Tag: The SASSI Institute

BADDS Sample Report

Mr. M. is a 38-year-old Caucasian male, presenting to the DUI Court with a second DUI offense. His first offense occurred and he was sentenced to time served (1 day), one year probation, paid a $500 fine, and his driver’s license was suspended for 90 days. Mr. M.’s probationary period from his first offense ended successfully.   

A year later, Mr. M. was arrested and entered into a no contest plea for drinking and driving under the influence. Mr. M. went before the court and asked for leniency on his conviction, yet expressed willingness to comply with any recommendations set by the court. Judge sentenced Mr. M. to 2 days served in the county jail followed by 2 years of DUI Court participation and 12 months driver’s license suspension.

Background Information: Mr. M. is a manager at a local insurance firm, where he has worked for the past nine years. Mr. M. has a bachelor’s degree in business from a state college. Mr. M. is married and has two young children. Mrs. M. is employed full-time as a teacher.

Medical and Mental Health History: Mr. M. is of average height and weight. He stated that his health is very good without significant medical problems, except for a back injury that he sustained last year that continues to cause him pain. Mr. M. does smoke cigarettes. He has a family history of cardiovascular disease and high blood pressure. Mr. M. did not report any history of mental health problems of his own or in his family.

Substance Use History: Mr. M. reported that he began drinking when he was 17 years of age during his senior year in high school. Mr. M. stated that he drank on weekends “with the guys” while in school and reported his use as “normal.”  He maintained above a 2.5 grade point average throughout college and did not report any alcohol violations during this time. He did report drinking to intoxication approximately two to four times per month.

After college, Mr. M. was hired by his current employer. He reported that during his years with the company, he received excellent evaluations and was quickly promoted to his current managerial position. Mr. M. stated that after his first DUI conviction, he has tried to maintain a “no drinking and driving” policy and limits his alcohol intake to weekends only.

Mr. M. attributed his recent absences from work to lower back pain. Mr. M. denied drinking in the morning, withdrawal symptoms such as shaking or sweating, or loss of control of his use. He denied experiencing any recent blackouts or other behavioral changes.

DUI Court Intake: The County DUI Court uses the Behaviors & Attitudes Drinking & Driving Scale (BADDS) at entry into the program and following the approximate two years of participation in drug court activities. Mr. M.’s BADDS results follow.

BADDS Pretest Results: Mr. M. has high scores on four scales: Rationalizations for Drinking and Driving (RD: 27), Lenient Attitudes (LA: 29), Likelihood of Drinking and Driving (LD: 35), and Drinking and Driving Behaviors (DB: 03). Mr. M. scored in the moderate range for Riding Behaviors with a Drinking Driver (RB: 01).

Mr. M.’s responses on the alcohol use and history items, in contrast to his stated attempts to limit his drinking to weekends, revealed that he drinks alcohol daily. Responses also showed that either he or someone significant to him has been in an alcohol-related accident. Despite his best efforts to refrain from drinking and driving, Mr. M. acknowledged that he drove under the influence and rode as a passenger in a vehicle of someone who had been drinking, within the month prior to his arrest.

Mr. M.’s high scores on the RD, LA, LD, and DB scales indicate that he has endorsed and acted upon risky beliefs and attitudes about drinking and driving. In addition, his responses on the LD scale suggest that it is acceptable to him to drive under certain circumstances after having at least three or four drinks. Mr. M.’s perception about how many drinks he can consume in one hour and drive safely and legally is just below probable legal limit based on his body weight.  Further, Mr. M.’s RB score indicates that he has recently ridden in a vehicle with an impaired driver.

Summary and Recommendations: Mr. M. enters into the DUI program as a sentencing requirement set by Judge Andrews after completing a 2-day incarceration. 

Mr. M.’s BADDS results indicate that he is a suitable candidate for a DUI program that would help him learn about the risks of drinking and driving, and examine his beliefs about safe driving behavior. In addition, an evaluation for substance use disorder will be conducted in the next session with Mr. M.  Without intervention, Mr. M.’s scores suggest that he is at high risk of recidivism. The re-administration of the BADDS prior to his completion of the DUI court program would help to assess if there has been change in his risky behaviors and attitudes that could continue to put him at risk for further problems with impaired driving, if they are not adequately addressed.

