ASSESSMENTISSUES

FEBRUARY 27, 2012

ADSAC

CONTACT INFORMATION

Ray Caesar Director of Addiction Specialty Programs

Oklahoma Department of Mental Health& Substance Abuse Services

(405)522-3870

(405)522-4470

rcaesar@odmhsas.org

ADSAC

CONTACT INFORMATION

Ray Caesar 405-522-3870 rcaesar@odmhsas.org

Patty Patterson 405-522-8537 ppatterson@odmhsas.org

Linda Clark 405-522-5837 lclark@odmhsas.org

John Bureman 405-522-8024 jbureman@odmhsas.org

PROBLEMSWITH

ALCOHOL AND OTHER DRUGS

Public Intoxication

Vandalism

Homelessness

Inappropriate aggression

Paranoia

Criminal behavior

Compromising situations

ADSAC

ADSAC is an acronym for; ALCOHOL AND DRUG, SUBSTANCE ABUSE SERVICES

This phrase is found in Title 47 Motor Vehicle Code and refers to the entire process of assessment, education and treatment.

Authority for the ADSAC process comes from Titles;

43A Mental Health Law,47 Motor Vehicle Code,22 Criminal Code.

ADSAC

ODMHSAS has specific responsibility for;

ASSESSMENT ~ defining type, duration and intensity of intervention.

FACILITATION ~ 10 & 24 hour coursesCERTIFICATION ~ Assessors

~ Assessment Agencies~ Facilitators~ Course Organizations

TRAINING ~ AssessorsInstruments, Interview

Technique, Oklahoma Administrative Code ~ Facilitators

Adult Education, Interactive Journaling and Oklahoma Administrative Code

ADSAC

230Certified ADSAC Assessors

25Certified ADSAC Assessment

Agencies

2012

ADSAC

Access to ADSAC services may be required of almost the entire population of Oklahoma

* Only a very small percentage of the population will not be possible candidates for ADSAC services. Those who never drink or use mood altering drugs and who never associate with those who do.

*

ADSAC

25% to 40% of 30% of the population the population consume 90% of never drink the alcohol

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* * * *

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Of this group only 30% or (10% of the total population) are physically dependent

ADSAC

Alcohol or other drug related driving offenses (upon arrest) DUI DUI D DWI APC

Drug convictions (with a vehicle involved) Possession Transportation Distribution Paraphernalia

ADSAC

HISTORY OF THE PROCESS

November 1, 1985 10 hour DUI school (Testing suspensions)

July 1, 1991 10 hour DUI school (All alcohol related suspensions)

May 26, 1993 10 hour DUI school (Drug convictions)

September 1, 1993 Assessment required

November 1, 1996 24 hour DUI school

July 1, 2003 Assessment driven

July 1, 2008 Recommendations in code

November 1, 2008 Change in assessment fee collection

ADSAC

ADSAC COURSES

ADSAC

TITLE 450

Chapter 21Certification of Alcohol and Drug Substance

Abuse Courses (ADSAC), Organizations and Facilitators

Effective July 1, 2009

ADSAC

The journals are interactive, requiring the participation of the offender

ADSAC

10 Hour Course (sub-clinical)Conducted in no less than three sessions

of three to three and one half hours each24 Hour Course (sub-clinical)Conducted in no fewer than twelve

sessions of two hours each, twice weekly for six weeks

24 Hour Course (clinical) Conducted in no fewer than twelve

sessions of two hours each, twice weekly for six weeks and offered in conjunction with a group intervention

ADSAC

Both the Ten and Twenty-four hour ADSAC journals contain two distinct, interrelated journals

The larger section of each journal is an interactive workbook addressing issues related to substance use, decision making and coping strategies

The smaller but, possibly more important section of each journal is a personalized change plan based on the transtheoretical model of change and allow the development of an individualized action plan based on the beliefs and decisions of the offender

ADSAC

INSTRUCTION

COUNSELING

THERAPY

FACILITATION

ADSAC

ADSACASSESSMENT

PROCESS

ADSAC

TITLE 450

Chapter 22Certification of Alcohol and Drug

Assessment and Evaluations Related to Driver’s License Revocation

Effective July 1, 2009

ADSAC

The ADSAC assessment is often the first clinically driven intervention

The ADSAC assessor has the opportunity to provide what may be the only assessment the offender will receive

The ADSAC assessment serves as a critical point of entry

ADSAC

Requirements for the assessment process

Face to face interview Bio-psych-social ASI Drivers Risk Inventory, revised DRI II Defendant Questionnaire DQ Additional supportive instrument

ADSAC

ADSAC assessments completed after July 1, 2008 are valid for six months.

If services have not been initiated within six months, successful completion of a new assessment is required.

ADSAC

All requirements must be able to be completed within ninety days (twelve weeks).

ADSAC

ADSAC assessors must be a current LADC or CADC in good standing.

An LADC under supervision may work as an assessor for a Certified ADSAC Assessment Agency.

