Screening and Assessing Adolescents for Substance Use Disorders

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Screening and Assessing Adolescents for Substance Use Disorders

Figures

Figure 1-1: Family Members

Figure 1-1
Family Members

Family can include

Figure 1-2 Screening and Assessment
Level	Content	Methods	Sources
Screening	Substance use disorder severity, plus Home life Psychiatric status School status	Short questionnaire Brief interviews	Client Parent(s)
Comprehensive Assessment	Substance use disorder severity, plus Home life Delinquency Physical/ sexual abuse Medical status Learning status Indepth psychiatric status Environmental risks Environmental assets/ strengths Sexual behavior Developmental status Leisure and recreation Family dynamics	Standardized questionnaire Structured interviews Laboratory tests Direct observation Diagnostic tests	Client Parent(s) Archival records Significant others

Figure 2-1
Indicators for Assessment

Substance Use Disorder-Related

Psychosocial

Physical or sexual abuse
Parental substance abuse (including driving under the influence/driving while intoxicated)
Sudden downturns in school performance or attendance
Peer involvement in serious crime
Marked change in physical health
Involvement in serious delinquency or crimes
HIV high-risk activities (e.g., intravenous drug use, sex with intravenous drug user)
Indicators of serious psychological problems (e.g., suicidal ideation, severe depression)

Figure 3-2
The Written Report

The written report should identify

The conditions/environment at the time of assessment
The severity of the substance involvement
Youth's conceptualization of reasons for substance use
Factors that contribute or relate to the substance involvement
Diagnosis as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth ed.
History of treatment services, including drug treatment and mental health treatment
A corrective action plan to address problem areas
A detailed plan to ensure that the treatment plan is
- Mindful of the adolescent's expressed views and desires in his own words
- Implemented
- Monitored to its conclusion

The written report should be careful to

Not reduce a youth to a test score or label
Emphasize the youth's strengths as well as problems
Capture the range of issues, strengths, and concerns
Integrate previous workups when they indicate progression of symptoms and problems
Not include opinions and descriptions from previous reports without thought and research (remember that the report can follow the youth for years)

The written report should be distributed

In compliance with the confidentiality requirements of 42 C.F.R.
Only with the signed approval of the adolescent (and, in some States, of the parent or guardian), as described in Federal or State laws

The report should

The report should be written so that it can be understood by the adolescent and all parties concerned.

Figure 4-1 Sample Consent Form
Consent for the Release of Confidential Information
I, ___________________________, authorize XYZ Clinic to receive (name of client or participant)
from/disclose to ________________________________________ (name of person and organization)
for the purpose of _______________________________________ (need for disclosure)
the following information__________________________________ (nature of the disclosure)
I understand that my records are protected under the Federal and State Confidentiality Regulations and cannot be disclosed without my written consent unless otherwise provided for in the regulations. I also understand that I may revoke this consent at any time except to the extent that action has been taken in reliance on it and that in any event this consent expires automatically on ____________________ unless otherwise specified below. (date, condition, or event)
Other expiration specifications:
_________________________ Date executed
_________________________ Signature of client
________________________ Signature of parent or guardian, where required

Figure 4-2 Qualified Service Organization Agreement
XYZ Service Center ("the Center") and the _______________________________ (name of the program)
("the Program") hereby enter into a qualified service organization agreement, whereby the Center agrees to provide (nature of services to be provided)
Furthermore, the Center: (1) acknowledges that in receiving, storing, processing, or otherwise dealing with any information from the Program about the clients in the Program, it is fully bound by the provisions of the Federal regulations governing Confidentiality of Alcohol and Drug Abuse Client Records, 42 C.F.R. Part 2; and (2) undertakes to resist in judicial proceedings any effort to obtain access to information pertaining to clients otherwise than as expressly provided for in the Federal Confidentiality Regulations, 42 C.F.R. Part 2.
Executed this ____________ day of _____________________, 199_____ __________________________ President XYZ Service Center [address] __________________________ Program Director [name of program] [address]

Source: The National Clearinghouse for Alcohol and Drug Information
DHHS Publication No. (SMA) 99-3282

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