12 Dec Read all the material, follow the directions, and answer all the questions in a separate Word Doc using APA format.? ?paper should be 5 – 8 pages, with an included cover sheet and
Read all the material, follow the directions, and answer all the questions in a separate Word Doc using APA format.
paper should be 5 – 8 pages, with an included cover sheet and reference page (for a total of 7 – 10 pages).
COUN 617 Assessment and Testing Final Examination CMHC and CRC students
Dr. Tara Overzat Please read all the information provided and answer the questions below. I have included supplementary documents to assist you. This test is designed to be a take home test; however, it is not intended to be a group test. You should work individually. You may use your textbook, notes, etc. You may NOT use fellow classmates. If I believe you worked with another individual in answering this test, I will follow the policies and procedures set forth in the syllabus, the Department of Counseling, and College of Professional Advancement regarding plagiarism and academic honesty. Any questions you have should be directed to Dr. Overzat at [email protected] Please answer all questions to the best of your ability. The exam is due in Canvas by 11:59pm on Thu., Dec. 15, 2022. Late exams will result in loss of points. All exams must also be uploaded in LiveText or there may be a loss of points.
Read all the provided information first.
Use the information from the Case Study below and the Additional Documents to answer the following questions. (Please create your response in a separate document; you may number your responses).
1. Follow the recommended decision steps and interpret the results of the SASSI.
Discuss and interpret EACH scale (except for the SAM scale)-Create a table to
identify the T Score, Percentile rank, and a qualitative description for each scale
except the SAM scale.. Steps for interpretation are provided below.
2. Discuss the results of the client’s BDI-II results. Identify specific items of interest.
3. Describe what you believe to be the strengths and limitations of each instrument.
(You must use the information provided to describe norming group data, validity,
reliability, potential biases, etc.)
4. Assuming you are the client’s counselor, consider the background information and
the results of both assessments:
a) Integrate and discuss your understanding of the assessment results and the
client’s presenting concerns as indicated in the case study.
b) Based upon the results, what would be your initial focus in future
counseling sessions and how would approach these sessions. (Use
information gleaned from the case study and the assessment results to
support your answer).
Client: Raymond Anderson
Instruments Administered: Substance Abuse Subtle Screening Inventory (SASSI-4) and The Beck Depression Inventory (BDI-2)
Raymond is a 37-year-old multiracial male who is being referred to treatment by his physician. Raymond was involved in a traffic accident three weeks ago in which he was charged with driving under the influence.
Upon your initial interview you learn that Raymond lost his job six weeks prior due to "the economy being bad because of Covid." He has worked in the finance industry for twenty years. He received a "small severance package" from his employer but he reports he is starting to utilize money from his savings to support his family.
He describes his life as though he is "driftwood, just floating through the river of life." He has been married to his wife for 10 years. They have two children, 7 and 5 years of age. Raymond believes his wife is having an affair though he "can’t prove it yet." He describes his relationship with his spouse as "argumentative" and "difficult." He describes the relationship with his children as "fine." His wife has offered to pick-up a part-time job, however, Raymond stated, "This is never going to happen, it's my job to support my family."
Raymond describes beginning drinking during his adolescent years. He was able to drink at home with his parents at the age of 16. He states that once in was in college he was consuming alcohol 2-3 times per week. He also describes "occasionally" using marijuana during college. He states that he "rarely" has ever blacked-out white drinking. He recalls two times in college. He reports that he can drink 2-4 alcoholic beverages before becoming intoxicated and drinks "socially" now. He states that when he does drink he will consume 4-6 alcoholic beverages per occasion. Rayond acknowledges that he has a prescription for OxyContin because of a knee surgery he had to undergo recently. He states that he “takes the pills regularly to help with the pain."
He acknowledges that he should not have been using substances while driving and "greatly regrets" his decision. He stated that "he has let his family down." He was out celebrating his best friend's birthday on the night he was involved in the accident. He stated at the end of the first session that he is "able to stop using at any given time…I just have to fix my famil."
Raymond appeared well-dressed and well-groomed to the appointment, though he had difficulty maintaining eye contact and presented with a flat affect.
Unemployed
Reggie T M 37 M
MBA
INFORMATION ABOUT THE INSTRUMENTS
SASSI-4
The Substance Abuse Subtle Screening Inventory (SASSI) is an instrument designed to assess probability of substance use symptomology in individuals. It includes face valid questions (ones that are clearly asking about substance use-i.e., do you drink every night) and subtle questions that try to assess less obvious symptoms. A document on reliability and validity is below.
Follow these steps (according to the manual), to interpret the results of the SASSI-4. A supplement that describes high and low scores on each scale is provided. The SASSI-4 is intended to be interpreted by working through the steps below.