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A SASSI-4 Profile Analysis: Reading Aloud the Questionnaire and Interpretation of Low Scores

We regularly get inquiries about the acceptability of reading the questionnaire to a client who may have difficulty with their reading skills. We discourage the evaluator from reading the questionnaire to the client for a variety of reasons, but the primary one concerns the validity of the results. No matter how careful the reader might be, the tone of voice or emphasis on a particular part of the question may lead the client in one direction or another. Or the client may interrupt with a question regarding the meaning of a word or intention of a particular question. This is why we offer a professionally read audio CD of the SASSI-4, Adolescent SASSI-A3 and Spanish SASSI paper and pencil versions for clients who have reading difficulties. We hope in the future to be able to offer this for the online platform as well. Please contact our customer service department for ordering information.

Another frequent question is related to the clinical interpretations of the “low” scores on the profiles. These mostly relate to the subtle scales which include the OAT, SAT, DEF and SAM scales. Most callers know what a low DEF indicates. And SAM has no clinical interpretation.

So what about those low OAT and SAT scales?  What does “low’ mean? A low score is anything below the 15th percentile on the graph.  In the example to the right, the caller indicated that she was doing an assessment on a health care professional who had been arrested for her one and only DWI the previous year, had completed her alcohol education class and needed this evaluation as a final step for probation. She was not in trouble in her job and in fact, highly regarded in her profession. Given the client was at the end of her requirements, the evaluator was somewhat concerned with the results and what it meant.  The instructions were given to answer the FVA/FVOD side for the last twelve months. Her RAP is zero. Her Prescription Drug Scale is zero. She has ‘no’ on all the rules so came up with a Low Probability of having a Substance Use Disorder. However, her DEF of 9 is highly elevated. Elevated DEF scores increase the possibility of the SASSI missing individuals with a substance use disorder. Elevated DEF may also reflect situational factors. Note that the SAM is within the norm so it is probably more likely that her DEF is situational given the context. She also has an OAT score of ‘O’ and a SAT score of ‘2’. Both are below the 15th percentile.  A low OAT indicates someone has difficulty acknowledging personal limitations or shortcomings. A low SAT indicates someone who might have a ‘chip’ on her shoulder, a hypersensitivity to others or feelings of rejection.

So even though this client is nearing the completion of her probation requirements, we still get a picture of someone who is highly guarded (DEF), has a hard time acknowledging shortcomings (OAT) and may continue to exhibit resentment (SAT) for the situation she is in. Perhaps this is due to her profession, or perhaps it is her personality. What the results give the evaluator is clinical direction on how to approach the client to help reduce her defensiveness and give her permission to open up. Affirming how demanding her job is and how on top of things she must be could be a pathway to discussing her feelings of shame related to the DWI and how it might be affecting her self-esteem. Could she be minimizing her use of alcohol and drugs? Perhaps, but as we strongly express, the SASSI is only one part of a clinician’s assessment. Hopefully, with the input of all the information you have, the clinician can evaluate the results which fit the context for this client.

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The Power of Narrative Therapy

Last month, Dr. Hugh Marr, a longtime trainer on the SASSI and clinical psychologist in the private practice of psychotherapy in the Washington, DC area gave an interview on the Shrink Rap Radio podcast. Dr. Marr has taught both substance abuse counseling and psychotherapy at area universities; and has worked in all phases of community mental health, culminating in running a partial hospital program for clients with the co-occurring disorders of substance use and major mental illness. He is the author of A Clinician’s Guide to Foundational Story Psychotherapy: Co-changing Narratives, Co-changing Lives (Routledge, 2020); and the coauthor of the books What Story Are You Living? (CAPT, 2009) and Introduction to Archetypes (CAPT, 2002). His forthcoming workbook for a general audience, also to be published by CAPT, will be titled Finding Your Story. You can view a clip from that interview here or a link to the interview in its entirety can be found here.

The SASSI Institute is excited that Dr. Marr has developed a workshop based on his five-star rated book: A Clinician’s Guide to Foundational Story Psychotherapy: Co-changing Narratives, Co-changing Lives. This workshop is being offered through The SASSI Institute’s Professional Development Platform. A link to a flyer with additional information on the workshop can be viewed here.

We hope you enjoy the interview and that you will join us for this informative webinar.

To register for the webinar and see our other titles, click here.

Turning the Corner on COVID-19

Dear Friends,

For more than a year now, our lives have been literally turned upside down. Many of us have lost loved ones and friends or had them severely affected by this terrible pandemic. It has caused upheavals in basically all areas of our lives.

