Cairo Addiction Severity Index Training

Addiction Severity Index (ASI):Addiction Severity Index (ASI):The Treatnet Version!The Treatnet Version!

Treatnet Training Volume A: Module 2 – Updated 9 September 2007

The Addiction Severity Index 2

Module 2: Module 2: WorkshopsWorkshops

Workshop 1: Workshop 1: Interviewer InstructionsInterviewer InstructionsIntroducing the ASIIntroducing the ASICodingCoding

Workshop 2: Workshop 2: Employment SectionEmployment SectionDrug & Alcohol Section Drug & Alcohol Section Drug & Alcohol GridDrug & Alcohol Grid

ASI: Administering and CodingASI: Administering and Coding

Workshop 3:Workshop 3:Legal SectionLegal SectionFamily SectionFamily Section

Workshop 4:Workshop 4:Psychiatric SectionPsychiatric SectionReviewReviewCompetency MeasuresCompetency Measures


PrePre--assessmentassessment

Please respond to the prePlease respond to the pre--assessment questions in your assessment questions in your workbook.workbook.

(Your responses are strictly confidential.) (Your responses are strictly confidential.)

10 Min.


Treatnet ASI Workshop 1Treatnet ASI Workshop 1

The ASI: Administering and CodingThe ASI: Administering and CodingInterviewer InstructionsInterviewer InstructionsIntroducing the ASIIntroducing the ASICoding:Coding:

General InformationGeneral InformationMedical SectionMedical Section


Goal of this workshopGoal of this workshop

Develop and or enhance interviewerDevelop and or enhance interviewercompetencies in the administration ofcompetencies in the administration ofthe Addiction Severity Index (ASI)the Addiction Severity Index (ASI)


ObjectivesObjectives

Identify the specific intention of each Identify the specific intention of each questionquestionConsistently apply correct coding in Consistently apply correct coding in response to clientresponse to client’’s answerss answersPhrase each question, adapt the Phrase each question, adapt the questionnaire to the clientquestionnaire to the client


StandardizedStandardized, semi, semi--structured, multistructured, multi--focused focused screening and assessment toolscreening and assessment tool

Used to collect information regarding the Used to collect information regarding the nature and severity of problems substance nature and severity of problems substance abusers often haveabusers often have

Clinical, program evaluation, and research Clinical, program evaluation, and research applicabilityapplicability

Addiction Severity IndexAddiction Severity Index


Purpose of the ASIPurpose of the ASI

Provides a comprehensive intake Provides a comprehensive intake assessmentassessment

Provides clinical information necessary for Provides clinical information necessary for treatment planningtreatment planning

Collects necessary data for systemCollects necessary data for system--wide or wide or national projects to track trends, answer national projects to track trends, answer questions, and set policyquestions, and set policy

Guides substance abuse treatment Guides substance abuse treatment intakeintake

Helps in design of intake summariesHelps in design of intake summaries

Helps in development of treatment plansHelps in development of treatment plans

Assists in identifying when to make Assists in identifying when to make referralsreferrals

Clinical applicabilityClinical applicability


Program EvaluationProgram Evaluation

Identifies types of patients presenting Identifies types of patients presenting for treatmentfor treatmentQuantifies level of problemsQuantifies level of problemsIdentifies nature and amount of changeIdentifies nature and amount of changeCan be used to monitor treatment Can be used to monitor treatment outcomesoutcomesAssists in managing resourcesAssists in managing resourcesProvides content for reports to funding Provides content for reports to funding sourcessources


7 Sections of the ASI7 Sections of the ASI

1.1. MedicalMedical2.2. Employment/SupportEmployment/Support3.3. DrugDrug4.4. AlcoholAlcohol5.5. LegalLegal6.6. Family/SocialFamily/Social7.7. PsychiatricPsychiatric


Interviewer InstructionsInterviewer Instructions

As seen on the ASI As seen on the ASI ““Face PageFace Page””

andand

QuestionQuestion--byby--Question Guide, Question Guide, Page 16Page 16


Interviewer Instructions 1 Interviewer Instructions 1 -- 77

1. Leave no blanks.1. Leave no blanks.2. Make plenty of comments. When noting comments, 2. Make plenty of comments. When noting comments,

please write the question number. Probe and clarify!please write the question number. Probe and clarify!

3.3. X = Question not answered. X = Question not answered. 4.4. N = Question not applicable.N = Question not applicable.

5. End the interview if client misrepresents or cannot 5. End the interview if client misrepresents or cannot understand two or more sections.understand two or more sections.

6. Half Time Rule! If a question asks the number of 6. Half Time Rule! If a question asks the number of months, round up periods of 14 days or more to 1 months, round up periods of 14 days or more to 1 month. Round up 6 months or more to 1 year. month. Round up 6 months or more to 1 year.

7.7. Hints and clarifications in the ASI are bulleted, "Hints and clarifications in the ASI are bulleted, "••". ".


Code all boxes, leave no blanks!Comments, comments – make plenty of comments!Indicate item number when making commentsProbing is essential for valid informationYou need not ask questions exactly as written –use paraphrasing and rephrasing as appropriate for the client

1. No Blanks!1. No Blanks!


3. Coding 3. Coding ““XX””


Code Code ““NN”” when item does not when item does not apply to clientapply to clientMust see instruction on the ASI Must see instruction on the ASI to insure that a code of to insure that a code of ““NN”” is is appropriateappropriateReview your Review your ““Coding N Coding N Reference SheetReference Sheet””!!

4. Coding 4. Coding ““NN””


End the interview if:End the interview if:client misrepresents two sectionsclient misrepresents two sectionsit is clear client cannot it is clear client cannot understand the questions after understand the questions after two sectionstwo sections

5. End the interview?5. End the interview?


6. The Half6. The Half--Time RuleTime Rule

1.1. If item asks about months, roundIf item asks about months, roundperiods of 14 days or more up to 1 periods of 14 days or more up to 1 monthmonth

2.2. If item asks about years, roundIf item asks about years, roundperiods of 6 months or more up toperiods of 6 months or more up to1 year1 year


7. Hints and Clarifications7. Hints and Clarifications

READ YOUR HINTS!READ YOUR HINTS!Many questions on the ASI have hints Many questions on the ASI have hints or clarification notes right under the or clarification notes right under the question!question!Hints and clarification notes in the ASI Hints and clarification notes in the ASI are bulleted (are bulleted (““••””). ).


Why Why ““IntroduceIntroduce”” the ASI?the ASI?

Gives the client a clear idea of what Gives the client a clear idea of what to expectto expect

Sets the toneSets the tone

Helps build rapportHelps build rapport


Introducing the Introducing the ASIASI

As seen on your ASI As seen on your ASI ““face face pagepage”” and in your manual, and in your manual, Pages 13 & 14.Pages 13 & 14.

INTRODUCING THE ASI:

1. All clients receive this same standard interview.

2. Seven Potential problem areasor Domains: Medical, Employment/Support Status, Alcohol, Drug, Legal, Family/Social, and Psychiatric.

3. The interview will take about 30-40- minutes.

4. Patient Rating Scale: Patient input is important. For each area, I will ask you to use this scale to let me know how bothered youhave been by any problems in each section. I will also ask you how important treatment is for you for the area being discussed.

The scale is:0 - Not at all1 – Slightly2 – Moderately3 – Considerably4 – Extremely

5. All information gathered is confidential

6. Accuracy - You have the right to refuse to answer any question, if you are uncomfortable or feel it is too personal or painful to give an answer, just tell us, “I want to skip that question.” We’d rather have no answer than an inaccurate one!

7. There are two time periodswe will discuss: 1. The past 30 days2. Lifetime


Seven Points Seven Points

1.1. All clients receive the same interviewAll clients receive the same interview2.2. Seven Problem Areas Seven Problem Areas 3.3. Takes approximately 30Takes approximately 30--40 minutes40 minutes4.4. Your input is important Your input is important –– use of Patient use of Patient

Rating ScaleRating Scale5.5. ConfidentialityConfidentiality6.6. You may choose not to answer You may choose not to answer 7.7. Two timeframes: past 30 days & lifetimeTwo timeframes: past 30 days & lifetime


1. Standard Interview, 2. Seven Areas, 1. Standard Interview, 2. Seven Areas, 3. Length of Interview3. Length of Interview

INTRODUCING THE ASIINTRODUCING THE ASI::1.1. All clients receive this same All clients receive this same standardstandard

interview.interview.2.2. Seven Potential Problem Areas, or Seven Potential Problem Areas, or

Domains: Medical, Employment/Support Domains: Medical, Employment/Support Status, Alcohol, Drug, Legal, Status, Alcohol, Drug, Legal, Family/Social, and Psychiatric.Family/Social, and Psychiatric.

3.3. The interview will take about 30The interview will take about 30--40 40 minutes.minutes.


4. Your input is important 4. Your input is important -- PRSPRS

4. Patient Rating Scale: Patient input is important. For each area, I will ask you to use this scale to let me know how bothered you have been by any problems in each section. I will also ask you how important treatment is for you for the area being discussed.

The scale is: 0 - Not at all 1 – Slightly 2 – Moderately 3 – Considerably 4 – Extremely


5. Confidential, 6. Accuracy, 7. Time5. Confidential, 6. Accuracy, 7. Time

What will confidentiality mean for your program?What will confidentiality mean for your program?Tell client: Tell client: ““Accurate information better equips us to help you.Accurate information better equips us to help you.””Time Periods Time Periods –– Important in Family and Psychiatric sections.Important in Family and Psychiatric sections.

5. All information gathered is confidential 6. Accuracy - You have the right to refuse to answer any question, if you are uncomfortable or feel it is too personal or painful to give an answer, just tell us, “I want to skip that question.” We’d rather have no answer than an inaccurate one! 7. There are two time periods we will discuss: 1. The past 30 days 2. Lifetime


Segue Segue –– After introducing the ASIAfter introducing the ASI

““Are you ready? LetAre you ready? Let’’s get started with s get started with some general information about some general information about yourself.yourself.””


