Assessing our youth: clinician perceptions of assessment practices with adolescents in substance abuse treatment

Abstract

This study documents the assessment practices of substance abuse counselors working with adolescents, to understand how these clinicians use information gathered during the assessment process, and to determine what factors influence counselors' use and perceived value of assessment data. The project helps to better understand assessment practices and, by implication, how these practices have been shaped by supervision and training, policy, culture, and other factors. Substance abuse assessment is the process of gathering information about an individual in order to identify the presence of substance abuse-related problems, placement and referral needs, and any additional problems to be addressed. Once the assessment is complete, the best practice in the field is to summarize the data gathered and use that information to create a treatment plan, which then guides the treatment process. A concurrent triangulation mixed methods design was used. Quantitative surveys and qualitative interviews were conducted with substance abuse counselors in Hawaiʻi serving adolescents. The theoretical basis for this study was Social Cognitive Theory, which conceptualizes counselors' engagement with the assessment process through the reciprocal interaction of environmental, personal, and behavioral determinants. The research findings indicate that assessment tools need to be appropriate and engaging for adolescents, with an emphasis on keeping the assessment brief and using language that is easy for youth to understand. It is important to encourage openness, honesty, and trust with youth by helping them know what to expect in the process and by explaining confidentiality. The assessment process is valuable for gathering information, as well as building rapport, establishing roles, and increasing the client's motivation. The domains of drug and alcohol history, family, peer/social relationships, and school background were identified as the most valuable sources of information and were also most frequently integrated into treatment planning. Experience, supervisory valuation of assessment, and role were associated with the valuation of assessment, while agency valuation of assessment was associated with use of assessment data. Based on these findings, recommendations for policy, education and training, stakeholder engagement, instrument development, and youth engagement were identified.