But I think it is safe to say that we are finally turning the corner. Science tells us that the required herd immunities and vaccinations are soon to be at optimal levels. Here at The SASSI Institute, we are at more than 95% capacity. And I am so proud of our staff, their dedication and professionalism as they continued to serve you, the heart of our business. They were with you through thick and thin, and despite the multiple obstacles, collectively we accomplished an extraordinary level of achievements throughout this time. For example, we have multiple publications that are now in the public domain. Please contact our Customer Service Team if you are interested in any of them, they are free of charge. If interested in our Training services and availabilities, contact our Training Director Ms. Scarlett Baker, or our Executive Assistant, Ms. Lauren Nelson. Kristin Kimmell LMSW, LCAC, our Clinical Director and her team are available for any of your clinical concerns. And by the way, Lauren also serves as our IT specialist, so she is available for any mishaps in your IT service provision.

In sum, I am very proud of you, our customers for maintaining our collaborations, our staff for making that possible, and to the many, many individuals we serve, may their path to recovery be enlightened by your services.

With warm regards,

We Want to Hear From YOU!

Here at The SASSI Institute we pride ourselves on the work we do to provide validated instruments that help you, as well as your clients.  To do an even better job, we are asking for your feedback.  We want to know how our instruments support your work.  But we also want to hear how we can improve our tools.  Our new Feedback Form gives you an outlet to share your ideas and critiques. 

Click here to complete the feedback form.

If you have a heartwarming experience you would like to share about how our instrument has helped you or a client, we would love to hear that too.  Please feel free to share your story* with us at blog@sassi.com.

*Please exclude identifying client information from the submission

Criminal Justice Publication Accepted

Hello friends and colleagues,

We hope you and your families are all doing well. We wanted to call your attention to our very latest peer reviewed publication, released earlier this month. The title is: Criminal Justice Alcohol and Drug Screening in Practice: Using the Substance Abuse Subtle Screening Inventory to Identify Substance Use Disorder in Offenders.

Now in its fourth iteration (SASSI-4), this article discusses the SASSI screening tools’ utility with criminal offenders and reviews a case study of a young male’s clinical evaluation while incarcerated. While SUD is not the only contributing factor to criminality, it significantly increases the likelihood of legal infraction and violations, placing these individuals at a higher risk of re-offending. Thus, identifying SUD as early as possible in the clinical relationship helps provide tailored treatment to those who need it, while simultaneously reducing the risk of future legal difficulties.

For this case study, we reviewed the SASSI-4 screening results of a 24-year-old male. The case presents an excellent example of the value of early identification of substance use disorder and potential problems in criminal justice settings.

We hope you enjoy the article, and as always, we look forward to your submissions and comments.

Addiction Professional Spotlight: Charlie Stookey, MA, LADC, LADC-S

I have had the pleasure of being on staff at The SASSI Institute for 22 years. Throughout that time, I have had the opportunity to work closely with many addiction professionals. Their dedication and passion for helping individuals in recovery or in need of recovery have always astonished me.

One of these professionals whom I have known throughout my time at the Institute is Charlie Stookey, MA, LADC, LADC-S. Charlie was a trainer for the SASSI when I started my career at the Institute. He presented training on the earliest versions of the SASSI, having been taught by none other than our late Founder and SASSI creator, Dr. Glenn Miller. Charlie retired from training many years ago, and while we have never met in person, we have stayed in touch over the years, and I am glad to call him a friend. He attended Whitman College and the University of Nevada, Reno, and is currently a substance abuse counselor in Reno, Nevada. Charlie also has a passion for poetry and has been published in the West Coast Poetry Review, Blue Moon, and The Meadow. He believes in the gift of the Wounded Healer and Joseph Campbell’s The Hero’s Journey. I want to share one of his poems with all of you today and encourage you to take the time to read it peacefully.

Charlie asked me to share that he hopes the heroine in Phases of the Moon, finds the beginning of her sober journey in the reflection in the detox mirror. And that she finds the “life that awaits us.” In our groups, we are in a gathering of miracles and he is grateful for the opportunity to sit with them.

Phases of the Moon The new moon is a cat’s claw in the night sky. Clint C. Ricketts