Introduction to General SectionIntroduction to General Section

Gather Gather identifying & identifying & demographic information demographic information about the clientabout the client

Determine Determine if client has if client has been in a living situation been in a living situation which restricted freedom which restricted freedom of movement and access of movement and access to alcohol and other to alcohol and other drugs in the past 30 daysdrugs in the past 30 days


G1 & G2 & G3: International VersionG1 & G2 & G3: International Version

G1. Patient G1. Patient ID_________________________________________ID_________________________________________

G2.CountryG2.Country G2a. CentreG2a. Centre

G2b.ProgramG2b.Program G2c. Modality G2c. Modality

G3. Will this treatment be delivered in a corrections facility? G3. Will this treatment be delivered in a corrections facility? 0 = No 1 = Yes0 = No 1 = Yes


G1: Patient IDG1: Patient ID

G1 is an G1 is an ““open item.open item.”” This This means that it can be used means that it can be used as needed. Record any ID as needed. Record any ID number assigned to the number assigned to the client by your program.client by your program.


G2: Treatnet Country CodesG2: Treatnet Country Codes

Country #Country Name Country #

Country Name

1 Australia 12 Kenya2 Brazil 13 Mexico3 Canada 14 Nigeria4 China 15 Russia5 Colombia 16 Spain6 Egypt 17 Sweden7 Germany 18 UK8 India 19 USA9 Indonesia10 Iran 20 Open11 Kazakhstan 21 Open

These codes are found on the back of the ASI.These codes are found on the back of the ASI.


G2a: Treatnet Site CodesG2a: Treatnet Site Codes

Codes for item G2 Codes for item G21 Asociación Proyecto Hombre, Spain 11 Mudra, Germany

2Carisma Centre for Attention and Integral Mental Health, Colombia 12

National Research and Clinical Centre on Medical and Social Problems of Drug, Kazakhstan

3Centre for Addiction and Mental Health CAMH, Canada 13 Neuropsychiatric Hospital Aro, Nigeria

4 Centros de Integración Juvenil A.C., Mexico 14 Brazil5 Cranstoun Drug Services, United Kingdom 15 St. Petersburg Pavlov State Medical University, Russia

6 Drug Rehabilitation Unit, Mathari Hospital, Kenya 16RS Ketergantungan Obat Drug Dependence Hospital, Indonesia

7 Fayette Companies, U.S.A. 17 Shanghai Drug Abuse Treatment Centre, China

8 General Secretariat of Mental Health, Egypt 18Stanley Street Treatment & Resources (SSTAR) Inc., U.S.A.

9Iranian National Prison Organisation /Iranian National Centre for Addiction Studies INCAS, Iran 19 TT Ranganathan Clinical Research Foundation, India

10 Maria Ungdom, Sweden 20 Turning Point Alcohol and Drug Centre Inc., Australia


G2b: Treatnet Program CodesG2b: Treatnet Program Codes

These codes are specific to These codes are specific to each Centre. each Centre.

See manual for details.See manual for details.


G2c: Treatnet Modality CodesG2c: Treatnet Modality Codes

G2c. Modality Codes:G2c. Modality Codes:1=Outpatient (<5 hours per week)1=Outpatient (<5 hours per week)2=Intensive Outpatient (2=Intensive Outpatient (≥≥ 5 hours per week)5 hours per week)3=Residential/Inpatient3=Residential/Inpatient4=Therapeutic Community4=Therapeutic Community5=Half5=Half--way houseway house6=Detox 6=Detox –– Inpatient (typically 3 Inpatient (typically 3 –– 7 days)7 days)7=Detox Outpatient/Ambulatory7=Detox Outpatient/Ambulatory8=Opioid Replacement, OP (Methadone, Buprenorphine, etc)8=Opioid Replacement, OP (Methadone, Buprenorphine, etc)9=Other (low threshold, GP, spiritual healers, etc.) 9=Other (low threshold, GP, spiritual healers, etc.) Specify____________________________________________Specify____________________________________________


G3: Treatment in Corrections G3: Treatment in Corrections

Answer Answer ““yesyes”” if the treatment will be if the treatment will be delivered within a corrections facility such as delivered within a corrections facility such as a prisona prison--based setting.based setting.Answer no if the treatment is not being Answer no if the treatment is not being provided within a criminal just setting.provided within a criminal just setting.

G3. Will this treatment be delivered in aG3. Will this treatment be delivered in acorrections facility? corrections facility? 0=No 1=Yes 0=No 1=Yes


G4G4--G7: Recording Interview Date and LengthG7: Recording Interview Date and Length

G4 and G5 track time between the interview and admission. G4 and G5 track time between the interview and admission. For example: John may have been assessed on 30/11/2005, For example: John may have been assessed on 30/11/2005, but may not have begun attending treatment until 9/12/2005but may not have begun attending treatment until 9/12/2005G6 and G7 track the length of the interviewG6 and G7 track the length of the interview

Longer interview times may indicate a difficult clientLonger interview times may indicate a difficult clientHelps to flag exceptionally long or short interviewsHelps to flag exceptionally long or short interviews

*Day / Month / Year


G8 & G9: Intakes and Contact CodeG8 & G9: Intakes and Contact Code

G8: G8: Most ASIMost ASI’’s are s are ““intakesintakes”” and are completed on and are completed on or near the admission dateor near the admission dateFollowFollow--up ASIup ASI’’s are generally used when s are generally used when conducting outcome studies conducting outcome studies

G9: G9: All intake ASIAll intake ASI’’s are conducted in persons are conducted in person

G8. Class: 1. Intake 2. Follow-up G9. Contact Code: 1. In person 2. Telephone (Intake ASI must be in person)


G10 & G11 : Gender & InterviewerG10 & G11 : Gender & Interviewer

G10: G10: Interviewing TechniquesInterviewing TechniquesCan you always assume a clientCan you always assume a client’’s s gender?gender?

G11: G11: Record your assigned interviewer Record your assigned interviewer number given to you by your program.number given to you by your program.

G10. Gender: 1. Male 2. Female

G11. Interviewer Code No./ Initials:


Address (Address (““G12 & G13G12 & G13””))

Although not numbered, Although not numbered, ““AddressAddress”” is is actually questions 12 & 13.actually questions 12 & 13.The place where you enter the address The place where you enter the address has been altered to be more has been altered to be more internationally applicable internationally applicable –– there are no there are no specific instructions, each user should specific instructions, each user should enter an address as it is understood in enter an address as it is understood in his/her culture.his/her culture.


Address informationAddress information

If the client is currently incarcerated or If the client is currently incarcerated or living in a recovery house, record the living in a recovery house, record the address to which he/she expects to return.address to which he/she expects to return.If the client is homeless, record an If the client is homeless, record an address where they can be reached (i.e. a address where they can be reached (i.e. a shelter, or friend or relativeshelter, or friend or relative’’s address)s address)Record homelessness in the comments Record homelessness in the comments section.section.


G14: Living placeG14: Living place

G14: IntentG14: IntentTo evaluate the stability of the clientTo evaluate the stability of the client’’s s living situationliving situationTo probe to determine the To probe to determine the ““actualactual””time a client has spent at this addresstime a client has spent at this address

G14. How long have you lived at this address?

Years Months


G16G16––18: DOB, Race & Religion 18: DOB, Race & Religion

Day Month YearG16. Date of birth:

16a. Age Years old

G17. What race/ethnicity/nationality do you consider yourself?Specify____________________________________

G18. Do you have a religious preference?1. Protestant 4. Muslim 7. Hindu2. Catholic 5. OtherChristian 8. Buddhist3. Jewish 6. None 9. Other(specify in comments)


G19 & G20: Controlled environmentG19 & G20: Controlled environment

G19 and G20: Intent G19 and G20: Intent To record whether the client has To record whether the client has ““theoreticallytheoretically”” had restricted access to had restricted access to drugs and/or alcoholdrugs and/or alcohol

G19. Have you been in a controlled environment in the past 30 days?

1. No 4. Medical Treatment 2. Correctional Facility 5. Psychiatric Treatment 3. Alcohol/Drug Treat. 6. Other: ______________ •A place, theoretically, without access to drugs/alcohol. G20. How many days? •"NN" if Question G19 is No. Refers to total number of days detained in the past 30 days.


G19 and G20: Controlled environmentG19 and G20: Controlled environment

““Controlled EnvironmentControlled Environment”” = Restriction = Restriction of Movement of Movement

Suggested interviewing technique: Suggested interviewing technique: ““Mr. Smith, in the past 30 days have Mr. Smith, in the past 30 days have you spent any time in a controlled you spent any time in a controlled environment that might have restricted your environment that might have restricted your access to alcohol and drugs, such as prison, access to alcohol and drugs, such as prison, detox, or a medical hospital?detox, or a medical hospital?””


G19 and G20: Controlled environmentG19 and G20: Controlled environment

If a client was in 2 different types of If a client was in 2 different types of controlled environments, enter the controlled environments, enter the number corresponding to that which number corresponding to that which he / she spent the majority of timehe / she spent the majority of timeIn these cases, G20 will reflect the In these cases, G20 will reflect the total time in all settingstotal time in all settingsIf G19 = 1 (No), then G20 = NIf G19 = 1 (No), then G20 = N


G21: Referral sourceG21: Referral source

This is an openThis is an open--ended item that ended item that programs can use as they see fit. programs can use as they see fit. Many will enter the name and contact Many will enter the name and contact information of a referring physician, information of a referring physician, legal official, or employer. You can legal official, or employer. You can also enter that the client is selfalso enter that the client is self--referred.referred.


Segue to Medical SectionSegue to Medical Section

““Okay. WeOkay. We’’ve finished with the general ve finished with the general information section. Letinformation section. Let’’s go next to s go next to the medical section, where Ithe medical section, where I’’m going m going to ask you questions about your to ask you questions about your health status, for example, whether health status, for example, whether youyou’’ve been hospitalized and what ve been hospitalized and what medications you may be taking.medications you may be taking.””


