NOTE: Assessment should not only be restricted to Intake Staff, but should be a critical part of early clinical sessions.
- Etiological Perspective; Physiological, Psychological, Sociological, Cultural
- Years of use
- Frequency of use
- Mood individual is in at time of ingestion
- Behavioral shifts or changes that occur after ingestion
- Attempt to identify events/incidents that have occurred which might have influenced, aggravated, or fueled frequency or dependency
- Attempt to pinpoint when use changed to abuse; time period when this occurred
- Addiction in other family members
- Support system of family or lack of such; included geographic availability of family member
- Types of drugs used; if polydrug use, provide in-depth explanation of synergy, half-life of drugs, etc...or any other appropriate terms associated with other drugs; ie., drug automatism, synesthesia, overamped, formication, Casey Jones Syndrome, gynecomastia, dopamine kindling, etc.
- Decline in activities which were once deemed important
- Have they fulfilled major role obligations at work, school, home, etc.
- Have there been important social, occupational, or recreational activities that they have given up or reduced?
- Determine changes in tolerance; both increase and decrease
- Listen for classic withdrawal symptoms which may be indirectly alluded to by patient or family may identify more directly
- Have each family member living at home provide a detailed account of the impact of addiction or use on the family unit generally and specific members individually
- Attempt to identify presence of dysfunctional family characteristics, children of alcoholic issues, co-dependency, enabling, etc. Help the patient and family understand the relationship of all of the above as by-products of the addictive process.
- Attempt to identify the personality traits of the patient to provide you a better understanding of patient thought process, motivation, drives, etc.
- Educate the patient and family to the hallmark signs of the addictive personality:
- Impulsivity, spontaneity, volatility
- Difficulty in establishing priorities
- Poor self-concept; low self-esteem
- Difficulty in identifying effective coping mechanisms
- Inability to handle long-term stress
- Dissonance...difficulty in making a decision, then, once one is made, individual vacillates and doubts if they made the right decision (self-doubt and skepticism)
- Procrastination
- Difficulty with anger control, displaced anger
- Harboring of resentments and hostilities
- Striving to achieve excellence and perfection in all they do
- Inability to accept moderation in their lives
- Oversensitivity; feelings easily hurt
- False expectations; expect people to behave they way they want them to
- Denial, lies, deceit, manipulation, con-like behavior, rationalization, minimization, intellectualization
- Difficulty to stay focused in here and now; they want to project ahead
- Easily overwhelmed; difficulty in handling multiple or complex tasks
- Biting off more than they can chew; they need to be reminded to keep it simple in the beginning
- Projection of blame onto others
- Self-pity; dwelling in the past; playing wounded
- Discuss recovery utilizing another medical model recovery plan
- Discuss difference between being sober and being dry
- Dwell on the need for honesty throughout counseling; commitment to treatment plan that will be developed, need to attend sessions consistently, consequences of non-attendance, etc.
- Recommend other ancillary treatment and/or fellowship options; marital, economic, legal, or AA, CA, CODA, COA, etc.
- Get an in-depth account of prior treatment experiences and whether patient has completed treatment or not
- Attempt to secure signed releases to procure information from appropriate people; employer, guidance counselor, siblings, etc.
