Tag: SASSI

Have You Been SASSI Trained?!

In my conversations with SASSI users on our free Clinical Helpline, I often run into people who have never participated in an official training led by a SASSI-certified trainer. Some of them have never been trained by anyone and are just trying to figure it out on their own or using the SASSI User Guide & Manual. Others have had a co-worker show them what they know about the instrument, sometimes inadvertently receiving misinformation or information lacking in important details. Thankfully, the SASSI was originally designed to be a simple and easy to use screening instrument that doesn’t necessarily require one to have a specific credential or college degree in order to successfully administer and score the instrument. So, anyone can easily learn to use the SASSI effectively and accurately with proper training.

I remember several years ago I was doing a training on the SASSI for a probation department and one of the attendees, who had been using the SASSI for over 10 years and who wasn’t sure why he had to be at the training, came up to me at the break and told me he had already learned several things in the first 1 ½ hours that he hadn’t known for the past ten years! He had never been to an official SASSI training done by a SASSI certified trainer until that day. For him, he was now glad he had been required to go to the training that day!

While the basics of administering and scoring the instruments are quite simple, the SASSI also has additional utility in the form of Clinical Interpretation of the Sub-Scales that can be used to help us in treatment planning, educating the client, making referrals for clients and just understanding our clients better. Like most things involving humans though, clinical interpretation can be rather complex and not as straight forward as the basics of administration and scoring. Getting good training by a SASSI-certified trainer is a first step to learning to master the interpretation of individual sub-scales on the instruments. The second step after training is to regularly utilize the free Clinical Helpline service offered by the SASSI Institute weekly M-F from 1:00pm-5:00pm EST. Through this service, callers are able to essentially extend their training on the SASSI for free and practice their clinical interpretation with SASSI clinical experts as often as they want or need each week.

So, if you’ve never been to an official SASSI-certified training or it’s been many years ago and you need to go to training again to get a “refresher,” let me encourage you to take that step in improving your knowledge base to get more out of this amazing screening instrument to better assist your clients. You can go to the Training section of the SASSI website by going here: https://sassi.com/sassi-training/. From there, you can click on United States or Canada to see if there are any trainings scheduled by state, province or region by our certified trainers; or you can click “Online” to view and register for any of our upcoming live public webinar trainings which are separated by those that are specifically for the Online/Web-based version of the SASSI and those for the traditional paper/pencil version of the SASSI. On this page you can also register for “On-Demand” recorded SASSI trainings if you don’t want to wait for a live training. The live trainings offer you the advantage of being able to interact in real time with the trainer and other participants and ask any questions you might have on the spot. The “on-demand” recordings offer the convenience of immediate viewing. Choose what works best for you but please consider getting training in an official SASSI-certified session. Who knows? You might find out some things about the SASSI you never knew that can help you use the instruments more effectively.

Reducing Stigma Through Objective Assessment

The Ethics of Standardized Screening

Stigma is perhaps the most significant “silent” barrier in behavioral health. When assessments are based purely on subjective interviews, they are vulnerable to the unconscious biases of the interviewer. These biases can be based on a client’s appearance, socioeconomic status, race, or even their “likability.”

The Role of Objectivity The SASSI Institute was founded on the principle of providing validated, objective data. When we use a standardized screening instrument as part of an assessment, we are providing the client with a fair hearing. The results are based on decades of empirical research and rigorous validation studies, not the “gut feeling” of a provider.

Humanizing the Data Standardization makes our care more human. It ensures that:

  1. Equity: Every client is screened using the same criteria.
  2. Accuracy: Diagnoses are backed by psychometric evidence, which is crucial for insurance authorization and legal standing.
  3. Communication: It provides a common language for the treatment team (doctors, counselors, and social workers) to discuss the client’s needs.

As we look toward the future of the SASSI Network, our goal remains clear: to empower clinicians with tools that see past the stigma and focus on the person’s clinical needs. By relying on evidence-based screening, we aren’t just filling out forms—we are advocating for the dignity of our clients.

Why Looking Beneath the Surface Matters in Screening

The Science of Face Valid vs. Subtle Items

In the world of substance use assessment, there is a recurring challenge: the “Honesty Gap.” When a client enters a screening environment, whether due to a court order, workplace requirement, or personal crisis—they are often operating under extreme pressure. This pressure frequently manifests as denial or purposeful concealment.