Medical SectionMedical Section

To gather basic To gather basic information about:information about:

ClientClient’’s medical s medical historyhistoryLifetime Lifetime hospitalizationshospitalizationsLongLong--term medical term medical problemsproblemsRecent physical Recent physical ailmentsailments


M1: HospitalizationsM1: Hospitalizations

M1. How many times in your life have you been hospitalized for medical problems? • Include O.D.'s and D.T.'s. Exclude detox, alcohol/drug, psychiatric treatment and childbirth (if no complications). Enter the number of overnight hospitalizations for medical

problems.

Coding issues:Coding issues:Must be overnightMust be overnightOnly code for medical problemsOnly code for medical problemsInclude ODs, DTsInclude ODs, DTsExclude Exclude detoxdetox, inpatient alcohol/drug and , inpatient alcohol/drug and psychiatric treatment, and normal childbirthpsychiatric treatment, and normal childbirthNumber of times, not number of daysNumber of times, not number of days


M3: Chronic problemsM3: Chronic problems

Describe Describe ““chronic problemschronic problems”” to client as those that to client as those that interfere with their life or require ongoing careinterfere with their life or require ongoing careProvide examples such as diabetes, hypertension, Provide examples such as diabetes, hypertension, asthmaasthmaSpecify in comments & probeSpecify in comments & probe

M3. Do you have any chronic medical 0=No 1=Yes problems which continue to interfere with your life? • If "Yes", specify in comments. • A chronic medical condition is a serious physical condition that requires regular care, (i.e., medication, dietary restriction) preventing full advantage of their abilities.


M4: MedicationsM4: Medications

EmphasiseEmphasise ““Regular BasisRegular Basis”” –– dondon’’t t include temporary meds (e.g., antibiotics)include temporary meds (e.g., antibiotics)EmphasiseEmphasise ““prescribed for youprescribed for you””

M4. Has a health care provider recommended you take any medications on a regular basis for a physical problem?

• Do not include various remedies given by a non-healthcare Provider.• Must be for a medical condition; don’t include psychiatric medicines. • Include medicines prescribed whether or not the patient is currently

taking them. • The intent is to verify chronic medical problems.


M5: Physical Disability SupportM5: Physical Disability Support

M5. Do you receive financial support for a physical disability?

• If Yes, specify in comments.• Include Workers' compensation, early retirement for

medical disability● Exclude psychiatric disability.

Must be Must be medicalmedical, not , not psychiatricpsychiatric disabilitydisabilityDoes not include support from family or Does not include support from family or friendsfriends


M6: Days of ProblemsM6: Days of Problems

Refer to physical medical problems Refer to physical medical problems discussed from M1 discussed from M1 -- M5, or any other M5, or any other problems they might not have mentionedproblems they might not have mentionedEmphasiseEmphasise number of number of daysdays

M6. How many days have you experienced medical problems in the past 30 days?

• Include flu, colds, injuries, etc. Include serious ailments related to drugs/alcohol, which would continue even if the patient were abstinent (e.g., cirrhosis of liver, HIV, HCV, HBV abscesses from needles, etc.).


M7: Troubled or botheredM7: Troubled or bothered

Refers to problems in M6Refers to problems in M6EmphasiseEmphasise medicalmedical problems (not psych or problems (not psych or drug / alcohol problems)drug / alcohol problems)USE PATIENT RATING SCALE!USE PATIENT RATING SCALE!

M7. How troubled or bothered have you been by these medical problems in the past 30 days?• Restrict response to problem days of Question M6.


Patient/Client Rating ScalePatient/Client Rating Scale

PATIENT/CLIENT RATING SCALEPATIENT/CLIENT RATING SCALE

00 NOT AT ALLNOT AT ALL11 SLIGHTLYSLIGHTLY22 MODERATELYMODERATELY33 CONSIDERABLYCONSIDERABLY44 EXTREMELYEXTREMELY


M8: Need for treatmentM8: Need for treatment

Refers to treatment needed for problems Refers to treatment needed for problems reported in M6reported in M6EmphasiseEmphasise treatment for treatment for medicalmedical problems problems USE PATIENT RATING SCALE!USE PATIENT RATING SCALE!

M8. How important to you now is treatment for these medical problems? • If client is currently receiving medical treatment, refer to the

need for additional medical treatment by the patient. Note: The patient is rating their need for additional medical services or referrals from your agency, above any services they may already be getting.


The The ““Final 3Final 3”” -- MedicalMedical

M6: M6: ““How many days have you experienced How many days have you experienced medical problems in the past 30?medical problems in the past 30?””M7: M7: ““How troubled or bothered have you been How troubled or bothered have you been by these medical problems in the past 30 by these medical problems in the past 30 days?days?””M8: M8: ““How important to you now is treatment for How important to you now is treatment for these medical problems?these medical problems?””


The Final 3 Scoring The Final 3 Scoring -- MedicalMedical

If M6 = 0, thenIf M6 = 0, thenM7 = 0 andM7 = 0 and

M8 should be 0.M8 should be 0.

If M6 > 0, thenIf M6 > 0, thenM7 > 0, and M7 > 0, and

M8 can be any number.M8 can be any number.


Last two items in every section of the Last two items in every section of the ASI:ASI:

Is the above information significantly Is the above information significantly distorted by:distorted by:

PatientPatient’’s misrepresentation?s misrepresentation?PatientPatient’’s inability to understand?s inability to understand?

M10 & M11: Confidence ratingsM10 & M11: Confidence ratings


The The judgementjudgement of the interviewer is important of the interviewer is important in deciding the veracity of the patientin deciding the veracity of the patient’’s s statements. statements. The The Misrepresentation CodeMisrepresentation Code is not to be used is not to be used as a as a ““denial meterdenial meter”” or to code a clientor to code a client’’s s minimisationminimisation”” of their problems. of their problems. Code a Code a ““YesYes”” in the Misrepresentation in the Misrepresentation question if you are assured (not simply question if you are assured (not simply ““have have a huncha hunch””) that the majority of the answers ) that the majority of the answers are inaccurate or contradictory.are inaccurate or contradictory.

M10: PatientM10: Patient’’s misrepresentation?s misrepresentation?


Three reasons to code Three reasons to code ““unable to unable to understandunderstand””

1.1. Language barrierLanguage barrier2.2. Client is under the influence of drugs or Client is under the influence of drugs or

alcohol and cannot understand the alcohol and cannot understand the questionsquestions

3.3. Client is cognitively limited or Client is cognitively limited or psychiatrically impaired and cannot psychiatrically impaired and cannot understand the questionsunderstand the questions

M11: PatientM11: Patient’’s inability to understand?s inability to understand?


M12: New question M12: New question -- HepatitisHepatitis

New items on the Treatnet ASI!New items on the Treatnet ASI!M12b: Does not necessarily mean that you will provide the test M12b: Does not necessarily mean that you will provide the test onon--site; you may make a referral for testing.site; you may make a referral for testing.

M12. Have you ever been tested for hepatitis?0 = No, 1 = Yes

M12a. If Yes, what was the result?1 = Hep Negative (not infected)2 = Hep positive (infected)3 = Don’t Know• If M12 = No, M12a = “N”

M12b. Would you like help obtaining a Hepatitis test?


M13: New question M13: New question –– HIV/AIDSHIV/AIDS

New items on the Treatnet ASI!New items on the Treatnet ASI!M13b: Does not necessarily mean that you will provide the test M13b: Does not necessarily mean that you will provide the test onon--site; you may make a referral for testing.site; you may make a referral for testing.

M13. Have you ever been tested for HIV?0 = No, 1 = Yes

M12a. If Yes, what was the result?1 = HIV Negative (not infected)2 = HIV positive (infected)3 = Don’t Know• If M13 = No, M13a = “N”

M13b. Would you like help obtaining an HIV test?


M14: New Questions M14: New Questions –– PregnancyPregnancy

New item on the Treatnet ASI!New item on the Treatnet ASI!M14b: Does not necessarily mean that you will M14b: Does not necessarily mean that you will provide the test onprovide the test on--site; you may make a referral for site; you may make a referral for testing.testing.

If patient is Male, code all “N” 0=No, 1=Yes, 2=Unsure M14. Are you currently pregnant? M14a. If pregnant; do you have prenatal care? M14b. If unsure; would you like help obtaining a pregnancy test? • If M14= 0 or 2 (No or Unsure), M14a = N • If M14= 1 (Yes), M14b = N


Questions?Questions?

Comments?Comments?

? ? ?


The ASI: Administering and CodingThe ASI: Administering and CodingEmployment SectionEmployment SectionDrug & Alcohol Section Drug & Alcohol Section Drug & Alcohol GridDrug & Alcohol Grid

Transition to Transition to Employment Employment

Support SectionSupport Section


TransitionTransition

"Well, we"Well, we’’ve talked about your ve talked about your medical status medical status –– now I'm going to now I'm going to ask you some questions about ask you some questions about any employment or support issues any employment or support issues you may have."you may have."


Employment / Support Status sectionEmployment / Support Status section

Resources a client Resources a client can record on a job can record on a job applicationapplication

Schooling / trainingSchooling / training

Current sources Current sources and amounts of and amounts of incomeincome


E1 & E2: Education & trainingE1 & E2: Education & training

E1.∗ Education completed: Code:

*Level 0 = No education* Level 1 = Primary 1-6 yrs Yrs. Mos.* Level 2 = Lower Secondary 7-9 yrs* Level 3 = Upper Secondary 10-12 yrs* Level 4 = Post Secondary, non-tertiary OR

(add’l preparation for level 5) Code Level #* Level 5 = First Stage Tertiary

(+4 -6 years, incl BS, MS)* Level 6 = Second Stage Tertiary (doctorate, etc).

• Code Years and Months, Level # or both.• Include formal education only.

E2.∗ Training or Technical education completed:• Formal/organized training only. Months


E1 & E2: Education & trainingE1 & E2: Education & training

E1. E1. ““Level of educationLevel of education”” was was added for the Treatnet ASI. Enter added for the Treatnet ASI. Enter the level of education or years of the level of education or years of education or both.education or both.

