Tag: High Probability of a SUD

Skillfully Using the SASSI

We want clinicians to find the SASSI to be helpful in their work in a way that enables them to affect the lives of their clients in a positive manner.

When a client is unable to acknowledge (sincerely deluded) or unwilling to accept they may have a problem, a clinician’s skillful and caring feedback on SASSI results may help break through those barriers and enable the client to take the courageous step toward recovery.

If you would like to learn more about clinically interpreting SASSI profiles, we encourage you to join us for one of Clinical Interpretation trainings. For more information on live, on-demand, and in-person workshops, please visit https://sassi.com/sassi-training/

Free assistance interpreting SASSI results is available M-F 1-5 pm ET at 800.726-0526 Option 2.

A SASSI-4 Profile Analysis: Drug Offender with SAT As Highest Score

The following profile result is of a 35-year-old male referred for screening and possible assessment after a drug-related arrest. He completed the FVA/FVOD side of the questionnaire based on his entire life timeframe. His RAP score was 0, indicating no random responding and that the result should be valid. His Prescription Drug Scale score (Rx) was 1, so he did not meet the cutoff for High Probability of Prescription Drug Abuse.

Looking at this profile, we see that he was classified as high probability of a substance use disorder based on the following Decision Rules:

  • Decision Rule 1 with a FVOD score of 32.
  • Decision Rule 3 with an OAT score of 9.
  • Decision Rule 4 with a SAT score of 14.
  • Decision Rule 5 with a SYM score of 6 (5 or more) and a SAT score of 14 (4 or more).
  • Decision Rule 7 with an OAT score of 9 (7 or more) and a SAT score of 14 (6 or more).

Looking at the graph on the SASSI Adult Male Profile sheet, we see an extremely high elevation on the FVOD scale score which is significantly above the 98th percentile. Individuals who score this high on the FVOD are able to acknowledge currently having or having had numerous negative consequences and problems as a result of their use of drugs. This can include loss of control of the drug use as well as using a coping mechanism.  It is important to note that, since he was asked to use the “entire life” timeframe for the FVA and FVOD scales, his admission of having these consequences and problems with drugs may be related to some time in his past and not necessarily currently. For example, the client’s score on the SYM scale (which is similar to the FVA/FVOD in what it is measuring), is not nearly as elevated as his score on the FVOD even though the questions are not that dissimilar from the FVOD questions.

This suggests that he is not showing as much acknowledgement on the SYM scale of the symptoms of substance misuse that he admitted to on the FVOD scale. This could be related to the fact that the SYM scale (like all scales on the True/False side of the questionnaire) has no specific timeframe associated with it and therefore the client may have the belief that, while he has had significant problems with drugs in the past, he may not believe his current drug use is as much of a problem currently. It is highly recommended that clinicians do a content analysis of the client’s answers to the FVOD and SYM scale questions as this will provide more insight into the client’s acknowledged problems with drugs.   

This client’s elevated OAT scale score, like the elevated FVOD scale score, suggests a capacity to acknowledge and identify with many of the typical negative attributes (general personality and behavioral characteristics) and personal limitations that are often common among those with substance use disorders – e.g. impatience, resentment, self-pity, impulsiveness).  While the client can often see these “character defects”, they may not always feel motivated to change them or feel capable of changing. Given that the OAT score in this case is above the 98th percentile, it is highly probable that this individual may be able to closely identify with individuals in recovery from substance use disorder, such as those found at recovery support groups, and therefore may be more willing to trust these recovering individuals and follow their recovery advice.

The client’s highly elevated SAT score (the highest score on this profile), which is higher on the graph than the OAT score, suggests that despite the client’s capacity to acknowledge the more obvious problems and negative consequences associated with his use of drugs, there are subtle aspects of his behavior, personality, and addiction that are extremely hard for him to acknowledge. In other words, he may not be able recognize the pervasiveness of his addiction, how it negatively affects and rules every aspect of his life with deeply held negative thinking patterns, beliefs and negative coping patterns driving his addictive behaviors.

Clients with a pattern of scores like this client who tend to be able to acknowledge heavy usage, negative consequences and problem behaviors, may still be convinced, sincerely deluded into thinking that they are not truly addicted. They will often present as more “superficial” saying things like “well, I go to work every day and do my job so I couldn’t be addicted”. Clients with elevated SAT scores (especially higher on the graph than their OAT score) tend to be more initially resistant to the need for treatment and are more likely to relapse. These clients tend to be detached from their feelings and have relatively little insight into the basis and causes of their problems (namely substance addiction). These clients typically need a more intensive level of treatment where they can receive constant support for their recovery efforts and can get the kind of group processing therapy needed to help them connect with their feelings and learn how to cope with them without drugs.