1. Check to see if the profile is valid (did the client answer all the items consistently)?
a. Check RAP (Random Answering Pattern Scale) b. Anything greater than 2 may be invalid, results should be interpreted with
caution. c. The RAP Scale is designed to try to detect random answering patterns,
high scores may be indicative of a person who did not read the questions and just answered the items randomly.
2. Check the Rules 1-9 on the right hand side of the answer sheet. (NOTE: These are already checked for you on the SASSI profile above)
3. Check the Decision Rule a. After answering the Rules 1-9, its time to answer the decision rule at the
bottom of the profile sheet. b. According to the SASSI manual, if ANY of the Rules 1-9 are checked
then there is 92% chance of substance use disorder c. BE MINDFUL OF FALSE POSITIVES and NEGATIVES
4. Check for high DEF (Defensiveness Scale) a. 8+ could mean an increased possibility of MISSING a person with
substance abuse. 5. Interpret remaining scales based upon the normative or standardized data
BDI-II Beck Depression Inventory II
The Beck Depression Inventory is a 21-Item Self-report measure of depression. Each items is rated from 0-3, with 3 being more severe 5-10 Minutes to complete
Females typically score higher. In one study in Europe, the Male avg. scores 4.18 while Female avg scores 10.69.
Categorical cutoff scores that have been proposed in the literature to detect increasing levels of depressive symptoms are as follows:
0-13 Minimal 14-19 Mild 20-28 Moderate 29+ Severe
Norm Group`
Two samples were used to evaluate the psychometric characteristics of the BDI-II: 1. A clinical sample of 500 individuals who sought outpatient therapy at one of four
outpatient clinics on the U.S. east coast (New Jersey and Pennsylvania, two of which were located in urban areas, two in suburban areas). The sample consisted of 317 (63%) women and 183 (37%) men, ranged in age from 13 to 86 years, and the average age was 37.2 years. The sample consisted of four racial/ethnic groups: White (91%), African American (4%), Asian American (4%), and Hispanic (1%).
2. A nonclinical sample of 120 Canadian college students was used as a comparative “normal” group. It consisted of 67 (56%) women and 53 (44%) men, was described as “predominantly White,” and the average age of the sample was 19.58.
Reliability
Internal consistency: Analysis of internal consistency yielded a Cronbach’s alpha of .92 for the clinical sample and .93 for non clinical sample (college students).
Test-Retest Reliability: Test-retest reliability was assessed over a one week interval among a sub-sample of 26 outpatients from one clinic site (r = .93).
Validity Content Validity: BDI-II item content was designed to be consistent with the diagnostic criteria for depression in the Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition (DSM-IV; American Psychiatric Association, 1994).
Convergent Validity: Correlations between the BDI-II scores and other scales are as follows: the Beck Hopelessness Scale (r = .68), the Revised Hamilton Psychiatric Rating
Scale for Depression (r = .71), and the Symptom Checklist-90-R Depression subscale (r = .89).
Discriminant Validity: The correlation between the BDI-II and the Revised Hamilton Anxiety Rating Scale = .47. The correlation between the BDI-II and the Beck Anxiety Inventory .60.
,
Rubric for Final – CRC/CMHC ONLY
Standards
Excellent – 50 pts
Good – 40
pts
Fair – 30 pts
Needs improvement –
20 pts
Needs significant
improvement – 10 pts
Score
Answering the FIVE questions fully 50 pts
All five questions are answered fully with appropriate numerical and/or clinical information.
More appropriate numerical and/or clinical information needed on one question.
More appropriate numerical and/or clinical information needed on two questions.
More appropriate numerical and/or clinical information needed on three questions.
More appropriate numerical and/or clinical information needed on four or five questions.
Standards
Excellent – 10 pts/ 20
pts
Good – 8pts/
16 pts
Fair – 6pts/
12 pts
Needs improvement – 4pts/ 8 pts
Needs significant
improvement – 2pts/ 4 pts
Timeliness of Assignment 10 pts
Submitted on-time or early.
Submitted the next morning.
Submitted the next afternoon.
Submitted the next evening.
Submitted 24 hours or more late.
Grammar, spelling, editing 20 pts
Fewer than 3 grammar, spelling, or editing errors per assignment page on average.
Four to five grammar, spelling, or editing errors per assignment page on average.
Six to seven grammar, spelling, or editing errors per assignment page on average.
Eight to ten grammar, spelling, or editing errors per assignment page on average.
Eleven or more grammar, spelling, or editing errors per assignment page on average.
