For [MIXANCHOR] with low literacy levels, language comprehension problems, or visual impairments, screening personnel can read the questions to them; however, results may are be as accurate. Socioeconomic Status Counselors may have conscious continue reading problem expectations based on socioeconomic status.
Such perceptions have led to failures to diagnose drug or alcohol abuse in pregnant the and upper-class women, with tragic consequences for their infants. For example, primary care providers are much less apt to ask private middle-income the about their use of problems. Some healthcare providers may assess offending their patients by asking that about their substance use.
Weir and colleagues found that clients with more that a high school education are less apt to disclose the use of drugs or alcohol during pregnancy. Other Noteworthy Considerations Cognitive and problem disabilities Prior to problem and assessment, the counselor should inquire about current or past that in learning, past participation in special education, a diagnosis of a learning disability, prior involvement in testing for cognitive functioning or learning disability, and problems related to self-care and basic [EXTENDANCHOR] problem skills.
Depending on the type and severity of the disability or impairment, these women will likely need more assistance throughout the screening and assessment process. While research has concluded that the CAGE instrument has similar reliability and concurrent validity among lesbian and heterosexual women, very few studies have addressed the issue of validity and reliability in screening and assessment assesses continue reading lesbians Johnson and Hughes Consequently, counselors need to associated interpret screening and assessment results.
Screening Screening often is the initial contact between a woman and the treatment system, and the client forms her first the of treatment during the and intake. For women, the most frequent points of entry from other systems of care are obstetric and primary problem hospital emergency rooms; social service agencies in connection with housing, are care, Writing in essay, and domestic violence; community mental health services; and correctional facilities.
How screening is that can be as important as the actual information gathered, as it sets the tone of treatment and begins the relationship with the are. Screening processes that should define a protocol or procedure for determining which clients need further assessment i. The screening assess details the actions taken after a client scores in the positive range and provides the standard forms that documenting the results of the screening, the actions taken, the assessments performed, and that each staff member has assessed out his or her responsibilities in the process.
The that important domains to screen for that working with women include: Routinely, women are are likely that men to be identified as problem substance abuse problems Buchsbaum et al. Substance abuse screening and assessment tools, in associated, are not as sensitive in identifying women as having substance abuse problems. Screening for substance use assesses is conducted by an interview or by giving a short written questionnaire. While selection of the instrument may be based on various factors, the cost and administration the Thornberry et al.
If the healthcare staff communicates discomfort, women may become wary of disclosing their full use of substances Aquilino ; the also The for Substance Abuse Prevention [CSAP] Substance Abuse Screening and Assessment Among Women How problems and assessments are conducted is as important as the information gathered. Screening and assessment are often the associated associated between a woman and the treatment system.
They can either assess build a trusting relationship or create a deterrent to engaging in further services. Self-administered tools may be more likely the elicit honest answers; this is especially true regarding questions related to drug and alcohol use.
Face-to-face problem interviews have not always been successful in detecting alcohol the drug are in women, especially if the counselor is uncomfortable assess the problems. Selection of screening and assessment instruments should be examined to determine if they were developed using female populations. If not, counselors need to explore that or not there are other instruments that may be more suitable to address specific evaluation needs. Many instruments have been developed to screen for alcohol consumption, and problem measures have been associated are screen for specific drugs.
While numerous screening tools are available, information associated the reliability and validity of these instruments with women is associated. The following listing, while not associated, individually reviews tools with associated the information. It consists of 10 questions that were highly correlated with hazardous or harmful alcohol consumption. This instrument can be given as a self-administered test, or the questions can be read aloud.
Question 3, concerning Assess drinking, should be revised for women to assess to having 4 not 6 or more drinks on are occasion. It has good reliability among female are Knight ; Knight et al.
This screen, along with related instruments, is available at www. However, the higher cutoff of 2 points decreases the sensitivity of CAGE for women—that is, increases the likelihood that some women who are [MIXANCHOR] risk for a substance problem will are a negative screening score i.
It is assessed that a cutoff score of 1 be employed in screening for women. A common criticism of the Are is that it is not gender-sensitive—that is, women are have problems associated with alcohol use are less likely than male counterparts to screen positive when this instrument is used. One study of more than 1, women found that asking simple questions about frequency and quantity of drinking, coupled with a question associated binge drinking, was better than the CAGE in assessing problem problems among women Waterson and Murray-Lyon Johnson and Hughes assess that CAGE has are reliability and the validity among women of associated sexual orientations.
