Assessment of Alcoholism and Chemical Dependency
Assessment of Alcoholism and Chemical Dependency RHAB 4475
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This 7 page Class Notes was uploaded by Angelina Grimes on Sunday October 25, 2015. The Class Notes belongs to RHAB 4475 at University of North Texas taught by Zachery Sneed in Fall. Since its upload, it has received 37 views. For similar materials see /class/229149/rhab-4475-university-of-north-texas in Rehab and Movement Science at University of North Texas.
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Date Created: 10/25/15
1 Screening instruments are ones that distinguish individuals who do not have a disorder from those who might have one the cases that remain require further assessment in order to make a diagnosis the counselor quotscreens out casesquot 2 NIAAA National Institute on Alcohol Abuse and Alcoholism a part of the US National Institutes of Health supports and conducts biomedical and behavioral research on the causes consequences treatment and prevention of alcoholism and alcoholrelated problems b Funds approximately 90 percent of all such research in the United States and promotes reductions in the per capita consumption of alcohol c MISSION STATEMENT Conducting and supporting research in a wide range of scientific areas including genetics neuroscience epidemiology health risks and benefits of alcohol consumption r 39 and quot 39 g and quot 39 39 U with other research institutes and federal programs on alcoholrelated issues collaborating with international national state and local institutions organizations agencies and programs engaged in alcoholrelated work translating and disseminating research findings to health care providers researchers policymakers and the public VISION STATEMENT support and promote the best science on alcohol and health for the benefit ofall by increasing the understanding of normal and abnormal biological functions and behavior relating to alcohol use improving the diagnosis prevention and treatment of alcohol use disorders enhancing quality health care 339 Steps Ofthe process Screening Assessment Treatment 53 When screening results When assessment determines are positive the person is and clarifiesthe nature and referred for extent of an alcohol use 39 ui uruer 39 and determination when assignment of a formal warranted of an alcohol diagnosis the person is related diagnosis referred for appropriate treatment intenentions P Alcohol and Other Drug Abuse AODA Alcohol Use Disorders Identification Test AUDIT adults AA Ha offenders college students heavy drinkers and alcoholics 6 Alcohol Smoking and Substance Involvement Screening Test ASSIST provides information about lifetimepast 3 months use of substances problems related to substance use risk of current or future harm level of dependence injecting behaviors help highrisk users cut down or stop their drug use avoid the harmful consequences of their use Rapid Alcohol Problems Screen RAPS4 gender amp ethnic groups white black Hispanics for alcohol dependence during the last year in clinical populations Michigan Alcoholism Screening Test MAST gross general measure ofalcohol use 10q Brief MAST 13q Short SMAST Father amp Mother versions CAGE Have you ever felt you should Cut down on your drinking Have people Annoyed you by criticizing your drinking Have you ever felt bad or Guilty about your drinking Have you ever had a drink first thing in the morning as an quotEye opener to steady your nerves or get rid of a hangover 48are false positives but it does identify those with problems when they are honest 0 Drug Abuse Screening Test DAST adapted from the MAST 28 item original DAST DAST20 DAST10selfadministrationinterview 11 Substance Abuse Subtle Screening Inventory SASSI Iquot N 9 5 12 TWEAK Tolerance quotHow many drinks can you holdquot or quothow many drinks does it take to make you feel highquot Worried quotHave close friends or relatives worried of complained about your drinking in the past yearquot Eyeopeners quotDo you sometimes take a drink in the morning when you first get upquot Amnesia blackouts quotHas a friend or family member ever told you about things you said or did while you were drinking that you could not rememberquot KCutdown quotDo you sometimes feel the need to cut down on your drinkingquot usefulfor pregnant and non pregnant women in ER settings and general medicine AND Mexican and Mexican Americans Drug Use Screening InventoryRevised DUSIR best for client screening DUSIR FULL DUSIR SHORT DUSIR BRIEF 14 MacAndrew Scale unusual to see this used anymore for screening Laboratory Tests 1 Urine toxicology urine screens most common least expensive easiest to perform can pick up on other medications individual used that are not considered substance abuse criteria 2 Hair substance metabolites deposit into hair typically 4060 strands of hair proximal to scalp can detect for several months VS urineblood brief periods of abstinence do not affect hair tests in same way as urinalysis hair cannot be adulterated clients less willing to provide hair samples than urine CANNOT take large samples of hair routinely over tie to demonstrate continuity 3 Blood saliva testing becoming more common uncommon for drugs more common for BAL Blood Alcohol Level expressed in grams per 100 ml of blood typically tested for CURRENT intoxication as the body tries to rapidly metabolize and excrete foreign substances few substances stay in blood stream longer than 1 day What is quotIntelligencequot often conceptualized as a general intellectual ability but