ADSAC

Drivers Risk Inventory, revised (DRI II)

Presumes an alcohol or drug related driving offense has occurred

Appropriate for all alcohol and/or drug related driving offenses resulting in license revocation

ADSAC

Drivers Risk Inventory revised (DRI II) Six scales

Truthfulness Alcohol Drug Substance Abuse/Dependency Drivers Risk Stress Coping Abilities

ADSAC

Defendant Questionnaire

Presumes a drug related criminal offense has occurred

Appropriate for drug convictions for possession, transportation, distribution or paraphernalia

ADSAC

Defendant Questionnaire

Seven scales Truthfulness Alcohol Drug Substance Abuse/Dependency Violence Antisocial

Stress Coping Abilities

ADSAC

Assessed areas in common

Truthfulness Alcohol Drug Substance Abuse/Dependency Stress Coping Abilities

ADSAC

ADSACASSESSMENT INTERVENTION

CATEGORIES

ADSAC

Intervention Category I 0 – 39 Low RiskIntervention Category II 0 – 39 Low Risk

(Second offense)

Intervention Category III40 – 69 ModerateIntervention Category IIIB Override - IV

or VIntervention Category IV70 – 89 ProblemIntervention Category V 90 – 100 Severe

ADSAC

INTERVENTION CATEGORY ILOW

RISK

Scoring 0 to 39 on the DRI II or DQ supported by the information from the additional instrument.

10 hour ADSAC courseVictims Impact Panel

ADSAC

INTERVENTION CATEGORY IILOW RISK

Scoring 0 to 39 on the DRI II or DQ supported by the information from the additional instrument and having a prior offense.

24 hour ADSAC courseVictims Impact Panel

ADSAC

INTERVENTION CATEGORY III MODERATE

RISK

Scoring 40 to 69 on the DRI II or DQ supported by the information from the additional instrument.

24 hour ADSAC courseVictims Impact PanelSix weeks substance abuse group

ADSAC

INTERVENTION CATEGORY IIIBfrom OVER

RIDE

Scoring 70 to 100 on the DRI II or DQ supported by the information from the additional instrument & appropriate for over ride from Intervention Category IV or V.

Twelve weeks substance abuse group(one or two times weekly)

Twelve weeks Mutual Support group

ADSAC

INTERVENTION CATEGORY IVPROBLEM RISK

Scoring 70 to 89 on the DRI II or DQ supported by the information from the additional instrument.

Intensive OutpatientMutual Support GroupAftercare if recommended by provider

ADSAC

INTERVENTION CATEGORY VSEVERE RISK

Scoring 90 to 100 on the DRI II or DQ supported by the information from the additional instrument.

Residential TreatmentMutual Support GroupAftercare if recommended by provider

ADSAC

Intervention Category I 0 – 39 Low RiskIntervention Category II 0 – 39 Low Risk

(Second offense)

Intervention Category III40 – 69 ModerateIntervention Category IIIB Override - IV

or VIntervention Category IV70 – 89 ProblemIntervention Category V 90 – 100 Severe

ADSAC

OVERRIDES

Services not available

Geographic accessibility

On waiting list for appropriate level of care

Language barriers

Sustained abstinence

ADSAC

Supportive Instruments

Juvenile Automated Substance Abuse Evaluation (JASAE)

Multidimensional Addictions and Personality Profile (MAPP)

NEEDS Assessment (NEEDS)

Triage Assessment for Addictive Disorders (TAAD)

ADSAC

Sixty million Americans are functionally illiterateor illiterate.

ADSAC

According to the U.S. Census of 2000

20% of Oklahoma residents are illiterate

40% of the residents in some Oklahoma Counties have less than a twelfth grade education

ADSAC

Generational issues

1922 to 1943 “The Greatest Generation”

Comfortable in formal settings Dislike too much familiarity Require respect Do not volunteer feedback, need

encouragement Incorporate life experiences Tend not to accept the concepts related to

addiction

ADSAC

Generational issues

1944 to 1960 “Baby Boomers”

Value teamwork May resist concept that certain drugs can be

problematic Value learning Value self-help strategies Incorporate life experiences

ADSAC

Generational issues

1961 to 1980 “Generation X”

See change as a norm Respect must be earned Value self-directed learning Expect learning to be fun Comfortable with technology Appreciate “hands on” activities

ADSAC

Generational issues

1981 to 1992 (1997) “Generation net”

Technology is taken for granted Diversity is valued Respect for expertise Flexible Require variety in learning

ADSAC

STAGES OF CHANGE

~ Precontemplation~ Contemplation

~ Preparation~ Action

~ Maintenance

ADSAC

M I TECHNIQUES

~ Express empathy~ Avoid arguments

~ Support self-efficacy~ Roll with resistance

~ Develop discrepancy

ADSAC

CONTACT INFORMATION Ray Caesar 405-522-3870

rcaesar@odmhsas.org Patty Patterson 405-522-8537

ppatterson@odmhsas.org Linda Clark 405-522-5837

lclark@odmhsas.org John Bureman 405-522-8024

jbureman@odmhsas.org