Exam 2: Interview, Screening, and Assessment

Correct Answer:

Verified

Older people may under-report their substance misuse due to perceived stigma. Ageism may distract clinicians from signs of substance misuse, such as low energy and mood changes, which may instead be misattributed to general physical illness or depression. Stereotyping may blind detection of symptoms, for instance, ignoring substance use in older women due to the misnomer that substance use is an uncommon occurrence for this population. In addition, when performing an interview, it is crucial to identify the psychosocial factors that may make substance misuse more likely in older adults, for instance, issues such as bereavement, retirement, or physical immobility. SAMHSA (2011) also highlighted the complexities in assessing older adult SUDs and related psychiatric conditions such as major and mild depression and dysthymia. For example, older adults may demonstrate depression-like symptoms such as hopelessness, worry, and loss of interest in tasks deemed once pleasurable. Furthermore, there are no established older adult DSM diagnostic guidelines .
The SMAST-G identifies problems common for older adults, such as drinking after a significant loss. Other alcohol measures designed specifically for the older adult population include an adaptation of the AUDIT (SAMHSA, 2001), with sensitivity and specificity shown for a cutoff score of 5 for older men and 3 for older women.

Correct Answer:

Verified

The initial interview serves as a data-gathering dialog where the counselor can also begin to craft the narrative regarding the need for treatment and what strengths the client brings to the treatment process. The interview also informs the need for any screening applications. Screening is not just testing, but rather a purposeful and applied clinical measurement to determine the existence of various problems. Assessment is a more comprehensive application where the pervasiveness or severity of various problems (including substance use disorder) may be further determined. In brief, the initial interview, screening, and assessment serve such functions as conceptualizing the problem or problems, clarifying the severity of these problems, and informing/motivating the client for the need for treatment. Consequently, the interview, screening, and assessment phases of the initial sessions eventually inform the diagnostic and treatment plan development process. Furthermore, these critical tasks are conducted not only within a substance use disorder (SUD) treatment facility. The substance use interview, screening, and assessment processes have expanded to such populations as emergency room (ER) patients in an attempt to target not only those with diagnosable substance use disorders but also those individuals who present with unhealthy use that does not yet rise to a diagnostic level.