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Steps of Addictions Assessment Processes



According to Perkinson, 'In time, the addict's brain adapts to the point that he or she cannot get high and cannot get sober. This is when addicts feel hopeless, helpless, and powerless, and their lives are unmanageable. This is when many of them commit suicide or come in for treatment' (Perkinson, 2016, p. 2), and the addictions assessment can begin. For more information visit
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By Fredrick Norfleet
Thursday, March 4, 2021
© FB. Norfleet Publishing
Steps of Addictions Assessment Processes
According to Perkinson, 'In time, the addict's brain adapts to the point that he or she
cannot get high and cannot get sober. This is when addicts feel hopeless, helpless, and
powerless, and their lives are unmanageable. This is when many of them commit suicide or
come in for treatment' (Perkinson, 2016, p. 2), and the addictions assessment can begin.
The steps of the addiction assessment should include:
Look and Listen
Why is this step important: it is essential to look and listen carefully to focus your skills to
identify abnormal behaviors, for example, depression and or anxiousness. Another example,
red swollen face, watery red eyes, or thin scabs indicates meth bugs. The following are
examples of behaviors identified by the clinical thermometer.
Activate the Healer Within You
Why is this step important: 'People recognize a healer when they see one' (Perkinson, 2016,
p. 3). The client will recognize the healer within the counselor. The counselor must be
truthful with the client during the addiction assessment process; the client's life is at stake.
Administer the Motivational Interview:
Why is this step important: Motivating the client toward change is good. Arguing with the
client to change is not acceptable. The motivation interview allows you 'to walk with the
client toward the truth' (Perkinson, 2016, p. 3). It is essential to know that client-centered
counseling is not self-centered counseling. Also, the questions asked during the
Motivational interview will not apply to all clients. For example, adult clients will have a
different array of questions than adolescent clients, and; adult/adolescent clients will have a
different variety of questions compared to the parent/caregiver.
How to Administer the Motivational Interview
It is essential to motivate the client to see the truth about their predicament. Questions
about alcohol and drug use must take place to obtain a history of personal habits. Ask
candid questions nonjudgmentally. The client-centered motivational interview is composed
of the following elements
Emphatic and objective feedback
Assessment of client readiness for change
Assessment recovery effort barriers and strengths
Reinterpretation of clients experiences as it relates to current problems
Negotiate a follow-up plan
Provide hope
The following is an example of the professional counselor assessing the client's readiness
for change and negotiating a follow-up plan:
Professional: Bob, have you ever worried about your drinking?
Client: No, honestly, I have not. (This comes across as real. When the words and the client's
affect match, they are probably telling the truth. Most addicts think their addictive behavior is
Professional: Maybe that is because you did not understand how much you could drink
safely. If alcohol is killing you, do you not want to know?
Client: Well, sure.
Professional: Looking at these pictures, and thinking about how much you have been
drinking, do you think you have been drinking too much? (The professional is taking the
biggest chance of all.)
Client: Maybe? (Maybe is very close to a yes. The client has admitted that he drinks too
much. That moves him from the pre-contemplation phase to the contemplation phase. For
the first time, he is considering the negative consequences of his drinking. This is a huge
step toward recovery.)
Professional: Did you know that 95% of untreated alcoholics die of their alcoholism? And
they die 26 years earlier than they would otherwise.
The client says nothing.
Professional: Knowing what you know now, would you like to learn how to drink less or even
stop drinking entirely? (The professional is negotiating how far the client is willing to go to
get better.)
Client: I did not know it was that bad. (Now, the client is contemplating change. We are on
the road to recovery. With a gentle approach, the professional can negotiate and listen to
the client's life from their perspective, allowing the client to move toward the truth.)
Professional: Why don't we meet again with your wife and talk about what we can do to help
you two feel better? Would that be all right with you?
Client: If you think it will help.
Professional: Most people who try to get better.
Client: Okay, let's do it. (A commitment to change has occurred. Now the client realizes he
has a problem and is making plans to take action. These are the first giant steps toward
recovery.) (Perkinson, 20160811, p. 8)
Source: Chemical Dependency Counseling: A Practical Guide, 5th Edition.
Develop the Therapeutic Alliance
Why is this step is essential: The therapeutic alliance is built from an initial foundation of
love, trust, and commitment (Perkinson, 2016, p. 5), between the counselor and the client.
Building the Therapeutic Alliance is essential; to do so, behave friendly toward the client, not
shame or blame the client, and commit to doing what is best for the client.
The multidisciplinary team is also known as clinical staff. According to Perkinson, 'the
staff of any treatment center is the lifeblood of treatment' (Perkinson, 2016, p. 221) and can
perform their duties anywhere. No one member of the multidisciplinary team is more
important than the other; they are all essential for a successful client outcome.
An excellent interdisciplinary team/clinical staff works together toward the success of
the client's treatment plan. However, each member/professional has their specialization, and
respect must be shown by one for the other. In the Multidisciplinary approach, treatment is
both holistic and traditional. For instance, 'methods used in this approach include
therapeutic assignments, individual therapy, arts, experiential, and psychoeducational
groups. For a person to achieve long-term recovery, the rehab treatment should cover
behavioral enhancement, healthy activities, education, and support' (The Multidisciplinary
Approach To Addiction Treatment 2019).
An example of a Multiplinary team trained to execute the above mentioned Multidioplnary
approach, and their contribution to the additions assessment and treatment follows:
The Psychologist/Psychiatrist
Provides assessment for diagnosis and treatment of mental disorders
Only the Psychologist can order medications
Both Psychologists and Psychiatrists are trained in evidence-based cognitive and
behavioral therapy and testing
The Social Worker/Mental Health Counselor
Both are mental health professionals trained and licenses.
Both are qualified to make assessments, administering tests, and treating co-occurring
They can handle any mental health task besides ordering medication.
The Registered Nurse and Licensed Practical Nurse
Both are front line medical professionals
Both take place in the absence of the physician
Both carry out the orders of the doctor.
The Clinical Director
Primary responsibility – ensures the clinical team provides the best treatment for the client
Develop and Implement the treatment program
Has advance training and experience in assessment and treatment of addiction and co-
occurring disorders
The Clinical Supervisor
Supervises the counseling staff
Does some hands-on work and sits in on individual sessions and group sessions.
Responsible for planning, charting, and therapy
The Chemical Dependency Counselor
Must shoe competency in 12 core functions, including assessment, treatment planning, and
case management.
Many are involved in their recovery program
Their on-the-job training in addictions and personal experiences gives addictions counselors
unique professional character.
The Rehabilitation Technician or Aide
Do a variety of work assigned by supervisory personnel
Work with individual clients and groups
Have a gift to say just the right thing at the right time to lead a client toward recovery.
The Recreational Therapist
In charge of getting clients involved in fund, exercise, and leisure time activities
Does activities assessment to see what the clients are doing for entertainment, fun, and
Encourage the client to develop healthy recreation activities and hobbies
Perkinson, R. R. (20160811). Chemical Dependency Counseling: A Practical Guide, 5th Edition.
[[VitalSource Bookshelf version]]. Retrieved from vbk://9781506307367
The Multidisciplinary Approach To Addiction Treatment. (2019, May 15). Retrieved October 19,
2020, from
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