In providing treatment to this type of client it is important to recognize that underneath the many excuses (other than substance addiction) for their problems, there is an individual with a substance use disorder who is likely in pain and scared. Individuals with high SAT scores may not be in touch with the pain and fear, largely because they immediately numb any negative feelings with substances as soon as they appear, but the pain and fear. In this case, intensive treatment and group work has to be accompanied by sensitive and skillful clinical intervention that lets the individual know that somebody is aware of their fear deep within and that it will be a relief to let it out to begin healing.

We hope you find this useful information regarding clinical issues.  As always, the Clinical Helpline at 888-297-2774 is open to serve you Monday through Friday, 9 am to 5 pm (EST).

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An Adolescent Trying to Mix Things Up!

The message this Adolescent was trying to send is as confused as he must be. A lot of contradictions in the numbers needed to be sorted out and made sense of.

This 16-year-old male responded to the FVA and FVOD questions for his whole lifetime.

The Prescription Drug Scale result was zero.

The VAL check was 4.

He met the criteria for a High Probability of a Substance Use Disorder based on Rules 1, 5, 6 and 7. A reminder, it requires only 1 yes to the 8 rules to meet the criteria for High Probability. More “yes’s” does not mean a more severe problem. Severity of a Substance Use Disorder is determined with a diagnosis from the DSM-5.

Another reminder, content analysis of the Face Valid scales i.e. FVA, FVOD, FRISK, ATT, SYM and Rx individual items can be examined to generate information regarding under what circumstances substances are used and with whom, along with underlying emotional reasons.

The FVA of 7 is elevated enough to meet the criteria of Rule 1.  The FVOD of 2 is below average and within the norm.

The FRISK score of 0 proves to be interesting given the context of the psychosocial history of this individual. It may be he did not want to disclose information regarding his friends or family.

The ATT score of 6 is highly elevated above the 98th percentile. This indicates he has a strong value and belief system regarding the use of substances. He may believe that everyone uses and that may be the case in his world.

The SYM score of 3 is within the norm so from his perspective, he has experienced minimal symptoms or consequences of his usage.

The OAT score of 7 is elevated above the 85th percentile so clinically significant but coupled with an higher SAT score of 6 as graphed is somewhat muted. On the one hand, an elevated OAT score indicates he can acknowledge personal limitations and shortcomings and may identify with other substance users though he may not want to change. On the other hand, the elevated SAT score can indicate denial or lack of awareness and insight or detachment from feelings.

The DEF score of 6 is within the norm and below average which can indicate self-esteem issues. It is a bit surprising the DEF score, in this case, is not elevated. The client was not defensive completing this questionnaire.

The SAM score, by itself, has no clinical interpretation.

The COR score of 5 is within the norm so there is no clinical interpretation.

What the psychosocial interview revealed: The client had a history of vaping nicotine with friends and had completed a Substance Use Education course. However, the client was smoking pot at home and minimizing his use. He was described as lying and manipulative. It was also disclosed his father is in recovery. As we all know, attitudes around Marijuana not being addictive or even a “drug” have been rapidly changing along with the legalization of Marijuana. However, the client’s risk of developing a significant risk of a substance use disorder is escalated by a family history of addiction.

Addressing the VAL score of 4:  With the High Probability of a Substance Use Disorder result, the VAL check score does NOT come into play. It would only be impactful if he had come up with a LOW Probability of a SUD. However, this score is quite high, and the administrator would rightly suspect the client was trying to skew the results even if it had no impact on the result.

Adult SASSI-4 Review: Does the SASSI evaluate for Video Gaming?

This is an interesting profile on a 23-year-old male as it brought up the question, we get on the helpline regarding video gaming. “Does the SASSI evaluate for video gaming addiction?”, especially if the administrator believes the client was possibly including video gaming as well as substance use in his answers. The simple answer is no, it does not, so please clarify with your client not to include video gaming.  A drug that is often associated with video gaming is Adderall so the follow-up question to a client who admits to excessive video gaming is to question what drugs are they using to maintain that level of energy and concentration.

