A three-stage evaluation procedure provides a systematic framework for connecting assessment and treatment. The first stage involves brief screening using the DUSI-R (Tarter, 1990). At this stage, the areas of disturbance that point to the need for comprehensive evaluation are identified. In the second stage, a diagnostic evaluation is performed in the identified problem areas. This information in turn is applied to a focused, in-depth evaluation to formulate a multi-disciplinary treatment plan.
Using a decision-tree multistage evaluation procedure has several advantages:
• The areas of disturbance can be quickly identified at minimal cost.
• Labor-intensive, comprehensive diagnostic evaluation is guided by the results obtained in initial screening.
• The client's rehabilitation needs are clearly delineated, based on aggregate findings from the initial screening and the comprehensive diagnostic evaluation.
• Once the required treatment interventions are specified, a coordinated intervention program can be developed. In this fashion, evaluation and treatment are integrally linked in an ongoing reciprocal and interactive manner.
Matching assessment results with treatment is rapidly becoming standard clinical practice. For example, Annis and Graham (1995) link treatment planning, including relapse prevention counseling, to particular client profiles on the Inventory of Drinking Situations (IDS; Annis, 1982). The IDS categorizes heavy alcohol abusers into four types: (1) the negative profile—individuals whose alcohol abuse is a consequence of negative emotions (e.g., boredom, anxiety, and depression); (2) the positive profile—individuals who drink heavily due to social pressure, wanting to have a good time, or wanting to relax; (3) low-testing personal control—individuals whose abuse of alcohol is undif-ferentiated, possibly due to lack of motivation to change and lack of awareness of the antecedents of abuse; and (4) low physical discomfort—individuals who also presents with an undifferentiated profile characterized by limited use of alcohol. Substance abuse treatment is thus individualized according to the four IDS client profiles. For example, in the case of the negative and positive profilers, the focus of intervention is on teaching alternate ways of coping with social pressures and interpersonal conflicts, teaching alternate forms of relaxation, providing assertiveness training, and resolving interpersonal stress. The point to be made is that psychological assessment is not an intellectual exercise. Rather, the information should be applied to improving treatment outcome. Toward that goal, psychological evaluation is pertinent to determining the client's readiness for treatment, designing the most appropriate treatment, monitoring change during the course of treatment, documentation of individual outcome, and determining effectiveness of the treatment program.
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