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Center for Substance Abuse Treatment. Substance Abuse Treatment for Adults in the Criminal Justice System. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2005. (Treatment Improvement Protocol (TIP) Series, No. 44.)

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Substance Abuse Treatment for Adults in the Criminal Justice System.

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Appendix C: Screening and Assessment Instruments

Addiction Severity Index (ASI)

Purpose: The ASI is most useful as a general intake screening tool. It effectively assesses a client's status in several areas, and the composite score measures how a client's need for treatment changes over time.

Clinical utility: The ASI has been used extensively for treatment planning and outcome evaluation. Outcome evaluation packages for individual programs or for treatment systems are available.

Groups with whom this instrument has been used: Designed for adults of both sexes who are not intoxicated (drugs or alcohol) when interviewed. Also available in Spanish.

Norms: The ASI has been used with males and females with drug and alcohol disorders in both inpatient and outpatient settings.

Format: Structured interview.

Administration time: 50 minutes to 1 hour.

Scoring time: 5 minutes for severity rating.

Computer scoring? Yes.

Administrator training and qualifications: A self-training packet is available as well as onsite training by experienced trainers.

Fee for use: No cost; minimal charges for photocopying and mailing may apply.

  • Available from:
  • A. Thomas McLellan, Ph.D.
  • Building 7
  • PVAMC
  • University Avenue
  • Philadelphia, PA 19104
  • Ph: (800) 238-2433

The Alcohol Use Disorders Identification Test (AUDIT)

Purpose: The purpose of the AUDIT is to identify persons whose alcohol consumption has become hazardous or harmful to their health.

Clinical utility: The AUDIT screening procedure is linked to a decision process that includes brief intervention with heavy drinkers or referral to specialized treatment for patients who show evidence of more serious alcohol involvement.

Groups with whom this instrument has been used: Adults, particularly primary care, emergency room, surgery, and psychiatric patients; DWI offenders, criminals in court, jail, and prison; enlisted men in the armed forces; workers in employee assistance programs and industrial settings.

Norms: Yes, heavy drinkers and people with alcohol use disorders.

Format: A 10-item screening questionnaire with 3 questions on the amount and frequency of drinking, 3 questions on alcohol dependence, and 4 questions on problems caused by alcohol.

Administration time: 2 minutes.

Scoring time: 1 minute.

Computer scoring? No.

Administrator training and qualifications: The AUDIT is administered by a health professional or paraprofessional. Training is required for administration. A detailed user's manual and a videotape training module explain proper administration, procedures, scoring, interpretation, and clinical management.

Fee for use: No.

Available from: Can be downloaded from Project Cork Web site:

www.projectcork.org

Beck Depression Inventory-II (BDI-II)

Purpose: Used to screen for the presence and rate the severity of depression symptoms.

Clinical utility: Like its predecessor, the BDI-II consists of 21 items to assess the intensity of depression. The BDI-II can also be used as a screening device to determine the need for a referral for further evaluation. Each item is a list of four statements arranged in increasing severity about a particular symptom of depression. These new items bring the BDI-II into alignment with Diagnostic and Statistical Manual for Mental Disorders, 4th edition (DSM-IV) criteria.

Items on the new scale replace items that dealt with symptoms of weight loss, changes in body image, and somatic preoccupation. Another item on the BDI that tapped work difficulty was revised to examine loss of energy. Also, sleep loss and appetite loss items were revised to assess both increases and decreases in sleep and appetite. The BDI-II shows improved clinical sensitivity and higher reliability than the BDI.

Groups with whom this instrument has been used: All clients aged 13 through 80 who can read and understand the instructions and clients who cannot read (requires reading the statements to them).

Norms: The BDI has been used with people with substance use disorders, psychiatric patients, medical inpatients, and many other populations.

Format: Paper-and-pencil self-administered test.

Administration time: 5 minutes, either self-administered or administered verbally by a trained administrator.

Scoring time: N/A.

Computer scoring? No. Any staff member can perform the simple scoring.

Administrator training and qualifications: Doctoral-level training or masters-level training with supervision by a doctoral-level clinician are required to interpret test results.

Fee for use: $66 for manual and package of 25 record forms.

  • Available from:
  • The Psychological Corporation
  • 19500 Bulderve
  • San Antonio, TX 78259
  • Ph: (800) 872-1726

CAGE Questionnaire

Purpose: The purpose of the CAGE Questionnaire is to detect alcoholism.

Clinical utility: The CAGE Questionnaire is a very useful bedside, clinical desk instrument and has become the favorite of many family practice and general internists—also very popular in nursing.

Groups with whom this instrument has been used: Adults, adolescents (over 16 years).

Norms: Yes.

Format: Very brief, relatively nonconfrontational questionnaire for detection of alcoholism, usually beginning “have you ever” but which can be phrased to refer to past month or current behavior.

Administration time: Less than 1 minute.

Scoring time: Instantaneous.

Computer scoring? No.

Administrator training and qualifications: No training required for administration; it is easy to learn, easy to remember, and easy to replicate.

Fee for use: No.

Available from: May be downloaded from the Project Cork Web site

www.projectcork.org

Circumstances, Motivation, and Readiness Scales (CMR Scales)

Purpose: The instrument is designed to predict retention in treatment and is applicable to both residential and outpatient treatment modalities.

Clinical utility: The instrument consists of four derived scales measuring external pressure to enter treatment, external pressure to leave treatment, motivation to change, and readiness for treatment. Items were developed from focus groups of recovering staff and clients and retain much of the original language. Clients entering substance abuse treatment perceive the items as relevant to their experience.