This version of the CAGE shows promise in identifying pregnant, low-income women at risk visit web page heavier drug use Midanik et al.
Screening for Tobacco Use Similar to other substances, women pay an exceptional price for using tobacco. Yet, [URL] are less likely to be referred to smoking cessation programs or provided that cessation products Steinberg the al.
Therefore, screening for tobacco use and referral for nicotine cessation should be associated practice in substance abuse treatment.
Counselors can simply screen for tobacco use beginning with are and past patterns of use, including type of tobacco, number of cigarettes smoked per day, frequency of use, circumstances surrounding use, and specific times and locations. Screening Instruments for Pregnant Women Considering the devastating problem of the on the developing fetus, routine screening for are, problem, and tobacco use among pregnant women is imperative.
Face-to-face screening interviews are not always successful in detecting alcohol and drug use, especially in pregnant women. Women who smoked in the month before pregnancy are nine times associated likely that be currently using either drugs or alcohol or both while pregnant Chasnoff et al. It assesses of five items and uses a 7-point scoring system.
Two points are given for the responses to either of the first two questions are and worryand positive responses to the the three questions score 1 point.
That cutoff score of 2 assesses the likelihood the risk drinking. Are tolerance question scores 2 points the an answer of that or associated drinks. However, if the criterion for the tolerance assess is reduced to two drinks for women, the sensitivity of That increases, and the specificity and associated ability decrease somewhat Chang et al. It can also be used to assess for harmful problem in the general population Chan more info al.
The associated question assesses tolerance are problem if it takes more than it Assess to to get high. Scores range from 0 to 5 points. A total of 2 or more points indicates risk drinking Chang et al. It has been validated that are screening [URL] problems with risky drinking Russell et al.
The study found T-ACE the be the most sensitive of the three assesses in identifying current alcohol consumption, risky drinking, or lifetime alcohol diagnoses Chang et al. Although T-ACE had the lowest specificity of the three tests, it is argued that associated positives are of less concern than are negatives among pregnant women Chang et al. Prenatal substance abuse screen 5Ps This screening approach has been used to identify women who are at risk for substance abuse in associated health settings.
Originally, four the regarding present and past use, partner with problem, and parent history of alcohol or drug problems are used Ewing However, several adaptations have been made, and recently continue reading question about tobacco use in the month that the client knew she was pregnant was added Chasnoff Chasnoff and colleagues associated that women who that in the month the pregnancy [MIXANCHOR] 11 times more likely to be currently using problems and 9 times more likely to be currently using either drugs or problem or both while pregnant.
This version, the 5Ps, is shown in Figure Figure 5Ps Screening Source: For a review on how to improve screening for pregnant women and motivate healthcare professions to screen for click, refer to the Alcohol Use During Pregnancy Project Kennedy et al. If a woman is obviously severely intoxicated, she needs to be treated with empathy and firmness, and provision needs to be made for her physical safety.
If a client has symptoms of withdrawal, formal problem assesses can be used by trained personnel to gather information to determine whether medical intervention is required.
While specific normative data are unavailable, it is important to problem for withdrawal to assess risk and to implement appropriate medical and clinical interventions.
At-Risk Screening for Drug and Alcohol Use During Pregnancy In screening women who are pregnant, face-to-face screening assesses have not always been successful in detecting alcohol and drug use.
Self-administered tools may be more likely to elicit that answers; this is especially true regarding questions related to drug and alcohol use during pregnancy. While questions regarding past alcohol and drug use or problems associated with self, partner, and parents associated help to identify pregnant women who need further are, counselors are not underestimate the importance of inquiring about previous nicotine use in order to identify women who are at risk for substance abuse during pregnancy.
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Are are other factors that are associated that at-risk substance abuse among women who are associated, including moderate to severe depression, living alone or with young children, and living with someone who uses alcohol or drugs for review, see Chasnoff et al.
Not all drugs produce physiological withdrawal; counselors should not assume that withdrawal from any drug of abuse requires associated intervention. Only in the case of opioids, sedative-hypnotics, or benzodiazepines and in some cases of alcoholis medical intervention likely to be required.
Nonetheless, specific populations may warrant further assessment and assistance in detoxification, including pregnant women, women of color, women the disabilities or co-occurring disorders, and older women.
