3-1 Discussion PSY 200

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Southern New Hampshire University *

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200

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Nursing

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Apr 29, 2024

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docx

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A clinical assessment is the most commonly used method for evaluating clients to obtain a comprehensive understanding of a client’s symptoms which is later used to formulate a treatment plan. Three types of assessments used are the unstructured clinical assessment, the structured clinical assessment, and the semi-structured clinical assessment. A typical unstructured clinical assessment is similar to a free-flowing conversation between a clinician and a client and there are no structured parameters for specific topics. The advantages of an unstructured assessment are that it allows a clinician to provide empathy and a chance to build a relationship with the client. A disadvantage to the lack of structure would be the clinician not being able to obtain all the information that is needed for an accurate diagnosis and full case history. A structured assessment, on the other hand, is typically comprised of a list of questions including follow-up questions and a uniform sequence of questioning, followed by a methodized rating of how the client responds. Structured assessments focus specifically on the diagnostic process. In contrast, a semi-structured assessment usually begins with specific questions; however, the clinician can then follow up on the client’s responses and can make alterations to the questions with individualized and contextualized modifications to more accurately rate symptoms (Mueller & Segal, 2015). Treatment-specific information that should be included in the assessment for substance abuse disorder is the current amounts and type of alcohol and/or drugs currently being taken, physical health conditions, co-occurring mental health disorders, cognitive and brain disorders or impairments, readiness for change and treatment, relapse prevention and continued use potential in the form of contextual issues such as internal and external cues, expectancy, and triggers, and the client’s recovery environment such as family, peers, work, legal, housing, financial, culture, transportation, and child care (Capuzzi & Stauffer, 2020). The two assessment instruments I chose to review are CAGE and PAI. The CAGE assessment is a preliminary questionnaire that is used to determine whether you may have a substance abuse problem. The letters in CAGE stand for cut, annoyed, guilty, and eye and further represent questions that you can ask yourself. Originally, it was developed for individuals who might have a problem with alcohol abuse; however, versions have been adapted to show whether you might have a problem with drug abuse, as well. The assessment to include drug abuse is often called the CAGE-AID assessment. Questions that have been adapted to include drug use are: 1. Have you ever felt you ought to cut down on your drinking or drug use? 2. Have people annoyed you by criticizing your drinking or drug use? 3. Have you felt bad or guilty about your drinking or drug use? 4. Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)? To score your responses to the questions, they are scored 0 for "no" and 1 for "yes," with a higher score being indicative of substance abuse problems. A clinically significant score would be a total score of two or greater ( Cage substance abuse screening tool 1984). The PAI assessment, or Personality Assessment Inventory, is a self-administered questionnaire that is designed to give a comprehensive assessment of a client’s personality as well as psychopathology. The assessment includes a total of 344 questions with a four-alternative scale
that includes false, not at all true, slightly true, mainly true, and very true. The questions consist of 22 scales that are not overlapping of 4 different varieties: Four validity scales, 11 clinical scales, 5 treatment scales, and 2 interpersonal scales (McCredie et al, 2021). The 22 non- overlapping full scales are somatic complaints, anxiety, anxiety-related disorder, depression, mania, paranoia, schizophrenia, borderline features, antisocial features, alcohol problems, drug problems, aggression, suicidal ideation, stress, nonsupport, treatment rejection, dominance, warmth, inconsistency, infrequency, negative impression, and positive impression ( The PAI Measures n.d.). The assessment takes 50-60 minutes to administer and scoring can be completed in 15-20 minutes. The PAI scales have an elevated degree of internal consistency in reliability studies and demonstrate confluent and discerning validity with more than 50 other measures of psychopathology in validity studies (Morey, 2023). References: Capuzzi, D., & Stauffer, M. D. (2020). Foundations of Addictions Counseling (4th ed.). Pearson. Ewing. (1984). Cage substance abuse screening tool . Johns Hopkins Medicine. https://portal.ct.gov/-/media/DPH/Maternal-Mortality/CAGE-Substance-Screening- Tool.pdf McCredie, M. N., Hopwood, C. J., & Morey, L. C. (2021). Personality Assessment Inventory (PAI) for assessing disordered thought and perception. In I. B. Weiner & J. H. Kleiger (Eds.),   Psychological assessment of disordered thinking and perception   (pp. 79–98). American Psychological Association.   https://doi.org/10.1037/0000245-006 Morey, L. C. (2023, December 22). Personality assessment inventory . SIGMA Assessment Systems. https://www.sigmaassessmentsystems.com/assessments/personality-assessment- inventory/ Mueller, A., & Segal, D. (2015, January). Structured versus Semi-structured versus Unstructured Interviews . ResearchGate. https://www.researchgate.net/publication/313966231_Structured_versus_Semistructured_v ersus_Unstructured_Interviews The PAI Measures . Sigma Assessment Systems. (n.d.). https://www.sigmaassessmentsystems.com/wp-content/uploads/2015/02/PAI-Scales.pdf
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