Treatment Planning Tools ASI-MV

1 Treatment Planning Tools ASI-MV These Treatment Planning Tools summarize the client s self-reported data from the ASI-MV. When used in conjunction with the Problem Lists & Key Clusters and the ASI-MV Narrative Report, they provide useful information that may be addressed on the client s treatment care plan. This is only a guide and not intended to identify all strengths, all risks and all problem areas. Clinicians must use their clinical judgment to fully evaluate the client in a face-to-face interview. Potential client worksheets and handouts can be customized and printed from the ASI-MV Clinician Toolbox. Domain Severity Ratings* Client s Perception: Is this a problem? Client s Motivation: Is help wanted? Medical 0 0 0 Employment 7 3 2 Alcohol 6 4 3 Drug 4 2 1 Legal 0 0 0 Family/Social 1 0 0 Psychiatric 1 1 1 0 = Not at all; 1 = Slightly; 2 = Moderately; 3 = Considerably; 4 = Extremely *Severity Rating Legend: 0 1 No real problem; 2 3 Slight problem; 4 5 Moderate problem; 6 7 Considerable problem; 8 9 Extreme problem KEY CLUSTERS ASI-MV Possible Psychiatric Risks 1 Has been thinking of hurting self today. 2 Has helpless & hopeless feelings today. 3 Has made a suicide attempt in the past 30 days. 4 Has had a suicide plan in the past 30 days. 5 Has hallucinated today. 6 Has hallucinated in the past 30 days. 7 Reports being sexually abused in past 30 days. 8 Reports being physically abused in past 30 days. 9 Reports being emotionally abused in past 30 days. 10 Has had temper problems in past 30 days. 11 Has had thinking problems today. No risks reported. Potential Strengths / Supports Has a close significant other and no serious problems with him 1 or her in, at least, the last 30 days. Has people who are close and no serious problems with them 2 in, at least, the last 30 days. 3 Capable of close, personal relationships. 4 Usual living arrangement the last 3 years is with: 5 Satisfied with living arrangements 6 Has, at least, a High School or equivalent (GED) degree 7 Currently employed: 8 Has a car or other transportation available 9 Has a profession, trade or skill. 10 Longest full-time job (35+ hours) has been greater than 1 year. Reports alcohol-related problems in the last 30 days &, at least, 11 a moderate

2 Potential Strengths / Supports 27 12 Reports drug-related problems in the last 30 days &, at least, a moderate 13 Reports psychologically-related problems in the last 30 days &, at least, a moderate 14 Reports family-related problems in the last 30 days &, at least, a moderate 15 Reports socially-related problems in the last 30 days &, at least, a moderate 16 Reports employment-related problems in the last 30 days &, at least, a moderate 17 Reports medically-related problems in the last 30 days &, at least, a moderate 18 Reports legal problems in the last 30 days &, at least, a moderate 19 Has had no medical problems in the past 30 days. 20 Has no chronic medical problems. 21 Has had no employment problems in the past 30 days. 22 Has had no alcohol problems in the past 30 days. 23 Has never drank alcohol regularly (more than 3 days a week). 24 Has had no drug problems in the past 30 days. 25 Has never used drugs. 26 Has never been arrested and charged with any nonmisdemeanor crime. Has never been arrested and charged with driving while intoxicated. 28 Has had no family problems in the past 30 days. 29 Has had no social problems in the past 30 days. 30 Has had no psychological problems in the past 30 days. 31 Currently is receiving professional help for psychological problems. No strengths reported. Potential Assets Close significant other Close mother, father or sibling Close Friends Usual living arrangements with: Satisfied w/ living arrangement Does not lives w/ an alcohol or drug abuser Thinks it is important to change living situation to stay clean and sober. Has a car or transportation available KEY CLUSTERS ASI-MV Recovery Environment Potential Liabilities No Close significant other No close mother, father or sibling No close friends Usual living arrangement is: Not satisfied w/ living arrangement Lives w/ an alcohol or drug abuser Has no car or transportation available Has at least 1 child at home under the age of 18. Is currently pregnant.