APA Format, Length, & Assignment Requirements 20 pts
APA format used correctly throughout. Assignment meets minimum length or longer. All instructions for the assignment were followed sufficiently.
One or two APA format errors present per assignment page. Assignment meets minimum length or longer. All instructions for the assignment were followed sufficiently.
One or more of the following: Three to four APA format errors present per assignment page; assignment does not meet minimum length; one to two instructions not followed sufficiently.
One or more of the following: Five or more APA format errors present per assignment page; assignment does not meet minimum length; three or more instructions not followed sufficiently.
One or more of the following: APA format not utilized at all; assignment significantly short of minimum (50% or more missing); none of the instructions followed sufficiently.
Comments:
,
List of phrases for discussing possible clinical indications
Might/may/could:
indicate
suggest
imply
signify
reveal
display
reflect
represent
demonstrate
be evidence of
Example sentences:
The elevated DEF score on the profile may indicate that the client is not acknowledging the extent of their drinking behavior.
The low symptom count may suggest that the client does not meet criteria for ADHD-combined presentation at this time.
,
Comment by Tara Overzat: Pagination needed.
Case Study One: Maria
11/20/22
Assessments
Substance Abuse Subtle Screening Inventory-4
Maria's SASSI-4 assessment results are 13 for face-valid alcohol, 1 for face-valid other drugs, 8 for symptoms, 5 for obvious attributes, 2 for subtle attributes, 4 for defensiveness, 6 for supplemental addiction measures, 9 for family vs. controls, and 9 for correctional. A score of 13 for face valid alcohol means that Maria acknowledges significant past and current alcohol use. Importantly, it indicates that she is aware of some of the behavioral challenges exhibited by people who engage in alcohol use. The substance abuse subtle screening inventory-4 uses obvious, logically derived, subtle, or empirically derived questions (John et al., 2016). As such, a score of 13 is high but below 20. Based on the decision rule for substance abuse subtle screening inventory-4, a score of below 20 means that an individual may have been exposed to alcohol but has a low probability of having a substance use disorder. Maria’s score for face-valid other drugs is 1, which is very low, indicating that she may not have been exposed to drugs other than alcohol. Maria's Symptoms (SYM) score was 8, which is elevated and above 7; based on decision rule 1, any rule answered 'yes' means the individual has a high probability of having a substance use disorder. Comment by Tara Overzat: RAP needs to be discussed at the beginning. Comment by Tara Overzat: Text needs to be left-justified. Comment by Tara Overzat: Inappropriate source as it refers to the SASSI-3 not the SASSI-4. The SASSI clinical manual provides everything you need to discuss the instrument. Comment by Tara Overzat: Unsure where this is coming from in the material. It is also out of scope for the question. Comment by Tara Overzat: It is normal range.
Table 1
Maria’s Scores on Each Scale of the SASSI-4
|
Scale |
SASSI Score |
T- Score |
Percentile |
Description |
|
FVA |
13 |
68 |
88th Comment by Tara Overzat: Likely closer to ~96th or 97th. |
Maria’s FVA score of 13 means she acknowledges exposure to alcohol use and related behavioral challenges that arise from such exposure. However, the score is below the rule 1 score of 20. That means whereas Maria may be exposed to alcohol, she has lower chances of developing substance use disorder. This is a good indicator of Maria's readiness for a lifestyle change. Part of the reasons why Maria might have been exposed to alcohol use is as a form of escapism from assignments or family issues, given that she is a single mother. Comment by Tara Overzat: Left-justified text only in APA style. Comment by Tara Overzat: Text in a table needs to be single-spaced. Comment by Tara Overzat: We do not judge the score's meaning based on this single rule. Please review the SASSI module and my video on SASSI. |
|
FVOD |
1 |
46 |
35th |
Maria's score for FVOD is very low, indicating that she has never had an experience with substances other than alcohol. Furthermore, the low score means a minimal probability of developing substance use disorder. Comment by Tara Overzat: It is normal range. |
|
SYM |
8 |
68 |
92nd Comment by Tara Overzat: Likely ~96th or ~97th. |
The score is more than 7, indicating a high chance of developing a substance use disorder. Notably, the results show that Maria could be a person who occasionally takes alcohol to either enjoy herself or run or relieve herself from family or pressure from assignments. Furthermore, based on the score, she perceived the use of alcohol as a regular use; it may not be different from her colleagues. Comment by Tara Overzat: She may perceive Comment by Tara Overzat: Good interpretation at the end here. |
|
OAT |
5 |
60 |
83rd |
The score indicates that the client does not have obvious symptoms of substance dependence. It essentially means that whereas the client has experience with alcohol use, she does not show any signs that she is dependent on it or any other substance. This score correlates with the client’s FVOD score. |
|
SAT |
2 |
38 |
10th |
The client’s score indicates that the client does not use any substance because it is below 7. The score is based on the indirect measure of substance use by using non-substance-related items. Based on the score, it is clear that the client does not use substances; as such, the probability of developing a substance use disorder is lowInc. Comment by Tara Overzat: Incorrect interpretation. |
|
DEF |
4 |
44 |
20th |
The score is below the rule 6 score, which puts six as the benchmark for determining if the client has a high chance of developing substance use disorder. Based on the score, the client has low denial; she is not defensive and does not minimize telling the truth. Summarily, the score shows that the client is truthful and honest with what she says. Comment by Tara Overzat: It is normal range. |
|
FAM |
9 |
48 |
48th |
The score is less than the benchmark; however, it is not part of the decision-making tools concerning substance abuse disorders. Based on the score, it can be determined that part of the reasons why the client is exposed to alcohol is family or work pressures. The pressure could be occasional, which is essentially occasional taking of alcohol. Comment by Tara Overzat: Incorrect interpretation. |
|
COR |
9 |
74 Comment by Tara Overzat: T-Scores look good. |
100th Comment by Tara Overzat: ~99th as percentiles cannot reach 100. |
The client’s COR score is not high, which means the client’s responses are not similar to the responses of individuals who have substance abuse disorder. Comment by Tara Overzat: It is very elevated. Comment by Tara Overzat: Incorrect interpretation. |
|
Rx |
1 |
The score is 1, which measures the client's misuse of prescription medications. Based on the score, the client has a low chance of misusing prescription drugs. The low scores in the SASSI-4 screening outcome and the low score in Rx mean the client is neither misusing prescription medications nor engaging in substance use. |
||
|
Comment by Tara Overzat: Extra space at end of table is not needed. |
Strengths and Limitations
The assessment has significant strengths that include high criterion validity for the scale. Studies revealed that it accurately classified 100% of offenders with SUDs as having a high probability (Wooley et al., 2012). In this case, the scores for the various items are valid, and the conclusion is reliable as to whether the client has a high probability or low probability of developing substance use disorder. Comment by Tara Overzat: There are myriad reliability and validity statistics in the provided SASSI clinical manual. Outside sources are not needed. Comment by Tara Overzat: Insufficient answer to this question.
There are limitations to the SASSI-4; the internal consistency is high for the overall SASSI and is direct but not its subtle or indirect subscales, suggesting that the tool captures a single face-valid construct. That means the indirect scales used in assessing the client could not be used to determine if the client is using substances; however, they can still hl the clinician understand the possible reasons for the scores in the direct scalesI. Comment by Tara Overzat: Source? Comment by Tara Overzat: Typo. Comment by Tara Overzat: Insufficient discussion of limitations.
Beck Anxiety Inventory
Maria scored 36 on tBeck Anxiety Inventory. The score is between 30 and 63, which is perceived to be severe. The severe score indicates that the client has many anxiety symptoms. As such, the treatment plan focusing on addressing the anxiety symptoms is the most suitable for the client. According to Borwin, Sophie, and Dirk (2017), an individual with a high Beck Anxiety Inventory score should be treated immediately using therapies such as cognitive behavioral therapy, which is regarded as having the highest level of evidence on its efficacy and efficiency. Furthermore, the use of first-line drugs, such as selective serotonin reuptake inhibitors, is a good choice (Borwin, Sophie & Dirk, 2017T). Comment by Tara Overzat: Good. Comment by Tara Overzat: "the" needed here Comment by Tara Overzat: Incorrect. Comment by Tara Overzat: Treatment plan belongs in the treatment plan section. Comment by Tara Overzat: This paragraph should also address items of concern (e.g., items client endorsed with a 3).
Strengths and Limitations
Among the strengths of BAI is having reliability of .75 in a sample of adult patients with psychiatric problems (Beck et al., 1988). The reliability is based on test-retest; concerning the validity, BAI's construct validity is consistent with DSM-III-R criteria for anxiety disorders, emphasizing generalized anxiety disorder and panic disorder. Significantly, the items selected correlate with other scores, such as the State-Trait Anxiety Inventory and Hamilton Anxiety Rating Scale (Beck et al., 1988). The client's score of 36 indicates a severe condition related to other scores. Comment by Tara Overzat: Good. Comment by Tara Overzat: More discussion on reliability and validity needed. These statistics were provided in the BAI file.
There are limitations to the BAI, including the inability to differentiate between depression and anxiety. Furthermore, the inventory is criticized for predominantly focusing on phobias-related anxiety. There are
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