The intake interview is an event of primary verbal communication between a client and an expert to elucidate the characteristic patterns of the client, particularly the patterns for which a client requires help.
Psychosocial interview is an important form of intake interview. The use of well-designed psychosocial interviews and questionnaires helps understand the problem of a client. A psychosocial interview is conducted in the form of a face-to-face interview with the client.
The Mental Status Examination (MSE) is a formal structured assessment of the client’s behavioral and cognitive functioning. It includes descriptions of the client’s appearance and general behavior, level of consciousness and attentiveness, motor and speech activity, mood and affect, thought and perception, attitude and insight, and, finally, higher cognitive abilities.
Screening is a process to identify the presence of a problem and the need for further evaluation, if there is a reason for concern. Screening should be conducted throughout client contact in a treatment program such as during detention, pretrial, probation, incarceration, parole or aftercare, and revocation hearings. During this process, particular attention is paid to key information such as types of substances abused, event that precipitated the use, frequency of use, amount of ingestion, and behavior during and after the ingestion.
There are a number of screening tools that a counselor can use to help in assessment and diagnosis. Factors such as age impact the screen tool selected. Let’s discuss the two commonly used screening tools in the treatment of substance abuse. It is important to remember there are many screen tools available,
Although a number of studies were conducted to test the reliability of this instrument, the results were mixed. Wolford conducted a study on people with severe mental illnesses to compare different instruments for screening. Although CAGE was found to be better than other approaches such as clinical variables, laboratory tests, and collateral reports, it yielded only a modest 60.9 percent sensitivity and 69.5 percent specificity. CAGE includes information related to lifetime rather than current substance abuse problems, which might be considered as its limiting factor. For best results, CAGE should be used in conjunction with other assessment tools such as an intake interview.
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One of the oldest and widely used tools for screening is MAST. The tool was developed by Melvin L. Selzer in 1971 to assess if the client has a drinking problem. MAST is a 24-item, self-report inventory of common signs and symptoms of a variety of problems resulting from alcohol abuse. Let’s look at the MAST questionnaire:
The MAST questionnaire comprises questions about the various aspects of alcohol consumption. The client answers each question in yes or no.
The total score helps evaluate the absence or the existence of excessive alcohol consumption.
- Question 1: One point if the answer is no and no point if the answer is yes.
- Question 2: One point if the answer is yes and no point if the answer is no.
- Question 3: One point if the answer is yes and no point if the answer is no.
- Question 4: One point if the answer is no and no point if the answer is yes.
- Question 5: One point if the answer is yes and no point if the answer is no.
- Question 6: One point if the answer is yes and no point if the answer is no.
- Question 7 to 17 and 19 to 22: One point if the answer is yes and no point if the answer is no.
- Question 18: Five points for each Delirium Tremens
- Question 23 and 24: Two points for each arrest
- Between 0 and 3 indicates low risks.
- Between 4 and 9 indicates high risks. Addiction to alcohol is likely.
- Greater than 9 indicates alcoholism.
A limitation of MAST is that adolescents seem to score higher than adults, which can be misleading. In addition, the tool helps to detect alcohol abuse only and not drug-related abuses. The tool also does not detect binge drinking. For best results, MAST should be used in conjunction with an intake interview.