NCAD: Free screener measures risk across multiple domains

Attendees on the last day of the National Conference on Addiction Disorders (NCAD) learned of the availability of a free screening tool that can assess patient risk across multiple domains, from substance use to infectious disease.

“The individual who walks through your door doesn't walk in with just one problem,” said Carlo DiClemente, PhD, director of the University of Maryland Baltimore County's (UMBC's) Center for Community Collaboration, which developed the No Wrong Door Integrative Screener.

Available at no charge because its development was funded by a Minority AIDS Initiative grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), the screener includes indicators for physical health, substance use, mental health, sexual behaviors, and infectious disease risk. It is designed to allow for comprehensive risk assessment regardless of where the individual enters the service system. The project also was supported by the Infectious Disease Bureau under the Maryland Department of Health and Mental Hygiene.

The self-report survey takes around 15 to 20 minutes for a patient to complete, with a recovery coach present to help, DiClemente said during his Aug. 20 session at the Baltimore conference. The screener also has optional modules for stigma, gambling and serious mental illness. Agencies can receive the screening instrument after staff completes free online training in its use.

Aggregate data

The integrative screener is being implemented in a variety of settings, including private practices and federally qualified health centers, said DiClemente, a professor of psychology at UMBC. Feedback sheets that are available to the patient offer information on how the individual's answers compare with norms. A determination of risk for two or more problems, based on the patient's responses, triggers a recommendation for case management services.

In addition, agency-level data is available to the provider or facility, allowing for an assessment of collective risk across the population being served by the program.

Another feature of the Integrative Screener that is not commonly seen with most widely used instruments involves its ability to measure client readiness to change. DiClemente is the co-developer of the Transtheoretical Model of Change, which gave rise to the stages-of-change approach that has had a huge impact on clinical service delivery in addictions.