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Billy Mondragon
A substance abuse disorder can be categorized as a medical illness that causes significant
impairments to a person's health, ability to function socially, and their ability to control substance
abuse. Substance abuse disorder can range from mild to severe complexity with the relations and
severity also varying. Making certain that the client is properly diagnosed is an important step in
ensuring the best possible treatment for someone who is suffering from substance abuse disorder
is found. Being aware of the most effective way to screen and process the patients as well as
utilizing the proper tools to do so is crucial and helping a client overcome their addictions.
Definitions
When a client first decides to reach out for help the screening process is where the
assistance starts. This can determine whether the client shows certain behaviors, signs or
symptoms that are caused by addiction or if in fact there are some other underlying mental
disorders that may need to be addressed first. Once this is determined help can truly begin.
Screening aids in evaluating the possibility of a problem. Well assessment is what is used to
determine the scope of the problem. Final diagnosis determines a client's abilities within the
process and most importantly aids in determining a specific treatment plan. Treatment planning
is like a map when followed will help a client meet their goals it is often used as a tool to ensure
that the client has the opportunity for change and growth.
Crisis Management
Safety should be the primary concern of not only the client but of everyone involved
from the counselors to the receptionists or other clients that may be a part of the group. That it is
important to be able to see the signs and symptoms as well as having the skills in place to deal
with a crisis “Effective counselors should be able to recognize if a client is suicidal, homicidal,
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(Capuzzi & Stauffer, 2016. p. 100). Crisis management skills should always be at the forefront
along with effective communication and the ability to implement an appropriate course of action
Assessment Process
Different types of addictions and levels of substance abuse require different interventions
and treatment plans. When a client has an addictive disorder, typically their assessment or the
assessment of their addiction concludes with a referral to one of many treatment options. Some
of those options include simply the management of the withdrawal symptoms, or a stay in a
facility that deals with addiction on an inpatient basis another option might be a treatment
program where the patient lives at home or even a referral in the form of a support group.
(Capuzzi and Stauffer 2016). While the assessment process is occurring, information obtained
will be comprised of the client’s demographic information, history, information that will benefit
the treatment, challenges the client faces in treatment, any mental health problems as well as how
far along the client is in the treatment substance abuse. The assessment goes farther than an
intake form because it takes so much of the client’s background into account.
Considerations
When choosing the most appropriate assessment tool, it is important to consider and
understand what the client is ready for as far as treatment goes their strengths and weaknesses
should be assessed, where they are at in regards to addictive substances used as well as the
frequency they are being taken. The length of time they have been taking the substance, the
reasons they have become addicted and the social impact the addiction has on their life are all
important things to considered along with what the client seek to ultimacy achieve during
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treatment (Network of Alcohol and Other Drugs Agencies, 2013). The councilor should make it
known to the client the type of methods they are using be it a standard on or perhaps an alternate
assessment tool. The client should have whatever method or selection that is made explained in a
way that makes them knowledgeable and understand it. Ensuring the client has a firm
understanding of the challenges and problems faced as well as the method selected for
Many counselors use the Diagnostic and Statistical Manual of mental disorders often referred to
as the DSM for short to help determine a client's diagnosis following their assessment “The Diagnostic
and Statistical Manual of Mental Disorders (DSM) is the standard classification of mental
disorders used for clinical, research, policy, and reimbursement purposes in the United States and
has a large effect on how disorders are diagnosed, treated, and investigated” (Hasin, et al., 2013,
p. 834). The DSM is fairly universally used by hospitals and clinics across the country. Insurance
Potential Problems
The DSM is a very useful tool for counselors, clients in anyone in the healthcare field
when in regard to treatment planning. However there remain a few issues with the DSM that may
prevent clients from being properly diagnosed. One of the bigger items one must consider while
using the DSM pertains to the criteria used in the manual, which reveals a certain cultural bias
this can cause improper diagnosis due to the same criteria not being applicable for
“underrepresented and marginalized groups.” The DSM also ignores questions related to a
client's culture. (Mannarino, Loughran, & Hamilton, 2007). The DSM includes conditions for
disorders but does not attach the disorders achievements. The DSM also fails to distinguish
between personality, personality traits, temperament and any personality disorders present, this
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can cause a huge problem and lead to an inaccurate diagnosis or a complete misdiagnosis
Examples
There are many tools available to assess substance abuse disorders. Law enforcement and
most companies primarily use two, these two are urinalysis or urine drug testing and
breathalyzers. Urine testing is often done by parole officers. Urinalysis is also done for pre-
employment screening and is used to determine whether a person has been taking opiates or
drugs that may include marijuana, cocaine, or phencyclidine otherwise known as PCP. Police
officers routinely administer breathalyzers during traffic stops to determine an individual's blood
alcohol level and whether or not they are impaired and unable to drive.
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References
Capuzzi, D., & Stauffer, M. D. (2016). Foundations of Addictions Counseling (3rd ed). Boston:
Pearson.
Hasin, D. S., O'Brien, C. P., Auriacombe, M., Borges, G., Bucholz, K., Budney, A., . . . Grant, B.
F. (2013, August 1). DSM-5 Criteria for Substance Use Disorders; Recommendations
Health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767415/
Mannarino, M. B., Loughran, M. J., & Hamilton, D. (2007, October). The Professional
Counselor and the Diagnostic Process: Challenges and Opportunities for Education and
Network of Alcohol and Other Drugs Agencies. (2013). Complex Needs Capable. Retrieved from
http://www.complexneedscapable.org.au/conducting-screening.html