Assessment of Addiction and Mental Health Issues

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Assessment of Addiction and Mental Health Issues Identifying the Problem

Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUsPodcast Host: Counselor Toolbox & Happiness isn’t Brain Surgery Author: Journey to Recovery (2015) & Happiness Isn’t Brain Surgery (2017)


Objectives Define screening and assessment Define the purpose of assessment Explore the steps in the assessment Recognize the stage of change a client is in

with regards to mental health and substance abuse and utilize this towards creating a treatment plan.

Learn about the first steps in moving toward happiness


Why Is This Important 47% of US Adults suffers from maladaptive

signs of an addictive disorder over a 12-month period

Co-Occurring Disorders are the EXPECTATION not the Exception

Statistics indicate that the majority of people seen in mental health treatment struggle with addictive behaviors.

Refer for treatment or treat yourself


Screening and Assessment Screening is a very quick process which can

be done by Physicians Coaches Specialists/Techs Counselors

Screening simply determines if there may be a need for further evaluation.


Purpose of Assessment To identify symptoms Explore the course of the symptoms Identify exacerbating and mitigating factors Determine the impact of symptoms Identify change goals Develop an action plan based on identified

goals


Assessment Provides Awareness of SNAP Strengths

◦ Resources◦ Skills◦ Mitigating Factors and exceptions

Needs◦ Biological◦ Safety◦ Love and Belonging

Attitudes◦ About recovery◦ Cultural


Awareness of SNAP Preferences

Learning style Treatment approach Quality of Life


5 Principles of Motivational Interviewing Generate a Gap Roll with Resistance Avoid Arguing Can Do Express Empathy


Stages of Readiness for Change Most people have multiple issues Readiness for change can be different for each

issue---even each symptom of each issue Stages

Precontemplation Contemplation Preparation/Determination Action Maintenance (needs attention when addressing new

issues)


Addiction (vs. Recreational Use) Tolerance need more to get the same rush, high or feeling. Withdrawal: Anxiety, irritability, shakes, sweats, nausea,

depression when unable to access the addiction Negative consequences: Continued to use even though

there have been negative consequences. Neglected or postponed activities because of your use? Significant time or energy spent obtaining, using,

concealing, planning, or recovering from your use. Unsuccessful attempts to cut down or control your use


Chemical and Behavioral Addictive behaviors causes a “flood” of neurochemicals This flood contributes to an imbalance Like a “hangover” occasional use does not necessarily

alter brain functioning Repeated use causes the brain to shut down certain

pathways so it is not constantly being flooded (tolerance)

Many other issues such as pre-existing anxiety or depression can indicate a pre-existing neurochemical imbalance which is being self-medicated

Requires additional stimulation to produce the same relief because many fewer “doors” are open


Mental Health Depression/Hopelessness/Apathy Anxiety/Worry Difficulty Concentrating Irritability Agitation Fatigue Changes in sleep duration or quality Changes in eating


First Steps Identify the Problem Identify the Solution Learn about what causes the problem in

general Learn about what causes the problem for

you Learn about possible solutions Identify solutions that will work for you Develop a plan to start implementing those

solutions


Presenting Problem Presenting problem

What are your symptoms (as evidenced by) How long has each been going on What makes it worse What makes it better What are the consequences of each symptom (as

evidenced by)


Resolution/Goal What does happiness look like for you?

What will be different?EmotionallyMentallyPhysicallySocially (self-esteem, relationships and recreation)Environmentally

What will be the same?


Transactional Model The way you feel emotionally or physically

impacts: How you interact with others Your stress response Your attitude and ability to concentrate Your environment

Each one of those things also impacts how you feel


Evaluate potential causes of the symptoms Physical

Sleep Nutrition Pain/Illness Sunlight Exercise Addiction

Alcohol Anxiety Depression Tremors


Evaluate potential causes of the symptoms Physical

AddictionAmphetamines, cocaine and other stimulants can trigger

Anxiety, panic Depression (withdrawal) Tremors

Marijuana can trigger Anxiety Apathy/Lack of motivation Impaired concentration Paranoid delusions/hallucinations


Evaluate potential causes of the symptoms

Physical Addiction

Opiates Depression Decreased pain tolerance Disruption of circadian rhythms



Age Many physiological changes take place as a result

of age. Taking this into account can assist in determining some of the possible causes of symptoms

Younger people have fewer experiences against which to judge current experiences

The culture and environment changes for people of different ages.


Evaluate potential causes of the symptoms Social

Your immediate family Social supports Stressors Self-Esteem

Environmental Active/Interruptions vs. Calm/Peaceful Supportive of sleep? Supportive of relaxation?



Emotions Anger Anxiety Depression Happiness

Thought triggers for each emotion


Symptom AssessmentBehaviors Thoughts Environments

Make the symptom worse

Make the symptom better

Impact of Symptom


Symptom Assessment: LennyBehaviors Thoughts Environments

Make the symptom worse

• Working out really hard for several days

• Not getting enough sleep

• Too much caffeine

• I am having another cardiac episode

• I can’t breathe• I have to make this

stop• I am overwhelmed

• Chaotic environments

• Negative people

Make the symptom better

• Working out moderately each day

• Getting sufficient sleep• No caffeine• Doing something each

day I enjoy to have a sense of accomplishment

• Petting Mojo

• Positive self-talk• Focus on what I need

to do better to eliminate the symptoms

• Focusing on the things I can change and letting go of what I cannot

• Aromatherapy• Clean/organized

environments• Calm

Impact of symptom

• Afraid to workout• Lethargic

• Increase a sense of helplessness

• Become “stressed”

• Withdraw from other people


Next Step Work on becoming mindful of your symptom

triggers Do a mindfulness scan prior to each meal to

identify how you feel and what you need…EmotionallyMentallyPhysically


Summary The Assessment is really the beginning point It helps clients get a clearer idea of what may be causing

their symptoms or making them worse. Proper nutrition, adequate quality sleep and pain

management are all necessary for happiness and recovery At this stage clients are starting to envision what

happiness looks like for them. Help them identify their strengths and what things are

good uses of their energy


Summary Identify which presenting symptoms the client is

most willing to work on a develop a treatment plan from there

From the perspective of the transactional model, improving any area will likely improve the person’s overall happiness

The symptom assessment chart can help identify current strengths and possible contributors to the symptom.


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Assessment of Addiction and Mental Health Issues

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