Groups with whom this instrument has been used: Adults.

Norms: Norms are available from a large secondary analysis of more than 10,000 clients in referral agencies, methadone maintenance, drug-free outpatient and residential treatment. Norms are also available for specific populations, such as clients with COD, prison-based programs, and women's programs.

Format: 18 items at approximately a third-grade reading level. Responses to the items consist of a 5-point Likert scale on which the individual rates each item on a scale from Strongly Disagree to Strongly Agree. Versions are also available in Spanish and Norwegian.

Administration time: 5 to 10 minutes.

Scoring time: Can be easily scored by reversing negatively worded items and summing the item values.

Computer scoring? No.

Administrator training and qualifications: Self-administered; no training required for administration.

Fee for use: N/A.

  • Available from:
  • George De Leon, Ph.D., or Gerald Melnick, Ph.D.
  • National Development and Research Institutes, Inc.
  • 71 West 23rd Street
  • 8th Floor
  • New York, NY 10010
  • Ph: (212) 845-4400
  • Fax: (917) 438-0894

The Drug Abuse Screening Test (DAST)

Purpose: The purpose of the DAST is (1) to provide a brief, simple, practical, but valid method for identifying individuals who are abusing psychoactive drugs; and (2) to yield a quantitative index score of the degree of problems related to drug use and misuse.

Clinical utility: Screening and case finding; level of treatment and treatment/goal planning.

Groups with whom this instrument has been used: Individuals with at least a sixth grade reading level.

Norms: Yes. A normative sample consisting of 501 patients, representative of those applying for treatment in Toronto, Canada.

Format: A 20-item instrument that may be given in either a self-report or in a structured interview format; a “yes” or “no” response is requested from each of 20 questions.

Administration time: 5 minutes.

Scoring time: N/A.

Computer scoring? No. The DAST is planned to yield only one total or summary score ranging from 0 to 20, which is computed by summing all items that are endorsed in the direction of increased drug problems.

Administrator training and qualifications: For a qualified drug counselor, only a careful reading and adherence to the instructions in the “DAST Guidelines for Administration and Scoring,” which is provided, is required. No other training is required.

Fee for use: The DAST form and scoring key are available either without cost or at nominal cost.

  • Available from:
  • Centre for Addiction and Mental Health
  • Marketing and Sales Services
  • 33 Russell Street
  • Toronto, Ontario, Canada M5S 2Sl
  • Ph: (800) 661-1111 (Continental North America)
  • International and Toronto area: (416) 595-6059

Michigan Alcoholism Screening Test (MAST)

Purpose: Used to screen for alcoholism with a variety of populations.

Clinical utility: A 25-item questionnaire designed to provide a rapid and effective screen for lifetime alcohol-related problems and alcoholism.

Groups with whom this instrument has been used: Adults.

Norms: N/A.

Format: Consists of 25 questions.

Administration time: 10 minutes.

Scoring time: 5 minutes.

Computer scoring? No.

Administrator training and qualifications: No training required.

Fee for use: Fee for a copy, no fee for use.

  • Available from:
  • Melvin L. Selzer, M.D.
  • 6967 Paseo Laredo
  • La Jolla, CA 92037-6425

Structured Clinical Interview for DSM-IV Disorders (SCID)

Purpose: Obtains Axis I and II diagnoses using the DSM-IV diagnostic criteria for enabling the interviewer to either rule out or to establish a diagnosis of “drug abuse” or “drug dependence” and/or “alcohol abuse” or “alcohol dependence.”

Clinical utility: A psychiatric interview.

Groups with whom this instrument has been used: Psychiatric, medical, or community-based normal adults.

Norms: No.

Format: A psychiatric interview form in which diagnosis can be made by the examiner asking a series of approximately 10 questions of a client.

Administration time: Administration of Axis I and Axis II batteries may require more than 2 hours each for patients with multiple diagnoses. The Psychoactive Substance Use Disorders module may be administered by itself in 30 to 60 minutes.

Scoring time: Approximately 10 minutes.

Computer scoring? No.

Administrator training and qualifications: Designed for use by a trained clinical evaluator at the master's or doctoral level, although in research settings it has been used by bachelor's-level technicians with extensive training.

Fee for use: Yes.

  • Available from:
  • American Psychiatric Publishing, Inc.
  • 1400 K Street, N.W.
  • Washington, DC 20005

University of Rhode Island Change Assessment (URICA)

Purpose: The URICA operationally defines four theoretical stages of change—precontemplation, contemplation, action, and maintenance—relevant to change of a “problem” determined by the subjects, each assessed by eight items. For an alcohol problem population, a 28-item version with 7 items per subscale is available.

Clinical utility: Assessment of stages of change/readiness construct can be used as a predictor of treatment and outcome variables.

Groups with whom this instrument has been used: Both inpatient and outpatient adults.

Norms: Yes, for outpatient alcoholism treatment population.

Format: The URICA is a 32-item inventory designed to assess an individual's stage of change, located along a continuum of change, in people who abuse alcohol or drugs.

Administration time: 5 to 10 minutes to complete.

Scoring time: 4 to 5 minutes.

Computer scoring? Yes, computer-scannable forms.

Administrator training and qualifications: N/A.

Fee for use: No; instrument is in the public domain. Available from author.

  • Available from:
  • Carlo C. DiClemente
  • University of Maryland
  • Psychology Department
  • 1000 Hilltop Circle Baltimore, MD 21250 Ph: (410) 455-2415
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