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ASSIST Screening for Substance use: Assessment 1 Answer

Summary: Assessment 1 requires you to analyse the interview techniques utilised in a video featuring a substance-use interview. The video resource can be found within the SNPG939 Moodle Site under Assessments. 

You will need to watch the video and then critique the interview techniques, paying attention to the following elements:

1. The interviewer's initial contact with the person experiencing a substance-use disorder (the 'interviewee') 2. The level of rapport and respect the interviewer show to the interviewee

3. The interviewer's assessment of the interviewee's readiness to change 4. The interviewer's identification of impact of substanc use on the interviewee's health

5. The interviewer's identification of impact of substance use on the interviewee's lifestyle

6. The interviewer's identification of other stressors the interviewee may be experiencing

7. The interviewer's level of overall engagement with the interviewee

8. The way in which the interviewer concluded (ended) the interview

You will need to write an essay, critiquing the techniques you have observed. 

You will need to watch the video and then critique the interview techniques, paying attention to the following elements:
1. The interviewer's initial contact with the person experiencing a substance-use disorder (the 'interviewee')
2. The level of rapport and respect the interviewer show to the interviewee
3. The interviewer's assessment of the interviewee's readiness to change 4. The interviewer's identification of impact of substanc use on the interviewee's health
5. The interviewer's identification of impact of substanc use on the interviewee's lifestyle
6. The interviewer's identification of other stressors the interviewee may be experiencing
7. The interviewer's level of overall engagement with the interviewee
8. The way in which the interviewer concluded (ended) the interview
You will need to write an essay, critiquing the interview techniques you have observed. That is, you need to not only name and describe the techniques, buts also critically analyse their use in this context. Ensure that you draw on appropriate and scholarly references explain and justify your responses.

Answer

ASSIST Screening for Substance use

Interview assessment

Introduction 

Mental health is explained as the state of well being in relation to psychological, emotional and social health that can be promoted through sharing of feelings in a regular manner and taking care of physical health. In Australia, the most prevalent mental disorders are depression, anxiety and substance use disorders. According to the available statistics, substance abuse and mental health problems affect over 4 million people in the year 2015 while $9 billion was spent on mental health in 2015-16 (AIHW, 2018). 

The paper introduces a scenario between an Interviewer named Mark, who is a therapist and Gavin, a young person with a substance use problem. Gavin was detoxified of the harmful chemicals three months ago and is present before Mark for consultation. The paper glances over ASSIST screening tools for preliminary detection and analysis of the substance use problem (ASSIST screening tool for problematic substance use).

ASSIST Screening interview assessment

Interviewer’s initial contact with interviewee 

The initial contact of the interviewer with the interviewee, Gavin was quite engaging as the interviewer, Mark asked Gavin to take the seat and explained to him the reason for the meeting. Gavin was pretty convinced from the start that the meeting was not necessary as he was doing well overall but Mark comfortably convinced that since Gavin's mother was worried about him, so it will be helpful to her if Mark provided an assessment of her son (Hasin et al., 2015). Mark started by asking about Gavin's daily activities in the TAFE program to which Gavin replied that he believes that the teachers in the program are pathetic and that he might know more than his teachers do (Beckley, Netherton & Barber, 2018). He also said that he is working on a tech project and wants to change the world in a better way. Mark went on to ask more questions about the project humorously rather than moving on to the next question.

Level of rapport and respect shown by the interviewer 

The interview projected that initially Gavin tried to be cooperative to the questions of the interviewer but was seemingly getting frustrated on as Mark was asking more questions. The sarcastic tone while answering was evident when he tried to explain the software project that he was working on. In spite of the frustration that Gavin was showing, Mark handled the situation pretty well and understood the situation accurately.  During the whole interview, Mark knew what kind of questions he could ask Gavin and was trying to get a clear idea about his mindset (Rieckmann, 2016). Despite knowing that Gavin had a substance use problem, he was calm and composed and respected the interviewee’s thoughts and ideas about the whole situation. Mark when trying to identify the drugs that Gavin was currently using and had used in the past, there was a tinge of worry in his tone but made sure that he was able to get Gavin to co-operate (Begun, Early & Hodge, 2016).

Interviewer’s assessment of the interviewee’s readiness to change 

Mark was assessing every detail of Gavin’s substance use problems intricately. The interviewer was taking written notes about the kind of substances Gavin was using and how much he was using the substances in a week. The interviewer was also reviewing the past assessment of Gavin’s behaviour and problems (Montgomery, Burlew & Korte, 2017). Mark had a questionnaire and was asking all the necessary questions. The interviewer was strictly sticking to the list of questions provided and was also indulging in the problems that were affecting his behaviour. Mark was seemingly coercing Gavin to provide all his activities in detail. The interviewer was actively listening to the issues that Gavin was facing and delivering solutions at times. The assessment was based on the substances used by Gavin currently, essentially on Alcohol, Cannabis, and Cigarettes (Jiang, Wu & Gao, 2017). The assessment result was converted into scores where low scores indicate a low risk of relapsing and high scores indicates a high risk of relapsing. Mark found that Gavin's alcohol problem falls on the low-risk zone, but cannabis and tobacco usage falls on moderate risk zone (Perron et al., 2017). After the identification of the problem, Mark provides an evaluation of the problem to Gavin and make him realise that he needs to completely stop smoking cannabis as it was messing with Gavin's mental health.

