Assessment, Diagnosis & Interview Techniques
Chapter 4 in the text presents information on various alcohol and drug assessment instruments that can be used during the substance abuse-dependency assessment. The use of motivational interviewing (MI) techniques, as developed by W.R Miller and Rollnick (2013) are included to help counselors work with initial client resistance and ambivalence to counseling. Students are introduced to The Diagnostic and Statistical Manual of Mental Disorders (DSM-5, American Psychiatric Association, 2013) and will learn about Comprehensive Assessments, and Minnesota’s Direct Access which replaced the former Rule 25 process on June 30, 2022.
Note: Students majoring in Alcohol and Drug Counseling will complete further studies in Assessment in the required core course HSCD 302 Assessment of Substance Use Disorders.
Learning Objectives
By the completion of this module, the student will be able to do the following according to the two conditions below:
Condition 1- completion of quiz 4 according to course standards (refer to syllabus):
Differentiate between abuse and dependency
Recognize approaches to improving accurate diagnoses
Examine a Comprehensive Assessment example
Understand Minnesota’s Direct Access process
Condition 2- completion of week 6 writing assignment relating to the text and resources:
Demonstrate critical thinking and reflection by completion of Week 6 writing assignment in one or more paragraphs relevant to Assessment, Diagnosis, and Interviewing Techniques.
Minnesota’s “Direct Access” and “Comprehensive Assessments”
Overview: Direct Access is the process in Minnesota in which publicly paid substance use disorder (SUD) treatment services can be accessed by individuals who are eligible for financial help. Direct Access allows an individual to go directly to an enrolled Minnesota Health Care Programs (MHCP) provider they choose to receive a comprehensive assessment and access care immediately. Direct Access removes barriers of timing associated with going through a placing authority, allows for individual choice, and removes duplication of comprehensive assessments.
How does Direct Access support client choice?
Direct Access allows for an individual to choose where they would like to access treatment. Individuals will be able to seek out the provider of their choice from the enrolled provider list. In the Direct Access process, there is no service agreement with a specified level of care and treatment location that the individual must follow. The Direct Access process allows for the individual to have a comprehensive assessment completed and then choose the provider and level of care they would like to participate in; up to the highest level of care determined necessary. i.e. An individual may be assessed for residential level of care, but due to a number of circumstances, they are only willing to participate in nonresidential care. This is an example of downward deviation occurring.
How is the Direct Acess/client financial eligibility determined?
People who qualify can get help paying for substance use disorder treatment through their local county or tribal office. Federal, state, and county governments put money into a Behavioral Health Fund (BHF) so that Minnesotans with low income can get needed treatment. For more information view the Behavioral Health Fund Eligibility Guidelines 2022
Clients are entitled to have substance use disorder services paid for by the BHF if the client:
Is enrolled in Medical Assistance (MA)
OR
Meets specific household size (HHS) and household income (HHI) limitations. Information about the HHS and HHI can be found on the MN DHS website: DHS Get Help
What is the comprehensive assessment?
The comprehensive assessment and comprehensive assessment summary go hand in hand, and are sometimes just referred to as the comprehensive assessment. There is no single, Commissioner approved or mandated “tool” or form for a comprehensive assessment. There are elements that are required to be included in the comprehensive assessment and summary and this can be found in 245G.05
Who can provide comprehensive assessments?
Comprehensive assessments must be completed by a provider enrolled as a Minnesota Health Care Programs (MHCP) provider for Substance Use Disorder (SUD) Services to provide, bill, and receive payment for SUD services
Eligible providers may include the following:
• Licensed Residential SUD treatment programs
• Licensed Nonresidential (Outpatient) SUD treatment programs
• Counties
• Tribes
• Recovery Community Organizations (RCOs)
• Hospitals
• Federally Qualified Health Clinics, and Rural Health Clinics (As long as they also have a substance use disorder program license)
• Licensed Professionals in Private Practice
A licensed professional in private practice must be someone who is licensed under Minnesota Statutes 148F, or is exempt from licensure under that chapter, but is otherwise licensed to provide alcohol and drug counseling services; practices solely within the permissible scope of the individual’s license as defined in the law authorizing licensure; and does not affiliate with other licensed or unlicensed professionals to provide alcohol and drug counseling services.
• Licensed Withdrawal Management programs
Detailed information about the phasing out of Rule 25 and the implementation of Comprehensive Assessments can be found on the MN Dept of Human Services (DHS) website at:
Assignments
Read Textbook Chapter 4
Watch the video Introduction to Motivational Interviewing (17:22)
Read DSM-5 document
Review the PDF of 245G Comprehensive Assessment Elements
Review a Comprehensive Assessment example and Comprehensive Assessment Summary
Complete Chapter 4 Writing Assignment
Complete Quiz 4 (content from this week only)
Optional Reading
Summary sheet comparing the former DSM IV Alcohol Abuse/Alcohol Dependence criteria to the newer DSM V Alcohol Use Disorder criteria (used for diagnosis):
Comparison Between DSM-IV and DSM-5.pdf
