Addiction severity index pdf form

Reliabilitymd validity in three centers, journal of nervous and mental disease, 1985. The addiction severity index lite asi lite adapted from. Addiction severity index reference addiction severity index last updated. Workshop 2 handout 1 making required data collection useful he has no history of regular or ongoing use of inhalants. Addiction severity index, 5th edition clinicaltraining version a. Introduce and explain the seven potential problem areas. Severity ratings the severity ratings are interview estimates of the patients need for additional treatment in each area. The asi is a semistructured interview designed to address seven potential problem areas in substanceabusing patients. In a study of male veterans, a preliminary evaluation of. The asi form is completed for each client admitted or readmitted after one year into a treatment. Recent status scores for version 6 of the addiction. This tool serves as a guidance instrument in treatment planning. Teen addiction severity index t asi brief description the tasi is a semistructured interview that was developed to fill the need for a reliable, valid, and standardized instrument for a periodic evaluation of adolescent substance abuse.

With this knowledge, a psychiatrist will be able to better implement a more personalized treatment plan. This competency based workshop will address the proper administration and scoring of the addiction severity index asi as well as the proper utilization of american society of addiction medicine asam placement criteria. The acok screen for cooccurring disorders mental health. Fill out, securely sign, print or email your addiction severity form instantly with signnow. A slightly modified version, the asi5, was introduced in 1992, but is essentially the same instrument that was developed over 30 years ago. Addiction severity index lite cf clinicaltraini ng version thomas mclellan, ph. Asimv addiction severity index multimedia version is the electronic version of the traditional paperand penciladministered. Addiction severity index page 10 of 14 client name. Medical, employmentsupport status, alcohol, drug, legal, familysocial, and. The addiction severity index asi is an instrument that is used in assessing the extent of a substance use disorder that has resulted in someone being referred to treatment. This paper describes the derivation of recent status scores rsss for version 6 of the addiction severity index asi6. Thomas mclellan, a man known for his pioneering work in the field of addiction treatment and specifically the development of two interviewbased modalities to measure addiction severity and treatment needs. Medical, employmentsupport status, alcohol, drug, legal, familysocial, and psychiatric. Medical, employmentsupport status, alcohol, drug, legal.

The asi was developed in the late 1970s and the asi3 was the first widely distributed version. Bhimv asimv addiction severity indexmultimedia version. Medical, employmentsupport status, alcohol, drug, legal, familysocial, and psychological. The addiction severity index asi, used throughout the united states and other countries, is the most widely used assessment tool in the addictions field. Mclellan at1, kushner h, metzger d, peters r, smith i, grissom g, pettinati h, argeriou m. Addiction severity index in order to create an assessment driven treatment process, to provide the assessor a better understanding of the crucial considerations for asam patient placement, and to understand the relationship of the asi and asam placement criteria in developing correctly individualized, assessment driven treatment plans. Thomas mclellan and his associates at the center for studies of addiction in philadelphia mclellan et al. Asimv addiction severity indexmultimedia version is the electronic version of the traditional paperand penciladministered. Addiction severity index lite cf clinicaltraining version thomas mclellan, ph.

Addiction severity index asi addiction severity index asi brief description target populations administrative issues the asi is a semistructured interview designed to address seven potential problem areas in substanceabusing patients. The advanced tools of the editor will lead you through the editable pdf template. Asimv addiction severity indexmultimedia version is the electronic version of the traditional paper and penciladministered asi. Medical, employment support status, alcohol, drug, legal. To read information, use the down arrow from a form field. The psychometric analyses to derive addiction severity index 6 recent status scores rsss support the multidimensionality of the asi6 i. To answer this question, we need to remember that the addiction severity index was created in 1980 to enable clinical researchers to evaluate treatment outcomes. Addiction severity index form fill out and sign printable. Gambling quiz this selfassessment is based on the canadian problem gambling index. Associate professor of psychiatry alcohol research center university of connecticut health center school of medicine 263 farmington avenue farmington, ct 060302103.

John has a history of using multiple module 4 substances, on an ongoing basis, for a period of 15 years. Item numbers circled are to be asked at followup introducing the asi. The asi form will provide a comprehensive, overall understanding of all aspects of the patients existence in order to properly evaluate any. Cairo addiction severity index training united nations office on the addiction severity index. Supplementary administration manual for the expanded female version of the addiction severity index asi instrument the asif. New items were added in existing sections to assess route of drug administration. Pdf reliability of the addiction severity index self. The addiction severity index asi was developed some 20 years ago, primarily for research purposes, by a. The higher your score, the greater the risk that your gambling is a problem. Download the addiction severity index form, which is often used by psychiatrists for the purpose of a more in depth patient evaluation with regard to the level of severity of addiction adobe pdf.

