Who Are You? Screening and Assessment in Addiction Treatment



You may be familiar with the terms “screening and assessment” when it comes to addiction treatment, but people are often confused by the differences between these two processes. Screening occurs when someone who is seeking help for their addiction makes that first call. They are evaluated for the presence of a problem with alcohol and/or drugs. The outcome of a screening process is usually a simple “yes” or “no.” An assessment is a more detailed process for defining the nature of a substance problem. An assessment is used to diagnosis and develop specific treatment recommendations.

The Nuts & Bolts of Assessment

The assessments done at Sanford House are performed by Master’s Level therapists. They explore the whole of a woman’s life, with emphasis on her preferences and priorities. Questions are asked about the history of her substance use and the reason she is seeking help. There are also queries about what has worked for her in the past, when she has tried to change her lifestyle and/or behaviors. Thoughtful consideration is given to her individual strengths and resources as well as potential opportunities for support with her family, friends, and community.


In addition, women are asked about their physical health history and medication use. They are asked about the history of alcohol or drug use among family members; mental health history and emotional concerns; issues related to cultural, ethnic, and spiritual matters; relationship issues with significant others, children and parents; employment, education and legal concerns, and more. All information gathered in an assessment is highly confidential and protected by HIPAA and federal confidentiality regulations. Furthermore, the interviewing strategy is non-judgmental and focused particularly on a woman’s most significant and valued accomplishments, strengths, gifts and natural talents.


We Also Use Tests and Inventories

We also use tests and inventories during assessments to help determine a woman’s level of care for treatment. These inventories are short, with mostly “true” or “false” or “yes” or “no” answers. Moreover, we look for inventories that have specific profiles for women.


We undergo all of the formal and professional procedures in gathering information. We also recognize the power of simple, direct questions when working with women. I often just ask, “What happened? What do you think would be helpful?” and “Tell me about the real you. The woman you know you are inside. Not the one caught up in this addiction.”


Who Are You?

Gathering pieces of information throughout treatment is all part of the continuing assessment process. I believe we are ever searching for the question, “Who are you?” Discovering this is not so much looking for an answer, but teaching women a process. We teach them to stay sober and to acknowledge their true core. We help them accept all their feelings, not just the socially acceptable ones. And we help them make decisions about their deepest values and their meanings.


It is interesting to note that after a lifetime of work, the brilliant psychoanalyst Sigmund Freud declared he didn’t know what women wanted. (Perhaps he didn’t have the proper assessment tools!) However, over 150 years ago journalist and female activist Margaret Fuller was able to assess and define women in a way that stands the test of time. She wrote,“What a woman needs is not as a woman to act or rule, but as a nature to grow, as an intellect to discern, as a soul to live freely and unimpeded to unfold such powers as are given to her.”


This too, is the gift of recovery…


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Author Christine Walkons (MA, LPC, CAADC, CCS-M) is the Clinical Director for Sanford House. She has been working in the addiction field for over 30 years, developing residential treatment, outpatient and intensive outpatient programs. Christine encourages partnerships between client and staff, resulting in individualized, person-centric recovery management. Christine lives in Elberta, Michigan among the scenic dunes of Lake Michigan and divides her time between Grand Rapids and her small northern village. At home she can be found walking on the beach or tending to her many fruit trees, vegetables and flower gardens.