Tag: Subtle Screening


A frequent question we get is regarding the web-based version of the SASSI-4 and how to identify the SYM (Symptoms) scale items on a client’s completed questionnaire. Because the SYM items are face valid they can give you information concerning the client’s substance use and it may be worthwhile to do a content analysis of the SYM items as they directly relate to substance use.

While logged into your sassionline.com account, click on the tab ‘My Clients’ and then click on ‘Support Materials.’ On the Support Materials page click on ‘SASSI-4 User Guide.’ Go to page 19 for the information on SYM. There you will see the 20 SYM items listed. We suggest you print this page out to assist in identifying the SYM items on your clients’ completed questionnaires.

As always, we encourage you to call our free clinical help line for interpretation assistance at 800.726.0526 Option 2.

A Good Assessment is Key to a Good Use of the SASSI

This SASSI-4 profile is an excellent example of why the comprehensive assessment is a crucial part of the evaluation process.

This 33-year-old male completed the FVA/FVOD side of the questionnaire for his whole lifetime.

His RAP is 0 as is his Prescription Drug Scale.

His profile graphs most of his scores within the norm, between the 15th and 85th percentiles. The one standout is the SAT score of 0. That score indicates someone who is hypersensitive to what others think about him and may harbor feelings of resentment coming across as having a chip on his shoulder. Although the DEF score of 7 is not quite high enough to trigger looking at the possibility of SASSI missing individuals with a substance use disorder, it is significantly above average so there may be a “hint” of him exhibiting defensiveness.

Based on the face of it and on the SASSI alone, he comes up with a Low Probability of a Substance Disorder.

So, what is missing? The information gathered from the rest of his evaluation.

This individual has a history of 3 DUI’s – one in 2013, 2020 and the last in 2023.

As you can see, he does not indicate in his FVA or SYM any issues with alcohol or negative consequences of his usage. From his perspective, he has not had negative consequences. It could be that what he was required to do historically was minimal i.e. an alcohol education class. As these offenses are spread over 10 years, it may mean that he has a problem with drinking and driving. What is his current usage? Does he have a diagnosable disorder based on the DSM-5? Knowing about his extensive history requires the Clinician to dig deeper into this client’s use history and question his perspectives.

A useful tool we offer for both individual administration and for alcohol-related education and treatment interventions is the BADDS – Behaviors & Attitudes Drinking and Driving Scale.

It identifies drinking and driving and riding behaviors, history of impaired driving, the likelihood of riding or driving with an impaired driver, rationalizations for drinking and driving and intervention effectiveness.

The BADDS can be used in Driver’s education classes, Impaired driving prevention, DUI courts and DUI programs, Colleges and Universities and Counseling and treatment programs.

The BADDS can be used as a pre-test or be re-administered to measure behavioral and/or attitudinal change in multiple intervals. The post-test can also assess overall program effectiveness.

The BADDS is available in a paper and pencil version only for those 18 years or older with a third grade reading level and takes about 15 minutes to administer. We do offer on-demand webinar training. For more information go to www.thebadds.com.

PDF Version Available for Download

Across the Pond and Beyond

Did you know that SASSI screening tools are available for use and are obtainable through our international distributors? If you are in, or have friends/colleagues in the UK, Australia, or Greece, please take note of our licensed distributors there for affordable access to SASSI screening tools.

In the UK, the paper & pencil version of the adult SASSI-4 and adolescent SASSI-A3 is available through SASSI Direct Ltd. For ordering information please email sassi@sassidirect.co.uk.

In Australia, the paper & pencil version of the adult SASSI-4 and adolescent SASSI-A3 is available through The Help Now Group. Since purchasing the web-based version of the SASSI through SASSI Online can be challenging for our Australian colleagues due to issues with credit card processing, access and administrations of the web-based version can also be purchased through The Help Now Group. For ordering information please email rodney@thehelpnow.org.

In Greece, a reliable and validated version of the translated adult SASSI-3 in Greek is available through Panagiota Kontoleon. For ordering information please email panagiota@kontoleon.com.gr.

We are pleased that these distributors are working with us to promote screening for those individuals suffering from substance use-related issues and disorders.

