2023).
Screening Tools and Prevention
. National Institute on Drug Abuse.
https://nida.nih.gov/nidamed-medical-health-professionals/screening-tools-prevention
American Psychiatric Association. (2013).
Diagnostic and statistical manual of mental
disorders
(5th ed.).
https://doi.org/10.1176/appi.books.9780890425596
Capuzzi, D., & Stauffer, M. D. (2015). Foundations of Addictions Counseling. In
Google Books
.
Pearson Education.
Chmielewski, M., Clark, L. A., Bagby, R. M., & Watson, D. (2015). Method matters:
Understanding diagnostic reliability in DSM-IV and DSM-5.
Journal of Abnormal
Psychology
,
124
(3), 764–769.
https://doi.org/10.1037/abn0000069
de Meneses-Gaya, C., Waldo Zuardi, A., Regina Loureiro, S., & Alexandre S. Crippa , J. (2009).
APA PsycNet
. Psycnet.apa.org.
https://psycnet.apa.org/fulltext/2011-13717-012.html
McNeely, J., & Adam, A. (2020). Substance Use Screening and Risk Assessment in Adults.
National Library of Medicine
.
https://www.ncbi.nlm.nih.gov/books/NBK565474/
Skinner, H., & University, Y. (1982).
GUIDE FOR USING THE DRUG ABUSE SCREENING
TEST (DAST)
.
https://socwel.ku.edu/sites/socwel/files/documents/Research
%20Projects/Family%20First/Survey%20Measures/DAST%20Guide%202019%20-
%20Remediated.pdf
Sripada, C. (2022). Impaired control in addiction involves cognitive distortions and unreliable
self-control, not compulsive desires and overwhelmed self-control.
Behavioural Brain
Research
,
418
, 113639.
https://doi.org/10.1016/j.bbr.2021.113639
8