Reproductions supplied by edrs are the best that can be made. Addiction severity index an overview sciencedirect topics. Addiction severity index asi dictionary definition of addiction definition of addiction severity index asi our online dictionary has addiction severity index asi information from encyclopedia of drugs, alcohol, and. The most secure digital platform to get legally binding, electronically signed documents in just a few seconds. Pdf reliability of the addiction severity index selfreport. Sometimes it may be required by a governmental agency to help them determine if they will require a person to undergo addiction chemical dependency treatment. Reliability of the addiction severity index selfreport form. An improved diagnostic evaluation instrument for substance abuse patients. Addiction severity index 5th edition dens clinicaltraining version a. Addiction severity indexmultimedia version hazelden. You will complete an addiction severity index form for this client and write a report approximate length 46 page in narrative form with each topic and subtopic covered in adequate depth, 12 point times new roman font, a combination of single and double spacing as demonstrated in the sample report. Each rating is based upon the patients history of problem symptoms, present condition and. In a study of male veterans, a preliminary evaluation of the asi has indicated reliability and validity.

Ever 0 no 1 yes age 1st past month 0 no 1 yes other 11 months 0 no 1 yes 1. Asi adikshun severite indeks a measurement instrument used to assess a patients level of substance abuse or dependency. Asi may be used on a clinical as well as a training level. Asi manual united nations office on drugs and crime. Selfhelp gambling tools this document contains both information and form fields. It is a semistructured assessment instrument designed for use with clients for substance abuse treatment.

This instrument is an interview process that assesses history, frequency, and consequences of alcohol and drug use. The addiction severity index lite version asilite is a shortened version of the addiction severity index asi. It is the first step in the development of a patient profile for subsequent use by clinical and research staffs. Mclellan, at, luborsky, l, woody, ge, obrien cp 1980. Items with an asterisk are cumulative and should be. Addiction severity index asi is an assessment tool widely used in the evaluation of substance abuse treatment. Us department of health and human services, substance abuse and. The addiction severity index asi is 12 years old and has been revised to include a new section on family history of. The fifth edition of the addiction severity index, journal of substance abuse. Addiction severity index alcohol and drug abuse institute. Addiction severity index definition of addiction severity. Studies of the reliability and validity of the addiction. The addiction severity index asi is 12 years old and has been revised to include a new section on family history of alcohol, drug, and psychiatric problems.

Addiction severity index reference addiction severity index last. Reliability of the addiction severity index selfreport form asisr. We will ask you questions in seven potential problem areas. Pdf improving the validity of addiction severity index severity. For each area, i will ask you to use this scale to let me know how bothered you have been by any problems in each. The scales range from 0 no treatment necessary to 9 treatment needed to intervene in lifethreatening situations. Addiction severity index this tool will tell us more about you such as the areas of need you have that brought you to this agency and how we can help you. The asi form will provide a comprehensive, overall understanding of all aspects of the patients existence in order to properly evaluate any addiction issues the patient experiences as. Aetna prescription drug authorization request form. Aims to examine the reliability and validity of the widely used addiction severity index asi. Reproductions supplied by edrs are the best that can be. In 1 hour, a skilled interviewer can gather information on recent past 30 days.

The asi is a semistructured instrument used in facetoface interviews conducted by clinicians, researchers or trained technicians. The asi form will provide a comprehensive, overall understanding of all aspects of the patients existence in order to properly. The bhimv behavioral health indexmultimedia version is an online, client selfadministered comprehensive behavioral health assessment tool which provides an overview of the clients functioning in multiple. Enter your official identification and contact details. Pdf the addiction severity index asi is a well known and frequently used structured assessment of substance abuse administered by a.

The way to complete the online addiction severity index form on the internet. The addiction severity index, lite version asilite is a shortened version of the addiction severity index asi. High internal consistencies have been reported regularly for only three of the. The addiction severity index is a relatively brief, semistructured interview designed to provide important information about aspects of a patients life which may contribute to hisher substance abuse syndrome. The addiction severity index asi was developed by a. Addiction severity index pdf fill online, printable. Module name module addiction severity index lite clinicaltraining version thomas mclellan, ph. The asi was the first standardized assessment tool of its kind to measure the multiple dimensions of substance abuse. Start a free trial now to save yourself time and money.

The two instruments are commonly used in tandem and this workshop will utilize case studies to enhance the. Jan 20, 2016 the addiction severity index asi is an instrument that is used in assessing the extent of a substance use disorder that has resulted in someone being referred to treatment. The addiction severity index asi is a clinicalresearch instrument which has been in wide use during the past 6 years to assess the treatment problems found in alcohol and drugabusing patients. Dec 31, 2017 the addiction severity index is a semistructured interview designed to address seven potential problem areas in substanceabusing patients. Addiction severity index fill out and sign printable pdf. The history of addiction severity index the addiction severity index is a semistructured interview designed to address seven potential problem areas in substanceabusing patients. The addiction severity index asi is one of the most widely used tools for the assessment of. The addiction severity index asi is a standardized semistructured interview used to assess the severity of problems. Reliability of the addiction severity index selfreport.