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Screening and Assessment for Alcohol and Other Drug Abuse Among Adults in the Criminal Justice System Treatment Improvement Protocol (TIP) Series 7

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Screening and Assessment for Alcohol and Other Drug Abuse Among Adults in the Criminal Justice System Treatment Improvement Protocol (TIP) Series 7 Screening and Assessment for Alcohol and Other Drug Abuse Among Adults in the Criminal Justice System Treatment Improvement Protocol (TIP) Series 7 James A. Inciardi, Ph.D. Consensus Panel Chair U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment Rockwall II, 5600 Fishers Lane Rockville, MD 20857 [Disclaimer] This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. All material appearing in this volume, except quoted passages from copyrighted sources, is in the public domain and may be reproduced or copied without permission from the Center for Substance Abuse Treatment (CSAT) or the authors. Citation of the source is appreciated. This publication was written under contract number ADM 270-91-0007 from the Center for Substance Abuse Treatment of the Substance Abuse and Mental Health Services Administration (SAMHSA). Anna Marsh, Ph.D., and Sandra Clunies, M.S., served as the CSAT Government project officers. Michelle Paul, M.A., Randi Henderson, and Deborah Shuman served as contractor writers. The opinions expressed herein are the views of the consensus panel members and do not reflect the official position of SAMHSA or any other part of the U.S. Department of Health and Human Services (DHHS). No official support or endorsement of SAMHSA or DHHS is intended or should be inferred. The guidelines proffered in this document should not be considered as substitutes for individualized patient care and treatment decisions. DHHS Publication No. (SMA) 94B2076. Printed 1994. What Is a TIP? CSAT Treatment Improvement Protocols (TIPs) are prepared by the Quality Assurance and Evaluation Branch to facilitate the transfer of state-of-the-art protocols and guidelines for the treatment of alcohol and other drug (AOD) abuse from acknowledged clinical, research, and administrative experts to the Nation's AOD abuse treatment resources. The dissemination of a TIP is the last step in a process that begins with the recommendation of an AOD abuse problem area for consideration by a panel of experts. These include clinicians, researchers, and program managers, as well as professionals in such related fields as social services or criminal justice. Once a topic has been selected, CSAT creates a Federal resource panel, with members from pertinent Federal agencies and national organizations, to review the state of the art in treatment and program management in the area selected. Recommendations from this Federal panel are then transmitted to the members of a second group, which consists of non-Federal experts who are intimately familiar with the topic. This group, known as a non-Federal consensus panel, meets in Washington for 5 days, makes recommendations, defines protocols, and arrives at agreement on protocols. Its members represent AOD abuse treatment programs, hospitals, community health centers, counseling programs, criminal justice and child welfare agencies, and private practitioners. A chair for the panel is charged with responsibility for ensuring that the resulting protocol reflects true group consensus. The next step is a review of the proposed guidelines and protocol by a third group whose members serve as expert field reviewers. Once their recommendations and responses have been reviewed, the Chair approves the document for publication. The result is a TIP reflecting the actual state of the art of AOD abuse treatment in public and private programs recognized for their provision of high quality and innovative AOD abuse treatment. This TIP provides practical information regarding the screening and assessment of AOD abuse among adults in the criminal justice system. It contains discussions of screening and assessment and treatment planning. The TIP also examines assessment issues related to primary health care, sexually transmitted diseases, mental health, safety, and relapse. Legal and ethical issues, such as the Federal regulations on confidentiality, are reviewed. This TIP, titled Screening and Assessment for Alcohol and Other Drug Abuse Among Adults in the Criminal Justice System, represents another step by CSAT toward its goal of bringing national leadership to bear in the effort to improve AOD abuse treatment. Consensus Panel Chair: James A. Inciardi, Ph.D. Professor and Director Center for Drug and Alcohol Studies University of Delaware Newark, Delaware Facilitators: Marcia D. Andersen, Ph.D., R.N., F.A.A.N., C.S. President Personalized Nursing Corporation Plymouth, Michigan Duane C. McBride, Ph.D. Professor and Chair Behavioral Sciences Department Institute of