Identification of the impact of substance use on health 

Drugs are chemicals that affect the body as well as the mind in diverse ways. Engaging substance use can have a long-lasting and permanent adverse effect on a person both mentally and physically. Drugs cause flooding of the brain with dopamine as well as neurotransmitters that regulates a person's emotions and feelings producing a "high" (Davies et al., 2015).

During the interview, Mark found out that the substances which Gavin was using on a regular and non-regular basis were causing anxiety, paranoia, depression, decreased memory problem and high blood pressure. Mark mainly expressed his concern over the use of cannabis among others. Gavin thought that using cannabis helped him focus on his project and Mark did not seem to indulge the idea but also did not deny it. The interviewer also believed that the substance problem in Gavin was making him weaker physically and mentally (Cecil et al., 2017). The interviewer knew that people suffering from addiction possess a risk to intentionally or unintentionally harm self and others.

Identification of the impact of substance use in lifestyle 

Drug addiction or substance use negatively affects the lifestyle of a person. The modern society is aware of the issues created by addiction; still people especially youths tend to indulge themselves into drug use. However the drugs are easily made using unsupervised chemicals, the prices of drugs such as ecstasy, cannabis, and cocaine among others are incredibly high depending upon the nature of the addiction (Barbosa et al., 2017).

In the interview, Mark realises that buying cannabis is burning a hole in Gavin’s pocket. The cannabis costs around 100 bucks to get his hands on but since he is addicted to the substance, it has led to dependence (Kotelchuck et al., 2017) When the interviewer asks him why he has not stopped using, Gavin gives an excuse that using cannabis helps to focus on his project and therefore he is willing to continue his current lifestyle.  

Identification of other stressors 

Psychosis refers to an event when a person has a split from reality. This often includes but doesn't necessarily require having hallucinations, delusions or false beliefs that are tightly held by the person despite the apparent indication of the contrary (Ham et al., 2017). Drug-induced psychosis is a phenomenon where due to excessive drug use; the person could suffer from a state of psychosis. 

During the interview, Mark could deduce that use of cannabis currently and use of other substances in the past is making Gavin mentally and physically weak. Mark finds that Gavin was suffering from paranoia, depression among other mental issues (Ogloff et al., 2016). Upon further investigation, Mark found out that Gavin was experiencing psychosis-like hearing voices among others for the last two months. This could necessarily mean that Gavin could have been in the verge to relapse.  

The overall level of engagement 

Individuals with substance use problems are often difficult to engage with during treatment. Poor commitments may lead to more impoverished conclusions like relapsing or rehospitalisation. Engagement occurs in the framework of an individual's personality, conditions, and symptoms (Das et al., 2016). Other than this numerous other factors contribute to maintaining someone's willingness and commitment to connect in treatment or for the individual to leave treatment.

In the interview, Mark uses various tools and approaches to detect the health concerns regarding substance use problem in Gavin. Mark uses ASSIST screening tools to screen Gavin's problematic substance use. Mark provides person-centered care during the whole interview and gives necessary feedback and advises to Gavin relating to his addiction to Cannabis (Vendetti et al., 2017). Mark uses various modes of engagement like asking questions to Gavin about his daily activities, work and types of substances he is using. Mark covers the primary assessment of Gavin based on the nature of his actions, strengths, and weaknesses, stages of diagnosis based on prior treatment and preliminary determination of the severity of the substance use (Neger & Prinz, 2015).

Ending of the interview 

The interview concluded with Mark expressing concerns about the mental state of Gavin. The interviewer declares that due to using of cannabis the mental health of Gavin is deteriorating. Mark advises him to keep health on the top of the list of priorities (Dahlberg, Anderberg & Wennberg, 2017). The interviewer warns Gavin that if he continues to indulge himself in substance use, he could be rehospitalised. Gavin insists on keeping with the cannabis as it helps him to focus on his work, but Mark tells Gavin to cut back on the work hours to get his sleep back on track then he might get over the danger of relapsing (Russett & Williams, 2015). Finally, Gavin realised the right thing to do and promised to keep in touch with Mark.

Conclusion

The scenario provides a fundamental idea of how substance abuse can harm the mental state of people. The case is also ideal for the therapist and other professionals to know how to treat substance abuse problems with the right tools. The tools helped mark to identify the leading cause of the psychotic episode that Gavin experienced and based on the analysis, he evaluated that cannabis is the substance which is causing the problem. Mark provides an evaluation of the question to Gavin and makes him realise that he needs to completely stop smoking cannabis as it was messing with Gavin's head. 

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