Online Repository of AOD screening and assessment instruments

February 2020

Screening and assessment instruments help identify AOD use, the degree of risk and associated problems. They can also be used to monitor progress in both acute situations and over time. In a primary care setting, early identification of AOD problems generally leads to better client outcomes. In a clinical setting, screening and assessment are an important aid in monitoring client progress. An increased emphasis on measuring AOD treatment outcomes has seen screening and assessment instruments increasingly used as a valuable tool to measure outcomes.

Standardised screening and assessment are crucial for early prevention, intervention and client/patient safety. Over the past decade, a number of documents have been produced synthesising AOD screening and brief intervention assessment tools. For example, the Queensland Alcohol and Other Drug Treatment and Harm Reduction Outcomes Framework released in 2019 recommended a suite of commonly used tools in Queensland AOD treatment settings.

However, currently there is no online central location where Australian AOD services can readily access relevant AOD screening and assessment instruments. NCETA identified a need for a specific repository of commonly administered AOD screening and assessment instruments, along with a description of each instrument’s utility and application.

Background

Routine screening and assessment help identify the needs of clients and are fundamental to case formulation which in turn allows for early diagnosis, intervention, and treatment and ultimately impacts client treatment outcomes [1]. Standardised screening and assessment tools also provide a reliable and valid view of a client’s current circumstances. A standardised assessment can also be used to build rapport between the client and worker [2].

Screening and assessment are interlinked but separate processes:

  • Screening identifies people who may be at risk of problematic AOD use. Screening forms the initial step in identifying possible issues and conditions. Screening is not a diagnostic tool but rather it helps to direct client care by identifying issues requiring further investigation and possibly treatment [1, 3].
  • An assessment is a formal clinical evaluation to ascertain whether a person meets the diagnostic criteria. It is used to obtain a detailed understanding of the client’s presenting issues and current circumstances [4].

Assessments can also be undertaken within specific clinical circumstances, for example, when a client is undergoing withdrawal. In these circumstances, withdrawal assessment scales are used to monitor a client’s withdrawal symptoms and severity [4].

Standardised assessments completed upon treatment entry and exit can also provide important information for evaluating treatment outcomes including effectiveness [2]. When measuring client outcomes, data obtained from screening and assessment tools can be used as an adjunct to client questionnaires, surveys, feedback mechanisms, client / practitioner record keeping and regular auditing procedures [5].

What we did

In developing the online repository, NCETA conducted a search of publicly available Australian government and non-government AOD-related documentation that mentioned AOD screening and assessment instruments. This included frameworks (e.g., treatment service delivery and treatment outcomes frameworks), guidelines, policies, websites and other repositories. Following advice from key stakeholders, the parameters of the repository were expanded to include measures commonly used for AOD withdrawal assessment. 

The initial repository comprises the AOD instruments which were:

  • Most often listed / referred to in the documents sourced by NCETA
    • Highlighted during stakeholder discussions.

Each instrument in the repository includes:

  • Electronic links to PDF, online, word and interactive formats
  • An accompanying briefing document describing the instrument and highlighting its application and utility.

Next Steps

The repository will be made publicly available via the NCETA website in mid-2020. It is intended for use by any organisation, including specialist and generalist AOD workers (e.g., nurses, doctors, social workers, peer workers) working with individuals and communities experiencing AOD issues.

The repository will subsequently be expanded to include mental and physical health and health-related quality of life screening and assessment instruments; and client-reported outcome measures.

References

  1. Deady, M. (2009). A review of screening, assessment and outcome measures drug and alcohol settings. Network of Alcohol and other Drug Agencies (NADA). Sydney, New South Wales.
  2. Marel, C., Mills, K.L., Kingston, R., Gournay, K., Deady, M., Kay-Lambkin, F., Baker, A, & Teesson, M. (2020). Standardised screening and assessment, Guidelines on the management of co-occurring alcohol and other drug and mental health condition in alcohol and other drug treatment settings. [Accessed: 5 February 2020], https://comorbidityguidelines.org.au/b2-identifying-comorbidity/standardised-screening-and-assessment
  3. Roche, A., & Pollard, Y. (2006). Improved services for people with drug and alcohol problems and mental illness: Assisting alcohol and other drug (AOD) non-government organisations to better respond to people with comorbid AOD and mental health issues. National Centre for Education and Training on Addiction (NCETA). Adelaide, South Australia.
  4. Stone, J., Marsh, A., Dale, A., Willis, L., O’Toole, S., Helfgott, S., Bennetts, A., Cleary, L., Ditchburn, S., Jacobson, H., Rea, R., Aitken, D., Lowery, M., Oh, G., Stark, R., & Stevens, C. (2019). Counselling Guidelines: Alcohol and other drug issues (4th ed.). Perth, Western Australia: Mental Health Commission.
  5. Queensland Alcohol and Other Drugs Sector Network. (2019). Queensland Alcohol and other Drug Treatment and Harm Reduction Outcomes Framework. Brisbane, Queensland Alcohol and Other Drugs Sector Network