Assessing Substance Use

There are a number of assessments that one can use to assess the severity of substance use. These assessments can be useful for diagnosing substance use disorder and tracking clients' progress in counseling. Using assessments requires knowledge of research terms, particularly internal validity (are we measuring what we think we are measuring), external validity (how well does this apply to the broader population), and reliability (are results likely to stay consistent across time). While reliability might seem like it is always a good thing, a counselor who is measuring a clients treatment progress before each weekly session might expect lower reliability, as the client's scores should decrease with treatment. If you need a research refresh, check out the Research in Counseling Class.

Recommended Readings & Resources

To get the most out of this unit, please review the following:

  1. NIDA Chart of Evidence-Based Screening Tools and Assessments
  2. DSM-5 Assessments Unit
  3. Assessing Suicidal Ideation Unit

Learning Objectives

After completing this unit, students will be able to:

  1. Locate and compare and contrast assessments that are useful when counseling clients who use substances.
  2. Practice administering and interpreting results from DSM-5 assessments.
  3. List factors, including substance use, that indicate a client may be at risk for attempting suicide.
  4. Practice using multiple verbal protocols for assessing suicidal ideation.
  5. Use CDC data to describe what age groups are most at risk for completing suicide.
  6. Describe the role that data plays in developing assessments for suicidal ideation.

Ethics & Assessments

Sections E.2 and E.3 of the American Counseling Association 2014 Code of Ethics provides counselors with guidance regarding their use of assessments.

Counselors use only those testing and assessment services for which they have been trained and are competent. Counselors using technology-assisted test interpretations are trained in the construct being measured and the specific instrument being used prior to using its technology-based application. Counselors take reasonable measures to ensure the proper use of assessment techniques by persons under their supervision.

ACA, 2014, E.2.a

Counselors are responsible for the appropriate application, scoring, interpretation, and use of assessment instruments relevant to the needs of the client, whether they score and interpret such assessments themselves or use technology or other services.

ACA, 2014, E.2.b

Counselors responsible for decisions involving individuals or policies that are based on assessment results have a thorough understanding of psychometrics.

ACA, 2014, E.2.c

NIDA EvidenceBased Substance Use Screening Tools

The National Institute of Drug Abuse (NIDA) maintains charts of evidence based substance use assessments for adolescents and adults. Many of the assessments are free to use. Click here to review the chart. Try taking a few of the different instruments.

DSM-5 Assessments

Spend some time checking out the DSM-5 Assessments webpage. Make sure that you review the Level 1 Cross Cutting Symptom Measures as well as the Level 2 measures that are specific to substance use.

Assessing Suicidal Ideation

Completing suicide is one of the leading causes of death in the United States, yet awareness of and information about suicide are not widely available. It is likely that every counselor will work with many clients who are experiencing some degree of suicidal ideation (thoughts). As you will see in the articles, misusing substances is a risk factor for people with suicidal ideation.

Spend some time reading the articles and looking at the resources on the Assessing Suicidal Ideation page.

Assessment Exploration Questions

  1. What are your personal views regarding assessments in counseling?
  2. Which, if any, of the above assessments would you consider using with your clients?
  3. What clients might it be culturally inappropriate to use these assessments with?
  4. What benefits do formal (e.g., pencil and paper) assessments have compared to informal (not written or following a script) assessments?
  5. What benefits do informal assessments have compared to formal assessments?