Ppt. Assessment Of Drug Abuse PDF

Ppt. ASSESSMENT Lecture 5: Assessment of drug abuse **Key areas of assessment:** - Problematic substance - Intoxication and/or withdrawal - Biomedical conditions - Emotional/psychiatric conditions - Motivation phase (transtheoretical model) - Resistance to treatment - Previous...

Ppt. ASSESSMENT Lecture 5: Assessment of drug abuse **Key areas of assessment:** - Problematic substance - Intoxication and/or withdrawal - Biomedical conditions - Emotional/psychiatric conditions - Motivation phase (transtheoretical model) - Resistance to treatment - Previous treatments - Potential for relapse - Medical evaluation **Assessment process:** - Includes clinical interviews, personal history, self-reports, lab tests, and additional reports as needed Reliability = the consistency of the instrument (test re-test method) Validity = whether the instrument accurately assesses the condition it is designed to - Whilst most instruments used are generally reliable and valid, their effectiveness may vary depending on specific contexts **Main evaluation techniques:** - Interview (covers all necessary aspects and establishes a good relationship) - Tests and self-reports - Observation (to observe the set of behaviours and skills the individual possesses) - Objective assessment tests (serve as a stimulus to maintain abstinence -- e.g. urine, blood, hair, sweat, saliva) - Third-party reports (when we need to ask another person about the patient -- e.g. previous doctor, psychiatrist, social worker) Structured interview = where the interviewer follows a rigid script, and each is asked in the same manner with no deviations Semi-structured interview = follow a basic script but allow for some flexibility where additional topics can arise and wording of questions can be modified **Addiction Severity Interview \[ASI\]:** Europ-ASI; McLellan et al (1980) - Semi-structured interview - Provides information on the patient's life about things related to their substance abuse - Evaluates 6 areas 1. General medical condition 2. Employment and financial status 3. Alcohol and drug use 4. Legal problems 5. Fam and social problems 6. Mental health **Questionnaires:** - Gather data in patients' behaviour, consumption habits and the consequences they've faced due to the addiction - E.g. Berman et al (2005): DUDIT (11 item, self-administrated) - For alcohol: CAGE and AUDIT - For nicotine: FTND, AAIST - For cannabis: CAST **Europe-ASI and case study:** - A semi-structured interview designed to collect key information about aspects of the client's life that may contribute to sub abuse disorders - Develops a client profile that will be used by clinical and research staff - Evaluates 7 problem areas: - Medical, Employment/support, Alcohol, Drugs, Legal, Family, Psychiatric **Important points:** - To begin, explain the purpose of the interview to the client (ensure confidentiality) - Uses a 5-point scale where patients must rate severity of their problems - Also rates importance of treatment on a 0-4 scale (not at all, extremely - Follow up interviews must be conducted at least one month after the initial interview - Ensure patients understand all questions, if the patient has difficulty, interview should be rescheduled - Evaluate whether the information provided is distorted by client misinformation or inability to understand -- document any discrepancies or inconsistencies and clarify them during the interview **Severity ranges:** - 0-1 = no real problem - 2-3 = mild - 4-5 = moderate - 6-7 = considerate - 8-9 = extreme problem **Considerations:** - Incarceration or inpatient treatment = adjust the assessment period - Inaccurate representation = disregard questionable data and document anomalies - Poor understanding = terminate the interview **Rating:** - Interviewers rating is based on responses to objective items - Interviewer relies on subjects' responses to subjective items (on the 5 point scale) - Higher scores indicate greater severity **Two types of scores are provided for each scale:** - Estimated rating by the evaluator \[ERE\] = ranging from 0-9 - Composite score \[CS\] = derived from the weighted sum of selected items within each scale [Lecture 6: Functional Analysis] **Introduction:** - Behaviour analysis suggests behaviour is systematic and determined - The unction of behaviour is assessed by examining the functional relationship between behaviour and its immediate and long-term effects - Behaviour is understood as an interaction between the individual and their environment rather than an isolated action - External conditions are significant and must be managed to facilitate change **Behavioural processes are categorised into two types:** - Respondent/reflexive = automatic (do not require conscious learning) and involuntary (physical or emotional responses that occur automatically - Operant = voluntary (requires a learning process and decision making) and controlled by consequences (reinforcement/punishment) **Three-term contingency: Focuses on the relationship between...** - The antecedent context (circumstance associated with SU) - The organism's response - The consequent stimuli that alter the future probability of the behaviour - Substance use is a behaviour influenced by biogenetic and psychosocial factors - Understanding its function allows for prediction and control - To address dependency issues, we must identify and manage the involved variables, using functional analysis as a key tool in clinical assessment and treatment **Functional analysis:** - Behavioural evaluation is crucial in clinical case formulation and behavioural therapy - Systematically assesses environmental factors in the context of behaviours - Essential for understanding addictive behaviours as it informs treatment - Mental health professionals use this approach to tailor treatment plans to meet their needs **Objectives of FA:** - Identify high-risk behaviours that could lead to relapse - Provide valuable information about triggers and problematic areas - Enable the creation of more effective and personalised treatment plans - Help individuals learn and develop tools to prevent relapse - Substitute negative behaviours with positive ones **Reinforcers and treatment elements:** - Psychoactive substances can act as reinforcers, increasing the likelihood of use - This can lead to long-term negative effects - Identifying reinforcing and punitive elements helps us understand the relationship with the substance and factors that sustain use **Behavioural modification:** - The 5Ws are key questions in functional analysis to modify contingencies responsible for drug use and teach healthier behaviours