An initial screening takes place before the client enters treatment. This is to assess if they are suitable for treatment with us; if we can help. This consists of a DSM-IV diagnosis, and an interview with an experienced addictions therapist. We also carry out some psychometric testing such as SASSI (Substance Abuse Subtle Screening Inventory) and NHS Minimum Dataset assessments for depression, anxiety, panic disorder, agoraphobia, PTSD and OCD. This is to determine pre-existing or comorbid mental health conditions and to assess if we can effectively work with them. Most of our screening and assessment instruments are now secure online forms and can be carried out in the clients home. A very high level of encryption is used (We use a 256-bit encryption mechanism to store client information and all online transactions are performed over SSL.)
The main comprehensive assessment is the next part of this phase and is considered to be important. It can take place during the pre-treatment phase or during the screening process before the client enters treatment but usually occurs during the first day in treatment and is part of the induction process. It provides much useful information and is a bedrock for the rest of the programme. An initial treatment plan is written immediately following assessment and the treatment planning process will follow a client throughout his or her treatment with us.
We use the Addictions Severity Index (ASI) v. 5 as our main assessment tool
The Addiction Severity Index (ASI) is a multi-dimensional interview used to measure the substance use, health and social problems of those with alcohol and other drug problems; both at admission to treatment and subsequently at follow-up contacts. It was developed in 1979 by a team of investigators as a semi-structured clinical-research interview designed to measure client status in seven functional domains:
- Alcohol use.
- Drug use.
- Medical health.
- Psychiatric health.
- Employment & Self-support.
- Family & Social relations.
- Legal Situation or Illegal Activity.
In each of these functional domains two time frames are sampled. Lifetime information is designed to help evaluate the duration and severity of each problem. Knowledge of the frequency and intensity of recent problems (past 30 days) in each of these domains is also used for these purposes; and for monitoring change in client status through subsequent re-administrations.
The items in each of the seven areas have been tested for understanding, and test-retest reliability as well as concurrent, predictive and discriminate validity among adults of both genders and most large ethnic groups.
The ASI has become very widely used mainly due to extensive psychometric testing, a comprehensive training manual (plus other instructional materials) and its availability in the public domain. It is a standard in virtually all clinical trials of addicted clients; it is part of the standard clinical assessment of alcohol and drug abusing clients throughout the USA. The ASI has been translated into over 20 languages and several international versions of the instrument is part of standard clinical practice and treatment evaluation studies throughout European countries.