The Limitation of Direct Questioning: Most screening tools rely almost exclusively on “face valid” items. These are questions where the intent is obvious, such as “How many times a week do you use stimulants?” While these questions are necessary, they are easily manipulated. A client who is not yet ready to change, or who fears the consequences of their answers, will likely underreport.

The SASSI Advantage: Subtle Scales The SASSI-4 (Subtle Substance Abuse Screening Inventory) is unique because it utilizes subtle items. These are questions that do not appear to be related to substance use on the surface, but are statistically correlated with individuals who have been diagnosed with Substance Use Disorders (SUD).

By integrating these subtle scales, the SASSI provides a “safety net” for the clinician. If a client’s face-valid scores are low but their subtle scores are high, it usually indicates a high probability of a substance use disorder based on the SASSI decision rules despite the client’s current inability or unwillingness to acknowledge it.

Clinical Application This isn’t about “tricking” the client. Instead, it’s about providing the clinician with a more accurate roadmap. Knowing that a client is defensive or in denial allows you to adjust your clinical approach—providing an opportunity for more open dialogue rather than immediate confrontation—thereby increasing the chances of long-term treatment retention.

The Purpose & Potential of Assessment and the Role of SASSI Screening

Engaging in assessment regularly can make it become routine; therefore, sometimes perspective is lost and the purpose forgotten. Time needs to be taken to remember the precise questions assessments are trying to answer. When forgetting the specific reasons for conducting assessments, they lose their value ­ both to the individual client and the clinician.

Screening is an important part of assessment for the purpose of triage, identification of risk factors, and referral for additional services. The basic question is whether an individual is likely to have a particular problem. If so, the subsequent assessment and treatment plan should address that problem. Since screening tools are used to identify people who are likely to have a problem or be at risk for developing a problem, they are never infallible. The key element is to use a screening tool that meets the needs of the clinician. As an example, the crucial factor in airport security screening is that the procedure be highly sensitive; they do not want to miss anyone who is a security risk. ln other words, they do not want any false negatives. However, in eliminating all false negatives, the procedure that is used produces false positives and anyone carrying metal is flagged by the airport security screening and given some degree of further scrutiny, even though most people who carry metal are not found to be a security risk. But different screening settings have different needs. ln developing and maintaining the SASSI, the researchers recognized that there are costs associated with both over and under-identification of substance use disorders (SUD). Therefore, the research and development aims were directed toward maintaining a high level of sensitivity (few false negatives) and a high level of selectivity (few false positives).

While a relatively comprehensive assessment may be needed to arrive at a diagnosis, the basic question is whether the individual meets the specific criteria (e.g., DSM-5) necessary to arrive at a diagnosis. There exists a long-standing controversy regarding the value of diagnoses. Some argue that diagnoses serve to label people unnecessarily and others argue that it is important to do whatever possible to specify an individual’s problem in a reliable and meaningful manner to ensure appropriate treatment recommendations. Regardless, most agencies require clinicians to formulate a diagnosis, and diagnoses are needed for third party payments and as part of the admission criteria for many treatment programs.

Assessments are also needed for reports. Often individuals are referred by outside agencies (e.g., other health service providers, courts, employers, schools). In these instances, the clinician is placed in the position of providing expert opinion in what may be controversial or even litigious situations. It’s vital for the clinician to have a clear understanding of the precise request being made by the referral agency – What are the questions to be answered? What are the issues that are to be addressed? What types of opinions and recommendations are requested?

In conducting the assessment and writing the report, the clinician should be clear in differentiating observations from inferences and opinions. For example, if the only information on frequency and quantity of consumption of alcohol and other drugs is the individual’s self-report, the written report should indicate that the individual reports using a certain amount, not that the individual actually consumes that amount. If the clinician has cause for concern regarding a symptom of SUD, it should be phrased as a cause for concern rather than an observation. When using the SASSI to screen it becomes possible to make a statement to the effect that the individual’s pattern of responses suggests, with a known level of certainty, that the client is or is not likely to have an SUD. (Note: In addition to screening results, supplemental clinical information is required to meet the accepted standards for a DSM-5 clinical diagnosis of an SUD). The SASSI Rx scale can also help identify individuals likely to be abusing prescription medications and the other additional scales can provide clinical insight into level of defensiveness, consequences of use, desire for change, family and social risk factors, and acknowledgement of problems.