SASSI FAQs: Volume 1 | Customer IDs

We are excited to bring you a new series covering common questions on various topics specific to our processes and policies. In this edition of SASSI FAQs we take a quick look at Customer Identifiers or commonly referred to at SASSI as the Customer ID.

All accounts at The SASSI Institute are assigned a Customer ID. That account identifier consists of six characters, with the first two being letters representing the State (US) Province (CA) and ZZ for all other countries. The other four characters can be letters or numbers, but are consistent with the Organization’s name, or the last name of the clinician if the account represents a private practice. Our online shopping cart requires the Customer ID to check-out for paper products. If you do not know your Customer ID, or are a new customer, you can fill out the qualification form at www.sassi.com/qualify to receive a temporary ID so your order can be processed. For SASSI Online customers the Customer ID is found on the My Account tab, and most frequently used during technical support situations, or when an order is placed for the online account over the phone. When purchasing digital products, that form is part of the registration process at www.sassionline.com.

If you ever have any questions about your account, please reach out to our Customer Service Team! They are happy to help you navigate the qualification form and/or registration process. They can be reached at 800.726.0526 option 1 or via email at sassi@sassi.com.

Introducing Our New Clinical Director

We wanted to take this opportunity to introduce our new Clinical Director, Mr. David Helton, LMSW, LCDC. David has worked in the behavioral health field in Texas for over 35 years as a clinician, a manager, division director, trainer, an evaluator, a program developer, and a grant writer/reviewer. In addition to training on the SASSI for over 30 years, David has been a member of the SASSI Clinical Team for the last several years assisting on the clinical helpline. David is a passionate and caring individual that brings a vast wealth of understanding of the initiates, correlates and consequences of substance use disorder. But in addition; he is a marvelous communicator able to disseminate complex theoretical paradigms into readily understandable language, which simultaneously assists providers with the sometimes-nuanced interpretations of SASSI clinical results.

Please join us at The SASSI Institute in welcoming David in taking on his new role. We are thrilled to have him continuing collaborations with the SASSI team.

SASSI Online Tips and Tricks: Volume 8 | Viewing Report Results

SASSI Online is our web-based platform that supports the digital administration of the Adult SASSI-4, Adolescent SASSI-A3, and Spanish SASSI.

In this edition of SASSI Online Tips and Tricks we highlight the steps to view a client’s completed SASSI questionnaire results.  When a client completes the questionnaire, responses are sent to the scoring server for immediate results. You will receive an email notification that the questionnaire is complete, with instructions on how to view the report from the Account Dashboard. For security reasons, report results are not sent via email. 

To view the report and questionnaire responses you must be logged in to your dashboard, and locate the client on your My Clients tab. To view the report or questionnaire responses for your client, click on their Client ID. In the window, select what you would like to view from the following options: View Report or View Questionnaire.

The SASSI report includes a graph of the client’s scale scores, the outcome of the decision rules based on the client’s responses, and a narrative report on the client’s profile. The completed questionnaire contains all questions asked, the client’s responses, and the scale scores.

Sample SASSI Online Reports are available here:

If you are not currently using SASSI Online and would like to experience the features of the digital platform, create an account at www.sassionline.com.  If you already have an account, let us know if you have any suggestions for our next edition of SASSI Online Tips and Tricks.  As a bonus for reading this blog post to the end, reach out to us at blog@sassi.com, with the code phrase: Report Results, to request two free SASSI Online administrations!

Last Clinical Q&A Until Summer | Register Now!

We wanted to welcome you to join us for a free one-hour online SASSI Q&A session hosted by our Clinical Director, Kristin Kimmell, LCSW, LCAC. This will be our last free Q&A session until Summer.

The Q&A is scheduled from Noon-1pm ET on: April 16th. You can save your spot by clicking here. We welcome you to share profiles to discuss with the group by sending them (de-identified) via email any time prior to the session to scarlett@sassi.com. These profiles will help others learn about the SASSI and offer insight into the various profile configurations.

Note: Q&A sessions do not provide CEUs and are not a substitute for SASSI Training.

In-Person SASSI Trainings

Happy Spring! Our certified SASSI trainers have been busy doing live in-person training this year and would like to hear from you about the need in your local area for this service. Please visit the training page on our website to view a list of currently scheduled workshops at www.sassi.com/sassi-training. If nothing is scheduled in your area, please reach out directly to the trainer so they know there is interest in their area, and they can plan accordingly. They are also happy to schedule private in-person training for your agency/organization.

