Evidence-based practice (EBP) is a method of clinical decision-making that relies on evidence-based medicine (EBM) (Hoffman et al., 2017). The term “EBM” was first introduced by Gordon Guyatt at McMaster University in Canada in the early 1990s (Guyatt, 1991). It was later defined by his mentor, David Sackett, and his colleagues as the conscientious, explicit, and judicious use of the best current evidence when making decisions about the care of individual clients (Sackett et al., 1996).
Screening Tests
Most clinicians agree that a balanced battery of tests is the most effective way of helping identify the needs of their clients. These tests provide quantifiable data about the client and their substance use. The main advantage of assessment testing is the ability to accurately measure patient characteristics. Additionally, testing ensures our decision-making process is consistent across all clients and based on the symptoms the client reports.
Each assessment uses all of the following screening tests:
- Alcohol Use Disorders Identification Test (AUDIT)
- Alcohol Michigan Alcohol Screening Test (MAST)
- Drug Abuse Screening Test (DAST)
- Substance Abuse Subtle Screening Inventory 4 (SASSI-4)
- Cannabis Use Problems Identification Test (CUPIT)
- Cannabis Use Disorder Identification Test (CUDIT-R)
- Cannabis Withdrawal Scale (CWS)
- South Oaks Gambling Screen (SOGS)
- Mental Health Screening Form III (MHSF-III)
- Overall Anxiety Severity and Impairment Scale (OASIS)
- Patient Health Questionnaire 9 (PHQ-9)
- The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES)
- University of Rhode Island Change Assessment Scale (URICA)
Face-to-Face Assessment Interview
The clinical interview is a face-to-face encounter between a substance abuse professional and the worker. During the session the SAP observes the worker and gathers data about the person’s behavior, attitudes, current situation, personality, and life history.
We utilize a semi-structured interview approach for this part of the assessment. Each client is presented with exactly the same questions. In the session the clinician follows a established outline and pattern of questions designed to gather essential information. However the SAP remains free to explore other directions to follow up on relevant information. The use of a semi-structured interview ensures our decision-making process is consistent across all clients and free from claims of bias.
Decision Making
Using the information from the screening tests and the semi-structured interview, we base our assessment decisions on the criteria published in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition by The American Psychiatric Association.
Our recommendations (early intervention/education, addiction counselling, or residential treatment ) are based on criteria published by The American Society of Addiction Medicine’s (ASAM).