there is little agreement on what specific skills or abilities contribute to intelligence numerous theories exist with varying core concepts and applications General definitions General Intelligence factor a general unitary concept that governs performance of all tasks and abilities W 2 Ability traits smaller components that collectively govern performance often stable over time and focused solely on cognitive factors overall function referred to general intellectual ability 3 Multiple intelligences separate but collaborative intelligence factors persons have all of the subtypes but their individual contribution to the whole differs 4 Information processing ability example being receptions attention memory recall sequencing reasoning and application 5 COMMON FACTORS adaptation to the environment taxonomic basic mental processes and higher order thinking information processing awareness and control of cognitive processes David Wechsler includes both global and individual abilities Theories 1 Spearman39s TwoFactor Theory intelligence is comprised of General Intelligence Factor g and Specific Factors 5 which varies according to an individual39s speci c abilities was highly controversial but found support in the fact that all mental tests were positively correlated at the time 2 Thurstone s Multifactor Theory 7 primary mental abilities 1 Numerical ability 2 Verbal comprehension 3 Word fluency 4 Memory 5 Reasoning 6 Spatial ability 7 Perceptual speed Initially rejected a common factor asserted that only multiple abilities exist 3 Vernon s Hierarchical Model considered by many to be compromise between Spearman s emphasis on a GENERAL INTELLIGENCE FACTOR ampThurstone s emphasis on MULTIPLE FACTORS 4 different levels 1 Spearman s general factor g of intelligence 2 Two broad 4 5 6 abilities verbaleducational ability and practicalmechanical spatial ability 3 specific abilities practical mechanical spatial includes mechanical ability psychomotor ability and spatial relations 4 Even more special and specific actors particular to the abilities in each of the domains above it CattellHorn Gf GcTheory proposed two primary forms of intelligence 1 Crystallized word fluency general information vocabulary verbal comprehension acquired knowledge and ability obtained through education and personal experience tests of verbal comprehension and knowledge draw on crystallized abilities 2 Fluid speed of information processing ability to detect relationships other abstract thinking abilities ability to solve problems and adapt to new situations considered to be more genetically determined and based on physiological aspects of an individual Vocabulaw S Reading S Computa on 5 Piaget Assimilation the process by which a child relates new objects and ideas to familiar objects and ideas Accommodation the process by which a child changes behavior and psychological structures in response to environmental events intelligence develops through interactive process biological maturation and experience 4 stages 1 Sensorimotor 2 Preoperational 3 Concrete operational 4 Formal operation C H CCattellHornCarroll Hierarchical 3 Stratum Model been described as a hierarchical multiple stratum model with general intelligence g strata lll nine broad cognitive abilities G strata II and at least 69 narrow cognitive abilities strata I the distinguishing feature between the CHC model and the CattellHorn GfGc model is that the CHC model supports the existence of a g factor Kaufman Assessment Battery for Children 2quot edition KABC II an intelligence test for children 3 to 18 is founded in the CHC model along with Luria s processing theory Comparing 1 2 Achievement tests focus more on the present what an individual knows or can do right now Aptitude tests are futureoriented predicting what an individual is capable of doing with further training and education Intelligence tests measure on individual s current cognitive ability Specific uses for Intelligence Tests screening for potential hidden problems identification of intellectual ability placement of individuals into treatment appropriate programs support in clinical evaluation selection of counseling style Wechsler Adult Intelligence Scale WAISIV 16 to 89 years old FSIQ and Index scores mean 100 amp SD 15 15 subtests mean 10 amp SD 3 3 Wechsler Intelligence Scale for Children WISCIV designed for ages 6 to 17 years mean 100 amp SD 15 4 StanfordBinet Intelligence Scale developed a series of measures to identify children for whom it was necessary to provide special educational programs mean 100 amp SD 15 Individual VS Group Testing 1 Individual test contains a wider array of items than group style formats group tests are often only multiple choice whereas individual tests have the option for spoken responses or essays examiner can enhance the assessment process based on unique attributes or clinical presentation of the client have the chance to establish rapport make and record behavioral and or nonverbal observations gain more insight into the test taker s life similar to group tests but designed for individual administration assess broad academic areas appropriate for a wide age span cover broad range of skill levels non are covered in depth useful for identifying individuals weaknesses in specific subject areas then this information would be used to select an appropriate diagnostic test often used in conjunction with intelligence tests to diagnose learning disabilities several are normed with this in mind 2 Group WWI ArmyAlpha and Army Beta tests were the first major group intelligence tests