ASSESSMENT SERVICES AT SUNSHINE COAST HEALTH CENTER

Stage 1 – Pre-Admission Screening and Self Assessment

Sunshine Coast Health Center Pre-Admission Self-Assessment Tools

Stage 2 – Admission

Assessment Provided During the Admission Stage

Stage 3 – Treatment

Assessment Provided During Treatment
Medical Assessment
Addiction Assessment
Psychological/Psychiatric Assessment
Client Self-Assessment

CONCLUSION

INTRODUCTION

Assessment is a critical tool for health professionals committed to providing appropriate care. Far more than simply determining if an applicant is an appropriate referral, assessment makes individualized care possible and can help gauge whether a client is responding to treatment.

Staff at Sunshine Coast Health Center is in a constant process of assessment and re-assessment as a client progresses through addiction treatment:

STAGE 1 – SCREENING AND PRE-ADMISSION SELF-ASSESSMENT

If you are trying to determine whether you or a significant other has an addiction to drugs and/or alcohol there are a number of self-assessment tools available. Although only a licensed professional such as a psychiatrist, psychologist, or addictionologist (a physician with specialized training in addictions) can make a conclusive diagnosis, self-assessment tools can provide some indication as to whether the line between drug abuse and dependence has been crossed.

Visit the Addiction Self-Test section for a selection of common addiction assessment instruments as well as a few developed by the staff of Sunshine Coast Health Center.

STAGE 2 - ASSESSMENT PROVIDED DURING THE ADMISSION STAGE

When you call to get information, the admission staff at Sunshine Coast Health Center is busy fact-gathering to ensure that we are a good fit for your needs. Assessment at this stage is conversational in tone but important to ensuring that there is a strong probability that you will benefit from our program. Pre-admission assessment also helps to protect you and your peer group from others experiencing medical or psychiatric complications that have the potential to negatively impact the treatment experience of all clients.

Prior to admission, clients or their loved ones must complete an admission form which reviews a client’s medical, legal, treatment, psychological and substance use history. Our Nursing Supervisor and Clinical Supervisor will then review your application and advise Admission staff if they have any concerns and, if not, advise the next available admission date.

Although we recognize that some callers are not sure whether problems with drugs and alcohol have progressed to the stage of addiction, our team of addiction professionals consider information provided in the telephone interview or, if not available directly, from independent confirmation of a health professional.

Sunshine Coast Health Center understands that to formally diagnose chemical dependency a face-to-face interview utilizing a scientific screening instrument administered by a mental health professional would be ideal. One can understand, however, that expediency makes it necessary given the urgency and narrow window of opportunity that presents when an individual with an addiction reaches out or agrees to get help.

STAGE 3 - ASSESSMENT PROVIDED DURING TREATMENT

Assessment during treatment is for a variety of purposes depending on the services offered:

Medical Assessment

A medical assessment is an important component of a client’s admission which begins with a minimum of one night in our alcohol and drug detox. Each client is expected to undergo a urine drug screen which helps identify which psychoactive substances are present when a client is admitted. Confirming the presence or absence of drugs will dictate what withdrawal symptoms are likely to occur and help prepare nursing staff following pre-determined withdrawal protocols. Urine drug screens do not detect the presence of alcohol and do not determine the quantity of drugs present.

Within 24 hours, all clients must be provided a medical assessment by our physician. The medical assessment involves observation to determine if additional detoxification, a review of medication, and/or lab work (*) at the hospital may be necessary.

(*) Note: lab work is primarily used to screen for possible infection or disease.

Addiction Assessment

Once a client is medically stabilized, counsellors at Sunshine Coast Health Center administer the Substance Abuse Subtle Screening Inventory (SASSI): an assessment tool which identifies substance abuse and dependence disorders. The SASSI test takes about 15 minutes to administer and a couple of minutes to score. SASSI produces a hypothetical psychological profile of the individual which addiction counselors can then use to engage the client and begin the process of creating a treatment plan. For more information visit the SASSI website.