Beneath Thunder Moons and Corn Moons, she names her four rescued cats, Moon Beam, Moon Light, Moon Shadow, and, of course, Moon Shine. The phases of the moon
are tattooed on the nape of her neck “to honor the mystery and permanence of the moon over time. It’s reliable.” It’s so easy to turn the course of her disease into the curse of the disease 
with its hungry ghosts. No glass Japanese floats lie atop the scarred nightstand; but earrings, ER receipts, doubts, matches, butt ends of relationships.
She regrets the drunken, meth-fueled fights with her husband, who later committed suicide. “Killed himself over…whatever. Me,
all that lottery money, heartache, whatever.” Moonlight creek sings to Cottonwoods in the darkness. Grief waxes and wanes.
When loneliness strikes, she writes lamentations: Full October moon Drowns pinpoint constellations. I miss your bright eyes.
The riptide from the fifth of a gallon a day floods the road of good intentions. Its ebb leaves tide pools of anxiety and depression ripening in a sour stomach. 
Each morning’s hangover brings the pounding of relentless reality, the ever-present eternal goddam now. Last night’s shame haloes her head in hangover vises. She pukes. Starts the hands-and-knees
search party for dimes or quarters or pennies for a half-pint of mercy. She ignores the snores of an anonymous cowboy under a throw and the spray of clothes.
She wipes withdrawal’s sweat from her face, swipes at the brain fog. The riptide created by her moons leaves an empty curse. She flings the empty purse
of promises into the furthest corners of cobweb resolve, another tourist attraction. When the new moon slides between sun and earth, the eclipse covers her soul like a shawl.
She peers into the silvered glass of the detox bathroom mirror, where a stranger greets her. A shadow of comfort arises when she strokes her new moon, colored and frozen on her neck

A Message to Our Colleagues, Customers and Friends

We would like to take this opportunity to invite you, our many colleagues, to express your views, research findings and other developments within our SASSI Network blog. Our intent with this forum has always been to embrace the opinions and experiences of so many professionals and treatment providers throughout the country and indeed throughout the world. This forum is meant to be one of inclusion, not exclusion. All professionals from the multitude of addiction services provided have value and merit inclusion. These might focus on screening, testing, assessment, treatment, interventions, and others. We invite your submissions, and welcome your viewpoints. We feel this forum provides an opportunity to enrich us all with a collective wealth of knowledge that will ultimately enrich the addiction field. If you would like to contribute, please contact us at blog@sassi.com.

We hope that all of you and your families have managed to stay healthy during this tumultuous year. Our hearts go out to those that have experienced loss, suffering or pain during this Pandemic that has taken far so many lives. We remain hopeful that now that several vaccines are in distribution, and vaccinations are proceeding expeditiously, that we are nearing the close of this chapter in all our lives.

Please consider joining us by contributing your knowledge to our blog!

Interpreting the Results of an Adolescent SASSI-A3 with a High OAT Score

Happy New Year everyone!

I received my first Adolescent A-3 call on the helpline and was so excited and when I heard the numbers, I knew exactly why the clinician was calling.

As you look at the profile, you can see most of the numbers are within the norm. He meets Rule 6 so comes up with a High Probability of a Substance Use Disorder and no Prescription Drug Abuse.  So, what clinical information can the scale scores give you with so few scales outside the norm?

Although the FVOD is within the norm, it is above average and as recommended, you can do content analysis of his Face Valid scales. Another scale to pay attention to is the OAT score of 7 which is elevated. This suggests the client can acknowledge personal limitations and shortcomings and identify with other substance abusers. However, he may not want to or think he can change. The other significant score is SAT with a score of 1 which is below the 15th percentile. This suggests he may be hypersensitive to others and comes across as having a chip on his shoulder. This gives you good information on how to approach this client, especially when giving him feedback as you process the results with him because he is not giving you a whole lot of direct information regarding his use.

A word about the VAL of 6. If the numbers had resulted in a Low Probability of a Substance Use Disorder, you would question the results and do further investigation. Because he met Rule 6, there is no need to address the VAL. That said, with the VAL being so high, was this individual trying to manipulate the questionnaire and didn’t succeed?

Finally, users of the older version will notice that the SCS has been eliminated. This will require your use of the DSM-5 to determine the diagnosis and level of severity from your assessment.

Hope this information is instructive and assists you in your practice. And remember, as usual, we are here to help, so give the clinical line a call at 800-726-0526, press 2.

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New Publication!

The SASSI Institute is pleased to announce the publication of its newest manuscript “Mental Health and Substance Use Disorder Co-Morbidities Among Teens in Treatment: SASSI-A3 Correlations in Screening Scores.” Within this article, we review data from teenagers in treatment focusing on mental health diagnoses alongside a DSM-5 diagnosis of substance use disorder. Our hope is that by identifying possible correlations between SASSI-A3 scale scores and diagnosed mental health disorders, (depression and anxiety in particular), will provide clinicians with additional tools to direct the course of subsequent clinical interviews, in particular for teens suffering from co-occurring disorders. This Open-Access article is available here: Mental Health and Substance Use Disorder Co-Morbidities Among Teens in Treatment: SASSI-A3 Correlations in Screening Scores