Home > A review of screening, assessment and outcome measures for drug and alcohol settings.

Deady, Mark (2009) A review of screening, assessment and outcome measures for drug and alcohol settings. New South Wales: Network of Alcohol & other Drug Agencies.

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Standardised tools cover a range of areas which may be relevant to Drug and Alcohol (D&A) services. This review provides an overview of some useful standardised tools that can be used to measure treatment outcomes and to screen and assess for mental health symptoms and conditions, drug and alcohol use and disorders and general functioning. Focus has been given to tools that require limited training to use and are freely available. It should be noted that some of these tools require specialist training, or else mislabelling, misinterpretation, or inappropriate use may occur (Groth-Marnat, 2003; Roche & Pollard, 2006). Some tools are copyright protected and need to be purchased, and/or require the user to have specific qualifications. It is important that workers are aware of what they are, and are not, trained to use, and seek training where required.

Screening is designed only to highlight the existence of symptoms, not to diagnose clients. Most of the measures described are completed as a self-report (i.e., they are completed by the client). Others, however, need to be administered by a worker. It should be noted that, unfortunately, there are no brief measures with established reliability and validity for the identification of possible personality disorders. The possible presence of these disorders needs to be assessed by a health professional that is qualified and trained to do so (e.g., a registered or clinical psychologist, or psychiatrist).

There is a general lack of a standardised approach to screening, assessment and outcome measurement in the D&A sector. A variety of different tools are used, some of which are empirically established instruments whilst others are purpose-built, internally designed tools with increased practicality and utility but unknown validity and reliability (Roche & Pollard, 2006). This review focuses solely on the former. Similarly, it is important to note that this review, in and of itself is not exhaustive, as the number of available instruments is vast. Nevertheless, all attempts have been made to include the most relevant and useful measures.

This review is broken down into several categories:
1. Global measures – tools that measure a range of client factors (e.g., substance use, psychological and physical health, social functioning).
2. General health and functioning measures – tools that rate an individual’s functioning abilities and limitations.
3. General mental health measures – tools that measure a range of psychological symptoms (e.g. distress).
4. Specific mental health measures – tools that measure the symptoms of one disorder class only.
5. Positive mental health measures – an emerging area for outcome measurement in mental health has come from the philosophies of recovery, wellbeing, empowerment and rehabilitation.
6. General substance misuse measures – brief tools to ascertain the existence/nature of the substance problem
7. Severity of substance misuse measures – more specific tools to measure the severity of the substance use problem
8. Craving measures – this section provides an outline of some potentially useful drug craving measures

For each tool, information has been included on its psychometric properties (according to available research), its suitability for particular client groups, availability/cost and scoring administration and expertise required.

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