This individual was instructed to complete the FVA/FVOD side of the questionnaire for the last 12 months.

RAP was 0.

High Probability of a Substance Use Disorder.

Prescription Drug Scale result was 3 so meets the cutoff for High Probability of Prescription Drug Abuse.

He met Rule 1 with a FVOD score of 21.

             Rule 2 with a SYM score of 7.

             Rule 4 with a SYM score of 5 (7) or more and a SAT score of 4 (7) or more.

Looking at the graph on the Profile sheet, you will see a significant elevation on the FVOD scale score – above the 98th% so he is openly acknowledging use of drugs. By analyzing his responses, you will gain insight into what circumstances he is using, including dealing with emotional or stressful issues. And remember, he is answering the FVOD questions based on the last 12 months.

The SYM elevation is above the 85th percentile – enough to meet Rule 2. Because SYM is a face valid scale, you can do content analysis on those questions to look at the symptoms and consequences of his substance use.

The OAT score is within the norm. It would probably be the case that he does not identify with other substance abusers. This may be related to his very low-DEF score.

The SAT score is within the norm but high. The administrator may pick up some denial or lack of insight on the part of the client. And again, it may be related to the DEF score.

The DEF score is very significant because it is so low, below the 15th percentile. This individual may be in emotional distress and may be suffering from depressive symptoms. He should be evaluated for depression as he may be using substances to self-medicate. He may also believe that if he wasn’t depressed, he would not be abusing substances thus the OAT and SAT scores may reflect this perception.

The Rx score is also very significant and warrants further investigation as to what prescription drugs he may be abusing and if, in fact, are related to video gaming.

The rest of the scores are within the norm, so not clinically significant.

In summary, these clinical results are hypotheses to explore with the client to determine the depth and scope of the client’s use in order to recommend a treatment plan which fits his particular needs.

We hope this is helpful to you.

The clinical helpline line is open for your inquiries, M-F, 12- 5 (EST) at 888-297-2774 and you will be directed to a clinical consultant. If we are not available, please leave a message and we will return your call.

And as always, Thank you for your interest in the SASSI.

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Explaining Results to a Client with a High Probability Result When Scale Scores are Within the Norm

Perplexed callers periodically raise the question of how to interpret the results to their clients when all the scores fall within the norm and are only one standard deviation above or below the T-score of 50. Clinical interpretation is minimal although you can glean some useful information than just reporting a high probability.

The following profile result is of a 48-year-old female. She completed the FVA/FVOD side of the questionnaire for the last 12 months. Her RAP score was 0. Her Prescription Drug Scale score was 4 which indicates a High Probability of Prescription Drug Abuse.

As you can see, her FVA of 2 indicates below average use of alcohol, her FVOD score of 8 indicates above average use of drugs though within the norm. Her SYM score of 4 is also within the norm and although above average, she is not endorsing a lot of negative symptoms or consequences of her usage. Content analysis is useful with the Face Valid scales because they will give the context or conditions of how the client is using substances. The OAT score of 4 is within the norm so one hypothesis to explore, given the High Probability of a Substance Use disorder result, is if this client identifies with other addicted folks and those issues we often see in that population i.e. self-pity, resentment, low frustration tolerance, impatience etc. I would suspect not.

The SAT score of 3 is well below average although within the norm, this client may be concerned with what you think about her.  The DEF scale score of 7 is above average but also within the norm so you may be picking up a bit of a defensive posture with this client.

The last 3 scales, SAM, FAM and COR have no clinical impact.

Moving onto the Rules, two rules are met: Rule 9 and Rule 10.

Rule 9

  • FVA 6 or more or FVOD is 4 or more
  • SAT is 3 or more
  • DEF is 7 or more
  • All three, a,b, c ?  YES

Rule 10

  • FVA is 14 or more or FVOD is 8 or more
  • SAT is 1 or more
  • DEF is 4 or more
  • SAM is 4 or more
  • All four, a,b,c, d ? YES

The Rules are research based. Single scores within one standard deviation above or below the normative scores for each scale are not likely to indicate strong evidence of a diagnosable substance use disorder or a clinical problem. However, validation research indicated that some combinations of scores within this normative range such as in Rules 9 and 10 were evidenced by people who were diagnosed with a substance use disorder, and yet this same pattern of scores was not evidenced by those without substance use disorders. The scoring rules identify patterns of scores that accurately and reliably identify individuals with substance use disorders- even when the individual scores in the rule are not indicative of SUD on their own. Also, Table 10 in Chapter 7 in the SASSI-4 User Guide & Manual shows that both Rules 9 and 10 have a 96% accuracy rate indicating that the rules rarely identify people who do NOT have an SUD as positive on these rules.

