03 -Screening-Addiction Counselor Exam Review
Addiction Counselor Exam Review

 
 
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Screening Review
Instructor: Dr. Dawn-Elise Snipes
Podcast Host: Counselor Toolbox, Happiness Isn’t Brain Surgery & The Addiction Counselor Exam Review
Objectives
~ Review key skills for engagement
~ Discuss factors impacting engagement
~ Define screening
~ Explore how to do a screening
~ Identify types of screening instruments

Engagement, Screening and Assessment
~ Demonstrate verbal and nonverbal skills to establish rapport and promote engagement
~ Discuss with clients the rationale, purpose and procedures associated with screening and assessment
~ Assess clients immediate needs including detoxification
~ Administer evidence based screening and assessment instruments to determine client strengths and needs
~ Obtain relevant history to establish eligibility and appropriateness of services
~ Screen for physical needs, medical conditions, co-occurring mental health issues
~ Interpret results of screening and assessment and integrate information to formulate a diagnostic impression and determine appropriate course of action
~ Develop a written integrated summary to support diagnostic impressions
Engagement
~ Establish rapport and an effective working alliance in which the client feels heard and understood
~ Respectful
~ Nonjudgmental
~ Attentive
~ Motivate and engage the client in identified service needs
~ Engagement puts the clinician in the best position to negotiate with the client about what to do and how to do it.
~ Engaged clients are more likely to
~ Participate willingly
~ Be treatment compliant
~ Successfully complete treatment
Engagement
~ Create a welcoming environment
~ Pleasant physical environment sensitive to
~ Age
~ Gender
~ Disability
~ Sexual orientation
~ Religion
~ Socioeconomic status

Factors Impacting Engagement
~ Stigma
~ About the diagnoses
~ About help seeking
~ Expectations
~ About the effectiveness of treatment
~ About one’s role/power in the treatment process
~ About the treatment process itself
~ Likeableness
~ Client’s social skills
~ Client’s attentiveness
~ Client’s attractiveness
Factors Impacting Engagement
~ First Impression
~ Professional presentation
~ Promptness
~ Courtesy
~ Smooth handling of paperwork
~ Environment
~ Calm, clean, comfortable
~ Not too formal or informal
~ Avoids interruptions
~ Provides appropriate privacy

Goals of the Initial Interview
~ Establish trust and develop rapport
~ Be empathetic
~ Convey warmth and respect
~ Explore client strengths and skills
~ Facilitate client’s understanding of rationale, purpose and procedures of the screening and assessment process
~ Explore the client’s problems and expectations regarding treatment and recovery
~ Determine whether a further assessment is needed
Screening
~ The process by which the counselor, client and SOs review the current situation, symptoms and collateral information to determine the probability of a problem
~ Used by all types of human service personnel to determine eligibility and appropriateness of services and needed referrals
~ Screening helps determine the immediacy of need
~ Must be a transparent process
~ Requires informed consent
~ Identification of early warning signs helps provide early intervention services and/or resources
Screening
~ Screening is the first opportunity to engage the client in the therapeutic relationship and treatment process
~ Sometimes, based on observation or other circumstances people may be referred directly for assessment.
~ The client’s internal motivation is the primary reason for engaging in treatment.
~ Internal motivation may be fleeting, so rapid engagement is vital.
Screening
~ Successful screening should be
~ Brief
~ Conducted in a variety of settings by a range of professionals on persons deemed to be at risk
~ A collaboration among a multidisciplinary team
~ Sensitive to racial, cultural, socioeconomic and gender related concerns
~ Developed from information gathered from multiple sources when possible

Screening
~ Assess signs and symptoms of intoxication and withdrawal
~ 3 key elements
~ Verify that behavior deviates from the norm
~ Rule out all non-drug related causes
~ Use diagnostic procedures to determine the types of drugs being used
~ Assess clients
~ Mental health/trauma history
~ Safety/environmental needs
~ Physical health needs
~ Other wrap-around needs
~ Danger to self or others
Screening Methods
~ Interview (client, SOs)
~ Screening instruments
~ Lab tests
Signs of SUDs or Mental Health Issues
~ Circumstances of contact
~ Client’s demeanor and behavior
~ Signs of acute intoxication or withdrawal
~ Physical signs of drug use or self-injury
~ Information spontaneously offered by the client or SOs
Screening Instruments for SUD
~ Can be developed by the agency or use standardized instruments
~ CAGE (Cut Down, Annoyed, Guilty, Eye Opener)
~ GAIN-SI
~ Michigan Alcohol Screening Test
~ SASSI
~ Must clearly detail what action should be taken based on received scores
Screening for Mental Health
~ Screen for
~ Acute symptoms such as hallucinations, delusions or depression
~ Suicidal thoughts and behaviors
~ Other mood and thought disturbances
~ Time, place, purpose, person
~ Short and long term memory
~ Prior involvement in mental health treatment
~ Use of prescription medication
~ Recent traumas
~ Family history of mental illness
Screening Instruments for Mental Health
~ Modified mini screen
~ Mental Status Exam
~ Mini Mental Status Exam
~ Brief Symptom Inventory
~ Brief Psychiatric Rating Scale
~ Symptom Checklist 90-R

Summary
~ Screening is the initial contact to decide if a person may need a more in-depth assessment
~ Screening is brief but requires the person to be engaged in the process in order to get an accurate result.
~ How well the person is engaged in the screening process is a direct predictor of whether he or she will continue the process.