Always present information clearly and distinguish observation from inference and opinion. It is important to help the individual become increasingly invested in the treatment process. Assessment is a critical part of the treatment process and provides an opportunity for the clinician and the individual client to mutually identify problems, set goals, and devise strategies to meet those goals. The individual client is the primary focus, and the information that’s gathered is useful to these individuals only to the extent that it helps them take action that enhances their quality of life. For information on interpreting SASSI scales, please consider completing our Clinical Interpretation training. Registration information can be found at https://sassi.com/sassi-training/.  Also, professionals can call our free clinical helpline at 800.726.0526 Option 2, M-F 1-5pm ET for help with profile interpretation.

High Probability by Subtle Scales Only

Many people know that the SASSI is possibly the best substance use disorder screening tool that exists in the behavioral health field today. The instrument can be easily administered in 15 minutes or less and manually scored in less than two minutes (or scored automatically in the online web-based version), resulting in an objective empirically-based statement of the likelihood of the client having a substance use disorder with an overall accuracy of 92% for adults and 89% for adolescents. And it achieves this kind of accuracy even in clients who are unwilling or unable to acknowledge their substance misuse or the symptoms associated with it!

Through extensive case study research, the SASSI has been found to be able to provide even more utility to clinicians in the form of clinical interpretations that go beyond just the high or low probability of a substance use disorder result. In addition to interpretations of individual scale raw scores that fall outside the boundaries of the research-based established normal distribution, we also have discovered some trends or characteristics in the specific situation in which the client scores as high probability of a substance use disorder based on SASSI decision rules that involve only subtle scales rather than face valid scales. That is the subject of our blog today.

The SASSI is made up of both face-valid scales and subtle scales. Face-valid scales such as FVA, FVOD and SYM are scales that are very obvious about what they are measuring, while subtle scales such as OAT, SAT and DEF are made up of items that do not seem to have anything at all to do with substance use. Our case study analysis showed that certain behaviors, characteristics or patterns emerge in individuals who score as high probability based only on subtle scales. Let’s take a look at an example. Byron is a 31-year-old male who was asked to be evaluated because of a child custody battle in which the mother alleges that Byron misuses drugs. Byron has not yet had a comprehensive assessment done, but has so far only admitted to some occasional use of marijuana. A SASSI was administered and the results showed that Byron met the criteria for Decision Rules 3, 4 and 7. Each of these decision rules involve only subtle scales and no face-valid scales. So, what characteristics do we tend to find in individuals with this type of scoring pattern?

One key feature of this type of scoring pattern is the fact that these individuals often have very little insight into the pervasive nature of the addictive disorder in their lives. Most of the time, this type of client actually has a very sincere delusion regarding their substance misuse. In other words, they are not trying to trick you into thinking they do not have a problem with substances; they simply do not see it. Often, every single activity this person is engaged in and every decision they make somehow involves substance use. Often, the substance misuse has become an unhealthy way to cope with emotions that are too overwhelming and so individuals with this type of scoring pattern are very emotionally avoidant. Many times, this individual has difficulty admitting their weaknesses or the personal limitations with which they struggle and instead choose to focus on very superficial things, ignoring the depth of the substance problem in their life. We can see these types of traits and behavior patterns manifested in this client’s individual face-valid scale scores such as lower than average (T-score of 50 is the mean) FVA and FVOD scores and only an average SYM score. These all indicate a client who does not acknowledge or admit to having any significant problems or negative consequences as a result of substance use. The client’s extremely high DEF score indicates a very high level of guardedness and the desire to be seen as having no weaknesses or faults. It’s even possible that the FVA, FVOD and/or SYM scale scores could be artificially low because of minimization of symptoms in the client’s answering patterns on these scales fueled by this defensiveness. However, as mentioned previously, it’s possible and even probable that this client really has very little insight into his problem with substance misuse and so he may be unable to even recognize the obvious negative consequences he is experiencing. This is especially typical of clients with high SAT scale scores as this client has. While this client does also have an equally high OAT score, which often indicates some ability to recognize negative attributes that are common in individuals with substance problems such as impulsiveness, self-pity, resentment, and impatience, it is more likely in this case that the client does not see these issues as having any relationship to his misuse of substances.