You can see for Rules 1-4, the cutoff scores are outside the standard deviation which allows for both meeting the rule criteria and allows for easier clinical interpretation as well.

It is also important to note that the cutoff scores for each scale in any rule are specific to the rule. Being close doesn’t count.

Giving feedback to this client, the administrator needs to be aware of the bit of defensiveness and sensitivity of the client and perhaps the reluctance to identify as an addict. Using the information, she did endorse in the FVA, FVOD and SYM scales along with the Prescription Drug Scale results. It may help her to connect the dots and thus become open to whatever treatment considerations are discussed.

As always, if you have any questions about your SASSI results, please contact us through the free Clinical Helpline. We are available M-F, 12 – 5 EST at 888-297-2774 or 800-726-0526.

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Adolescent A3 – Emphasis on COR Scale

This profile is a good example of needing to be careful with assumptions.

Overview of CORRECTIONAL (COR) SCALE

The COR scale provides information pertaining to the possibility that the client may have a relatively high risk of experiencing legal problems. It is composed of items that differentiated between people who had a history of involvement in the juvenile justice system and those who did not.

It is very important not to over-interpret elevated COR scores. Teens who have elevated COR scores are responding similarly to individuals who have violated the law. This does not mean that all clients with elevated COR scores have broken laws. Also, there is no empirical evidence that these clients are at risk for future offenses.

If a client has an elevated COR score, it is worth exploring those behaviors which may be leading the client to make poor choices, especially after using substances and magnifying the tendency to exhibit those behaviors. These include anger management issues, impulsivity, risk taking behaviors, low frustration tolerance or poor social skills. The task of the clinician is to help the client see the relationship of their behavior to the consequences they have experienced and introduce alternatives to regulate their emotions and behavior.

The SASSI A3 was administered on a 15-year-old male and the time frame for the FVA/FVOD was for the past 6 months. The caller explained this time frame was used as the client identified that his substance use became problematic during this time. He indicated he had initially started smoking marijuana but in the last 6 months started abusing Percocet.

There is a lot to look at in this profile below.

He meets Rules 1, 3, 4, 5, 6 and 8 so met the criteria of a High Probability of having a Substance Use Disorder. A reminder that more “yeses” does not necessarily mean a more severe problem or meets the DSM-5 criteria for severity.

His Rx scale score was 1.

The FVA (2) is below average and within the norm.

The FVOD (18) is highly elevated and close to the 98th percentile so he is very open about his use and under what circumstances he is using.

As seen on the profile graph, both the FRISK (2) and ATT (3) are within the norm though above average.  These scores indicate he is not necessarily using due to peer pressure nor does he have a strong belief or value system that endorses substance use.

The SYM (9) is off the chart. He is endorsing negative consequences and symptoms of his use as well as loss of control.

It is worth taking the time to look at how he has answered his face valid scales and do content analysis of his answers because these will generate a lot of information for clinical insight and discussion on how and why he is using substances. As a reminder, the face valid scales are the FVA, FVOD, FRISK, ATT, SYM and Rx scales. You cannot do content analysis on the subtle scales.

Both the OAT (8) and SAT (7) are above the 85th percentile. Although the OAT indicates he can acknowledge personal limitations, the higher SAT score indicates a level of denial or lack of awareness or detachment from feelings and may present himself functioning well.

The DEF (4) score is very significant as it is below the 15th percentile. This indicates severe emotional pain, and he may be exhibiting depressive symptoms so it is suggested a mental status exam should be conducted.

As usual, there is no individual clinical interpretation to SAM (4).

The last scale, COR (10) is highly elevated above the 98th percentile. He is identifying with those issues that are normally seen in juveniles with legal issues.

This is where one must be careful with assumptions because this client has had no legal issues for any reason. It is more productive to explore those issues he is identifying with and affecting his choice making.

It is also curious that one can be very open (based on the FVOD and SYM) yet have an elevated SAT score as well. This may be due to the DEF score and the emotional pain he is in. Hypothetically, he may believe that if he was not “depressed” he would not be abusing drugs.

Another aspect of the profile is to explore his Rx result. According to the client’s report, he is primarily abusing Percocet. His score may reflect he is getting it illicitly and not through a doctor.

