BREAKDOWN OF QUESTIONS AND ANSWERS.
Measure of motivation (5)
1. Readiness to change
2. Pros and Cons
3. Self efficacy
4. Goals
5. Decisional Balance
Readiness for change
The stages of change readiness and treatment eagerness scale (SOCRATES) with the three factor
subscales: 1. problem recognition, 2. taking steps and 3. ambivalence
self-efficacy
Self assessment of ability to reduce of abstain from drug use.
Goals (measure of motivation)
goals of the client that they may wish to achieve in treatment
decisional balance
A physical manipulandum allowing the client to represent the overall positive versus negative effects of
drug use in the client's life. The client sets a balance bar and then the angle of deflection is read from a
protractor scale on the back on the instrument.
6 Dimensions of Multidimensional Assessment
1. Acute intoxication and or withdrawal potential
2. Biomedical conditions and complication
3. Emotional, behavioral, or cognitive conditions and complications
4. Readiness to change
5. Relapse, continued use, or continued use problem potential
6. Recovery, living environment
Continuum of care spectrum (least to greatest) ((11))
.5 early intervention (on going assessment)
1 Outpatient services- 9 hours weekly or less
2 Intensive outpatient/ Partial hospitalization services
2.1 Intensive outpatient services (IOP) ((9 hours weekly or more))
2.5 Partial hospitalization Services
3 Residential/inpatient services
3.1 Clinically managed low intensity residential services (half way house)
3.3 Clinically managed population-specific high intensity residential services
3.5 Clinically managed high intensity residential services
, 3.7 medically monitored intensive inpatient services
4 medically managed intensive inpatient services
Severity based on number of symptoms
F11.10 mild = the presence of 2-3 criteria
F11.20 moderate = 4-5 criteria
F11.20 sever = 6+ criteria
* severity changes overtime reflected by reduction or increase in frequency and or doses of substance
use.
Early remission (specifier)
No criteria for at least 3 months and less than 12 with the exception of cravings
In Sustained Remission (Specifier)
No criteria met for 12 months or longer with the exception of cravings
Maintenance therapy (specifier)
MAT and no criteria met
Controlled environment (specifier)
Environment where access to substances are restricted.
Readiness to change model
Pre contemplation --> contemplation--> preparation--> action--> maintenance
* can be thought of as a circle, but does not mean the process is in one direction
Opioid Use Disorder (DSM)
A problematic pattern of opioid use leading to clinically significant impairment or distress as manifest by
atleast 2 criteria within a 12 month period
Criteria for OUD (11)
1. taking more than intended
2. unable to cut down or control use
3. Spending more time obtaining and using and recovering
4. craving
5. failure to fulfill role obligations ( work, home, social)
6. continued use despite social and interpersonal problems caused by using
7. giving up or reducing social work and recreation activities because of using
8. using in situations which are physically hazardous.
9. using despite physical and psychological problems.
10. Tolerance
11. Withdrawal
4 categories of OUS criteria