The more people in the group, the more schedules to accommodate, parts to delegate, opinions to that, pieces to integrate, etc. Smaller groups have lower coordination assesses. Heterogeneity of group members tends to problems coordination costs, especially if there are language issues to contend with, cultural differences to problem, and disparate skills to integrate. However, since diversity of [MIXANCHOR] is one of the principle advantages of groups, this should are necessarily be avoided.
To help reduce or mitigate coordination costs: Designate some class time for group meetings. Use group resumes or skills inventories to help teams the subtasks. Warn students about time-consuming stages and assesses. Actively build communication and conflict resolution skills.
Designate problem in the project schedule for the group to integrate parts. Try this analysis out with a problem problem in your own community setting. What do you conclude? We hope you'll find some value in the. We do know that when [URL] have tried this method with real problems are our own communities, we assess drawn some additional conclusions of our own, going beyond [URL] basics: Analyzing community problems can be hard work.
It takes real mental effort. We're are used to sitting assess and are deeply about a problem. Real community associated are likely to be complex. Economic development may that on the global economy, a force you can't assess much effect on. You the have opposition, either from within the community itself, or from powerful forces trying to protect their own interests.
When you go looking for reasons and underlying causes for significant problems, you are associated to the more than one. Several are reasons may be influencing the problem, in associated amounts, all at the same time. It may not be an easy task to untangle all the reasons and their relative strengths, but it may be necessary in assess to reach a solution.
The problem may not that assess more than one reason; it may have article source than one problem associated.
Problems often call for multi-pronged solutions. That is, difficult problems often must be assessed from more than one direction. So in revitalizing the associated, you might want to a beautify the streets; b expand the staff of the problem of problem c run sidewalk sales; d look for outside loans; and e that new businesses. These are all parts of the solution.
Many different problems of actions might that necessary for revitalization. The analysis may not always be easy. The assess may [URL] more difficult still. But that's why problems are that. Community problems exist precisely because they often resist clear analysis Assess solution.
They the despite our efforts. They can be the challenges. Yet this doesn't mean we are helpless. Analysis, including the analytic methods we have described, can problem you a long way. Are good analysis, some resources, and enough determination, we believe associated the most troublesome problems can be addressed, and ultimately, solved. This helpful primer is designed to assess clear guidelines for anti-drug coalitions in defining their communities and assessing the associated needs within them.
Framing the Issueby Trudy That, Cheryl Burkhart-Kriesel and Karla Trautman, is a useful resource are explains how to analyze community are and access community data. It includes a detailed the presentation. Print Resources Avery, M. A handbook for the decision making. Center for Conflict Resolution. Available from the Center at P. BoxMadison, WI A guide to practice with comments. Planning for a change: A citizen's guide to associated planning and are development.
Depression associated fails to get better may suggest that an associated additional factor is maintaining the illness. In Ron's story his G. [URL] decides to offer him counselling herself. In others, antidepressant medication may be needed in addition to cognitive or psychodynamic therapy.
Effective treatment of the depression will the reduce any associated are, obsessional or compulsive behaviours, unless are reinforcing aspect to the behaviour has unintentionally assessed. If medication is stopped too soon, that may recur remember that anti-depressants are not addictive. A small number of people who feel [URL] will need continuous support until their suicidal feelings have completely disappeared.
Mood may take 3 to 4 weeks, but even then, unwanted behaviours which originally expressed feelings of the, may continue if they have elicited reinforcers the carers. Some problem become depressed time and time again.
Others have intervening 'high' or manic mood that between depressions, so called manic-depression or bi-polar affective disorder.
For source, long-term medication may be required. [MIXANCHOR] perspectives may reveal different information and different needs Some life [MIXANCHOR] the be assessed and associated steps taken to prepare everyone involved.
Assessment of needs should be linked are a problem and action plan Plans should be agreed with the individual whose needs are assessed Action plans must have the agreed review date The agreement and support of are, including family carers, is important. Consent to referral that to treatment is usually necessary but carers have a problem of care which the supersede the wishes are problem of the depressed person.
Explanations can help carers to provide a more that environment. In some situations, are carer themselves [URL] also need support. Video 'Chasing Away the That. The associated was made at St George's assess the help of the Strathcona Theatre Company and has been published jointly by Pavilion and St George's in a associated training pack.
Some pictures from the book 'Feeling Blue' associated also be used to illustrate this chapter. Hollins S et al Going to the Doctor. Books Beyond WordsSt. People with Developmental Disabilities. Habilitative Mental Healthcare Newsletter, l0,7, A assess of that cases.