Finally, regarding treatment considerations, the caller reported he has tried to quit using the Percocet for a week but relapsed. A treatment plan including inpatient should be considered considering his reported relapse.

We hope this is helpful to you.

The clinical helpline line is open for your inquiries, M-F, 12- 5 (EST) at 888-297-2774 and you will be directed to a clinical consultant. If we are not available, please leave a message and we will return your call.

And as always, Thank you for your interest in the SASSI.

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A SASSI-4 Profile: When the Drug Use is Marijuana

It is no news that the use of marijuana is viewed by many, no matter what the demographic, as innocuous and far less than alcohol and certainly any other drugs. It has become increasingly difficult to convince users of the harm associated with marijuana use when the legal status ranges from fully illegal, to medicinal and/or decriminalized to fully legal. Users often describe marijuana as simply a plant so it is a natural and therefore a healthy alternative to alcohol and other drugs. This, along with the misconception that marijuana is not addictive, creates an inherent struggle for both the evaluator and evaluatee. As an aside, when writing this, I came across an article in the New York Times by Dana G. Smith (April 10, 2023), titled “How Do You Know If You Are Addicted to Weed?” The article itself gives good basic information but the most interesting part was the comments from readers which were all over the map.

Substance use evaluations for marijuana use become problematic when the client comes in with that strong point of view which may be reflected in the results of the SASSI and in the scales.

The question of diagnosis based on the DSM-5’s 11- symptom criteria and whether the client meets either mild, moderate or severe must be answered before any treatment considerations can be raised.

The following is a good example of what a profile looks like when the drug use in question is marijuana.

The client is a 19 year old female and the FVA/FVOD questions were answered for the last 12 months. The RAP and Prescription Drug Scale scores are 0.

CLINICAL INTERPRETATION

The client’s FVA is average but her FVOD of 13 is elevated above the 85th percentile so clinically significant. Her SYM score of 9 is above the 98th percentile so she is endorsing significant symptoms and consequences. It also indicates she is associating with either family or friends who are heavy users. This gives important information regarding her environment and the difficulty of a social system that supports recovery.

The OAT scale score of 5 is neither elevated nor extremely low. It would be plausible to say she does not identify with or see herself as a substance abuser. This is reinforced by both the SAT(6) and DEF(6) falling in the normative range. She is not in denial because she believes there is nothing wrong with smoking marijuana and so was non-defensive when completing the questionnaire. The only other clinically significant scale is COR with a score of 7, also above the 85th percentile. Whether or not she has legal problems, she has answered in a similar way to others with legal issues. Anyone looking at that result can evaluate impulsivity, anger management issues, low frustration tolerance, poor social skills or risk taking behaviors, all of which impacts choice-making abilities.

THE RULES

Out of the 10 rules evaluating for either a high or low probability of a substance use disorder, she meets 4 of them:

          Rule 2 (SYM=7+)

          Rule 5 (SYM=5 + and SAT=4+)

          Rule 6 (SYM=6+ and DEF OR SAM=7+)

          Rule 10 (FVA=14+ or FVOD =8+ and SAT=1+ and DEF= 4+ and SAM 4+)

To meet the criteria of a High Probability of a Substance Use disorder requires meeting only ONE rule. Meeting more than one rule does not necessarily mean a more severe disorder. The DSM-5 evaluates for severity ranging from mild, moderate to severe based on the number of diagnosable criteria met.

CLINICAL ISSUES TO CONSIDER

Giving clinical feedback to this client or any client for that matter, is to use the information they have given you from the questionnaire. Pulling information from this client’s questionnaire, the FVOD and the SYM responses can help start the conversation regarding how she is using drugs, under what circumstances and consequences of her use. For online users wanting access to the SYM questions, go to sassionline.com, log-in: go to ‘my clients’ tab; then ‘support materials’ tab. Under Adult SASSI-4 Online User’s Guide go to the SYM section, Pg.19. You will find a list of the SYM questions you can coordinate with your client’s completed questionnaire. A reminder: only with face valid scales i.e FVA, FVOD, SYM and Rx scales can you do content analysis of the questions.

The purpose of feedback is not trying to convince her that marijuana is a drug and she has a disorder but to use the information she, herself, has given you to explore how her drug use is impacting her in a negative way or in some ways interfering in her life.