At this point, a comprehensive assessment needs to be done along with a formal diagnosis and possible treatment plan formulated. Since the SASSI does not provide an actual diagnosis and does not, by itself, indicate a need for treatment or the level of treatment, it is important to gather more information such as self-reports of the client’s current usage patterns, collateral reports, naturally occurring records, behavioral records, etc. to determine a diagnosis and course of action. Typically, clients with this scoring pattern do have a significant substance use disorder and many of them, if they need treatment, will often need a relatively intensive level of treatment which includes individual and group therapy sessions; more than just cognitive/educational programming. However, individuals with this type of scoring pattern will often be initially resistant to any treatment as they honestly do not see a problem that needs to be treated. The high level of defensiveness will require lots of time spent in developing a therapeutic alliance and positive rapport, affirming and supporting him throughout the process. Clients like this are often a high relapse risk and so it is important to provide wraparound supports and a level of intensity in the treatment regimen which allows for quicker and stronger intervention in the event the client attempts to relapse. Individuals who score as high probability of a SUD based only on subtle scales are often some of the most challenging clients, but with information gained from the client’s scoring patterns on the SASSI combined with additional information from other sources, you are in a better position to know what to address to increase the possibility of success with this client.

Don’t forget that full training on administering/scoring the SASSI and clinical interpretation of the sub-scales is available. Check out https://sassi.com/sassi-training/ to register for an upcoming training. Also, our free Clinical Helpline is available M-F from 1:00pm to 5:00pm EST to answer any questions you have about the SASSI.

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Help Us Shape the Future of SASSI Online

At The SASSI Institute, our mission has always been to provide you with tools that make your work easier, more accurate, and more effective. SASSI Online has grown into an important resource for clinicians, educators, and professionals in the field of substance use screening — and that growth is thanks to the support and feedback of our valued customers.

Now, we’d like to hear directly from you.

What features would make SASSI Online even more useful in your daily work?

  • Are there tools or functions that could save you time?
  • Are there any enhancements to reporting, data management, or integrations that would make your workflow smoother?
  • Is there something you’ve always wished SASSI Online could do?

No suggestion is too small or too big. Whether it’s a streamlined way to organize client assessments, a new type of dashboard, or a feature you’ve seen in other platforms that you’d love to have here—we want to know.

Your input will help guide our development team as we continue to improve SASSI Online and ensure it remains a tool that truly supports your practice.

👉 Please share your ideas with us by clicking here.

Thank you for being part of the SASSI community and for helping us shape the future of SASSI Online!

The Value of the SASSI in University Counseling Centers

1. Benefits

  • Early identification: The SASSI’s screening tools (the SASSI) can help identify students who may be struggling with substance use disorders, even if they are not openly acknowledging the issue.
  • Targeted interventions: The SASSI can provide valuable insights for tailoring interventions and treatment plans to individual student needs.
  • Reduced stigma: The SASSI is a tool for understanding and supporting students, rather than a judgmental “test.” 

2. Training and education

  • Accessible training: We offer workshops and webinars (live or recorded) for counseling center staff on the proper administration, scoring, and interpretation of the SASSI.
  • Free resources: Staff can utilize our free clinical helpline and free clinical Q&A webinars to address questions and concerns related to using the SASSI.
  • Collaboration with academic programs: We welcome partnerships with university departments to integrate SASSI training into relevant courses (e.g., counseling, social work, psychology). 

3. How to integrate SASSI into existing practices

  • Part of intake: Incorporate the SASSI as a routine part of the intake process for all students seeking counseling services.
  • Utilize online options: Online administration is convenient and SASSI Online can be used for telehealth and remote screening, including increased accessibility, client comfort, immediate results, and streamlined record-keeping.
  • Referral protocols: Clear protocols for referring students based on their SASSI results to appropriate internal or external resources, including addiction counseling,  or specialized treatment programs can be developed. 

By implementing these strategies, University Counseling Centers can effectively use the SASSI and provide crucial support to students struggling with substance use concerns. 

Looking Ahead to the New Year

The promise of a new year is the promise of renewed focus, fresh goals, and continued opportunity to make a positive impact. We remain committed to helping people who suffer from substance use problems and the professionals who serve them.