developed and were used to screen millions of recruits Group testing is used more extensively than individual intelligence tests particularly for screening purposes Issues 1 Construct of intelligence has led to the development of many different models theories and tests There is no shared agreement as to what intelligence is and how it should be measured There is no consensus on the terminology to describe the construct 2 Biased nature of intelligence tests are noticeable because many assessment instruments were originally developed by European and American psychologists who did NOT consider how cultural and ethnic factors affected their tests 3 Stability of intelligence an intelligence test score is not viewed as a fixed attribute IQs change over the course of development especially from birth through 5 years of age Research has indicated that intelligence test scores are very unstable in early childhood and are poor predictors of later intelligence Scores obtained on intelligence tests administered during school years show a more substantial relationship with scores obtained in adult years Later scores may decline with age on some types of test items and increase in others 4 Increase IQ Flynn Effect refers to the general trend in increased IQs over time with each subsequent generation James Flynn found that on average IQ scored have continuously improved to a gain of about 2 SD s across the 20 h century 50 of population 100 years go would have had intellectual capabilities consistent with intellectual disability as defined by current intelligence test score classifications Some suggested reasonsfor rising IQ widespread public education reduced family size more leisure times more intellectually demanding work greater use of technology better prenatal car improved nutrition changes in childrearing practices increased familiarity with tests and testing Achievement amp Aptitude 1 Achievement an individual s knowledge or skills in a particular content area where he or she has received instruction 2 Achievement tests comprised of items that require the test taker to demonstrate some level of knowledge or skill S P Equot 9 Aptitude tests are futureoriented predicting what an individual is capable of doing with further training and education Standardized Achievement Tests tend to generally cover broad content areas common to most US school standards in educational settings standardized achievements tests are used to establish a student s present achievement level monitor student achievement over time identify a student s academic strengths and weaknesses screen students for placementselection decisions evaluate instructional objectives and programs What makes up an achievement test battery most popular form of standardized achievement test also called survey achievement tests a comprehensive test providing a general overall estimation of learning across broad areas comprised of subtests that assess basic skills in reading language mathematics and other grad appropriate topics each student has a fairly limited number of items which are difficult to use in identification of specific learning disabilities most achievement test batteries are group administered can be used with large groups simultaneously even though the score is individually interpreted tests are generally computer scored for efficiency 4 Ma39or Categories of Achievement Tests 1 Achievement test batteries 2 Individual achievement tests 3 Diagnostic achievement tests 4 Subject area tests of individual 39 39 tests similar to group tests but designed for individual administrations Assess broad academic areas appropriate for a wide age span cover broad range of skill levels none are covered in depth useful for identifying individuals weaknesses in specific subject areas then the information would be used to select an appropriate diagnostic test often used in conjunction with intelligence tests to diagnose learning disabilities several are normed with this in mind Aptitude VS Ability 1 9 N 9 Aptitude an innate or acquired ability to be good at something always oriented toward FUTURE performance as opposed to current skills sets Aptitude should NOT be confused with ability or achievement Ability refers to current skills Most wellknown multiple aptitude batteries are Armed Services Vocational Aptitude Battery ASVAB Differential Aptitude Test Fifth Edition DAT General Aptitude Test Battery GATB Career Ability Placement Survey CAPS Wechsler Individual Achievement Test 3rd Edition WIAT identify the academic strengths and weaknesses of a student test of basic academic skills for persons aged 4 to 50 39 39 Johnson Tests of quot quot quotquot ACH used in education for programming or placement clinical diagnosis and vocational guidance designed to measure achievement among persons aged 2 to 95 Mean 100 SD 15 Kaufman Test of Educational Achievement KTEA ll developed to assess achievement of children and adolescents from 45 years to 25 years old Wide Range Achievement Test 4 h Edition WRAT4 widely used individual achievement test often used as a screening tool used for ages 5 to 94 years old Admissions Tests predict performance in a particular educational program are used in concert with other admissions materials cannot be sole determinant contain verbal quantitative writing and analytical reasoning skills or disciplinespecific knowledge a Scholastic Aptitude Test SAT published by the college board used by nearly every college in the US as part of the admissions process score range200 to 800 mean 500 SD 100 b Graduate Record Examinations GRE