E2. Enter number of months of E2. Enter number of months of training or technical education.training or technical education.


E4a: InternationalE4a: International

E4a. Are your job options limited by lack of transportation?

0 = No 1 = Yes

This item is used to evaluate if transportation This item is used to evaluate if transportation problems contribute to employment problems problems contribute to employment problems or underor under--employment.employment.


E6 & E7: Job & occupationE6 & E7: Job & occupation

E6. How long was your longest full time job? • Full time = 35+ hours weekly; does not necessarily mean most Years Months recent job. E7.∗ Usual (or last) occupation? (specify) ___________________________________ (Use International Classification references page 1)

E6. Code length of longest fullE6. Code length of longest full--time job, not time job, not necessarily the most recent job.necessarily the most recent job.E7. Code E7. Code ““usualusual”” occupation, not necessarily occupation, not necessarily what the client is doing currently.what the client is doing currently.


E7 Codes: ISC0 CategoriesE7 Codes: ISC0 Categories

International Standard Classification International Standard Classification of Occupationsof Occupations

1.1. Legislators, officialsLegislators, officials2.2. Professionals Professionals 3. Technicians / assoc. professionals 3. Technicians / assoc. professionals 4. Clerks4. Clerks5. Service & sales5. Service & sales6. Skilled agricultural / fish6. Skilled agricultural / fish7. Craft & trades7. Craft & trades8. Plant / machine operators8. Plant / machine operators9. Elementary occupations9. Elementary occupations0. Armed forces0. Armed forces


E9: Contribution to supportE9: Contribution to support

E9 Does someone contribute the majority of your support?

0 - No 1 - Yes • Is patient primarily financially supported on a regular basis from family/friends. Include spouse's contribution; exclude support by an institution. “Housing” is considered the majority of someone’s support.

Asks about support (i.e., cash, food, housing)Asks about support (i.e., cash, food, housing)Must be from an individual (including spouse), Must be from an individual (including spouse), not an institutionnot an institutionMust be the majority of support Must be the majority of support CrossCross--check with E12 check with E12 -- E17E17


E10: Usual employment patternE10: Usual employment pattern

E10. Which of these represents how you spent the majority of the past three years? 1. Full time (35+ hours) 5. Military 2. Part time (regular hours) 6. Retired/Disability 3. Part time (irregular hours) 7. Unemployed 4. Student 8. In controlled environment 9. Homemaker

• Answer should represent the majority of the last 3 years, not just the most recent selection. If there are equal times, select category which best represents the current situation.

Usual pattern for last 3 years, not most recentUsual pattern for last 3 years, not most recent

Full time = >35 hours per weekFull time = >35 hours per weekPart time = <35 hours per weekPart time = <35 hours per weekIf equal time spent in different categories, code the If equal time spent in different categories, code the current situationcurrent situation


E11: Days paid for workingE11: Days paid for working

Include paid sick days, vacation, etc.Include paid sick days, vacation, etc.Regular 5Regular 5--day work week = 20 daysday work week = 20 daysSome places report paying employees for 30 Some places report paying employees for 30 days each month; if this is the case, code that days each month; if this is the case, code that here.here.Include any paid work done on weekendsInclude any paid work done on weekends

E11. How many days in the past 30 did you work for pay? • Include days actually worked, paid sick days and paid vacation.


E12 to E16: Income SourcesE12 to E16: Income Sources

Purpose: Purpose: Record Record various various sources of sources of income in past income in past 30 days30 daysUse your local Use your local currency and currency and specify in specify in commentscomments

For questions E12-17: How much money did you receive from the following sources in the past 30 days? * Use your local currency. E12. Employment? • Net or "take home" pay, include

any money earned except illegal income E13. Unemployment Compensation

E14. Social Welfare • Money given by government to assist with living expenses.

E15. Pensions, benefits, social security? • Include disability, pensions, retirement, & workers' compensation and veterans benefits.

E16. Mate, family, or friends? • Money for personal expenses. Also code unreliable sources of income, windfalls (unexpected money) money from loans, inheritance. (Record cash payments only, etc.).

E17. Illegal?


E17: Illegal money receivedE17: Illegal money received

Question asks about money received from illegal Question asks about money received from illegal activities, not simply illegal activities activities, not simply illegal activities Include cash obtained from drug dealing, fencing Include cash obtained from drug dealing, fencing stolen goods, illegal gambling, prostitutionstolen goods, illegal gambling, prostitutionDo not convert drugs or services rendered to a Do not convert drugs or services rendered to a cash valuecash value

E17. Illegal?

•Cash obtained from drug dealing, stealing, selling stolen goods, Illegal gambling, prostitution, etc.

Do not count estimated cash value of drugs or other items obtained illegally


E18: Number of dependentsE18: Number of dependents

Must regularly depend on client for the majority of Must regularly depend on client for the majority of their supporttheir supportProbe for type of support and amount of moneyProbe for type of support and amount of moneyMake commentsMake commentsCrossCross--check with F4 check with F4 –– usual living arrangementsusual living arrangements

E18. How many people depend on you for the majority

of their food, shelter, etc.? • Must be regularly depending on patient, do include

alimony/child support, do not include the patient or self- supporting spouse, etc.


E19: Days of employment problemsE19: Days of employment problems

Employment problems include inability to find work, Employment problems include inability to find work, if looking, and problems jeopardizing current jobif looking, and problems jeopardizing current jobRephrase question based on prior informationRephrase question based on prior informationIf client hasnIf client hasn’’t had opportunity to work, code E19 = t had opportunity to work, code E19 = ““00””

E19. How many days have you experienced employment problems in the past 30 days? • Include inability to find work, if they are actively looking for

work, or problems with present job in which that job is jeopardized. • If the patient has been incarcerated or detained all of the

past 30 days, code "NN", they can’t have had problems


E20 & E21: Patient ratingsE20 & E21: Patient ratings

E20 E20 –– Refer to problems identified in E19Refer to problems identified in E19E21 E21 –– Asks about help preparing for a job Asks about help preparing for a job and onand on--thethe--job problems, not giving client job problems, not giving client a joba job

For Questions E20 & E21, ask the patient to use the Patient Rating scale. E20. How troubled or bothered have you been by these employment problems in the past 30 days? • If E19=N, code N E21. How important to you now is counseling for these employment problems?

• Stress help in finding or preparing for a job, getting training for a job, not giving them a job. Note: The patient is rating their need for employment/support Services, referrals, etc from your agency.






The The ““Final 3Final 3”” -- EmploymentEmployment

The The ““Final ThreeFinal Three”” convention does not convention does not apply to the Employment / Support apply to the Employment / Support section. section. OnlyOnly items E19 (days of problems) and items E19 (days of problems) and E20 (troubled / bothered rating) are linked. E20 (troubled / bothered rating) are linked. E21 is an independent rating of the E21 is an independent rating of the patientpatient’’s desire for assistance with s desire for assistance with employment issues.employment issues.


E19 E19 –– E21: Final 3E21: Final 3

E19 & E20 are E19 & E20 are linkedlinked

If E19 = If E19 = ““00””, then , then E20 = E20 = ““00””

E21 is coded E21 is coded independently of independently of E19 & E20bE19 & E20b

E19. How many days have you experienced employment problems in the past 30 days? • Include inability to find work, if they are actively looking for

work, or problems with present job in which that job is jeopardized. • If the patient has been incarcerated or detained all of the

past 30 days, code "NN", they can’t have had problems For Questions E20 & E21, ask the patient to use the Patient Rating scale. E20. How troubled or bothered have you been by these employment problems in the past 30 days? • If E19=N, code N E21. How important to you now is counseling for these employment problems?

• Stress help in finding or preparing for a job, getting training for a job, not giving them a job. Note: The patient is rating their need for employment/support Services, referrals, etc from your agency.


The Final 3 The Final 3 -- EmploymentEmployment

Therefore, a patient can be, for example, Therefore, a patient can be, for example, unemployed (with no days of problems, not unemployed (with no days of problems, not at all troubled or bothered), but they may at all troubled or bothered), but they may still request treatment or counseling for still request treatment or counseling for employment problems such as help finding employment problems such as help finding or preparing for a job.or preparing for a job.


E23 & E24: Confidence RatingsE23 & E24: Confidence Ratings

Remember Remember ““MisrepresentationMisrepresentation”” = proof that the = proof that the majority of the section has been misrepresentedmajority of the section has been misrepresentedMisrepresentation does not include Misrepresentation does not include ““denialdenial””Code Code ““inability to understandinability to understand”” if client is too if client is too intoxicated or cognitively impaired to understand intoxicated or cognitively impaired to understand questions, or if there is a language barrierquestions, or if there is a language barrier

CONFIDENCE RATINGS Is the above information significantly distorted by: E23. Patient's misrepresentation? 0-No 1-Yes

E24. Patient's inability to understand? 0-No 1-Yes

Transition to Drug & Transition to Drug & Alcohol SectionsAlcohol Sections


List of Commonly Used DrugsList of Commonly Used Drugs

Treatnet International List of Commonly Used Drugs

LIST OF COMMONLY USED DRUGS:

Alcohol: Beer, wine, liquor, grain (methyl alcohol)Heroin: Smack, H, Horse, Brown SugarMethadone: Dolophine, LAAMOpiates: Opium, Fentanyl, Buprenorphine, pain killers -

Morphine, Dilaudid, Demerol, Percocet, Darvon, etc.Barbiturates: Nembutal, Seconal, Tuinal, Amytal, Pentobarbital,

Secobarbital, Phenobarbital, Fiorinal, Doriden, etc.Sed/Hyp/Tranq: Benzodiazepines = Valium, Librium, Ativan, Serax

Tranxene, Dalmane, Halcion, Xanax, Miltown, Other = Chloral Hydrate, Quaaludes

Cocaine: Cocaine Crystal, Free-Base Cocaine, Crack, Rock, etc.Amphetamines/: Monster, Crank, Benzedrine, Dexedrine, Ritalin, Stimulants Preludin, Methamphetamine, Speed, Ice, Crystal, KhatCannabis: Marijuana, Hashish, Pot, Bango Igbo, Indian Hemp,

Bhang, Charas, Ganja, Mota, AnashaHallucinogens: LSD (Acid), Mescaline, Psilocybin (Mushrooms),

Peyote,PCP, MDMA, Ecstasy, Angel DustInhalants: Nitrous Oxide (Whippits), Amyl Nitrite (Poppers),

Glue, Solvents, Gasoline, Toluene, Etc.