In the coming year, we look forward to providing you with more opportunities for professional development through our in-person and online training workshops. We will also continue to support research that ensures the SASSI remains a leading, reliable instrument in the field of substance use screening.

From our family at The SASSI Institute to yours, we wish you a peaceful, joyful, and restful holiday season. May you find time to recharge and reflect before continuing your essential work in the new year.

Best Wishes for a healthy and hopeful 2026!

Season’s Greetings From Our CEO

Dear SASSI colleagues and friends,

As has become our tradition, we would like to extend our warm holiday greetings to you and your loved ones. This end-of-year message also allows us to inform you of our newest developments, initiatives and plans.

We continue to focus our efforts on better assisting all of you in doing the valued work of treating, helping, and addressing the many issues your clients face daily and doing it with passion and dedication. In 2026 and the years to follow, we will be providing you with new and exciting tools to further help in treating your clients. This coming year we are planning initiatives that will better capture your needs, as expressed by your surveys and postings to us. Our plans include the ability for you to customize reports and various toolboxes that will allow you to focus on the specific needs of your clients. Among other things, we will enhance our focus on co-morbidities, the needs of special populations and the more recent proliferation of substances like isotonitazene, a drug about one hundred to one thousand times more potent than morphine that has emerged as a primary drug on the illicit market. It sometimes feels like we can never get ahead of these onslaughts of new and deadlier substances. Please stay in touch with us and check out our blogs as we report the many things we will have available as they happen. We remain grateful and thankful for your many efforts and the challenges you face. As always, we remain a phone call or email away from helping you in your missions, so we can better fulfill our own, providing the necessary tools and assistance to those that assist others.

Many have lost family, friends and loved ones to various issues, and our hearts go out to them; but especially to those that we have lost to the various sequalae of addiction, disease, overdose and any combination of complications. May you be now joined by the higher power of your choosing, and with the love from those that preceded you, as well as those that will miss you here. It is our sincerest hope that your pains and sorrows may ease over time. For those that continue in their struggles in their fights against the many ravages of addiction, there is always hope, help, and survival tools. Continue to demonstrate that inner strength and believe that you indeed have the power to change and find that personal place where you can achieve whatever you desire. And please know that you do not have to do it alone, one day or moment at a time, keep the fight alive. Please know that we are all in your corner.

In the meantime, our Board of Directors, senior management, consultants, contractors and myself, want to share that we are available to you, and reassure you that we remain committed to providing the critical assistance so many of you seek to help your clients. There are no words sufficient to thank you for the work you do, the struggles you engage in and your quests to help those less fortunate than ourselves. For that and so many more reasons, we at The SASSI Institute share our thanks, gratitude and admiration!

We will continue doing our best to allow you, our licensees and collaborators, to continue to do your jobs, offer your many services and continue to assist those that need us the most. I am extremely proud of our staff and the non-stop work they have continued to perform. In closing, we all wish you a happy holiday season and a happy and healthy year full of joy.

Reflecting on a Year of Service

Looking back at this past year, we are proud of the work we’ve accomplished together. The accurate, subtle screening provided by the SASSI instruments – including the Adult SASSI-4, Adolescent SASSI-A3, and Spanish SASSI – remain cornerstones for evidence-based decision-making in diverse clinical settings.

This year, we’ve focused on:

  • Enhancing Clinical Insight: Providing professionals with the training and resources needed to interpret SASSI profiles, helping you understand client dynamics, even those who may be minimizing or unaware of their substance use.
  • Supporting the Recovery Community: Sharing valuable insights and research through The SASSI Network, contributing to the broader conversation and dialogue around substance use disorders.
  • Streamlining Your Work: Continuing to improve the SASSI Online platform to make administration and scoring as efficient as possible, giving you more time to focus on your clients.

If you work with DUI offenders, in 2026 we encourage you to consider incorporating the Behaviors & Attitudes Drinking & Driving Scale (BADDS) which identifies preintervention risk of future impaired driving, and changes in DUI-related risky behaviors & attitudes following intervention. It is ideal for initial risk assessment, pre and post-test screening, and program evaluation. Training is available

Every accurate screening and every step toward appropriate treatment is a testament to the powerful combination of sound clinical tools and professional expertise. We look forward to our continued collaborations.