Patient assessment may be one of the most important yet underemphasized elements of contemporary addiction treatment. The initial assessment interview is an opportunity for a patient to discuss his/her problems and for the counselor to engage the patient into the process of care. In this regard, the Addiction Severity Index (ASI) is a research-derived interview which has been shown to provide a comprehensive assessment of patients' problems at treatment admission. Despite NIDA's efforts to disseminate training materials to assist programs in learning to administer the ASI, it is not clear that programs are using the instrument properly. Thus, while there is empirical evidence that the ASI can provide reliable and valid patient assessments, and there is wide agreement that patient assessment is the foundation of good treatment planning - it is not clear whether programs learn how to do an ASI correctly from the standard NIDA packet of manuals and video; whether this information is translated into individualized treatment plans and services received; or whether patients who receive individualized treatment plans are more likely to engage in treatment, participate longer, or report more treatment satisfaction. The purpose of the present proposal then is to evaluate a new method of training in administration and use of the ASI compared to the currently available NIDA training packet. The central premise to be tested is that by improving the relevance, ease of use, and support for a research-based, patient assessment, we will show: 1) more accurate and comprehensive assessment of the client, 2) better helping alliance and client satisfaction, 3) better services-to-patient matching, and 4) better performance during treatment (length of stay, completion, etc.). The study builds upon a peer-reviewed, health services research project in progress funded by ONDCP and CSAT. The study employs a between-groups design with two technology transfer interventions tested with 60 counselors from 12 randomly selected abstinence-oriented outpatient substance abuse treatment programs. Ech counselor will provide ASI assessments and treatment care plans from 5 consecutive admissions one month after their training, and again six months following completion of their training.