Alcohol / Drug Use InstructionsAlcohol / Drug Use Instructions

ALCOHOL/DRUG USE INSTRUCTIONS: The following questions refer to two time periods: the past 30 days and lifetime. Lifetime refers to the time prior to the last 30 days. ⇒ 30 day questions only require the number of days used. ⇒ Lifetime use is asked to determine extended periods of regular use. ⇒ Regular use =

1. Three or more times per week 2. Binges 3. Problematic irregular use

⇒ Ask these questions with the following sentence stems - → “How many days in the past 30 have you used....?”

→ "How many years in your life have you regularly used....?"

D2. Alcohol to intoxication does not necessarily mean "drunk", use the words “to where you felt the effects", “got a buzz”, “high”, etc. instead of intoxication. As a rule, 3 or more drinks in one sitting, 4 or more drinks in one day for women (5 or more for men) is coded under “intoxication" to designate heavy drinking


Alcohol & Drug Grid: CodingAlcohol & Drug Grid: Coding

Past 30 days:Past 30 days:The number of days the client reports The number of days the client reports usingusing in the in the past month, regardless of amount of use.past month, regardless of amount of use.

LifetimeLifetime: : Code Extended Periods of Regular UseCode Extended Periods of Regular Use

Extended Periods: 6+ months in one yearExtended Periods: 6+ months in one yearRegular Use:Regular Use:

Three or more times per weekThree or more times per week ORORProblematic irregular use Problematic irregular use ORORBinge useBinge use


Routes of administrationRoutes of administration

1.1. OralOral Least SevereLeast Severe2.2. NasalNasal3.3. SmokingSmoking4.4. NonNon--IV InjectionIV Injection5.5. IV InjectionIV Injection Most SevereMost Severe

If client reports routinely utilizing two or more ROAs, code the most severe and note the alternate route(s) in your comments.


Alcohol Alcohol and Drug and Drug Use GridUse Grid


Coding D13: >1 Substance Per DayCoding D13: >1 Substance Per Day

Start with the highest Start with the highest number of days / years.number of days / years.For example: For example: ““I know you I know you said you used alcohol 15 of said you used alcohol 15 of the past 30 days and pot the past 30 days and pot on 20 of the past 30 days. on 20 of the past 30 days. Would you have used the Would you have used the alcohol and pot on the alcohol and pot on the same days?same days?””If so, count these days / If so, count these days / years in D13.years in D13.If not, do not include the If not, do not include the days/years in D13.days/years in D13.

1 5 1 00 5 1 00 0 0 00 0 0 01 0 0 50 0 0 00 0 0 0

0 0 0 00 0 0 02 0 1 50 0 0 00 0 0 015 1 0


D14a & D14b: Major ProblemsD14a & D14b: Major Problems

Interviewer determines problem substance Interviewer determines problem substance (not client)(not client)Code the number next to drug on gridCode the number next to drug on grid

(Example: Cocaine = 08 )(Example: Cocaine = 08 )

D14a. Identify the primary substance of abuse: D14b. Identify the secondary substance of abuse: • Interviewer should determine the primary and secondary drugs of abuse. Code the number next to the drug in questions 01-12


D15 & D16: AbstinenceD15 & D16: Abstinence

Refers to the drug / alcohol problem coded in D14a & bRefers to the drug / alcohol problem coded in D14a & bAsks Asks ““How long?How long?”” not not ““How long ago?How long ago?””Refers to most recent attempt, not longest period of abstinenceRefers to most recent attempt, not longest period of abstinenceTime in a controlled environment is not includedTime in a controlled environment is not includedIf D15 = 00, then D16 = NN. If still abstinent, then code D16 =If D15 = 00, then D16 = NN. If still abstinent, then code D16 = 0000

D15. How long was your most recent period of voluntary abstinence from these major substance(s)? Months

• Most recent sobriety lasting at least one month. Periods of hospitalization/incarceration do not count. Periods of antabuse, methadone, or naltrexone use do count.

• Code 00 = never abstinent.

D16. How many months ago did this abstinence end? • If D15 = 00, then D16 = NN. . • Code 00 = still abstinent. Months


D17: DTD17: DT’’s s

D17 D17 -- Define DTDefine DT’’s s –– they usually occur 24 they usually occur 24 -- 48 hours 48 hours after last drink or major decrease in drinking after last drink or major decrease in drinking Usually requires medical attention Usually requires medical attention Not just Not just ““the shakesthe shakes””>5 DT episodes very unlikely>5 DT episodes very unlikely

D17.∗ How many times have you had: Alcohol DT's? • Delirium Tremens (DT's): Occur 24-48 hours after last drink,

Or significant decrease in alcohol intake, shaking, severe disorientation, fever, hallucinations, they usually require medical attention.


D38 & 38a: Risky drug useD38 & 38a: Risky drug use

Intent – Assess medical risk associated with drug use

Code any use of needles, works, or other materials that could result in transmission of a virus

If any item D3 - D11 Route of Administration = 4 or 5 (injection) Past 30 days Lifetime D38. Have you ever used needles or works after someone else had used them? D38a. How many times in the past 30 days?

• If D38 past 30 days = 0, then D38a = N


D19a: Treatment historyD19a: Treatment history

D19a. How many times in your life have you been treated for Alcohol or Drug abuse? •Include detoxification, halfway houses, in/outpatient counseling, and AA (if 3+ meetings within one month period).

Include detox, halfway houses, and inpatient or outpatient Include detox, halfway houses, and inpatient or outpatient counselingcounselingInclude Alcoholics or Narcotics Anonymous (AA/NA) if the Include Alcoholics or Narcotics Anonymous (AA/NA) if the client attended 3 or more meetings / monthclient attended 3 or more meetings / monthDo not include needle exchange programsDo not include needle exchange programsOne continuous episode of care should be counted as One continuous episode of care should be counted as ““0101””

Example: if a client was in an inpatient setting and then Example: if a client was in an inpatient setting and then immediately moved to outpatient counseling, this is immediately moved to outpatient counseling, this is considered one continuous episode of careconsidered one continuous episode of care


D21a: Detox TreatmentD21a: Detox Treatment

““Detox onlyDetox only”” is not linked to any other treatmentis not linked to any other treatmentWe ask this so we can determine whether the client received We ask this so we can determine whether the client received any care outside of detox treatmentany care outside of detox treatment

If D19a = 00, then D21a = NNIf D19a = 00, then D21a = NNIf no treatment, then no If no treatment, then no detoxdetox, only treatment., only treatment.

D21a. How many of these treatments were detox only: • If D19a = "00", then question D21a is "NN" or Not Applicable • Note: Code the number of treatments listed in D19a that consisted only of Detoxification and no other treatment.


D23 & D24: Financial burdenD23 & D24: Financial burden

Must be actual money spent, not trades / barteringMust be actual money spent, not trades / barteringThe purpose of the question is to determine the The purpose of the question is to determine the amount of financial burden on the clientamount of financial burden on the client

Generally restricted to money spent on personal consumptionGenerally restricted to money spent on personal consumption

D23. How much would you say you spent during the past 30 days on alcohol? • Only count actual money spent. What is the financial burden

caused by alcohol? D24 How much would you say you spent during the past 30 days on drugs? • Only count actual money spent. What is the financial burden

caused by drugs?


D25: Outpatient treatmentD25: Outpatient treatment

Asks about the last Asks about the last 30 days30 days –– do not enter do not enter a number more than 30a number more than 30Include AA/NAInclude AA/NA

If attended more than one meeting in a day, still If attended more than one meeting in a day, still code as one daycode as one day

Must be outpatientMust be outpatient

D25. How many days in the past 30 have you been treated in an outpatient setting for alcohol or drugs in the past 30 days? • Include days attended AA/NA, other support groups, OP detox, methadone or treatment, etc.


D26,D28,D30 Alcohol: D26,D28,D30 Alcohol: ““Final 3Final 3””

These are the These are the ““Final ThreeFinal Three””questions for alcohol problemsquestions for alcohol problems

D26. How many days in the past 30 have you experienced

Alcohol problems? • Include: Craving, withdrawal symptoms, disturbing effects of use, or wanting to stop and being unable to. For Questions D28+D30, ask the patient to use the Patient Rating scale. The patient is rating the need for additional substance abuse treatment. D28. How troubled or bothered have you been in the past 30 days by these alcohol problems? D30. How important to you now is treatment for these

alcohol problems?


D27,D29,D31 Drug: D27,D29,D31 Drug: ““Final 3Final 3””

These are the These are the ““Final ThreeFinal Three””questions for drug problems.questions for drug problems.

D27. How many days in the past 30 have you experienced: . Drug problems? • Include: Craving, withdrawal symptoms, disturbing effects of

use, or wanting to stop and being unable to. For Questions D29+D31, ask the patient to use the Patient Rating scale. The patient is rating the need for substance abuse treatment. D29. How troubled or bothered have you been in the past 30 days

by these drug problems?

D31. How important to you now is treatment for these drug problems?


D28 D28 –– D31: Patient / Client Rating scaleD31: Patient / Client Rating scale




The Final 3 The Final 3 –– Alcohol / DrugAlcohol / Drug

D26/27: D26/27: ““How many days in the past 30 have How many days in the past 30 have you experienced alcohol / drug problems?you experienced alcohol / drug problems?””

D28/29: D28/29: ““How troubled or bothered have you How troubled or bothered have you been in the past 30 days by these alcohol / drug been in the past 30 days by these alcohol / drug problems?problems?””

