Assessment Interview approaches

As we covered in the text this lesson, there are many different tools and approaches to the assessment interview. How would you approach an assessment interview? What are some questions you would absolutely include? What are the most important areas to cover, in your opinion? Please answer this question and respond to two other students’ posts. Thank you.

Screening: Brief procedures used to determine if there may be a problem, indicating the need for a more thorough assessment.

CAGE

  • Have you ever tried to CUT down on your drinking?
  • Have you ever gotten ANNOYED at someone else’s concern about your drinking?
  • Have you ever felt GUILTY about your drinking?
  • Do you ever drink an EYE-opener in the morning?

The Michigan Alcohol Screening Test (MAST) and the Substance Abuse Subtle Screening Inventory (SASSI) are both widely used standardized screening tools.


The assessment may be the most important aspect of the treatment continuum. It is during the assessment that one identifies a person’s strengths as well as their problems, and begins the process of building a treatment plan. If the assessment misses something important, the person may not get the treatment they need. Great care must be taken in the assessment, as it is the foundation upon which the rest of the treatment experience is built.

Assessment:

The assessment seeks to determine:

  • The severity of the problem
  • Possibly influences that have perpetuated chemical use, culminating in addiction
  • Related difficulties
  • The individual’s perceptions of and attitude toward treatment.

When completing an assessment, the professional gathers information from a variety of sources. These may include a clinical interview, use of standardized screening/assessment tools, information provided by family members, prior records and urine analysis for substances of abuse. The professional must always be vigilant to the presence of denial in the person being assessed. Substance abusers tend to minimize the nature and amount of their substance abuse.

The objectives of assessment include:

  • Identify those who are experiencing problems related to substance abuse and/or have progressed to the stage of addiction.
  • Assess the full spectrum of problems for which treatment may be needed.
  • Plan appropriate interventions.
  • Involve appropriate family members or significant others, as needed, in an individual’s treatment.
  • Evaluate the effectiveness of the interventions that are implemented.

A comprehensive assessment examines:

  • Medical status and problems
  • Psychological status and possible mental disorders
  • Social functioning
  • Family and peer relations
  • Educational and job performance
  • Legal problems
  • Socioeconomic status and problems

There are three basic steps to assessment:

  • Information gathering
  • Data analysis
  • Treatment plan development

Based on the outcome of the assessment, a treatment plan is developed, consisting of appropriate interventions designed specifically for the client.

These interventions may include:

  • Referral for medical care
  • Testing for infectious disease
  • Random drug testing
  • Referral for medication
  • Group counseling
  • Substance abuse counseling
  • Life skills counseling
  • General health education
  • Peer/Support groups (AA/NA, for example)
  • Substance-free social and leisure activities
  • Alternative housing
  • Relapse prevention

The initial interview has four goals:

  • Establish trust, rapport and effective communication with the client
  • Facilitating the client’s understanding of the rationale, purposes, proceduures associated with screeening and assessment
  • Exploring the client’s problems and expectations
  • Determining whether further assessment is needed

Pre-interview considerations:

  • Stigma – Be aware that for some there is a stigma to seeking professional help.
  • Expectations – The client will come to the meeting with preconceived expectations.
  • Likableness – Some clients will have better interpersonal skills than others.
  • First Impressions – Professionals should present themselves in a professional manner.
  • Professional Manner – Professional dress and conduct is important.
  • Environment – Interviews should take place in a comfortable environment, free of distraction.
  • Privacy/Confidentiality – Setting should support privacy and confidentiality.

Building the Relationship:

  • Rapport – Be natural, warm, authentic, polite in the interview.
  • Support – Encourage, reinforce, validate the client for seeking help.
  • Reassurance – Where possible, reassure client that their situation can improve.
  • Empathy – Demonstrate understanding of the client’s situation.
  • Acceptance – Accept the client as worthy of help.

Listening:

There are two types of listening: Active and Passive.

  • Active Listening
    • Reflecting – Verbally restating an understanding of what has been said.
    • Clarification – Rephrasing what the person is having difficulty expressing clearly.
    • Focusing – Narrowing the focus of the discussion to a manageable topic.
    • Summarizing
      • Attend to the various themes and emotional overtones as the person speaks
      • Unite key elements into a broader picture.
      • Do not add new ideas to the summary
      • Often it is helpful for the client to summarize.
  • Passive Listening – Nonverbal communication
    • Eye contact
    • Body language
    • Leaning forward, open posture
    • Nodding one’s head to indicate understanding
    • Smiling and other facial expressions, when appropriate

Interviewing Questions

  • Ask open and indirect questions
  • Ask simple questions rather than a double question
  • Avoid “why” questions
  • Avoid antagonizing questions
  • Avoid confrontational questions

Here are a couple references for the assignment.

 

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