TREATMENT CONSIDERATIONS

The OAT score result implies group treatment intervention would not be the first choice for this client. Information specifically regarding marijuana’s addictive qualities and impact on the body could be included in individual motivational counseling. Establishing a goal regarding her use, including reduction or abstinence is part of treatment planning no matter the context. Even though she is not defensive, establishing rapport and trust may be instrumental in facilitating this client to take a closer look at her drug use and eventually be open to group experiences.

If you have any clinical questions, be sure to call our free helpline to talk to our clinicians. We are available M-F, 12-5 EST at 800-726-0526.

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The Interrelationship of Bullying, Shaming & SUD among LGBTQ Adolescents

As we approach the end of PRIDE month, we are pleased to share a short article we recently published that discusses substance misuse and explores the genesis and exacerbation of drug use among Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) teens. In the article, we look at the possible connection between bullying and other oppressive behavior (such as shaming) and acknowledged substance use and suicide. We hope you will take the time to read and share it. “Bullying and Oppressive Behaviors Towards LGBTQ Adolescents: Substance Use Disorders in the Making?”

We hope you will take the time to read and share it. “Bullying and Oppressive Behaviors Towards LGBTQ Adolescents: Substance Use Disorders in the Making?”

Elevated RAP/ High Probability Results on an Adult SASSl-4

This profile on a 21-year-old female with the FVA and FVOD, based on the last 12 months, is interesting primarily because it is so unusual.

As you look at the profile graph, all the scale scores are within the norm, i.e., between the 15th and 85th percentiles except for the SYM score which is above the 85th percentile. This tells you that she is acknowledging symptoms and consequences of her use and indicates she is associating with friends or family who are also heavy users. This is a bit of a contrast to her FVA and FVOD scores, both of which are above average but not above the 85th percentile.

The SAT score of 5 is within the norm which is a positive – no denial or lack of awareness or insight is indicated. However, with the OAT score within the norm, it is a possibility that she does not identify with other substance users and those characteristics we associate with substance users such as impatience, self-pity, resentment, or impulsivity. If marijuana is her primary drug, she may not see it as a problem so the high probability of a substance use disorder may be an unexpected result for the client.

Another positive is the DEF score, which is above average but not clinically significant since it is below the 85th percentile.

The client meets decision rules 5, 6 and 9 and 10 thus meeting the criteria for a high probability of a substance use disorder. As a reminder, more rules that are met does not mean a more severe problem. As we often mention on the clinical helpline, the diagnosis and severity of a substance use disorder is based on the criteria in the DSM-5.

Note the Prescription Drug Scale score of 2. It does not meet the cut-off criteria for prescription drug abuse, but it is worth a look at those items she endorsed.

The caller was puzzled by the RAP score of 2 and how it affected the result of the SASSI.

A RAP score of 2 or more always needs to be explored, preferably with the client. The two items which posed the problem were ‘I never have been picked on and I have never been sad’.
Cultural and language contexts need to be considered for possible reasons the client answered as she did. The possibility of her deliberately trying to ‘skew’ the questionnaire is low given the high probability result. More likely, the client answered accurately for her based on her life experience.

The clinician can now safely accept the overall result as valid.

As a reminder, the free clinical helpline, (800-726-0526) is available M-F, 12- 5 pm (EST) for any questions you may have. We also offer a free Q&A zoom meeting once a month for an hour as well. Please check the blog notice for dates and time to register. And finally, if you have additional inquiries, please contact the Clinical Director, Kristin Kimmell, LCSW, LCAC at kristin@sassi.com.

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Clinical Q&A and Live SASSI Training Webinar 

We are pleased that people have been joining us for our free one-hour online Clinical Q&A sessions hosted by our Clinical Director, Kristin Kimmell, LCSW, LCAC.  

We enjoy hearing how you are using the SASSI in your clinical practice and agencies as well as answering your questions and speaking to you all.  We have scheduled additional sessions that we hope you can join in on. You can reserve your spot and view available dates and times by clicking here. If you have profiles you would like to share with the group for discussion, please send them (de-identified) via email any time prior to the session to scarlett@sassi.com. Your contributions would be of great value. Also, a reminder that we have a live webinar on Administration & Scoring of the paper & pencil version of the SASSI on April 18th and Clinical Interpretation on April 25th. You can register by clicking here.   

Note that the Q&A sessions do not provide CEUs and are not a substitute for SASSI Training. SASSI training provides 3.5 NAADAC CEs per session. 

We hope to see you there!