D30/31: D30/31: ““How important to you now is How important to you now is treatment for these alcohol / drug problems?treatment for these alcohol / drug problems?””


The Final 3 Scoring The Final 3 Scoring –– AlcoholAlcohol

If D26 = 0, thenIf D26 = 0, thenD28 = 0 andD28 = 0 and

D30 should be 0.D30 should be 0.

If D26 > 0, thenIf D26 > 0, thenD28 > 0, and D28 > 0, and

D30 can be any number.D30 can be any number.


The Final 3 Scoring The Final 3 Scoring –– DrugDrug

If D27 = 0, thenIf D27 = 0, thenD29 = 0 andD29 = 0 andD31 should be 0.D31 should be 0.

If D27 > 0, thenIf D27 > 0, thenD29 > 0, and D29 > 0, and D31 can be any number.D31 can be any number.


D34 & D35: Drug & Alcohol Confidence RatingsD34 & D35: Drug & Alcohol Confidence Ratings

Remember: Misrepresentation = you have Remember: Misrepresentation = you have legitimate proof that the majority of the legitimate proof that the majority of the section has been misrepresentedsection has been misrepresentedThis does not include This does not include ““denialdenial””!!

CONFIDENCE RATINGS Is the above information significantly distorted by: D34. Patient's misrepresentation? 0-No 1-Yes

D35. Patient's inability to understand? 0-No 1-Yes


D36: Quit without treatment?D36: Quit without treatment?

Code the number of times the patient Code the number of times the patient has tried to quit using drugs or alcohol has tried to quit using drugs or alcohol without treatment. without treatment.

This would include any attempt at This would include any attempt at behavior change with or without behavior change with or without support groups.support groups.

D36. How many times have you tried to quit using substances without treatment?


D37: NicotineD37: Nicotine

D37. NicotineLifetime Past 30 Days Route (years) of Admin

1.1. Oral / Chew Oral / Chew 2.2. Nasal Nasal 3.3. Smoking Smoking 4.4. NonNon--IV injection IV injection 5.5. IVIV

Code the same way Code the same way the Drug & Alcohol the Drug & Alcohol grid is coded.grid is coded.


D39aD39a--e: Motivation questionse: Motivation questions

Intent Intent –– Assess motivation for decreasing Assess motivation for decreasing drug or alcohol use. Note: This is not drug or alcohol use. Note: This is not assessing motivation for treatment.assessing motivation for treatment.

D39. Using the patient rating scale, how would you rate your level of agreement with the following statements?

a. I am ready to decrease my drinking.

b. I am ready to decrease my drug use.

c. I believe I can manage my alcohol use.

d. I believe I can manage my drug use.

e. I know I have a drinking or drug problem and I am motivated to work on it!

Addiction Severity Index Addiction Severity Index (ASI)(ASI)


TreatnetTreatnet ASI Workshop 3 ASI Workshop 3

The ASI: Administering and CodingThe ASI: Administering and CodingLegal SectionLegal SectionFamily SectionFamily Section

Transition Transition to Legal to Legal SectionSection


Introduction to the Legal SectionIntroduction to the Legal Section

Legal HistoryLegal History

Information About Information About Probation & ParoleProbation & Parole

Charges, Convictions, & Charges, Convictions, & IncarcerationsIncarcerations

Illegal ActivitiesIllegal Activities

Desire, Need for Legal Desire, Need for Legal CounselCounsel


L1 & L2: Current Criminal Justice InvolvementL1 & L2: Current Criminal Justice Involvement

Intent: Intent: To determine the relationship between To determine the relationship between the clientthe client’’s treatment status and their s treatment status and their criminal justice status.criminal justice status.

LEGAL STATUS L1. Was this admission prompted or suggested by the criminal justice system? 0 - No 1 -Yes L2. Are you on parole or probation? 0 - No 1 - Yes • Note duration and level in comments.


L3 L3 –– L16: Criminal ChargesL16: Criminal Charges

The client must The client must be arrested and be arrested and officially officially charged.charged.

Juvenile charges Juvenile charges are not includedare not included


L17: Criminal ConvictionsL17: Criminal Convictions

What is a conviction?What is a conviction?Includes guilty pleas, parole / probation Includes guilty pleas, parole / probation violationsviolationsIf given a fine, probation, suspended sentence If given a fine, probation, suspended sentence or incarceration, there was a convictionor incarceration, there was a conviction

L17∗ How many of these charges resulted in convictions? • If L3-16 = 00, then question L17 = "NN". • Do not include misdemeanor offenses from questions L18-20

below. • Convictions include fines, probation, incarcerations, suspended sentences, guilty pleas, and plea bargaining.


L18 L18 –– L20: Other ChargesL20: Other Charges

Relate to public annoyance crimesRelate to public annoyance crimesExplain Explain ““major driving violationsmajor driving violations”” and provide and provide examplesexamplesIf drivingIf driving--related problems donrelated problems don’’t apply to your t apply to your country, code country, code ““00””

How many times in your life have you been charged with the following: L18. Disorderly conduct, vagrancy, public intoxication?

L19. Driving while intoxicated?

L20. Major driving violations? • Moving violations: speeding, reckless driving, no license, etc.


L21: Months IncarceratedL21: Months Incarcerated

Record total number of months spent in prison or Record total number of months spent in prison or detention centre since the age of 18detention centre since the age of 18Coding Issues:Coding Issues:

DO NOTDO NOT record number of overnight record number of overnight incarcerationsincarcerations

L21. How many months were you incarcerated in your life?

• If incarcerated 2 weeks or more, round this up Months to 1 month. List total number of months incarcerated.


L24 & L25: Current CJS InvolvementL24 & L25: Current CJS Involvement

L24 & L25: IntentL24 & L25: Intent

Evaluate current involvement with Evaluate current involvement with Criminal Justice System (CJS) and Criminal Justice System (CJS) and how it might impact current treatment.how it might impact current treatment.

L24. Are you presently awaiting charges, trial, or sentencing? 0 - No 1 - Yes

L25. What for? • Use the number of the type of crime committed

03-16 and 18-20 in previous questions. • Refers to Q. L24. If L24=No, code NN.

If awaiting on more than one charge, choose most severe.


L26 & L27: L26 & L27: Incarcerations and illegal activitiesIncarcerations and illegal activities

L26 & L27: Intent L26 & L27: Intent

Evaluate very recent illegal activity Evaluate very recent illegal activity and detainment.and detainment.

L26. How many days in the past 30, were you detained or incarcerated?

• Include being arrested and released on the same day. L27. How many days in the past 30 have you engaged

in illegal activities for profit? • Exclude simple drug possession. Include drug dealing,

prostitution, selling stolen goods, etc. May be cross checked with Employment Question E17.






L 28 & L29: L 28 & L29: Client ratings of legal problemsClient ratings of legal problems

For Questions L28-29, ask the patient to use the Patient Rating scale. L28. How serious do you feel your present legal problems are? • Exclude civil problems, such as divorce, etc. L29. How important to you now is counseling or referral

for these legal problems?

• NOTE: Patient is rating need for referral (or services) from your agency to legal counsel for defense against criminal charges.

Patient Ratings: Note, rating is generally Patient Ratings: Note, rating is generally low unless there is need for legal counsel!low unless there is need for legal counsel!


The The ““Final 3Final 3”” –– Legal?Legal?

L26: L26: ““How many days in the past 30 were you How many days in the past 30 were you detained or incarcerated?detained or incarcerated?””

L27: L27: ““How many days in the past 30 have you How many days in the past 30 have you engaged in illegal activities for profit?engaged in illegal activities for profit?””

L28: L28: ““How serious do you feel your present How serious do you feel your present legal problems are?legal problems are?””

L29: L29: ““How important to you now is counseling How important to you now is counseling or referral for these legal problems?or referral for these legal problems?””


No real Final 3 in the legal sectionNo real Final 3 in the legal section

Note: A patient can report no days Note: A patient can report no days incarcerated or engaged in illegal incarcerated or engaged in illegal activity for profit in the past 30, but activity for profit in the past 30, but they may still request counseling or they may still request counseling or referral for legal problems that referral for legal problems that occurred in prior months.occurred in prior months.


The final scoring The final scoring –– LegalLegal

L26 and L27 are not necessarily L26 and L27 are not necessarily linked to L28 and L29linked to L28 and L29Note that patient is rating need for Note that patient is rating need for legal referral or services from your legal referral or services from your agency related to problems with agency related to problems with current criminal charges.current criminal charges.


L 31 & L32: Confidence RatingsL 31 & L32: Confidence Ratings

Remember: Misrepresentation = you have Remember: Misrepresentation = you have legitimate proof the section has been legitimate proof the section has been misrepresentedmisrepresented

CONFIDENCE RATINGS

Is the above information significantly distorted by: L31. Patient's misrepresentation? 0 - No 1- Yes L32. Patient's inability to understand? 0 - No 1 - Yes



Comments?Comments?

? ? ?

Transition to Transition to Family/Social Family/Social

StatusStatus


Family Social / StatusFamily Social / Status

This section examines the nature of the This section examines the nature of the clientclient’’s personal relationships and s personal relationships and marital and living status marital and living status Determines if the client has relationship Determines if the client has relationship problems with family, friends, or othersproblems with family, friends, or othersDocuments the clientDocuments the client’’s satisfaction with s satisfaction with their current statustheir current status


Example: Example: ““What is your present marital status?What is your present marital status?””““Are you currently married?Are you currently married?””““Is this your first marriage?Is this your first marriage?””

F1 F1 –– F3: Marital StatusF3: Marital Status

FAMILY/SOCIAL STATUS F1. Marital Status: 1-Married 3-Widowed 5-Divorced 2-Remarried 4-Separated 6-Never Married • Common-law marriage = 1. Specify in comments.