3 Potential Assets Spends most of free time with family or friends. Has lived at current address for more than 2 years. Reports to be not at all troubled by problems at work or looking for work. No assets reported. Recovery Environment Potential Liabilities Spends most of free time alone. Has lived at current address for less than year. Reports alcohol-related Reports drug-related problems in the last 30 days, but less than a moderate motivation to get help for them. Reports psychologically-related Reports family-related problems in the last 30 days, but less than a moderate motivation to get help for them. Reports socially-related Reports employment-related Reports medically-related Reports legal problems in the last 30 days, but less than a moderate motivation to get help for them. Reports to be at least moderately troubled by problems at work or looking for work. No liabilities reported. Consistency of Response Summary 1 Skipped questions: # 2 Inconsistent Responses (see Narrative Report): #

4 Alcohol Client reports more than one episode of DTs (delirium 1 tremors). This is more than 95% of clients who have taken the ASI and should be followed up on. 2 Reports days of using alcohol in past 30: 3 Reports days of using alcohol to intoxication in past 30. Reports days of alcohol related problems in the past 4 30. 5 Perception of alcohol problems is: 6 Motivation for help with these problems is: No alcohol problems reported. 1 2 Drugs Client reports using more than two different substances in the past 30 days. This is a higher number than reported by 75% of clients who have taken the ASI and should be followed up on. Client reports more than two episodes of overdoses. This is more than 95% of clients who have taken the ASI and should be followed up on. 3 Reports usual route for using cocaine or crack is smoking it. 4 Reports having used needles to inject drugs. 5 Reports using drugs in the past 30 days. 6 Reports days of drug related problems in the past 30. 7 Perception of drug problems is: 8 Motivation for help with these problems is: No drug problems reported. Psychiatric Client reports more than two inpatient psychiatric 1 hospitalizations. This is more than 90% of clients who have taken the ASI and should be followed up on. 2 Has no history of serious depression or anxiety. 3 Has no history of visual or audio hallucinations. Reports days of psychological problems in the past 4 30. 5 Perception of psychological problems is: 6 Motivation for help with these problems is: No psychiatric problems reported (see Possible Psychiatric Risks section above).

5 Family / Social 1 Client reports being emotionally abused in past 30 days. 2 Client reports being emotionally abused in lifetime. 3 Client reports being physically abused in past 30 days. 4 Client reports being physically abused in lifetime. 5 Client reports being sexually abused in past 30 days. 6 Client reports being sexually abused in lifetime. 7 Reports days of family problems in past 30. 8 Reports days of social problems in past 30. 9 Has had a child removed from custody 10 Perception of family problems is: 11 Motivation for help w/ family problems is: 12 Perception of social problems is: 13 Motivation for help w/ social problems is: No family problems reported. Medical Client reports having more than 6 lifetime medical 1 hospitalizations. This is a higher number than reported by 90% of clients who have taken the ASI and should be followed up on. 2 Has chronic or other medical problems 3 Reports days of medical problems in the past 30. 4 Reports days of ER visits in the past 30. 5 Is currently pregnant. 6 Is currently receiving medical help. 7 Perception of medical problems is: 8 Motivation for help with these problems is: No medical problems reported.

6 Employment 1 Highest level of education is: 2 Current employment situation is: 3 Has drivers license or car available Client reports earning more than $7,500 in the past 30 days. 4 This is more than 98% of clients who have taken the ASI and should be followed up on. Client reports receiving more than $1,000 in the past 30 days 5 from unemployment compensation. This is more than 99% of clients who have taken the ASI and should be followed up on. Client reports receiving more than $800 in the past 30 days 6 from welfare. This is more than 99% of clients who have taken the ASI and should be followed up on. Client reports receiving more than $1,000 in the past 30 days 7 from pension or social security. This is more than 99% of clients who have taken the ASI and should be followed up on. Client reports receiving more than $1,000 in the past 30 days 8 from family or friends. This is more than 99% of clients who 9 have taken the ASI and should be followed up on. Client reports receiving income from illegal sources. This might include drug dealing, stealing, fencing stolen goods, illegal gamboling, prostitution, etc. This should be followed up on. 10 Reports days of employment problems in the past 30. 11 Perception of employment problems is: 12 Motivation for help with these problems is: No employment problems reported. Legal Client reports more than 6 arrests. This is more than 75% of 1 clients who have taken the ASI and should be followed up on. Client reports more than two convictions. This is more than 75% 2 of clients who have taken the ASI and should be followed up on. Client reports more than 17 months lifetime incarceration. This 3 is more than 75% of clients who have taken the ASI in noncriminal justice settings and should be followed up on. Has been arrested and charged with driving while intoxicated in 4 the past. Has been arrested and charged with non-misdemeanor crimes 5 in the past. 6 Is currently on probation or parole 7 Has had child removed from custody 8 Perception of legal problems is: 9 Motivation for help with these problems is: No legal problems reported.