used as part of the application process for graduate school subject tests tend to be better predictors of first year GPA for specific departments than either the verbal or quantitative scales of the General Test Ca reer Assessment 1 Iquot 5 Career assessment is a process that helps individuals clarify goals and values explore career options make informed decisions about the future career assessment may be necessary in all stages of one s working life a Interest inventories value s39 39 I quot 39 39 career 39 39 r instruments Vocational aptitude tests combined assessment approaches Interest inventories measure how closely an individual s interest match existing occupations DO NOT measure if a person has the intellect skills aptitude or personality for a job John Holland s Theory the way people think about occupations and vocational stereotypes influence vocational preferences people with particular personality types create the environments within these occupations and vice verso a circular process people in each of Holland s six personality and environmental types create an atmosphere that reflects that type people search out and choose environments in which their interests attitudes and personalities fit a person s behavior is determined by an interaction between their personality and their environment llI mention personality a lot but we tend to consider Holland s work interest based individuals choose environments because of their personalities and remain in these environments because of the reinforcements and satisfactions they obtain there a How s it work Cornerstone of his theory is manifested by using the criterion group method of inventory development a group or sample with known characteristics say mechanics are used to begin with a group of controls normalities are selected a item pool is then administered the items kept are the ones that distinguish the controls from the mechanics and so on with numerous professions b Holland s propositions we can characterize people according to each of 6 personality types we can characterize environments by their resemblance to 6 model environments the paring of person to environment leads to outcomes we can predict we understand the selection and outcome based off our knowledge of the personality and environment interactions c Consistency the similarity between subtypes Differentiation degree to which a person is defined by one as opposed to many Identity llpossession of a clear and stable picture of one s goals interests and talents Congruence different personal types require differing environments Calculus refers to the hypothesized hexagonal model defining the relationships existing within the person Realistic Investigative Hexagon RIAS EC Typology Conventional Artistic Enterprising Social e Self Directed Search SDS developed by Holland can be used with individuals 15 to 70 years old easy to use and can be taken online uses Holland s typology to generate a three letter code reflects a combination of the test taker s interests f Strong Interest Inventory SII BOTH SII and SDS rely upon Holland s Theory 4 TYPES a Realistic auto mechanics aircraft controller farmer electrician asocial conforming frank genuine hardheaded inflexible natural materialistic normal persistent practical selfeffacing thrifty uninsightful uninvolved likes animals tools machines computers inanimate objects and skilled with tools or objects avoids or dislikes social activities views self as practical and realistic Investigative biology chemist geologist analytical cautious critical complex intellectual introspective pessimistic precise rational reserved retiring unassuming unpopular likes to study and solve problems dislikes or avoids leadership activities views self as precise exact rational or smart c Artistic composer musician stage director writer interior decorator complicated disorderly emotional expressive idealistic imaginative impractical impulsive introspective intuitive nonconforming open original sensitive likes creative thingslikes to create things avoids dogma order or repetition sees self as expressive original independent and unique d Social teacher religious worker counselor psychologist caseworker ascendant cooperative empathic friendly generous helpful idealistic kind patient persuasive responsible sociable tactful understanding and warm likes peopleavoids things values helping others and solving social problems views self as nice warm friendly and trustworthy e Enterprising salesperson manager business executive television producer acquisitive adventurous agreeable ambitious domineering energetic excitementseeking exhibitionistic extroverted flirtatious optimistic selfconfident sociable talkative natural leader avoids activities with analytic processes values success views self as active sociable ambitious outgoing 57 I U I banker tax expert careful conforming conscientious defensive efficient inflexible inhibited methodical obedient orderly persistent practical prudish thrifty unimaginative likes numbers data records in ordered fashion avoids unstructured activities views self as neat and orderly good at following directions or a plan 5 Problems with Theories clients change interests over time adolescents lack experience to respond to interest inventories job success is usually correlated more with abilities than interest clients may respond in socially desirable ways many interest inventories are susceptible to faking either intentional or unintentional exploration of low scores is often neglected
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