Assessing Alcohol Use Disorders

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If you are going into any sort of alcohol or drug treatment program, one of the first things that will happen is an assessment of your drinking problem.

Whether you are voluntarily entering a long-term residential treatment facility, an outpatient program, or you are entering a mandatory drug court program or a drunk-driving school, the first step will be an evaluation of your drinking.

An initial assessment is a necessary first step to determine if you do have an alcohol or drug problem, the severity of the problem and to determine a plan for treatment.

Goals of the Assessment

In most cases, the goals of the assessment include:

  • Aid in the diagnosis of alcohol use disorder.
  • Establish the severity of the problem.
  • Guide treatment planning.
  • Define a baseline of your status.

The assessment is an on-going process that continues throughout your treatment to evaluate progress and adjust the treatment plan if needed.

Answering Essential Questions About Treatment

Typically, the assessment is designed to determine:

  • If you can go through withdrawal without medication.
  • Whether you need outpatient or inpatient treatment.
  • If inpatient will you also need psychiatric services.
  • What mix of therapies is best for your specific situation.
  • How has your status changed during treatment?

Depending on the type of program that you are entering, the initial assessment may be comprised only of a questionnaire. If the program is comprehensive, however, the initial assessment will include a medical examination and a clinical interview, as well as several tests or questionnaires.

Clinical Interviews

At some point during the early part of your treatment, you will find yourself sitting down and talking with a clinician—a specifically-trained professional who will interview you face-to-face about your situation.

Usually, you will have completed a medical exam and at least one questionnaire prior to talking to the clinician—who may be a medical professional, a counselor, caseworker, social worker, probation officer or some other officer of the court.

A treatment clinician will ask you questions about yourself and may use a variety of tests and questionnaires—known in the treatment field as formal assessment instruments—to try to find the best treatment approach for your personal situation.

The assessment instruments will be helpful in guiding the clinician toward the right treatment program for you, but in the end, it will be the counselor's experience and judgment that will determine what course of action is needed.

The Battery of Tests Available

There are literally more than 100 alcohol assessment questionnaires and tests that are available to help the clinician determine your treatment needs.

One of the first tests you might be given would assess the severity of your withdrawal symptoms when you stop drinking. This will tell the counselor whether or not you will need medications to help you deal with withdrawal.

Assessing the Complete Problem

To help diagnose the severity of your alcohol abuse disorder, there are dozens of tests available—ranging from short four- and five-question tests usually used in busy primary care offices, to questionnaires that are several pages long.

The questions on these tests usually do not ask you directly about how much or how often you consume alcohol because most people who have an alcohol problem deny or minimize their alcohol consumption.

Instead, the tests ask you about problems associated with alcohol consumption, such as, "Have you ever missed work because of your drinking?"

Psychological and Other Problems

Depending on your situation, the clinician may give you other questionnaires that have nothing to do with drinking directly. You may be given a general psychological test to assess your personality, cognition, and neuropsychological characteristics.

The amount that you drink may be just part of the problem. You may also be given tests to determine if you have developed problems in other areas such as medical, legal, psychiatric, drug abuse, employment, and family.

Trying to Help You

The purpose of this entire process is to try to find the best approach to help you deal with whatever problems you are facing. The counselor or court officer is not there to judge you or criticize you, but to help you.

The best thing that you can do, if you find yourself in such a situation, is to cooperate and answer the counselor's or the test questions as honestly as possible, so that those who are trying to help can make the best, most informed decisions.

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  1. Oscar-Berman M, Valmas MM, Sawyer KS, Ruiz SM, Luhar RB, Gravitz ZR. Profiles of impaired, spared, and recovered neuropsychologic processes in alcoholism. In: Handbook of Clinical Neurology. Vol 125. Elsevier; 2014:183-210. doi:10.1016/B978-0-444-62619-6.00012-4

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