In North Carolina, there are two levels of certification in substance abuse counseling: the Substance Abuse Counselor Intern (SACI) and the Certified Substance Abuse Counselor (CSAC). The certifications are acquired by applying to the North Carolina Substance Abuse Professional Practice Board (NCSAPPB). While SACI requires only a high school diploma or GED, a Bachelor’s degree in Addiction Counseling is recommended. An applicant for becoming a SACI must complete a 300-hour practicum in 12 Core Functions and pass the International Certification & Reciprocity Consortium (IC&RC) Computer Based Test (NCSAPPB). A CSAC is to have 6000 hours of supervised work experience over three years and 270 hours of training or education, with 190 being substance abuse specific (NCSAPPB). Specialists can file an application after passing the IC&RC Alcohol and Drug Counselor Test (NCSAPPB). In short, the acquisition of needed certificates in North Carolina does not differ considerably from the process in other states.
Participation in this course has let me develop several crucial competencies for becoming a certified addiction professional. I believe that the most valued skill I have started to develop is writing an assessment report. This competence is vital for summarizing and structuring the knowledge acquired from the intake process and screening test results. Additionally, it helps to understand the importance of the multidisciplinary approach that provides a holistic patient-centered approach to the treatment process. At the same time, I believe that my decision-making in terms of screening tools requires further training. This course has provided an opportunity to review several screening and assessment instruments. However, during the research process, I came across multiple tools that need further evaluation to understand how they may be used in practice. In brief, while I have acquired several vital skills, there are some areas that require further improvement.
Assessment Report
Assessment Findings Summary
Logan Edward demonstrates the symptoms of moderate or severe alcohol use disorder coded F10.229 according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association 491). The interview and a screening test confirmed that the client had six symptoms during the last 12 months associated with problematic alcohol use. First, the test results show that Mr. Edward applied for help to address his drinking problem. Second, the interview shows that the client recurrently drank alcohol, resulting in a failure to fulfill major obligations at work. Third, he continues to use alcohol despite persistent social and interpersonal problems caused by the effects of alcohol. Fourth, most of the social, occupational, and recreational activities are reduced due to alcohol abuse. Fifth, the client used alcohol in situations where it was physically dangerous. Sixth, Mr. Edward demonstrates signs of alcohol tolerance since he admits that he needs more to achieve intoxication. In short, the current severity of alcohol misuse is coded 303.90(F10.20) Severe according to DSM-5.
Logan Edward was referred to addiction assessment by the judge in order to evaluate if he needs treatment to see his son. The reason for referral explicitly demonstrates that the client shows the signs of symptom 6 stated by American Psychiatric Association, which is having recurrent social problems due to alcohol use (491). During the interview, Logan confirmed that his two marriages ended in divorces, and his last relationship ended due to alcohol misuse. Additionally, Mr. Edward has domestic violence, drunk driving, and bar fight charges. The fact that he was drunk while driving leads to the understanding that the client also has symptom 8, alcohol use in physically hazardous situations. However, the signs of the symptom are open to interpretation since it is unclear whether the behavior in such cases is recurrent.
The client is experiencing difficulties in finding leisure activities without alcohol use. The interview showed that the only things he did for fun were spending time with his brother, watching TV and playing video games. However, all these activities are accompanied by drinking alcohol. This matter is interpreted as having symptom 7 of alcohol abuse, according to DSM-5, which is giving up important activities because of alcohol use.
Even though the client does not admit it, Logan’s occupational problems hint at symptom 5 of problematic alcohol use as per DSM-5. While there is no direct evidence that alcohol misuse led to failure to fulfill his duties at work, the fact that the client was fired due to having a hangover is confirmed. Moreover, Mr. Edward claimed that he previously asked for help to quit drinking in the test; however, the interview showed that he did not admit he had a problem. Therefore, DSM-5’s symptom 2, or persistent desire to control alcohol use, is not confirmed.
The client demonstrates the signs of symptom 10, according to DSM-5, which is tolerance, or a need for markedly increased amounts of alcohol to achieve intoxication. During the interview, Logan agreed that he requires more “to get the buzz” than he used to need when he was in the army. Additionally, he admitted that sometimes he drinks whiskey with beer to achieve the desired effect. Therefore, the presence of tolerance to alcohol is clear from the interview.
In summary, the assessment generated substantial evidence that the client has a problematic pattern of alcohol use leading to clinically significant impairment or distress according to DSM-5. However, the severity of the problem may be interpreted as moderate or high due to the controversy of assessment results. The client demonstrates from four to six symptoms of alcohol misuse, leaving the results open to interpretation. If the client has 4-5 symptoms, the condition is moderate, while if he demonstrates 6 or more issues, the problem is severe. Further assessment may be needed to specify the diagnosis.
Referral Recommendations
Clinical Assessment
Logan Edward can benefit from full clinical check-up for comorbid conditions. Therefore, the present report recommends scheduling an appointment with a physician to perform a thorough clinical examination of the client. According to the American Psychiatric Association, repeated intake of high doses of alcohol can affect almost any organ (492). The clinical assessment should focus on the gastrointestinal tract, cardiovascular system, and the central and peripheral nervous system (American Psychiatric Association 492). Additionally, the client reports that he has not visited a doctor for an extended time period. Therefore, Logan Edwards is recommended to schedule an appointment with a physician to avoid possible adverse effects in physical health.
Psychiatrist
The present report suggests a referral to a psychiatrist to improve emotional stability of the client. The interview results demonstrated that Mr. Edward has signs of depression associated with the consequences of problematic alcohol use. Moreover, the American Psychiatric Association states that alcohol use disorder is associated with a high risk of suicide during intoxication or in the context of alcohol depressive and bipolar disorder (493). Additionally, since Logan has a domestic violence charge, he is advised to visit anger management courses. Therefore, the client is recommended to visit a psychiatrist qualified to treat substance-related emotional distress.
Social Services
Mr. Edward requires assistance to address the problem of his current employment status. The client has been unemployed for the last three months, which is the longest he has been without a job. His previous employer terminated the contract due to alcohol misuse. Logan is recommended to schedule an appointment with a social worker to find a new job. The client identifies his carpenter skills as one of his evident strengths. Therefore, the social worker should focus on finding a job in construction, as the client has all the appropriate skills and experience.
Confidentiality
The present report and its findings are to be stored and discriminated in accordance with the standards of the American Psychological Association (APA). The document is to be treated according to the general principles of APA, which are beneficence and nonmaleficence, fidelity and responsibility, integrity, justice, and respect for people’s rights. The information about the present assessment should not be disclosed without the will of Logan Edward (American Psychological Association). The information may be shared with third parties only if written consent is received or if required by the US laws.
The cases of information disclosure about the mental health of the client may be released if required by a court order. If Logan Edward’s mental health comes to a question during court proceedings, the results of the present assessment can be disclosed to the judge (American Psychological Association). Additionally, the information about treatment may be disclosed to insurance companies if they pay for the procedures (American Psychological Association). The findings of the assessment must not be shared with employers or family members without the client’s written consent.
Work Cited
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed., American Psychiatric Association, 2013.
American Psychological Association. “Ethical Principles of Psychologists and Code of Conduct.”APA. 2017, Web.
NCSAPPB. North Carolina Substance Abuse Professional Practice Board, Web.