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Substance Abuse Screening & Diagnosis

Instructor: Gaines Arnold
Substance abuse screening and diagnosis are used to determine first whether a person has a substance abuse issue and then to determine what that problem is and how it can be treated. This lesson looks at how screening and diagnosis take place.

What is Mark's Problem?

Betty realized the powerlessness of Mark's situation. His job was a constant stressor and while family life was fine, there always seemed to be tension between them. Mark just didn't seem to be fulfilled in his life. Sure Mark took a few drinks from time to time to cope, but was that really a problem? She knew that the stress he faced was real, so his issues with constant forgetfulness and irritability could just be caused by pressure. But she needed to know.

Unlocking the Issue - Screening

After a few months of working on him, Betty was finally able to get Mark to see a psychologist, a professional specializing in evaluating and treating a wide range of emotional and behavioral problems. Betty reasoned that if it was stress, the doctor could help him find some coping mechanisms that may help him deal with his problems better. She was hopeful that Mark would be able to calm down and have some peace in his life.

The psychologist spoke to Mark about what was bothering him. Mark started by saying that there was nothing in his life that he couldn't handle, but that his wife was concerned so he had agreed to come see a counselor. He said that work had become more hectic because they had a new owner who expected more from them. He and his wife were fine, but sometimes the kids were too noisy and it kind of drove him bonkers. The more he talked, the more the doctor realized that he needed to find out more about Mark's coping skills.

The doctor asked Mark if he would be willing to take an assessment at their next session. Mark was agreeable, so they set a time to take the test. The doctor had a number of substance abuse screening assessments available for him, so he chose a test that seemed the most appropriate along with some that examined coping methods unrelated to substance abuse.

In the screening process, the doctor wanted to assess how Mark dealt with stressful situations. In the interview process he asked questions about:

• What stressors did he have?

• Did he have trouble dealing with those stressors?

• When he had problems what did he do?

• Did he ever drink or take drugs to relieve some of the pressure?

• Did it seem like he used substances more now than he used to?

The assessment asked basically the same questions during Mark's next visit to the psychologist, but it delved into more specific details regarding both substance abuse and coping.

Discovery - Diagnosis

After talking to Mark about what he perceived as his issues and giving him an assessment, the counselor was ready to provide Mark with a diagnosis. First of all, he told Mark that talking to a counselor and taking a few tests did not mean there was a diagnosable issue. Sometimes people who were under stress used coping mechanisms that just needed a little tweaking. They were basically healthy in their attitudes, but needed to talk through the stress. However, there were cases where the stress had reached a point where the individual was using unhealthy coping mechanisms that had caused further problems.

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