Alcoholism and Drug Dependency Andrews University Berrien Springs, Michigan Harvey A. Siegal, Ph.D. Director Substance Abuse Intervention Programs Wright State University Dayton, Ohio William R. Williford, M.P.H., Ph.D. Deputy Director New York Office of Alcoholism and Substance Abuse Services Albany, New York Workgroup Members: Richard Asarian, Ph.D. Clinical Director Ielase Institute of Forensic Psychology Pittsburgh, Pennsylvania Virginia Blackburn Director Women's Alcohol and Drug Prevention Fort Wayne Women's Bureau Fort Wayne, Indiana LaClaire Green Bouknight, M.D., F.A.C.P. Medical Director Residential Care Division Michigan Department of Social Services Maxey Training School Whitmore Lake, Michigan Margaret K. Brooks, J.D. Consultant Montclair, New Jersey Leah Colette Clendening, R.N., M.P.A. Associate Executive Director Queens Hospital Center Jamaica, New York Preston A. Daniels, M.S. Director Central Assessment Center and Mid-City Programs National Council on Alcoholism and Other Drug Dependencies Des Moines, Iowa Zoila Torres Feldman, R.N., M.S. Executive Director Great Brook Valley Health Center Worcester, Massachusetts Michael L. Green, M.S.W. Chief Probation Officer Mercer County Probation Department Trenton, New Jersey Howard Isenberg, M.A. Project Director North East Treatment Centers Wilmington, Delaware Pamela F. Rodriguez, M.A. Director of Program Services Treatment Alternatives for Special Clients of Illinois Chicago, Illinois Gerald L. Vigdal, M.S.W., B.C.D. Director Office of Drug Programs Wisconsin Department of Corrections Madison, Wisconsin Foreword The Treatment Improvement Protocol Series (TIPs) fulfills CSAT's mission to improve alcohol and other drug (AOD) abuse and dependency treatment by providing best practices guidance to clinicians, program administrators, and payers. This guidance, in the form of a protocol, results from a careful consideration of all relevant clinical and health services research findings, demonstration experience, and implementation requirements. A panel of non-Federal clinical researchers, clinicians, program administrators, and patient advocates employs a consensus process to produce the product. This panel's work is reviewed and critiqued by field reviewers as it evolves. The talent, dedication, and hard work that TIPs panelists and reviewers bring to this highly participatory process have bridged the gap between the promise of research and the needs of practicing clinicians and administrators. I am grateful to all who have joined with us to contribute to advance our substance abuse treatment field. Susan L. Becker Associate Director for State Programs Center for Substance Abuse Treatment Chapter 1 -- Introduction Alcohol and other drug (AOD) abuse and AOD abuse-related problems are among society's most pervasive medical and social concerns. Reliable, valid, and clinically useful instruments, as well as procedures for wide general use in screening and assessment for AOD-abusing adults, are available as complements to clinicians' experience. A panel of experienced researchers and clinicians who work with AOD-abusing adult offenders was convened in 1993 by the Center for Substance Abuse Treatment (CSAT) to develop guidelines for screening and assessing drug users' problems as the basis for appropriate program referral and treatment. This treatment improvement protocol (TIP) on screening and assessment is an outgrowth of that meeting. It should be viewed as a companion volume to two other TIPs that are available or being developed for use by State AOD abuse agencies and AOD abuse treatment programs in the criminal justice system that are funded with Substance Abuse Prevention and Treatment Block Grant funds. The other two TIPs are: Combining Alcohol and Other Drug Abuse Treatment Services with Intermediate Sanctions for Adults in the Criminal Justice System Planning for Alcohol and Other Drug Abuse Treatment for Adults in the Criminal Justice System The panel on AOD abuse screening and assessment among adults in the criminal justice system was charged with developing guidelines to: Identify AOD abuse screening and assessment services that need to be provided to offenders with various levels of AOD abuse problems and concurrent needs for correctional supervision Identify specific screening and assessment tools that appear to be particularly appropriate for offender populations and help to facilitate treatment planning Assist criminal justice agencies in the use of screening and assessment tools to enhance treatment outcomes. The emphasis of this document is on practical screening, assessment, and treatment planning procedures that can help to improve care and treatment outcomes. Underlying the clinical experience reflected in the consensus panel membership, and in this TIP, is the goal to prepare guidelines, based on best practices, that can be used easily
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