F3. Are you satisfied with this situation? • Satisfied = generally liking the situation. • Refers to Questions F1 & F2. 0-No 1-Indifferent 2-Yes


F6 asks if the patient was satisfied during the F6 asks if the patient was satisfied during the time living in category selected (even if not time living in category selected (even if not current)current)If F4 is split, then code for the most recent living If F4 is split, then code for the most recent living arrangements in the past 3 yearsarrangements in the past 3 years

F4 & F6: Living arrangementsF4 & F6: Living arrangements

F4. Usual living arrangements (past 3 years): 1-With partner & children 6-With friends 2-With partner alone 7-Alone 3-With children alone 8-Controlled Environment 4-With parents 9-No stable arrangement 5-With family

• Choose arrangements most representative of the past 3 years

F6. Are/were you satisfied with these arrangements? 0-No 1-Indifferent 2-Yes


F4a documents most recent living arrangementsF4a documents most recent living arrangementsUse codes from F4Use codes from F4

F4a: Living arrangementsF4a: Living arrangements

F4a. Living arrangements past 30 days? (Use codes above)


F7 & F8: Living with others who useF7 & F8: Living with others who use

Code where the client will be returning to, (if Code where the client will be returning to, (if they are in inpatient treatment) or their current they are in inpatient treatment) or their current living situation (if in outpatient)living situation (if in outpatient)

Do not include institutionsDo not include institutions

Do you live with anyone who: F7. Has a current alcohol problem? 0-No 1-Yes

F8 Uses non-prescribed drugs? 0-No 1-Yes

(or abuses prescribed drugs)


F9 & F10: Free timeF9 & F10: Free time

F9. With whom do you spend most of your free time? 1-Family 2-Friends 3-Alone

F10. Are you satisfied with spending your free time this way ? 0-No 1-Indifferent 2-Yes • A satisfied response must indicate that the person generally likes the situation. Refers to Question F9.

Code anyone the client views as a part of Code anyone the client views as a part of their family as their family as ““Family.Family.”” They do not need They do not need to be a blood relative or spouse.to be a blood relative or spouse.


F11a: Close friendsF11a: Close friends

F11a. Stress that you mean F11a. Stress that you mean closeclose. Exclude . Exclude family members. family members. These are "reciprocal" relationships or These are "reciprocal" relationships or mutually supportive relationships. mutually supportive relationships. ““They They would help you move, get to treatment, and would help you move, get to treatment, and you would help them. You can tell them you would help them. You can tell them personal things about yourself, and they personal things about yourself, and they would do the same, etc.would do the same, etc.””

F11a. How many of your close friends use drugs or abuse alcohol? Note: If patient has no close friends, code “N”


F18 F18 –– F26: Problems getting alongF26: Problems getting along

Have you had significant periods in which you have experienced serious problems getting along with: 0 – No, 1 - Yes Past 30 days In Your Life F18. Mother

F19. Father

F20. Brother/Sister

F21. Partner/Spouse

F22. Children

F23. Other Significant Family (specify)_________________________

F24. Close Friends

F25. Neighbors

F26. Co-workers • "Serious problems" mean those that endangered the relationship. • A "problem" requires contact of some sort, either by telephone or in person. If no contact code “N” If no relative (ex: no children) Code N.


F18 F18 –– F26: Coding InstructionsF26: Coding Instructions

““SignificantSignificant”” periods for lifetime!periods for lifetime!Past 30 days, if client has no contact but has Past 30 days, if client has no contact but has lifetime history of problems getting along with lifetime history of problems getting along with them; Last 30 days = them; Last 30 days = ““NN””, Lifetime = , Lifetime = ““1.1.””Contact in past 30 days means by phone, mail, eContact in past 30 days means by phone, mail, e--mail, or in person. If no contact, code mail, or in person. If no contact, code ““N.N.””F23. Must have had a significant relationship with F23. Must have had a significant relationship with this person and specify!this person and specify!F24. If F11a = 0, then F24 = 0.F24. If F11a = 0, then F24 = 0.F26. If unemployed for past 30 days, F26 = N.F26. If unemployed for past 30 days, F26 = N.


F28 F28 –– F29: Abuse historyF29: Abuse history

Has Has anyoneanyone ever abused you, not just ever abused you, not just family or friendsfamily or friendsBe sensitive. Rephrase the questions Be sensitive. Rephrase the questions using the hintsusing the hintsDonDon’’t probe extensively if you are not the t probe extensively if you are not the clientclient’’s treating clinicians treating clinician

FAMILY/SOCIAL (cont.) Has anyone ever abused you? 0- No 1-Yes Past 30 days In Your Life F28. Physically? • Caused you physical harm. F29. Sexually? • Forced any sexual advances/acts.






F30, 32, 34: F30, 32, 34: ““Final 3Final 3”” family problemsfamily problems

““Days of conflictDays of conflict””refers to more refers to more immediate immediate confrontational confrontational actions; yelling, actions; yelling, fighting, physical, fighting, physical, or verbal abuse or verbal abuse and loss of and loss of control. control.

How many days in the past 30 have you had serious conflicts: F30. With your family? Ask the patient to use the Patient Rating scale: How troubled or bothered have you been in the past 30 days by: F32. Family problems? How important to you now is treatment or counseling for these: F34. Family problems • Patient is rating his/her need for counseling for family problems, not whether they would be willing to attend .

Note: The patient is rating their need for you/your program to provide or refer them to family services, above and beyond any services they may already be getting.

You are rating importance of treatment for family You are rating importance of treatment for family problems, not whether family will attend.problems, not whether family will attend.


F31, 33, 35: F31, 33, 35: ““Final 3Final 3”” social problemssocial problems

““Days of conflictDays of conflict”” also also refers to confrontational refers to confrontational actions, such as yelling, actions, such as yelling, fighting, physical/verbal fighting, physical/verbal abuse, and loss of abuse, and loss of control.control.F33. Refers to social F33. Refers to social problems that are problems that are defined by ASI questions defined by ASI questions not related to family.not related to family.F31F31--F35. Include F35. Include feelings of loneliness, feelings of loneliness, dissatisfaction with dissatisfaction with friends, etc.friends, etc.

How many days in the past 30 have you had serious conflicts:F31. With other people (excluding family)?

Ask the patient to use the Patient Rating scale:

How troubled or bothered have you been in the past 30 days by:F33. Social problems?

How important to you now is treatment or counseling for these:F35. Social problems

• Include patient's need to seek treatment for such social problems as loneliness, inability to socialize, anddissatisfaction with friends. Patient rating should refer todissatisfaction, conflicts, or other serious problems.

Note: The patient is rating their need for you/your program to provide or refer them to these types of services, above and beyond treatment they may already be getting somewhere else.


The Final 3 The Final 3 –– Family / supportFamily / support

The The ““Final ThreeFinal Three”” convention does not apply convention does not apply to this section. to this section. Unlike Medical, D / A, and Psychiatric, the Unlike Medical, D / A, and Psychiatric, the Family / Social questions on Family / Social questions on ““days of days of problemsproblems”” are limited to days of are limited to days of ““serious serious conflicts.conflicts.””As a result, it would seem inappropriate to As a result, it would seem inappropriate to limit a patientlimit a patient’’s rating for treatment simply s rating for treatment simply because they had no because they had no ““serious conflicts.serious conflicts.””


The Final 3 The Final 3 –– Family / supportFamily / support

The patient rating items for Family / Social, The patient rating items for Family / Social, F32/F34 and F33/35 are independent of the days F32/F34 and F33/35 are independent of the days of conflict items and can refer to of conflict items and can refer to anyany problem(s) problem(s) reported throughout the section. reported throughout the section. Therefore, someone may not have had Therefore, someone may not have had ““serious serious conflictsconflicts”” in the past 30 days, but might be in the past 30 days, but might be troubled or bothered and / or want treatment or troubled or bothered and / or want treatment or counseling for other family problems. counseling for other family problems.


F37 F37 -- F38: Confidence RatingsF38: Confidence Ratings

Did the client overtly give false information that you Did the client overtly give false information that you caught and asked about?caught and asked about?Did the client cognitively understand your questions?Did the client cognitively understand your questions?Coding Coding ““YesYes”” will negate entire Family / Social section.will negate entire Family / Social section.

CONFIDENCE RATING

Is the above information significantly distorted by: F37. Patient's misrepresentation? 0-No 1-Yes

F38. Patient's inability to understand? 0-No 1-Yes


F39 & F39a: ChildrenF39 & F39a: Children

F39 Intent: To determine the number of F39 Intent: To determine the number of children and their living situation.children and their living situation.Assists in evaluating family and support Assists in evaluating family and support issues. issues.

Living Living

with you outside your home F39. How many children do you have? F39a. How many of these are under age 18

The ASI: Administering and CodingThe ASI: Administering and CodingPsychiatric SectionPsychiatric SectionReviewReviewCompetency MeasuresCompetency Measures


Transition to Transition to Psychiatric Psychiatric

SectionSection


Psychiatric SectionPsychiatric Section

This section is used to This section is used to determine determine symptomssymptoms of of psychological and emotional psychological and emotional distress; not provide a distress; not provide a diagnosis.diagnosis.Symptoms associated Symptoms associated exclusivelyexclusively with results of with results of ingesting a drug (i.e. ingesting a drug (i.e. hallucinating on acid) or hallucinating on acid) or detoxification (detoxification (““II’’m anxious m anxious when I when I detoxdetox..””) ) should notshould not be be recorded.recorded.


Psychiatric section: IntentPsychiatric section: Intent

To determine longTo determine long--term and recent term and recent psychological and emotional functioningpsychological and emotional functioningTo document current and past history of To document current and past history of treatment treatment To explore the potential for the need for further To explore the potential for the need for further evaluation or referralevaluation or referral

Mood disordersMood disordersAnxiety disordersAnxiety disordersThought disorders, etc.Thought disorders, etc.


P1P1––P2: Prior Psychological TreatmentP2: Prior Psychological Treatment

Include treatment for any psychiatric Include treatment for any psychiatric problems; problems; DO NOTDO NOT include substance include substance abuse, employment, or family counseling.abuse, employment, or family counseling.

