● Late adolescence: During late adolescence, rebellion typically diminishes. As a young adult, there is a sense of self and preparation for establishing and meeting life Assessment Screening Tools Youth who are using substances, whether or not they are using addictively, tend to be guarded about the subject and are likely to share accurate information only if they trust that the healthcare professional genuinely cares about their well-being. A nonjudgmental attitude is critical when building a therapeutic relationship with youth. The following evidence-based assessment tools are frequently used with adolescents who are using substances. ● The Problem-Oriented Screening Instrument for Teenagers (POSIT) is a 139-item, self-administered, holistic tool for use with 12- to 19-year-old adolescents. It is composed of yes/ no questions under the following 10 subscales: Substance Use and Abuse; Physical Health Status; Mental Health Status; Family Relations; Peer Relations; Educational Status; Vocational Status; Social Skills; Leisure and Recreation; and Aggressive Behavior and Delinquency. The POSIT is appropriate for adolescents with at least a fourth- to fifth-grade reading level and can be completed in 20 to 30 minutes. No special training is required to administer the tool. One of the advantages of POSIT lies in its comprehensiveness; while the POSIT is recommended especially for evaluating adolescent substance use and abuse problems, the screening results can identify potential problems in various areas. Such comprehensiveness may help mental health professionals make better referrals for further assessment or necessary services based on the patient’s particular needs. Those wanting to use the POSIT may do so without training or permission and at no charge (Alcohol and Drug Abuse Institute [ADAI], n.d.). A computerized administration and scoring version of the POSIT has been developed by PowerTrain, Inc., in Landover, Maryland. This version is designed to reduce administration and scoring time. This computerized tool automatically prepares a summary bar graph that compares individual scores with normative cut-points. This summary may be printed out and used to initiate a discussion between the adolescent and provider (ADAI, n.d.). ● The Drug Use Screening Inventory (revised; DUSI-R) is a 150-item, multidimensional instrument created to assess the severity of an adolescent’s problems in areas such as Multidimensional Assessment Data Assessment data provide the material for an evaluation of the adolescent’s weaknesses, strengths, problems, and needs. This information should be used to create a treatment plan. All assessments and treatment plans must be evaluated regularly throughout the course of treatment. ● Some areas that should be addressed in the assessment process include the following (Meadows-Oliver, 2019; Videbeck, 2020). ● Complete medical and psychiatric health history ● Psychological and emotional functioning ● Mental status examination ● History of chemical use or abuse ● Chief complaint ● Treatment history for mental and physical conditions ● Psychological tests ● Age ● Assigned gender, gender identity, and sexual orientation ● Family background and functioning ● Cultural identification ● Education and work history ● Socioeconomic status ● Legal involvement history ● Community resources ● Strengths, weaknesses, problems, and needs
goals. Although specific commitments to a particular role or career may not be made, the young adult is exploring and determining what such commitments might be.
substance abuse, psychiatric disorders, social functioning, family systems, peer relationships, and leisure activities. The screening not only assesses for drug and alcohol problems but can also help with comprehensive treatment planning (eINSIGHT, n.d.). ● The Substance Abuse Subtle Screening Inventory for Adolescents (SASSI-A2) is a 67-item instrument validated for the assessment of both substance dependence and substance abuse among adolescents. The unique aspect of this tool is that it includes both direct questions and more subtle questions to reduce defensiveness and extract more accurate responses. This instrument is available from the SASSI Institute at www.sassi.com (SASSI, n.d.). ● The Screening to Brief Intervention (S2BI) and Brief Screener for Tobacco, Alcohol, and other Drugs (BSTAD) are screening tools launched by the National Institute on Drug Abuse (2019a). These tools are brief and available online. They are designed to help healthcare professionals swiftly and easily introduce brief, evidence-based screenings into their clinical practices. Adolescents are asked about frequency of substance use within the past year, and the results are triaged into one of three levels of SUD: No reported use, lower risk, and higher risk. The BSTAD and S2BI can be administered in less than 2 minutes and are scientifically validated in adolescent samples. Both tools can be either self-administered or provider administered using a tablet or computer. In addition to risk scores, healthcare professionals receive information about the implications of results, recommended actions, and additional resources compiled via subject matter expert consensus. Healthcare Professional Consideration: It is important to note that it is unwise for a healthcare professional to rely solely on data from screening tool diagnoses and treatment plans. It is best to supplement information obtained through standardized instruments with other assessment data, such as psychosocial assessments, mental status examinations, collateral reports (from family, peers, teachers, therapists, physicians, probation officers, or clergy, if indicated), and direct observation. ● History of sexual, physical, and/or emotional abuse (as victim and/or perpetrator) ● History of traumatic events ● Behavioral definitions of problems related to Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), criteria (APA, 2013). Drug screening may also be implicated in cases related to criminal activity, legal jeopardy, and/or physical and/or emotional abuse. If patients are implicated in the juvenile court system, they must be given a thorough evaluation for substance use problems, physical disorders, mental disorders, school performance, sexual abuse accounts, and other comorbid conditions. It is difficult to achieve successful outcomes with an adolescent under these circumstances unless they are removed from their pathological environment. Immediate intervention is critical when working with youth who are involved in the juvenile court system (Guerrero et al., 2015). Healthcare Professional Consideration: It is imperative for assessment to incorporate physical, cognitive, social, and emotional domain indicators. Without consideration of all facets of an adolescent’s life, a complete and useful assessment cannot be conducted
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