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Assessment
of Substance Use and
Mental Health Disorders
The
Assessment of Substance Abuse and
Mental Health Disorders is a course developed by MJ
Eliason and Anne
Helene Skinstad of the University of Iowa, and converted
by
Jane Li of the U of I. It
is
a
course worth 3 hours of continuing education credit.
The
purpose of this course is to introduce students
to assessment issues and tools related to substance
abuse and mental health
disorders. Accurate assessment is vital for adequate
treatment planning, and is a vital part of treatment.
There are several
goals for this course. The first is to provide students
with knowledge about the basic characteristics
and differences between
abuse of and dependence on various substances. Students
will learn to make adequate DSM-IV (Diagnostic
and Statistical Manual
of Mental Disorders, fourth edition, 1994) diagnoses
of disorders, and will be introduced to a variety
of other assessment methods
used to diagnose abuse of, or dependence on, several
different substances, as well as compulsive disorders
like overeating
and gambling. Comorbidity, or dual diagnoses (psychiatric
disorders and substance abuse in a single individual),
are quite common
among drug abusers. As a consequence, students will
be introduced to the major psychiatric disorders
and learn to differentiate
symptoms of substance abuse from symptoms of psychiatric
disorders, as well as one psychiatric disorder
from another.
Upon
enrolling in the course, students are asked to complete and
submit a “PRAIRIELANDS
ATTC PARTICIPANT INFORMATION FORM" providing background information about themselves.
Information provided on the form is kept confidential and does
not affect evaluation of students' work in the course. After
all other components of the course have been completed, there
is a 1-hour, forty-question multiple-choice FINAL EXAM.
• Outline
of lessons: top
-
Lesson
1 Introduction to the Assessment
of Substance Abusing
Clients
This lesson includes information
on the purposes, ethics of assessment,
cultural competence, and basic
interview techniques,
and collecting background information.
-
Lesson 2 The Assessment of Alcohol Abuse and Dependence
Several methods for assessing alcohol abuse and dependence
are presented, along with a careful study of the DSM-IV criteria.
-
Lesson 3 The Assessment of Tobacco and Gambling Behaviors
This lesson focuses on the consequences and varieties of motivations
for smoking and the types of gambling
-
Lesson 4 The Assessment of Drug Use
This assignment contains information about illicit and prescription
drug abuse and includes several assessment methods for interviewing
about drug use.
-
Lesson 5 The Assessment of Clients with Dual Diagnoses, Axis
I Disorders
The major disorders discussed in this lesson include mood disorders,
anxiety, eating disorders and psychotic disorders. Implications
of dual diagnosis for assessment and treatment are presented
-
Lesson 6 The Assessment of Clients with Dual Diagnoses, Axis
II Disorders
In this final lesson, two personality disorders are highlighted:
antisocial personality and borderline personality.
• Assignments: top
Each of the six lessons has an assignment that includes a
written component based on a case study presentation; four
of the lessons also include clinical components. The written
components involve short answer and essay responses to questions
based on material presented in the online study guide lessons
and the reading materials. The clinical components involve
conducting audiotape interviews with four clients (from a substance
abuse treatment center, halfway house, or mental health clinic
or agency) and submitting reports of the interviews along with
the tape for grading and feedback (Each student is to make
their own arrangements for these interviews.)
Interviews should be conducted concurrently with Lessons 2,
3,4, and 6.
-
For
the first interview, the student should arrange
to interview
a client who has a potential
problem with alcohol, whether or not he or she uses
or abuses other substances
as
well.
-
The
second interview should include a person with a
primary alcohol
problem who also uses tobacco products.
-
The
third interview should include a person with
a problem
with illicit or prescription drugs.
-
The
last interview should be with a person
with a potential dual diagnosis
(Axis I or II).
Each report should include basic background information about
the client (in a form that protects the client's identity),
a brief description of the assessment situation and perceived
validity of the interview, a summary of the findings of the
assessment, and a working DSM-IV diagnosis. The written report
should be no more than four pages in length, and the audiotape
should be submitted with the report. The written report should
be edited in either MS WORD format or rtf format, and submitted
to instructor by email. The audiotape should be mail to instructor
through the conventional postal system or drop directly to
PATTC home office.
After completing all six lessons and the corresponding assignments,
there is a 1-hour, fortyquestion, multiple-choice final examination.