PSYCHIATRIC STATUS How many times have you been treated for any psychological or emotional problems: P1∗ In a hospital or inpatient setting? P2∗ Outpatient/private patient? • Do not include substance abuse, employment,

or family counseling. • Treatment episode = a series of continuous visits or treatment days, not the number of visits.


P3: Financial support for psychiatric disabilityP3: Financial support for psychiatric disability

Coding Issues: Only record pensions Coding Issues: Only record pensions received for psychological disorders / received for psychological disorders / disabilities; pensions for disorders such as disabilities; pensions for disorders such as a heart condition should be recorded in the a heart condition should be recorded in the Medical SectionMedical Section

If a client does not know the disorder for If a client does not know the disorder for which they receive the pension, code which they receive the pension, code ““XX””

P3. Do you receive financial support for a psychiatric disability? Can be from government or employer, etc. 0-No 1-Yes


P4 P4 –– P7: Psychological symptomsP7: Psychological symptoms

Have you had a significant period of time (that was not a direct result of alcohol/drug use) in which you have: 0-No 1-Yes Past 30 Days Lifetime P4. Experienced serious depression- sadness, hopelessness, loss of interest?

P5. Experienced serious anxiety/tension uptight, unreasonably worried, inability to feel relaxed?

P6. Experienced hallucinations-saw things/ heard voices that others didn’t see/hear? Code other psychotic symptoms here also.

P7. Experienced trouble understanding, concentrating, or remembering?


P4 P4 –– P7: Psychological symptomsP7: Psychological symptoms

Describe the symptomsDescribe the symptomsAsk about serious symptoms over lifetime Ask about serious symptoms over lifetime first, then ask about the past 30 daysfirst, then ask about the past 30 daysLifetime coding symptom Lifetime coding symptom >> 2 weeks 2 weeks

NoteNote: P6 is of sufficient importance that : P6 is of sufficient importance that even its brief existence should be even its brief existence should be recorded recorded

Past 30 days code Past 30 days code ““11--yesyes”” if the client has if the client has experienced the symptom experienced the symptom at allat allCode other psychotic symptoms in P6Code other psychotic symptoms in P6


P8: Psychological SymptomsP8: Psychological Symptoms

Coding Issues:Coding Issues:Due to the severity of the symptom, code even Due to the severity of the symptom, code even if it happened only once in the lifetime sectionif it happened only once in the lifetime sectionFurther, code even if the patient was under the Further, code even if the patient was under the influence of drugs and / or alcohol, or suffering influence of drugs and / or alcohol, or suffering from withdrawal at the time of the symptom.from withdrawal at the time of the symptom.

Have you had a significant period of time (regardless of alcohol and drug use) in which you have:

0-No 1-Yes Past 30 Days Lifetime P8. Experienced trouble controlling violent behavior including episodes of rage, or violence?


P9 & P10: Suicidal ideologyP9 & P10: Suicidal ideology

If a client endorses serious thoughts of If a client endorses serious thoughts of suicide:suicide:

Ask how recently the client has seriously Ask how recently the client has seriously considered suicide, or attempted suicideconsidered suicide, or attempted suicideAsk details of the suicide plan (i.e., Ask details of the suicide plan (i.e., ““How were How were you going to commit suicide?you going to commit suicide?””))

P9. Experienced serious thoughts of suicide? • Patient seriously considered a plan for

taking his/her life.

P10. Attempted suicide? • Include actual suicidal gestures or

attempts.


P11: Prescription medicationsP11: Prescription medications

P11. Has a health care provider recommended you take any medications for psychological or emotional problems? • Recommended for the patient by a physician or other health care provider as appropriate. Record "Yes" if a medication was recommended even if the patient is not taking it.

DonDon’’t include temporary medicationst include temporary medicationsEmphasiseEmphasise ““prescribed for youprescribed for you””


P12: Days of problemsP12: Days of problems

Note:Note: Use the symptom the patient reports Use the symptom the patient reports having problems with, not simply the term having problems with, not simply the term ““psychological problems.psychological problems.””

For example:For example: ““Mr. Smith, you mentioned Mr. Smith, you mentioned that you were experiencing depression, that you were experiencing depression, could you tell me how many days in the could you tell me how many days in the past 30 days you felt depressed?past 30 days you felt depressed?””

P12. How many days in the past 30 have you experienced these psychological or emotional problems?

• This refers to problems noted in Questions P4-P10.


The The ““Final 3Final 3”” -- PsychiatricPsychiatric

P12: P12: ““How many days in the past 30 have you How many days in the past 30 have you experienced these psychological or emotional experienced these psychological or emotional problems?problems?””P13: P13: ““How much have you been troubled or How much have you been troubled or bothered by these psychological or emotional bothered by these psychological or emotional problems in the past 30 days?problems in the past 30 days?””P14: P14: ““How important to you now is treatment How important to you now is treatment for these psychological or emotional for these psychological or emotional problems?problems?””






P12 P12 –– P14: Psych Final 3P14: Psych Final 3

P12 refers to symptoms mentioned in P4P12 refers to symptoms mentioned in P4--P10P10P12 must be >0 if any past 30P12 must be >0 if any past 30--day item in P4day item in P4--P10 > 0.P10 > 0.


• This refers to problems noted in Questions P4-P10. For Questions P13-P14, ask the patient to use the Patient Rating scale P13. How troubled or bothered have you been by these

psychological or emotional problems in the past 30 days? • Patient should be rating the problem days from Question P12.

P14. How important to you now is treatment for these psychological or emotional problems? Note: The patient is rating their need for you/your program to provide or refer them to psychological/psychiatric services, above and beyond treatment they may already be getting somewhere else.


P12 P12 –– P14: Psych Final 3P14: Psych Final 3

For P14, stress that For P14, stress that ““treatmenttreatment”” does not necessarily does not necessarily mean going to a psychiatric ward or being put on mean going to a psychiatric ward or being put on medication.medication.


• This refers to problems noted in Questions P4-P10. For Questions P13-P14, ask the patient to use the Patient Rating scale P13. How troubled or bothered have you been by these

psychological or emotional problems in the past 30 days? • Patient should be rating the problem days from Question P12.

P14. How important to you now is treatment for these psychological or emotional problems? Note: The patient is rating their need for you/your program to provide or refer them to psychological/psychiatric services, above and beyond treatment they may already be getting somewhere else.


Final 3 Scoring Final 3 Scoring -- PsychiatricPsychiatric

If P12 = 0, thenIf P12 = 0, thenP13 = 0 andP13 = 0 andP14 should be 0.P14 should be 0.

If P12 > 0, thenIf P12 > 0, thenP13 > 0, and P13 > 0, and P14 can be any number.P14 can be any number.


Psychiatric diagnosisPsychiatric diagnosis

Specify the patientSpecify the patient’’s diagnosis in the s diagnosis in the PSYCHIATRIC STATUS COMMENTS area if PSYCHIATRIC STATUS COMMENTS area if known.known.______________________________________________________________________________Specify Diagnoses if known:Specify Diagnoses if known:____________________________________________________________________________________________________________________________________________________________


P22 & P23: Confidence RatingsP22 & P23: Confidence Ratings

Did the client overtly give false information Did the client overtly give false information that you caught and asked about?that you caught and asked about?Did the client cognitively understand your Did the client cognitively understand your questions?questions?

CONFIDENCE RATING

Is the above information significantly distorted by: P22 Patient's misrepresentation? 0-No 1-Yes

P23. Patient's inability to understand? 0-No 1-Yes


G12: G12: ““Special CodesSpecial Codes””

Code Code ““11”” if the interviewer terminated the session if the interviewer terminated the session for any reason (e.g., feeling threatened by client)for any reason (e.g., feeling threatened by client)Code Code ““22”” if the client refused to complete the if the client refused to complete the interviewinterviewCode Code ““NN”” if the interview was completedif the interview was completed

G12. Special Code - If ASI is not completed: 1. Interview terminated by interviewer 2. Patient refused to finish interview 3. Patient unable to respond (language or intellectual barrier, under the influence, etc. ) Code “N” if Interview completed.


G50: Expected Treatment ModalityG50: Expected Treatment Modality

G50. Expected Treatment Modality:G50. Expected Treatment Modality:1=Outpatient (<5 hours per week)1=Outpatient (<5 hours per week)2=Intensive Outpatient (2=Intensive Outpatient (≥≥ 5 hours per week)5 hours per week)3=Residential/Inpatient3=Residential/Inpatient4=Therapeutic Community4=Therapeutic Community5=Half5=Half--way houseway house6=Detox 6=Detox –– Inpatient (typically 3 Inpatient (typically 3 –– 7 days)7 days)7=Detox Outpatient/Ambulatory7=Detox Outpatient/Ambulatory8=Opioid Replacement, OP (Methadone, 8=Opioid Replacement, OP (Methadone, Buprenorphine, etc)Buprenorphine, etc)9=Other (low threshold, GP, spiritual healers, etc.) 9=Other (low threshold, GP, spiritual healers, etc.) Specify_________________________________________Specify_________________________________________


WrapWrap--up interviewup interview

Importance of wrapImportance of wrap--upupAcknowledge clientAcknowledge client’’s time & works time & workSummariseSummarise clientclient’’s strengths and assets, s strengths and assets, and discuss treatment needsand discuss treatment needsClientClient’’s next stepss next steps……


Finalize the ASIFinalize the ASI

Review ASI for completeness Review ASI for completeness Leave no empty boxesLeave no empty boxesAdd additional commentsAdd additional commentsWhen possible, a psychiatric evaluation is When possible, a psychiatric evaluation is always desirable in addition to the ASIalways desirable in addition to the ASI



Comments?Comments?

? ? ?


PostPost--assessmentassessment

Please respond to the postPlease respond to the post--assessment assessment questions in your workbook.questions in your workbook.

(Your responses are strictly confidential.)(Your responses are strictly confidential.)

20 Min.

Thank you for your time!Thank you for your time!

End of Workshop 4End of Workshop 4