The SASSI and Other Assessment Tools
description
Transcript of The SASSI and Other Assessment Tools
![Page 1: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/1.jpg)
The SASSI and Other Assessment Tools
Diane A. Tennies, Ph.D., LADC
Lead TEAP Health Specialist
June 5, 2013
![Page 2: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/2.jpg)
Learning Objectives• After this presentation, participants will be able
to:– List three reasons why the assessment process is an
effective use of time/resources and consistent with the new PRH
– List commonly available assessment tools that are empirically validated and recommended for use in TEAP
– Administer and interpret the SASSI3/SASSIA2– Begin to develop assessment protocols for their own
TEAP programs
![Page 3: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/3.jpg)
![Page 4: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/4.jpg)
PRH 6.11 R1 (c) • Assessment for identification of students at risk for
substance use problems to include:– Review of Social Intake Form (SIF) or intake
assessment of all students performed by counseling staff within 1 week of arrival
– Formalized assessment measures (e.g., SASSI3 or SASSIA2), and clinical judgment to determine students’ level of risk for substance use
– Collaboration with the Center Mental Health Consultant to determine when a MSWR or medical separation is appropriate and should be recommended for a student with substance use conditions
![Page 5: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/5.jpg)
But Who Do We Assess?
Everyone? Just a few?
![Page 6: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/6.jpg)
Screening• Screening for disease has become a mainstay of today’s
preventive health care. • SBIRT defined:
– Screening for alcohol/drug problems with a validated brief questionnaire
– Brief intervention by a professional who discusses alcohol and drug use issues with those who may be at risk
– Referral to treatment, if warranted• Becoming a recommended best practice.• Increased screening allows clinicians to intervene early
before they become too serious. How does this apply to JC?
![Page 7: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/7.jpg)
What is the screening at JC?
• Alert Questions on JC Health History Form
• Urine toxicology screening• Clinical judgment during interactions• Review of SIF – CRAFFT
– total score– specific items
• Others?
![Page 8: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/8.jpg)
Job Corps Health History Form
• The Job Corps Health History Form (completed within 48 hours of a student’s arrival):– Are you currently feeling stressed out and need to
talk with someone today?* – In the past 2 weeks, have you used alcohol or used
drugs frequently or daily?*
• An affirmative answer these questions may signify a serious problem. A member of the medical and/or nursing team should review all questions on this form with the new student and refer as needed
![Page 9: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/9.jpg)
Reminder – CRAFFT Questions
• C-Have you ever ridden in a CAR driven by someone (including yourself) who was "high" or had been using alcohol or drugs? **
• R-Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in?
• A-Do you ever use alcohol/drugs while you are by yourself, ALONE?
• F-Do you ever FORGET things you did while using alcohol or drugs?
• F-Do your family or FRIENDS ever tell you that you should cut down on your drinking or drug use?
• T-Have you gotten into TROUBLE while you were using alcohol or drugs?
• Answers two or more = further assessment required
![Page 10: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/10.jpg)
**Car Question?• This screens for the greatest public
health problem
• Motor vehicle deaths are the leading cause of death among this age group (don’t have to be behind the wheel to die)
![Page 11: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/11.jpg)
When Further Assessment is Needed
• What are the ‘critical elements’?– Multiple data sources– Therapeutic alliance– Increased time and effort with individual focus– Narrow focus to specific issue to assess –
individualized – What else is in your ‘tool bag’?
• What about validity of self-report and how do we enhance?– Reality of drug screening– Review the ‘data’ you have (653; SIF; other info in
SHR)– Motivational Enhancement strategies – examples?
![Page 12: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/12.jpg)
![Page 13: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/13.jpg)
Value of an Assessment Process
• How are ‘high-risk’ students identified in TEAP now?
• Are there better ways to identify and intervene with the higher-risk students?
