If you are an individual in need of a SASSI screening and evaluation, please use the SAMHSA.com provider locator to find professional services in your area that may offer SASSI screening.
SAM scores are used in the Decision Rules to increase the accuracy of other subscales. Interpretation of the SAM is not a function of its use.
Although some clinicians draw on ‘anecdotal’ reports to predict behavior patterns based on the slope of the line, this practice is not supported by SASSI data and is discouraged. Individual subscales may be interpreted with caution only as directed by the SASSI User’s Guide.
Either is acceptable. Your client and the court should be made aware that the SASSI cannot determine if a client is currently drinking. The Face Valid items may show no drinking during the past year, but the subtle scales reflect personality traits that do not change quickly. For instance, someone who is in recovery for an extended period of time will more than likely still show as having a high probability of a substance use disorder.
Another option is to administer the Behaviors & Attitudes Drinking & Driving Scale (BADDS) to determine the extent to which your client may be at risk for drinking & driving.
If your objective is to identify those who are likely to have a substance use disorder, screening instruments such as the adult, adolescent, or Spanish SASSI measures can assist you to this end. If your goal is to identify more specifically those who are likely to engage in impaired driving behaviors, or if your goal is to evaluate the effectiveness of an impaired driving intervention, the BADDS is a highly valuable tool.
No. The SASSI should not be used to determine whether or not someone has a gambling addiction. However, there does appear to be a high probability that the client has a substance use issue and further exploration into her prescription drug use would be appropriate. For instance, does the client take only prescribed medications in quantities approved and overseen by a single physician?
Occasionally reading the questionnaire to a client is acceptable. However, we do strongly recommend that clinicians take advantage of our professionally read CD and/or audiotape. Using the professional CD or audiotape will ensure that the questions are read to the client in a way that would not interfere with the accuracy of the responses.
The SASSI questionnaires have been validated as screening instruments to identify individuals likely (and unlikely) to be diagnosed with a substance use disorder. These screening instruments are not measures of therapeutic change. Therefore, readministration of a given SASSI questionnaire to the same individual is not recommended, except in circumstances where the screening results yield an elevated Random Answering (RAP) score and after conversation with the individual, the clinician determines that instructions for completing the questionnaire were not followed or understood. In addition it may sometimes be helpful to readminister the questionnaire if an individual’s defensiveness (DEF) score is elevated and the clinician feels greater rapport has been established with the client. See the SASSI User Guides for additional information on RAP and DEF scores.
The Adult SASSI-4 has a validated 92% overall rate of screening accuracy in identifying mild, moderate, and severe substance use disorders. The Adolescent SASSI-A3 has an overall empirically tested accuracy of 89%. Validation research on the Spanish SASSI indicates an overall accuracy rate of 84%.
The Adolescent SASSI (SASSI-A3) should be used with youth between the ages of 13 and 18 years. Exceptions can be made. For example, it may be appropriate to administer the SASSI-4 (adult version) to a 17 year old who no longer lives with his/her parents and is full self-supporting. On the other hand, the SASSI-A3 may be more appropriate to use with an 18 year old in high school who is still dependent on his or her parents.
Yes. Validation research on the SASSI-4 found an overall accuracy rate of 93.5% for adults 60 years or older.
If you mean will the judge always agree with the results of SASSI decision rules, we actually hope not. For example, the Adult SASSI-4 is a highly accurate screening instrument but does not agree with clinical judgment 100% of the time. In 7% of cases of adults diagnosed with mild, moderate or severe substance use disorders, the SASSI screening results will likely fail to identify the disorder (i.e., the SASSI-4 demonstrated 93% sensitivity in validation research). Similarly, in 10% of adults diagnosed by a clinician as NOT having a substance use disorder, the SASSI-4 decision rules are likely to indicate a high probability screening result (i.e., 90% specificity). This is why we encourage counselors to use their judgment and other information from interviews with the individual and family members when possible, as well as other information on treatment and court records when formulating their diagnoses. The SASSI does not yield a clinical diagnosis but rather a screening result that can be used as one piece of information when conducting clinical diagnostic evaluations
Yes. One reason is the accuracy of the screening results. One important part of this credibility is that many other screening measures deliberately set their cutoff scores very low in order to maximize sensitivity of their instruments, often at the cost of misidentifying those without substance use disorders as test positive (i.e., low specificity). In contrast, one goal in developing the SASSI decision rules was to balance the false positive and false negative error rates.
Another reason the SASSI-4 has high credibility is that while other screening instruments may misidentify individuals with emotional problems as if they were alcoholic or drug addicted, the SASSI was developed to not confuse difficulties associated with other psychological conditions with substance use disorder. Research on the SASSI-4 has found that patients who are receiving clinical services for psychiatric disorders such as anxiety or depression, for example, but who do not have alcohol or drug problems are correctly identified with “low probability” SUD screening outcomes 93% of the time (i.e., with a 93% specificity rate). In addition, the SASSI-4 showed a 98% accuracy rate in identifying dual diagnosis clients with “high probability” SUD screening outcomes (i.e., 98% sensitivity in a sample of individuals with co-occurring SUD and other disorders), indicating the instrument is highly accurate in detecting the presence and absence of SUD even when non-substance related psychological symptoms are evidenced.
Counselors who have their diagnoses, including test results subpoenaed by defense attorneys have told us that they often offer instead to loan the attorney a copy of the SASSI manual. Frequently the attorney will review the manual and successfully convince their client to plea bargain rather than try to challenge the diagnosis.
The SASSI is not only accepted, but is actually required in a sizeable number of courts. For example, we are aware of five states that require everyone arrested for a DUI (DWI) to be given a SASSI and Behaviors & Attitudes Drinking & Driving Scale (BADDS) as part of the evaluation. Other examples of government mandated administrations occur in areas such as detention and correctional facilities, and probation departments.