Psychological/Psychiatric Assessment

Sunshine Coast Health Center utilizes the EASY Diagnostic Survey, a psychological assessment instrument designed by renowned psychiatrist David D. Burns, MD. This survey takes about one to two hours to complete and focuses on common problems, such as:
•           Difficulties in your work or personal relationships
•           Mood problems such as depression
•           Anxiety, such as feelings of shyness, panic attacks, chronic worrying, and phobias
•           Painful reactions to stressful or traumatic events
•           Physical problems such as chronic pain
•           Addictions to gambling, drugs, or alcohol
•           Eating problems, such as overeating, anorexia nervosa, or purging (bulimia)

The EASY Diagnostic survey helps our clinical team identify problems that might otherwise be overlooked. After a client fills out the survey, mental health specialists review any high scores that may represent possible or definite disorders. For more information on DSM-IV disorders visit the American Psychiatric Association website.

Sunshine Coast Health Center is blessed to have the services of both a psychologist and psychiatrist on our clinical team. The following diagram illustrates how we determine whether a client is referred to our psychologist or psychiatrist:

Protocol for Referring Clients for Psychiatric or Psychological Sessions

	Client completes EASY Diagnostic while in Detox portion of treatment. Administered by Nursing Supervisor or nursing staff.
	Nursing Supervisor or nursing staff score the EASY Diagnostic. Referral form for a psychiatric or psychological session completed by Nursing Supervisor or nursing staff. Reviewed by Clinical Supervisor.

Key indicators that the client should be referred for a psychiatric session.		Key Indicators that the client should be referred for a psychological session.
-Previous treatment (i.e. hospitalized for psychiatric problems) -Anger towards self, others, violent urges -Mood problems: feelings of depression (suicidal) or dramatically-elevated mood, hyperactivity. -Anxiety problems: (chronic worrying, panic attacks, somatic anxiety, agoraphobia, feared situations, shyness, social anxiety, obsessions and compulsions -Dissociative experiences (disorientation, hallucination) -Unusual experiences (i.e. bed wetting, fire-setting, torture of animals as a child etc.) -Suspicious feelings (paranoia) -Feelings of isolation -Unique experiences (abuse, grief/loss) -Suicide assessment review		-Relationship problems (school, job, identity, parent-child, partner, sibling, illness in family, grief) -Stressful or traumatic events (adjustment disorders, PTSD) -Eating problems (overeating, undereating, purging) -Dissociative experiences (disturbance in space and time) -Wild tendencies (anti-social behaviour) -Problems growing up -Borderline tendencies (fears of abandonment, and rapid expression of mood) -Dramatic tendencies (exaggerated expression of mood) -Feelings of importance (ie. narcissism) -Avoidant tendencies -Dependent tendencies -Perfectionistic tendencies -Suicide assessment review

Client Self-Assessment during Treatment

Another form of assessment, often overlooked during addiction treatment, is client self-assessment. When clients self-report on indicators such as depression, suicidal urges, anxiety, panic, and anger, clinicians are better able to determine if treatment is having a positive or negative impact on a client. Without self-assessment, clinicians end up judging treatment effectiveness by a client’s body language, compliance and ability to get along with his/her peer group. While these factors are important, they do not necessarily predict long-term outcomes.

Studies have shown that a warm, trusting therapeutic relationship (commonly referred to as therapeutic alliance) is critical to helping clients solve personal problems and overcome depression and anxiety. Sunshine Coast Health Center utilizes the David Burns Empathy Scale to measure (1) Positive Feelings about the Therapist, (2) Negative Feelings About the Therapist and (3) Helpfulness of the Session. While negative feedback from clients is never easy, counselors are encouraged to dig deeper and consult with the rest of the clinical team to find alternative ways to connect with the client.

As relationships are a critical part of successful recovery from drug and alcohol addiction, Sunshine Coast Health Center also utilizes the David Burns Relationship Satisfaction Scale. With this instrument, counseling sessions can be rated by how satisfied a client feels about communication and openness, conflict resolution, degree of affection and intimacy with his closest relationship.

Sunshine Coast Health Center is proud to be the first in the addiction treatment field to be using the David Burns Assessment Program developed by the best-selling author of Feeling Good: The New Mood Therapy. Dr. Burns has created a uniquely effective approach to assessment, which we believe will revolutionize addiction treatment.

CONCLUSION

Additional self-assessment instruments and information is available in the Addiction Self-Test section of this website.

If you need more information on how assessment services will impact treatment for you, your loved one, employee or client we invite you to schedule an appointment with our Program Director, who would be glad to clarify the role of assessment in the clinical program at Sunshine Coast Health Center. Please call us today toll-free at 1-866-487-9010.