• What does screening and assessment ‘add’ to TEAP?– Improved identification means improved retention– Early intervention means improved outcomes – Enhanced therapeutic alliance for future
interventions – Utilization of your skills as the ‘addiction specialist’
![Page 14: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/14.jpg)
Assessment Tools Options
• These are well-established with adequate reliability and validity: – MAST– DAST– SASSI-3/SASSI-A2
![Page 15: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/15.jpg)
Michigan Alcoholism Screening Test (MAST)
• One of most widely used measures for alcohol abuse
• 25 items• Paper/pencil or interview formats• Takes total of 15 minutes to administer
and score• Good psychometric properties
![Page 16: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/16.jpg)
Drug Abuse Screening Test (DAST)
• 10, 20, or 28 item versions• Self-report with binary (yes or no
responses)• Face valid*• Modified from MAST• Relatively good psychometric properties
• *A test has face validity if it "looks like" it is going to measure what it is supposed to measure
![Page 17: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/17.jpg)
Substance Abuse Subtle Screening Inventory - 3
• Initially published by G. Miller, Ph.D. in 1988 (initial adolescent version in 1990 for ages 12-18)
• Administered and scored in about 15 minutes• Computer or hand scored• Overall accuracy in distinguishing people with
substance dependence from those without is 94%
![Page 18: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/18.jpg)
SASSI Specifics• One side has face valid items – asks
about frequency of use of drugs/alcohol as well as presence of ‘known’ difficulties related to substance misuse = obvious questions
• True/false side – asks statements which appear unrelated to substance use, such as ‘I have been tempted to leave home.’
![Page 19: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/19.jpg)
Why Subtle Items?• Based on research showing that individuals with
substance dependence diagnosis answered differently than the general population
• Statistical analysis detected a set of questions which substance dependent individuals consistently answered differently
• Not based on a theory of substance dependence• Does not matter why they answered as they did
but rather research has shown that people who answer questions this way have a high probability of a substance dependence disorder
![Page 20: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/20.jpg)
More Specifics• Ten subscales (two face-valid scales and eight
clinical subscales)• FVA (Face Valid Alcohol) – acknowledged use
of alcohol• FVOD (Face Valid Other Drugs) – of other
drugs• SYM – Substance Misuse Symptoms• Causes, consequences and correlates of
substance misuse• RAP – random responding• OAT – obvious attitudes – characteristics
commonly associated with substance misuse
![Page 21: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/21.jpg)
More Specifics (cont.)• SAT – subtle attitudes – basic personal style similar to
substance-dependent individuals• DEF – defensiveness – may or may not be related to
substance misuse, may be either enduring trait or temporary reaction
• SAM – supplemental addiction measure – supplements other scales and not used for clinical interpretation
• FAM – family vs. controls – similarity to family members of substance dependant people
• COR – correctional – similarity to people with extensive legal difficulties
![Page 22: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/22.jpg)
Decision Rules
• FVA 18 or more• FVOD 16 or more• SYM 7 or more• OAT 10 or more• SAT 6 or more• Rule 6 -9 combinations of above
![Page 23: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/23.jpg)
![Page 24: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/24.jpg)
What Happens Next?• Determine the level of risk –
– Putting all the data together– Using clinical judgment to decide level– Is a ‘rating’ of low, medium, or high
possible?
• What is possible range of outcomes?– Brief intervention (using MI strategies) with
everyone– Then consider:
• Offering intervention services • MSWR (in collaboration with CMHC)
![Page 25: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/25.jpg)
Brief Interventions: The Elements
• Three Elements with acronym FLO:– Provide Feedback about assessment results – Ask student for their reaction and views
about their own drug use. Listen carefully to encourage their thinking and decision-making process.
– Provide advice, and negotiate a decision about Options, including establishing a goal and developing an action plan
![Page 26: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/26.jpg)
Document in the SHR
• Need to be efficient• Easily accessible to other Health
and Wellness staff• Options?
![Page 27: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/27.jpg)
Create a Summary Sheet for Rapid Review
![Page 28: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/28.jpg)
Learning Objective - Revisited
1. List three reasons why the assessment process is an effective use of time/resources and consistent with the new PRH– Improved identification means improved retention– Early intervention means improved outcomes – Enhanced therapeutic alliance for future interventions – Utilization of your skills as the ‘addiction specialist’
2. List commonly available assessment tools that are empirically validated and recommended for use in TEAP– MAST– DAST– SASSI’s
![Page 29: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/29.jpg)
Learning Objectives - Revisited
3. Administer and interpret the SASSI3/SASSIA2
4. Begin to develop assessment protocols for their own TEAP programs
![Page 30: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/30.jpg)
• Main:(800) 726-0526• Clinical:(888) 297-2774• Training:(800) 697-2774• Tech Supt.:(888) 251-4147• Email:[email protected]
![Page 31: The SASSI and Other Assessment Tools](https://reader035.fdocuments.net/reader035/viewer/2022081420/56815027550346895dbe1197/html5/thumbnails/31.jpg)
Wrapping Up