The Addiction Severity Index (ASI) is a multi-dimensional interview used to measure the substance use, health, and social problems of those with alcohol and other drug problems, both at admission to treatment and subsequently at follow-up contacts. This article first discusses the conceptual and practical importance of the ASI's multi-dimensional approach to measuring addiction severity, as illustrated by two case presentations. The second section of the paper reviews how this measurement approach has led to some important findings regarding the prediction and measurement of addiction treatment effectiveness. The third section describes the historical and practical considerations that have changed the instrument over time, details the problems with the instrument, and describes our efforts to correct those problems with the ASI-6. Finally, some recent ASI data collected from over 8,400 patients admitted to a nationally representative sample of U.S. addiction treatment programs are presented.
This article reports on the study of differential change trajectories for early childhood approaches to leaming. A large sample (N = 2,152) of Head Start children was followed through prekindergarten, kindergarten, and first grade. Classroom learning behaviors were assessed by teachers through the Preschool Learning Behaviors Scale twice in Head Start and through the Leaming Behaviors Scale twice in both kindergarten and first grade. Item response theory was applied to form continuous scales of Competence Motivation and Attentional Persistence, using multiple-group calibration with linking items and Bayesian score estimates. Cross-classified multilevel growth models demonstrated that the new vertical scales are able to detect distinct linear and higher order change pattems for Competence Motivation and Attentional Persistence across the transition years and to differentiate change trajectories emblematic of eventual second-grade academic proficiency versus nonproficiency in reading, vocabulary, language, mathematics, and science.
There is increasing evidence that a chronic care model may be effective when treating substance use disorders. In 1996, the Betty Ford Center (BFC) began implementing a telephone-based continuing care intervention now called Focused Continuing Care (FCC) to assist and support patients in their transition from residential treatment to longer-term recovery in the "real world". This article reports on patient utilization and outcomes of FCC. FCC staff placed clinically directed telephone calls to patients (N=4094) throughout the first year after discharge. During each call, a short survey was administered to gauge patient recovery and guide the session. Patients completed an average of 5.5 (40%) of 14 scheduled calls, 58% completed 5 or more calls, and 85% were participating in FCC two months post-discharge or later. There was preliminary evidence that greater participation in FCC yielded more positive outcomes and that early post-discharge behaviors predict subsequent outcomes. FCC appears to be a feasible therapeutic option. Efforts to revise FCC to enhance its clinical and administrative value are described.
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