Self Reporting Screening Inventories
When assessing whether or not someone
has a drug or alcohol problem treatment professionals are best to
help to determine
to what degree or if at all a person has a drug or alcohol dependence
that deserves professional treatment. A helpful tool that is utilized
is the self report inventory or screening.
An important distinction is that
while "screening" is
useful in assessment, a screen and an assessment are not the same.
The difference is that a screen (such as a self-reporting inventory)
is a brief process that identifies potential problems or high risk
criteria, but does not neccesarily indicate a true addicted or alcoholic
person and should not be relied on as a definitive answer to the
question of whether or not a person is suffering from chemical dependency.
The caution is that while a vital instrument in a comprehensive assessment,
these inventories are not to be used in isolation from other assessment
data that is gathered through interviews with the potential client,
family and friends - all of which are best conducted by a qualified
addictions counselor.
Another issue with self reporting
inventories is that they are "self reporting". This opens the door
for validity issues, wherin if a client has a strong denial system
or is not
reporting
truthfully, a false result will be extracted from the assessment.
Despite the few drawbacks of Self Reporting Tests,
they are still an invaluable tool in helping determine the existence
of a drug or alcohol problem. There are currently three most commonly
used inventories. The CAGE, the MAST and the SASSI.
CAGE
This is perhaps the simplest and sometimes
most debated screening instrument. The name is simply an acronym
for four questions.
The screen was originally used to determine alcohol problems, but
may be modified to accomodate a range of substance abuse problems.
The test was originally developed by Ewing and Rouse and as been
a cornerstone in addiction assessment.
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C - Have you ever felt the need to Cut down on your drinking?
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A - Have you ever felt Annoyed by someone criticizing your
drinking?
-
G - Have you ever felt Guilty about your drinking?
-
E - Have you ever had to drink in the morning to quiet your
nerves or relieve a hangover? (Eye-opener).
Responding affirmative to two or more
questions will indicate an alcohol problem. The test was originally
developed by
Ewing and Rouse and has been a cornerstone in addiction assessment
and can help open the door to further investigation by a certified
addictions counselor or social worker.
MAST
The Michigan Alcohol Screening Test was
developed as an easily administered and scorable 24 item test that
can either
be administered in written or oral form. Each question carries a
score of either 0, 1, 2, or 5. "0" indicating a nondrinking response
and "1, 2, and 5" indicating a drinking response. A score of 1 or
2 indicates a typical social or moderate drinker's response, while
5 is an indication of an alcoholic characteristic reply. While a
social drinker might reveal one or two responses that carry a score
of 5, the overall score is more revealing. An overall score of 0-4
would indicate a nonalcoholic drinker, while 5-6 would suggest an
alcohol problem, 7-9 determines one alcoholic, 10-20 would point
to a moderate alcoholic and 20 or more a severe alcoholic. However,
the questions are so obviously designed around determining an alcohol
problem, that false negatives are not uncommon. Later Jacobsen suggested
a cutoff score of 12 as opposed to 7, which proved to yield a considerably
lower rate of false positives; between 5 to 8% as opposed to 21 to
34% at a cutoff of 5. Still the false negatives were in the 7 to
12% range, which is still sufficiently high to prompt professionals
to continue to rely on training and instinct over scores and formulas.
SASSI
In surveying college populations Cooper
and Robinson decried earlier screening inventories and hailed the
SASSI, which
made a considerable effort to do away with the short comings of earlier
tools by overcoming the problem of strong denial systems in the typical
chemically dependent person. Since that time, the SASSI is now in
it's third revision by Glen Miller, the author of the inventory.
The SASSI intends to scale the subtle attributes inherent in the
substance abuser by asking questions seemingly unrelated to an addiction
problem. The SASSI has found its way into treatment centers, college
social workers offices, mental health hospitals, employee assistance
programs and court-ordered substance abuse programs. The SASSI also
is administered in both cases of adolescents and adults, with the
adolescent version claiming a reading level of 5th grade. The test
also receives markes for separating scoring for both male and female
clients. Audiotape versions have also been developed for those with
reading difficulties. However, the SASSI is not without it's critics,
who point to a higher than claimed reading level. In the same breath,
one of it's critics, Kerr, still upholds that the test does a good
job in identifying chemically dependent persons, and is at the edge
of efforts in giving psychometrically sound results in identifying
chemically dependent persons.
Pre-Treatment Assessment
As the above- mentioned tools of the Treatment
Professional are useful, it is important that a full assessment be
taken by a trained
and qualified couselor. While most people have a very firm belief
in what deems use, misuse and abuse, the lines are very clear and
are best determined when a full client history can be taken. The
sociological background, psychological makeup, educational and work
history, family and marriage difficulties and medical issues all
have to be taken into account and weighed carefully against specific
criteria that determine the prevalance of a chemical dependency problem.
In many cases where all of these factors and histories
can be documented and reviewed by a counselor, the need for screening
inventories does not weigh as heavily, but in the short term can
give the professional a good idea of whether a chemical dependency
issue is at heart of the clients' problems.
If you or a loved one might think they
have a chemical dependency, Narconon provides
pre-treatment
assessments at no-cost and are available via online or phone consultations.
If you would like to speak with one of
our qualified counselors, please feel free to call (800) 722-5570
or fill out our
online form here.
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