7 Outcome Comparison Chart The following chart contains the client s current Composite Scores. If you wish to compare those scores to a previous ASI administration, hand-enter those previous scores in the designated column. Composite Scores are sensitive to change in the last 30 days and can be used in assessing outcomes. Domain Medical Employment Alcohol Drug Legal Family/Social Psychiatric Current Composite Scores* Previous Composite Score (enter by hand) Date: Difference/ * Composite Scores range from a low of.00 to a high of 1.00. Clinician Impressions:

8 Domain Possible Client Handouts & Worksheets Severity Ratings* Client s Perception: Is this a problem? Client s Motivation: Is help wanted? Possible Handouts/Worksheets (see ASI-MV Clinician Toolbox) Medical CC-1,2,10; HO-5 Employment CC-1 to 10 Alcohol RP-1 to 23; HO-1 to 5; CC-1 to 10 Drug RP-1 to 23; HO-1 to 5; CC-1 to 10 Legal CC-1, 2, 9, 10 Family/Social RP-20,21,22; HO-2, 5;CC-1 to 10 Psychiatric RP-20, 21, 22; CC-1 to10 RP-1 RP-2 RP-3 RP-4 RP-5 RP-6 RP-7 RP-8 RP-9 RP-10 Relapse Prevention Preventing Relapse Quiz How Well Are You Preventing Relapse? Stages of Recovery Relapse Prevention Self Assessment Treatment Attitudes Questionnaire Negative Behaviors in Treatment Recovery Behaviors Form High Risk Situations for Relapse My High Risk Situations Some Common Dilemmas RP-11 My Recovery Dilemmas RP-12 Managing Cravings: Tricks and Tools RP-13 My Craving Triggers RP-14 Protracted Withdrawal RP-15 Abstinence Violation Effect RP-16 Seemingly Irrelevant Decisions RP-17 My Relapse Attitudes RP-18 Managing My Relapse Thinking RP-19 Think Your Way Out of Using RP-20 Assessing Your Lifestyle HO-1 HO-2 HO-3 HO-4 HO-5 CC-1 CC-2 CC-3 CC-4 CC-5 Addictions What is Addiction? Points for the Family to Remember Denial Myths of Addiction Ten Things You Should Know About Alcohol and Addiction Continuing Care Self-Care Goals Worksheet Self-Care Assessment Feeling Management Ideas Feeling Skills Handout Assertiveness Skills CC-6 Learning To Say No CC-7 Unrealistic Thinking CC-8 What is Depression and Anxiety CC-9 Support Network Survey CC-10 Relaxation Employment RP-21 RP-22 RP-23 Leisure Activity Exercise Social Survival Manual Safe and Dangerous Contacts E-1 The Ready-for-Work Checklist E-2 The Right Job Checklist E-3 Thinking About a More Open Recovery E-4 Making Work Work for You Resources R-1 General Resources for Help & Info

9 Treatment Care Plan: Initial Review Date: Problem #1: Behavioral Goal: Intervention(s): Target Date: Person Responsible: Problem #2: Behavioral Goal: Intervention(s): Target Date: Person Responsible: Problem #3: Behavioral Goal: Intervention(s): Target Date: Person Responsible: Review Date: Name: Signature: Date: