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Training manual (C) Oberg & Sallmen 2004 1
Training manual
(C) Oberg & Sallmen 2004
1

Outcome of after care

treatment outcome

Quality assurance

Long term

Matching

Implementation

MAPS-ut

Maintenance

MAPS-upp

EuropASI

Treatment need

EuropASI

MAPS-in

Maintenance MAPS-upp EuropASI Treatment need EuropASI MAPS-in emoctuotnemtaertmrettrohS Preconditions MAPS-unit
emoctuotnemtaertmrettrohS
emoctuotnemtaertmrettrohS

Preconditions

MAPS-unit

Maintenance MAPS-upp EuropASI Treatment need EuropASI MAPS-in emoctuotnemtaertmrettrohS Preconditions MAPS-unit

3

GoalsASI-X

(C) Oberg & Sallmen 2004

3 GoalsASI-X (C) Oberg & Sallmen 2004 T r e a t m e n t
3 GoalsASI-X (C) Oberg & Sallmen 2004 T r e a t m e n t
3 GoalsASI-X (C) Oberg & Sallmen 2004 T r e a t m e n t
T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n

Treatment

T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n

plan

T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n
T r e a t m e n t p l a n

4 TP meeting

2004 T r e a t m e n t p l a n 4 TP

3 Goal discussion

Other assessment AFF Change PriorityRAFF Interventions MAPS-unit 2 Feed back session
Other
assessment
AFF
Change
PriorityRAFF
Interventions
MAPS-unit
2 Feed back session
discussion Other assessment AFF Change PriorityRAFF Interventions MAPS-unit 2 Feed back session 1 Client interview

1 Client interview

4

Complements the EuropASI manual General guidelines for the interview Introduction to the client General coding of questions Severity ratings Instructions for specific items Comments and interpretation of specific questions

(C) Oberg & Sallmen 2004

Instructions for specific items Comments and interpretation of specific questions (C) Oberg & Sallmen 2004
Instructions for specific items Comments and interpretation of specific questions (C) Oberg & Sallmen 2004
Instructions for specific items Comments and interpretation of specific questions (C) Oberg & Sallmen 2004

5

Developed by Thomas McLellan and colleagues in Philadelphia 1975 The 5 th edition 1992

Developed within the framework of COST A6 Work led by Kokkevi and Hartgers Manual published 1994, Blanken et al.

(C) Oberg & Sallmen 2004

of COST A6 Work led by Kokkevi and Hartgers Manual published 1994, Blanken et al. (C)
of COST A6 Work led by Kokkevi and Hartgers Manual published 1994, Blanken et al. (C)
of COST A6 Work led by Kokkevi and Hartgers Manual published 1994, Blanken et al. (C)

6

Should investigate the clients whole situation Should concern problems within different life areas Should measure both current and lifetime Should be a client interview

(C) Oberg & Sallmen 2004

life areas Should measure both current and lifetime Should be a client interview (C) Oberg &
life areas Should measure both current and lifetime Should be a client interview (C) Oberg &
life areas Should measure both current and lifetime Should be a client interview (C) Oberg &

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ASI-X is a slightly expanded version of the EuropASI. The complementary questions are based on the

that mainly

version of the Addiction Severity

vulnerability. ASI-X is used in for example Iran, the Netherlands,

Scotland and Sweden, within social services, psychiatry, prison and substance abuse treatment.

and social

questions

risk behaviours

complementary

Friedman.

female

children,

by Alfred

includes

“Expanded

concerns

(C) Oberg & Sallmen 2004

Index” ASI-X

Friedman. female children, by Alfred includes “Expanded concerns (C) Oberg & Sallmen 2004 Index” ASI-X
Friedman. female children, by Alfred includes “Expanded concerns (C) Oberg & Sallmen 2004 Index” ASI-X
Friedman. female children, by Alfred includes “Expanded concerns (C) Oberg & Sallmen 2004 Index” ASI-X

8

(C) Oberg & Sallmen 2004

8 (C) Oberg & Sallmen 2004
8 (C) Oberg & Sallmen 2004
8 (C) Oberg & Sallmen 2004
8 (C) Oberg & Sallmen 2004

9

“Troubled or Bothered” and “Help” is rated by the client

Subjective estimates by the client

Subjective measure – for clinical use

Measures severity and need for help

Interviewer rating of severity

Objective measure – for research Measures change

Composite scores

(C) Oberg & Sallmen 2004

Information from ASI Fact based description from the client Current situation – occurrence Lifetime -
Information from ASI
Fact based description from the client
Current situation – occurrence
Lifetime - risk
2004 Information from ASI Fact based description from the client Current situation – occurrence Lifetime -
2004 Information from ASI Fact based description from the client Current situation – occurrence Lifetime -
2004 Information from ASI Fact based description from the client Current situation – occurrence Lifetime -

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MAPS EuroADAD NetMAPS MAPS Lifeline

ASI Feedback Form ASI Crime ASI Gambling Treatment Service Review

(C) Oberg & Sallmen 2004

MAPS Lifeline ASI Feedback Form ASI Crime ASI Gambling Treatment Service Review (C) Oberg & Sallmen
MAPS Lifeline ASI Feedback Form ASI Crime ASI Gambling Treatment Service Review (C) Oberg & Sallmen
MAPS Lifeline ASI Feedback Form ASI Crime ASI Gambling Treatment Service Review (C) Oberg & Sallmen

11

Medical Status Employment/Support Status Alcohol Use Drug Use Legal Status Family/Social Relations

i Psychiatric Status

C
D

F
H

Alcohol Use Drug Use Legal Status Family/Social Relations i Psychiatric Status C D F H E
Alcohol Use Drug Use Legal Status Family/Social Relations i Psychiatric Status C D F H E
Alcohol Use Drug Use Legal Status Family/Social Relations i Psychiatric Status C D F H E
E E
E
E
(C) Oberg & Sallmen 2004
(C) Oberg & Sallmen 2004

12

Be conducted after the client has been informed Be conducted at one occasion Be conducted in a calm and separate environment Be properly introduced

(C) Oberg & Sallmen 2004

General Guidelines The interview should:
General Guidelines
The interview should:
and separate environment Be properly introduced (C) Oberg & Sallmen 2004 General Guidelines The interview should:
and separate environment Be properly introduced (C) Oberg & Sallmen 2004 General Guidelines The interview should:
and separate environment Be properly introduced (C) Oberg & Sallmen 2004 General Guidelines The interview should:

Do means not try to interpret what the client eventually

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seems unclear concerning the intention of the question:

so that the

Reformulate it Exemplify or ask clarifying or complementing questions

If the client doesn’t seems to understand or

If it is still impossible, code ”X” and make a note under

the question

it.

understand

to phrase

try easily

comments

client can

Always

(C) Oberg & Sallmen 2004

make a note under the question it. understand to phrase try easily comments client can Always
make a note under the question it. understand to phrase try easily comments client can Always
make a note under the question it. understand to phrase try easily comments client can Always

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0 = No 1 = Yes N = Not relevant X = Does not understand/no answer/ question not asked

(C) Oberg & Sallmen 2004

14 0 = No 1 = Yes N = Not relevant X = Does not understand/no
14 0 = No 1 = Yes N = Not relevant X = Does not understand/no
14 0 = No 1 = Yes N = Not relevant X = Does not understand/no

15

As a consequence on answers on earlier questions

Explain the reason for coding X under comments

i.e.: If No on questions like ”If Yes on …”

X = Question not answered

N = Question not relevant

Consequence questions

Ascending questions

Can not answer Will not answer Question not asked

(C) Oberg & Sallmen 2004

questions Ascending questions Can not answer Will not answer Question not asked (C) Oberg & Sallmen
questions Ascending questions Can not answer Will not answer Question not asked (C) Oberg & Sallmen
questions Ascending questions Can not answer Will not answer Question not asked (C) Oberg & Sallmen

16

The questions strives to provide practical information concerning the client, the interviewer and the interview They are of administrative type and is not a part of the client interview

(C) Oberg & Sallmen 2004

A. Administrative questions
A. Administrative questions
of administrative type and is not a part of the client interview (C) Oberg & Sallmen
of administrative type and is not a part of the client interview (C) Oberg & Sallmen
of administrative type and is not a part of the client interview (C) Oberg & Sallmen

17

Those questions suppose to collect information of more general type

Living situation Current treatment Age and nationality Children and there situation

(C) Oberg & Sallmen 2004

B. General information
B. General information
treatment Age and nationality Children and there situation (C) Oberg & Sallmen 2004 B. General information
treatment Age and nationality Children and there situation (C) Oberg & Sallmen 2004 B. General information
treatment Age and nationality Children and there situation (C) Oberg & Sallmen 2004 B. General information

Moderately Considerably Extremely

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4

3

1 = Slightly = Moderately =Considerably

= Extremely

2

Slightly

1

4

2

3

(C) Oberg & Sallmen 2004

Not at all

0

18 4 3 1 = Slightly = Moderately =Considerably = Extremely 2 Slightly 1 4 2
18 4 3 1 = Slightly = Moderately =Considerably = Extremely 2 Slightly 1 4 2
18 4 3 1 = Slightly = Moderately =Considerably = Extremely 2 Slightly 1 4 2

19

Concerns how troubled or bothered the client is about problems within the areas – not how severe they are

That why it is of utter importance that complementing information are noted under comments

Concerns how important further help is for the client

Concerns current situation Concerns problems expressed in the interview

Troubled or bothered

(C) Oberg & Sallmen 2004

Help

current situation Concerns problems expressed in the interview Troubled or bothered (C) Oberg & Sallmen 2004
current situation Concerns problems expressed in the interview Troubled or bothered (C) Oberg & Sallmen 2004
current situation Concerns problems expressed in the interview Troubled or bothered (C) Oberg & Sallmen 2004

20

A subjective interviewer rating based on a structured technique IS provides a summary of the client’s problem severity and need for help ISR could be used for:

Matching client-unit Treatment planning Prediction of treatment outcome

(C) Oberg & Sallmen 2004

be used for: Matching client-unit Treatment planning Prediction of treatment outcome (C) Oberg & Sallmen 2004
be used for: Matching client-unit Treatment planning Prediction of treatment outcome (C) Oberg & Sallmen 2004
be used for: Matching client-unit Treatment planning Prediction of treatment outcome (C) Oberg & Sallmen 2004

21

An estimation concerning the need for treatment, independent on the availability or even existence of treatment

A information combination of “objective” and “subjective”

A two step procedure Provides a structured method to summarize and “understand” the nature of the client’s situation

(C) Oberg & Sallmen 2004

a structured method to summarize and “understand” the nature of the client’s situation (C) Oberg &
a structured method to summarize and “understand” the nature of the client’s situation (C) Oberg &
a structured method to summarize and “understand” the nature of the client’s situation (C) Oberg &

22

(C) Oberg & Sallmen 2004

Interviewer Severity Rating - ISR 1 Objective Objective information1 information
Interviewer Severity Rating - ISR
1 Objective Objective information1 information

to 3 3 digits2 digits

rating, 2 2 to

Preliminary rating,

Preliminary

2

for help3 help

need for

of need

rating of

Client rating

Client

3

prel. rating4 rating

from prel.

digit from

rating, 1 1 digit

Final rating,

Final

4

f r o m prel. d i g i t from r a t i n
f r o m prel. d i g i t from r a t i n
f r o m prel. d i g i t from r a t i n
f r o m prel. d i g i t from r a t i n

23

(C) Oberg & Sallmen 2004

Interviewer Severity Rating - ISR 10 degree scale with 5 descriptions 0-1 No 2-3 Slight
Interviewer Severity Rating - ISR
10 degree scale with 5 descriptions
0-1
No
2-3
Slight
4-5
Moderate
6-7
Considerable
8-9
Extreme
- ISR 10 degree scale with 5 descriptions 0-1 No 2-3 Slight 4-5 Moderate 6-7 Considerable
- ISR 10 degree scale with 5 descriptions 0-1 No 2-3 Slight 4-5 Moderate 6-7 Considerable
- ISR 10 degree scale with 5 descriptions 0-1 No 2-3 Slight 4-5 Moderate 6-7 Considerable

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Make the severity ratings simple and consistent

Provides a template for structured feedback to

Connects the different life areas and identifies

Provides a comprehensive summary of the

Pedagogical tool, facilitates learning

the client

interview

patterns

(C) Oberg & Sallmen 2004

summary of the Pedagogical tool, facilitates learning the client interview patterns (C) Oberg & Sallmen 2004
summary of the Pedagogical tool, facilitates learning the client interview patterns (C) Oberg & Sallmen 2004
summary of the Pedagogical tool, facilitates learning the client interview patterns (C) Oberg & Sallmen 2004

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(+

importance

If adequate treatment is already in use

If they are disabling or life threatening

Critical items (bold and underlined)

Has a history, chronic and duration

are:

if they

1. Look over the interview. 2. Use objective information

of more

or - negative)

are considered

Close in time

positive

Acute

Items

(C) Oberg & Sallmen 2004

information of more or - negative) are considered Close in time positive Acute Items (C) Oberg
information of more or - negative) are considered Close in time positive Acute Items (C) Oberg
information of more or - negative) are considered Close in time positive Acute Items (C) Oberg

The absence of problem or symptoms are considered as positive If treatment is considered effective and helps the client to better handle problems, it is considered positive

- negative is information that points towards a high rating

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+ positive is information that points towards a low rating

Write in the information under + and – in AFF Chose a 2 to 3 digit interval

Use the whole range between 0 and 9 but be conservative concerning extreme values

continues

(C) Oberg & Sallmen 2004

2.

3.
4.

whole range between 0 and 9 but be conservative concerning extreme values continues (C) Oberg &
whole range between 0 and 9 but be conservative concerning extreme values continues (C) Oberg &
whole range between 0 and 9 but be conservative concerning extreme values continues (C) Oberg &

27

2. No3.

4. Maybe5.

Final Range 4-5-6

Could be

No

(C) Oberg & Sallmen 2004

27 2. No3. 4. Maybe5. Final Range 4-5-6 Could be No (C) Oberg & Sallmen 2004
27 2. No3. 4. Maybe5. Final Range 4-5-6 Could be No (C) Oberg & Sallmen 2004
27 2. No3. 4. Maybe5. Final Range 4-5-6 Could be No (C) Oberg & Sallmen 2004
27 2. No3. 4. Maybe5. Final Range 4-5-6 Could be No (C) Oberg & Sallmen 2004
8 9
8
9
2 3 7
2
3
7

1

0

27 2. No3. 4. Maybe5. Final Range 4-5-6 Could be No (C) Oberg & Sallmen 2004
27 2. No3. 4. Maybe5. Final Range 4-5-6 Could be No (C) Oberg & Sallmen 2004
27 2. No3. 4. Maybe5. Final Range 4-5-6 Could be No (C) Oberg & Sallmen 2004
27 2. No3. 4. Maybe5. Final Range 4-5-6 Could be No (C) Oberg & Sallmen 2004
27 2. No3. 4. Maybe5. Final Range 4-5-6 Could be No (C) Oberg & Sallmen 2004
1. No
1. No

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Use the subjective information from the clients rating for help to choose a final value in from the preliminary interval.

For 2 digit interval If client rating is 0 or 1 – choose the Lower value If client rating is 2 – look at “troubled or bothered” If client rating is 3 or 4 – choose the Higher value

For 3 digit interval If client rating is 0 or 1 – choose the Lower value If client rating is 2 – choose the Middle value If client rating is 3 or 4 – choose the Higher value

(C) Oberg & Sallmen 2004

is 2 – choose the Middle value If client rating is 3 or 4 – choose
is 2 – choose the Middle value If client rating is 3 or 4 – choose
is 2 – choose the Middle value If client rating is 3 or 4 – choose

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How would you rate the client’s need for help or counselling for …

8-9 Extreme 6-7 Considerable 4-5 Moderate 2-3 Slight

(C) Oberg & Sallmen 2004

No

0-1

for help or counselling for … 8-9 Extreme 6-7 Considerable 4-5 Moderate 2-3 Slight (C) Oberg
for help or counselling for … 8-9 Extreme 6-7 Considerable 4-5 Moderate 2-3 Slight (C) Oberg
for help or counselling for … 8-9 Extreme 6-7 Considerable 4-5 Moderate 2-3 Slight (C) Oberg
for help or counselling for … 8-9 Extreme 6-7 Considerable 4-5 Moderate 2-3 Slight (C) Oberg

Concerns health status and risk for future problems

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Need for Medical Treatment

Medical History Current medications Hospitalizations Long Term Medical Problems Recent Physical Ailments

(C) Oberg & Sallmen 2004

C Medical Section
C Medical Section
Hospitalizations Long Term Medical Problems Recent Physical Ailments (C) Oberg & Sallmen 2004 C Medical Section
Hospitalizations Long Term Medical Problems Recent Physical Ailments (C) Oberg & Sallmen 2004 C Medical Section
Hospitalizations Long Term Medical Problems Recent Physical Ailments (C) Oberg & Sallmen 2004 C Medical Section

31

Resources a client can record on a job application Schooling/training Current Sources and amounts of income Number of dependents

Interest in help with employment problems

Concerns support and work situation

(C) Oberg & Sallmen 2004

D Employment/Support
D Employment/Support
in help with employment problems Concerns support and work situation (C) Oberg & Sallmen 2004 D
in help with employment problems Concerns support and work situation (C) Oberg & Sallmen 2004 D
in help with employment problems Concerns support and work situation (C) Oberg & Sallmen 2004 D

32

Need for Alcohol/Drug treatment

Substance Abuse History Recent Substance Use/Abuse Consequences of Abuse Periods of Abstinence Treatment Episodes Financial Burden of Abuse

(C) Oberg & Sallmen 2004

E Alcohol & Drug Section Provides a picture of both use and abuse
E Alcohol & Drug Section
Provides a picture of both use and abuse
Burden of Abuse (C) Oberg & Sallmen 2004 E Alcohol & Drug Section Provides a picture
Burden of Abuse (C) Oberg & Sallmen 2004 E Alcohol & Drug Section Provides a picture
Burden of Abuse (C) Oberg & Sallmen 2004 E Alcohol & Drug Section Provides a picture

33

Legal History Information about Probation & Parole Charges, Convictions Incarcerations Detainments, & Illegal Activities

Desire/need for legal counsel

(C) Oberg & Sallmen 2004

F Legal Section Concerns the clients trouble with the law
F Legal Section
Concerns the clients trouble with the law
Desire/need for legal counsel (C) Oberg & Sallmen 2004 F Legal Section Concerns the clients trouble
Desire/need for legal counsel (C) Oberg & Sallmen 2004 F Legal Section Concerns the clients trouble
Desire/need for legal counsel (C) Oberg & Sallmen 2004 F Legal Section Concerns the clients trouble

34

Covers the family history of different problems that resulted or should have resulted in treatment

Hereditary risk factor for future problems

Alcohol, problems Drug, Psychiatric and Legal

No client or interviewer rating

(C) Oberg & Sallmen 2004

G Family History Section
G Family History Section
problems Drug, Psychiatric and Legal No client or interviewer rating (C) Oberg & Sallmen 2004 G
problems Drug, Psychiatric and Legal No client or interviewer rating (C) Oberg & Sallmen 2004 G
problems Drug, Psychiatric and Legal No client or interviewer rating (C) Oberg & Sallmen 2004 G

35

To discuss relationships, support systems, and conflict with family and others To document living situations, satisfaction, and experiences of abuse

Maps the clients social life situation

Need for help for social problems

(C) Oberg & Sallmen 2004

H Family & Social Status
H Family & Social Status
social life situation Need for help for social problems (C) Oberg & Sallmen 2004 • H
social life situation Need for help for social problems (C) Oberg & Sallmen 2004 • H
social life situation Need for help for social problems (C) Oberg & Sallmen 2004 • H

36

To determine long term & recent psychological & emotional functioning To Explore the potential for dual diagnosis

Need for help with emotional and pshychiatric problems

Concerns psychiatric and emotional problems

Mood disorders Anxiety disorders Thought disorders

(C) Oberg & Sallmen 2004

i Psychiatric Section
i Psychiatric Section
problems Mood disorders Anxiety disorders Thought disorders (C) Oberg & Sallmen 2004 i Psychiatric Section
problems Mood disorders Anxiety disorders Thought disorders (C) Oberg & Sallmen 2004 i Psychiatric Section
problems Mood disorders Anxiety disorders Thought disorders (C) Oberg & Sallmen 2004 i Psychiatric Section

37

Provides a possibility for the interviewer to summarize the ASI interview and to get a global rating of the clients need for help Documents positive and negative patterns Connects items between areas

Provides a concise summary of the complete ASI interview The rating could be used for matching clients to

the areas to follow the rigid

for clinicians

between

Makes it easier

treatment level

separation

(C) Oberg & Sallmen 2004

Global rating
Global rating
the rigid for clinicians between Makes it easier treatment level separation (C) Oberg & Sallmen 2004
the rigid for clinicians between Makes it easier treatment level separation (C) Oberg & Sallmen 2004
the rigid for clinicians between Makes it easier treatment level separation (C) Oberg & Sallmen 2004