Summary: Goal Attainment Scaling

Contact between an addictions counsellor and a client is usually initiated by the client referring him/her self, an outside agency refers them, family physician or the addictions counsellor initiates contact through outreach or other agencies. Assessment can be seen as the beginning of treatment and it becomes an opportunity to encourage the client to begin to move towards change. The initial assessment involves a mutual investigation and exploration between the client

There are many assessment processes that are used to identify substance abuse as well as many other disorders that are addictive. These processes include the SBIRT, AUDIT (Alcohol Use Disorders Identification Test), NIDAMED, CAGE AID (which is used frequently within the counseling foundation), AUDIT-C, and also the DAST-10 which is an assessment process used to evaluate drug abuse within the patients. These are many different processes that are currently used to identify these addictions in clients. The activity of identifying these processes can be over a period of time or can be evaluated in that same day or after the evaluation is completed.

In an effort to aid in the proper treatment recommendations for individuals presenting with substance abuse or dependence issues, the ASI was created for study purposes through the Veteran’s Administration in 1977 (McLellan et Al., 2006). It is a multidimensional assessment tool that expands its focus outside of simply substance abuse, but into other key complex domains that that either directly impact the individual’s substance abuse, or their subsequent recovery efforts (Denis, et AL., 2012). The ASI is a semi-structured assessment tool, that while it utilizes direct answers, also allows for the expansion of certain questions and the ability for assessor notes outside of provided questions, in order to allow a clearer understanding within certain domains. While I have never personally used a precise ASI assessment professionally with a client, I did notice an undeniable, almost succinct, similarity with the biopsychosocial assessment I use with clients in my position.

Bering the uniqueness of each individual, people seek psychotherapy propelled by unique problems and conditions. Generally, many people will look for therapy because of sense of dissatisfaction with emotional pain or life. Sometimes it can be from immediate distress that is related to a definite crisis like addiction, separation or a loss, maybe on ongoing difficulty in part of their lives like work or relationship. For some people it might be due to suffering strong sadness, worry or fear. To some extent individuals might not have a clear external problem, but having inner sense of emptiness, dissatisfaction, or missing something. Screening and assessment play a critical role in psychotherapy. Extend of collecting details during assessment always differ depending on the settings of treatment as well as circumstances. For example, within primary settings like hospitals and medical practices, the aim of screening tends to be for determining hazardous or dependent drinkers.

A therapist assist each client to set individualized goals, the following goals appertain to all clients. Clients are to live a drug-free lifestyle; improve their social skills build up their self-esteem, become motivated and develop personalized prevention plan (New Horizons Community Mental Health Center, 2014).

Through standardized testing, the Commission is able to set a benchmark for professionals and monitor the abilities of those who treat addictions (NAADAC, 2013). It is extremely important to focus on the individual counselor to determine the current knowledge and competence at the national level. In addition, the process was created to establish, measure, and monitor the requirements for knowledge in the profession while providing assistance to identify quality counselors who have met the national competency standards. As one can see the certification, professional licensing, and credentialing of substance abuse professionals are important to ensure quality service is received by the client, counselor, and service provider

So how does an addicted individual escape addiction? Miller (1998) argues that there can be a sudden shift in how the person perceives the pros and cons of their behavior. This is often seen over time as the suffering directly attached to the addiction increases and the ratio of pros and cons shifts. Through motivational interviewing, Miller suggests that therapists and other helping professionals can lend clients another perspective, a mirror image of themselves, so as to increase the client's conception of the consequences and saliency of their

Astramovich, R.L., & Hoskins, W.J. (2013). Evaluating addictions counseling programs: Promoting best practices, accountability, and advocacy. Journal of Addictions & Offender Counseling, 34, 114-124.

The assessment serves many purposes. By giving simple, yet specific questionnaires, the professional can determine whether additional screening or diagnosing is necessary. "Relevant assessment information includes consumption patterns, substance-related problems, expectancies and motives for use and situational context for use" (Carey & Correia, 1998, p. 736). Three of the best tools or methods include collateral information, biochemical methods, and self-report

As a counselor to Alan I would used the following 5 assessments. I would use either Beck Depression Inventory or/both Hamilton Depression Inventory to look at the client’s depression. Alan admits to “being mildly depressed but insists, its not something I cant handle”. I think I would used the depression inventory to see where he would fall on the scale of his depression and then see how we can work with Alan. Though the client is well aware of the amount of alcohol or drug he uses. I would still apply both the Alcohol Use Inventory and the Substance Abuse subtle screening inventory. I think once we can show Alan how much alcohol and marijuana is affecting his life and how it will continue to affects his life. After we assess both his depression

He then described the five testing instruments, Steps Questionnaire (“To assess adoption of attitudes associated with AA steps 1, 2, and 3”), Step Questionnaire (“To assess practice of AA steps 11 and 12”), Brown-Peterson Recovery Progress Inventory (“To assess patient functioning in terms of working the AA program”), AA Involvement Scale (“To assess AA attendance and involvement”), AA Affiliation Scale (“To assess AA involvement”) and the Surrender Scale (“To assess surrender” to a higher power) (Allen, 2000, p. 228). Researchers then suggested that by utilizing these instruments, clinicians could better determine the likelihood of success of an individual’s continued sobriety in conjunction with that of therapeutic

In this regard, the assessment that will fit the needs of our community will have 8 key steps: • Engage the client This step will involve engaging the client with high empathy level and building rapport to help facilitate collaboration. A proper engagement with the client facilitates disclosure of information in regards to substance abuse, mental health problems and other health-related issues. • Contact family members to obtain more information Gathering information from substance abuse clients or individuals with mental health issues is important.

On the contrary, the comprehensive multi-dimensional assessment tool documents medical history, physical exams, family and social history, alcohol/drug histories. In addition to, documentation which includes sexual/mental health information collateral reporting of family and friends signed/or consented from the client, before any contact with others sharing of information and lab test. In summary, relapse education strategies include, teaching clients how incorporate self-regulation and relapse skills or strategies, to avoid a lapse and stay in recovery or continue sobriety. Next, to develop an understanding of General factors as to what causes a person to relapse begins with basic information such as medical social or clinical information.

Stevens, P., & Smith, R. L. (2013). Substance abuse counseling: Theory and practice (5th ed.). Upper Saddle River, NJ: Pearson Education, Inc.

In Counseling for Alcohol and Drug Abuse, the need to use different techniques is an integral part of the process. Working with an individual that is either entering into recovery or actively in recovery, the clinician must take their time with introducing the 12 Steps. The individual may not be open to the 12 Step philosophies at the onset. Addiction is very complex and actively affects the person on a daily basis; therefore, it is so important to start from the beginning of counseling to create a structured program.