Reminder: Our clinical team is available M-F to answer questions about the administration, scoring, and interpretation of our instruments at 800.726.0526 option 2. This is a free service, and we encourage you to call often.

Adolescent SASSI-A3 Review: High Probability Result with a VAL of 6

This adolescent male profile presents some initial complications for the reviewer in regards to the clinical interpretation as seen on the graph. The face valid scales fall either within the norm or below the norm. One of the subtle scales is above the 85th percentile so is clinically significant, and another is below the norm. An examination of the scales produces useful information to guide the discussion of the results with the client and directing appropriate treatment considerations.

This 17-year-old male completed the FVA/FVOD side of the questionnaire for his whole lifetime.

The VAL is 6.

Rx Scale is 0.

High Probability of a Substance Use Disorder is based on Rule 6.

Rule 6: a. FVOD 7 or more. (8)

            b. FRISK or ATT or SYM is 3 or more. (SYM – 3).

            c. OAT 5 or more (7).

Clinical Discussion

The FVOD of 8 is above average and should be noted. Examining those particular questions, he endorsed will provide the groundwork for how and under what circumstance he is using drugs. With the FRISK (0) and ATT (1) scores so low, his use is not necessarily tied to his peers, nor does he have a belief or value system that supports the idea that everyone uses substances. Looking at his one ATT score will help to evaluate any beliefs he may hold around substances.

The SYM (3) score is above average and again, because it is a face valid scale, content analysis will provide information regarding the consequences that he does acknowledge.

The OAT (7) scale is significant because it is elevated above the 85th percentile. This is the subtle scale that you want elevated as it indicates someone who can acknowledge limitations and shortcomings. He can probably identify with other substance users and those behaviors represented in that population such as impatience, resentment, self-pity, or impulsiveness. This, of course, does not mean he wants to or believes that he can change. But this information can be used as a positive to recognize the insights he may have around his use.

The low SAT (1) score (below the 15th percentile) gives some clues on how best to approach this client. This score indicates he is very hypersensitive to what others think about him. He may come across as having a chip on his shoulder so tread lightly!

The DEF (8) score, though above average, is still within the norm so does not indicate significant defensiveness on the client’s part.

The SAM (3) and COR (3) have no clinical significance.

Does the VAL score of 6 impact the results? Given the outcome was High Probability based on Rule 6, the impact is nil. The VAL is significant only if the outcome was Low Probability. However, with that score, the evaluator may hypothesize that perhaps the client was trying to skew the results but failed.

Questions remain regarding the current use of substances by the client. Is he minimizing his use or is he presenting an accurate picture? He was not defensive so perhaps his overriding concern was how he was viewed by the evaluator.

Treatment Considerations

Recommendations for the level of treatment need to be considered if he does have a diagnosable disorder based on the DSM-5. Actual current use also needs to be established. The elevated OAT score does indicate he will not feel out of place in a group setting. Prior history of substance use issues also need to be considered. It would appear, however, that outpatient treatment would be a consideration with the level of intervention to be determined by the overall assessment.

We recommend administrators of the SASSI have access to The Adolescent SASSI-A3 User Guide and Manual. It contains information on scoring, interpreting profiles and includes examples of profiles. It defines all the scales, what they represent, clinical considerations and giving feedback. The Manual also contains the research and validation information. Please call our Customer Service number for more information on how to order – 800-726-0526.

PDF Version Available for Download

Another Public Health Threat: The Extensive Use of Bromazolam

We recently published a commentary in Public Health Open Journal regarding Bromazolam (fake Xanax) use. It is increasingly being found in the illicit drug supply, mixed with other drugs like fentanyl and heroin, among others. Within the commentary, we examine the current state of the science as it pertains to the public health dangers of Bromazolam and its various illicit distribution networks, not only in North America but across the world. We also examine possible directions the substance use disorder (SUD) field may undertake to address the proliferation and abuse of this substance along with overdose prevention efforts that include the public health dangers of Bromazolam use. 

We invite you to download this free commentary to read and share with your friends, family, and colleagues. 

Yet Another Public Health Threat: A Commentary and Examination of the Extensive Use of Bromazolam