Addictions Counselor Core Skills, Part III: Applying ASAM Criteria

Summary

The video script offers an in-depth look at the ASAM Criteria, guidelines by the American Society of Addiction Medicine for assessing and treating substance use disorders. It outlines six bio-psycho-social dimensions for client evaluation, including acute intoxication, medical conditions, psychological issues, readiness to change, relapse potential, and recovery environment. The script also explains various levels of care, from outpatient to medically managed inpatient, tailored to the severity and needs of the individual, emphasizing continuous assessment and adjustment throughout the treatment process.

Takeaways

• 📊 ASAM Criteria are guidelines by the American Society of Addiction Medicine for assessing and determining the appropriate level of care for clients with substance use disorders.
• 🧬 The assessment process is based on a bio-psycho-social (BPS) model, which involves looking at six different dimensions of a client's background and needs.
• 🍷 Dimension 1 focuses on acute intoxication or withdrawal potential, assessing the client's current state of intoxication and the risk associated with withdrawal from substances.
• 🏥 Dimension 2 examines general medical conditions and complications that could affect the treatment and need for medical monitoring during the recovery process.
• 🧠 Dimension 3 addresses cognitive, behavioral, and emotional conditions, including mental illnesses and psychological issues that may complicate treatment.
• 🚀 Dimension 4 evaluates the client's readiness to change, including their motivation and stage of change, which is crucial for tailoring the treatment approach.
• 🔄 Dimension 5 looks at the potential for relapse and continued use, considering the client's environment and support system that could influence their recovery.
• 🏡 Dimension 6 assesses the recovery environment, including the client's living situation, family dynamics, and access to community resources and support.
• 🔄 Assessment is an ongoing process that should be continuously re-evaluated throughout the treatment to ensure the client receives the appropriate level of care.
• 🏢 The levels of care range from Level 0.5 (early intervention) to Level 4 (medically managed intensive inpatient care), with varying intensities and types of support.
• 💊 Special mention is given to opioid maintenance therapy programs that combine medication-assisted treatment with comprehensive clinical support.

Q & A

What are the ASAM Criteria?

The ASAM Criteria are guidelines established by the American Society of Addiction Medicine for assessing and placing clients into appropriate levels of addiction treatment based on a bio-psycho-social model.

How many dimensions does the ASAM assessment model consist of?

The ASAM assessment model consists of six dimensions that cover biological, psychological, and social aspects of a client's situation.

What does Dimension 1 of the ASAM assessment focus on?

Dimension 1 focuses on acute intoxication or withdrawal potential, assessing the client's current state of intoxication, the last time of use, and the severity of symptoms that may interfere with functioning.

Why is it important to assess general medical conditions and complications in Dimension 2?

Assessing general medical conditions and complications in Dimension 2 is important to determine how they may affect the type of treatment the person will receive and to ensure these medical issues are addressed throughout their care.

What psychological issues are considered in Dimension 3 of the ASAM assessment?

Dimension 3 considers cognitive, behavioral, and emotional conditions, including current mental illnesses or psychological/behavioral problems that may affect treatment or create risks.

Can you explain the concept of 'readiness to change' in Dimension 4?

In Dimension 4, 'readiness to change' refers to the client's motivation and willingness to receive services, including whether they are mandated into treatment or voluntarily seeking help, and their stage of change from pre-contemplation to maintenance.

What factors are evaluated in Dimension 5 regarding relapse and continued use potential?

Dimension 5 evaluates factors such as immediate danger of distress, continued drug use, relapse triggers, and the client's ability to cope with high-risk situations.

How does Dimension 6, the recovery environment, relate to the client's living situation?

Dimension 6 assesses the client's family and living situation, including the presence of drugs, supportive or harmful influences, educational and vocational status, legal issues, and the availability of community supports.

What is the significance of ongoing assessment in the ASAM model?

Ongoing assessment in the ASAM model is significant as it allows clinicians to continuously evaluate and adjust the level of care needed by the client, ensuring the treatment remains appropriate throughout the recovery process.

Can you provide an example of a level of care according to the ASAM Criteria?

An example is Level 3.5, high-intensity residential care, which involves 24-hour care with trained staff, suitable for clients who can tolerate a high-intensity therapeutic environment and require a stable living situation with group support.

What is the role of opioid maintenance therapy programs in the ASAM framework?

Opioid maintenance therapy programs, using medications like methadone or suboxone, provide pharmaceutical assistance along with case management and clinical support to help individuals with opioid addiction, offering a comprehensive approach to recovery.