Since the written assignments draw heavily on Donovan and Marlatt's
book, the exam focuses primarily on the assigned chapters from
the Schuckit book; however, students should review the first
chapter of Donovan and Marlatt as well. Students are allowed
up to one hour to complete the exam. A practice exam, which
includes similar items to those found on the final exam, is
available in the appendix of this study guide to assist in
preparation.
-
Textbooks & Other
Materials: top
There
are three textbooks and
a course materials packet which
are required for all students.
American
Psychiatric Association. Diagnostic and Statistical Manual
of Mental Disorders, fourth edition. Washington, DC.,
1994.
Donovan,
D. M.
and G.
A. Marlatt.
Assessment of
Addictive Behaviors.
New York:
Guilford Press,
1988.
Schuckit,
M. A.
Drug and
Alcohol Abuse:
A Clinical Guide
to Diagnosis
and Treatment.
New York:
Plenum Press,
1995.
• Required
Materials: top
07C:252
Course Materials Packet
07C:252
Supplemental
Course Packet
One copy of each of the assessment tools itemized below is
included in the materials packet. For some lessons, you may
choose among some of the tools listed; for others, the tools
will be referenced, but not actually used in assignments; for
still others, you may re-use a tool that has been used in a
previous lesson. None of the assessment tools included in this
packet are needed for Lesson 1. You may purchase additional
copies of the SCID-I and screening module from Iowa Book and
Supply (you may use this for up to four lessons, although only
one copy is included in the course materials packet); they
are available as a packet of three sets in the supplemental
course packet.
• Comprehensive
Drinkers
Profile (CDP)
• Addiction Severity Index (ASI)
• Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I)
• SCID- I Screening Module
• South Oaks Gambling Screen (SOGS)
• Hamilton Inventory
• Beck Depression Inventory (BDI)
• Structured Interview for DSM-IV Personality (SIDP-IV)
• Required
Instructional
Media: top
This
course will use several media to deliver course material
and facilitate communication
among students and instructors.
Audiotape: Students will record four interviews on audiotape
for the instructor to review and evaluate. Students must obtain
their own blank tapes for this purpose. All students must have
access to an audiocassette tape recorder.
Electronic mail: Students may send questions and submit written
assignment directly to the instructor.
Print: required and optional textbooks and assessment tools
are in print, as well as recommended journals.
• Recommended
Materials: top
In addition, students are strongly recommended to obtain The
Center for Substance Abuse Treatment's (CSAT) Treatment Improvement
Protocols (TIP) #3, #7, #9, and #10; these are available online,
or print materials may be ordered through the mail.
Online version: National Library of Medicine
Go to http://text.nlm.nih.gov/ and select SAMHSA/CSAT Treatment
Improvement Protocols in the first pull down menu
box--this will take you to the collection of Treatment
Improvement
Protocols.
Print version:
USDHHS
Public Health Service
SAMHSA
Center for Substance Abuse Treatment Rockwall II, 5600 Fishers
Lane Rockville, MD 20857
-
Evaluation
and Grading:
top
• Grading
of the Clinical Component Reports: top
The instructor will listen to the audiotapes and read the
clinical component reports that you submit as a part of Assignments
#2, #3, #4, and #6. You will be graded on the appropriateness
of your working diagnoses, your interpretation of client's
responses, and whether your report captures the main points
of the interview. Some attention also will be paid to the grammar
and style of writing--it is imperative that substance abuse
counselors be able to report, concisely and clearly, the results
of assessment--so proofread and spell check your work. Each
report potentially is worth 20 points.
The point value of each of the six assignments and final exam
are indicated in the table below.
| Assignment
#1 |
Written
component10 points |
10
points |
| Assignment
#2 |
Written
component 10 points |
30
points |
| Clinical
component 20 points |
| Assignment
#3 |
Written
component 10 points |
30
points |
| Clinical
component 20 points |
| Assignment
#4 |
Written
component 10 points |
30
points |
| Clinical
component 20 points |
| Assignment
#5 |
Written
component 10 points |
10
points |
| Assignment
#6 |
Written
component 10 points |
30
points |
| Clinical
component 20 points |
| Final
Exam |
40
multiple-choice questions |
40
points |
Total
Possible Points |
180
points |
You will receive a standard letter grade of A, B, C, D, or
F for your final course grade with plus or minus grades assigned
as appropriate, based on a percentage of the points earned.
Course grades are determined on the basis of the following
percentages:
| 98-100%
A+ |
88-89
B+ |
78-79
C+ |
68-69
D+ |
| 92-97
A |
82-87
B |
72-77
C |
62-67
D |
| 90-91
A- |
80-81
B- |
70-71
C- |
60-61
D- |
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