This article presents an overview of a study investigating the co-occurrence of teen mental health and substance use disorders. These co-morbidities have proven problematic and difficult to treat and/or identify in this population. The data for this study was collected as part of The SASSI Institute's third iteration of the Adolescent Substance Abuse Subtle Screening Inventory (SASSI-A3). A total of 515 teenagers in treatment, whose cases consisted of a valid and complete SASSI-A3, DSM-5 diagnostic evaluation, and client demographics, served as the dataset for the present study. Specifically, we focused on the frequencies of mental health diagnoses alongside a DSM-5 diagnosis of substance use disorder for teens who were seeking treatment for substance misuse issues. All participant cases were provided by clinicians working in service settings throughout the U.S. Census Regions (Northeast, Midwest, South, West). These professionals served in a variety of venues including substance use treatment and criminal justice programs, community corrections, private clinical practices, behavioral health centers, and social service organizations. All clinicians were qualified SASSI users who administered the SASSI-A3 via the SASSI Institute's SUD web-based screening application. Substance abuse in teens can often be a sign of an attempt to self-medicate an untreated mental health disorder. Identifying possible correlations between SASSI-A3 scale scores and diagnosed mental health disorders, depression and anxiety in particular, can enable clinicians to direct the course of subsequent clinical interviews, and further assessments needed early in the counseling relationship.
Objective This article examines one key aspect of the Substance Abuse Subtle Screening Inventory (SASSI) Institute’s forthcoming third iteration of the Adolescent Substance Abuse Subtle Screening Inventory (SASSI-A3). Overall project aims were to revise the second version of the adolescent SASSI (SASSI-A2), and to update new symptom-related identifiers of substance use disorders in adolescents according to the diagnostic and statistical manual of mental disorders, Fifth Edition (DSM-5) guidelines. Methods We added new questions regarding cannabidiol (CBD) edible consumption and the extent of vaping to review and subsequently address these dangers in teens. Identifying these patterns will inevitably direct the course of subsequent clinical interviews and treatment planning. Early intervention is a critical component towards preventing possible negative outcomes for substance misusing teens. Results This aspect of the research demonstrated a connection between a higher acknowledged usage pattern of teens in treatment versus teens not in treatment. Correlations between beliefs associated with marijuana legalization, marijuana usage by family and friends, tobacco use, connection between age at first use, and the onset of regular usage patterns were also shown to be significantly higher among teens in treatment. Conclusions Teens that begin using alcohol, drugs, and tobacco early in adolescence are more likely to engage in vaping and edible usage. They are also more likely to use at a more frequent rate. In addition, teens who are surrounded by family and friends who engage in marijuana use are more likely to be supportive of its recreational use and legalization. This acknowledged information on the SASSI-A3 can help direct treatment planning early in the counseling relationship and provide a gateway for bringing family in the treatment and education process.
Objective This article presents an investigation of the defensiveness demonstrated by teens who are mandated to participate in treatment as compared to their non-mandated peers. Methods The data for this study was collected as part of The Substance Abuse Subtle Screening Inventory (SASSI) Institute’s third iteration of the Adolescent SASSI-A3. A total of 164 teenagers in treatment served as the dataset for the present study. All participant cases were provided by clinicians working in service settings throughout all U.S. Census Regions and serving in a variety of venues including substance use treatment, criminal justice programs, community corrections, private clinical practices, behavioral health centers, and social service organizations. Results We present two brief de-identified treatment case studies, aptly demonstrating defensiveness and denial from a clinical standpoint. Additionally, we review cases demonstrating high-levels of defensiveness and denial in mandated teen clients, and ethical ways to break through that barrier to treatment engagement. Conclusion Working with teens can be extremely difficult given their rapid mood changes, intensely felt experiences and shifting states of compliance, openness and defiance. When teens are mandated for treatment, they may often feel their choices have been taken away and the counselor may be viewed as more of a power authority rather than a concerned and helping figure. Contingencies placed on the teen as part of the mandated treatment experience are generally the primary focus, rather than addressing their underlying substance use disorder (SUD). As a result, the teen, as well as the counselor, require greater focus than just making sure those requirements are met
Objective The substance abuse subtle screening inventory (SASSI) has been used successfully in correctional treatment settings and correctional screening since 1988. These screenings include outpatient evaluations of offenders within community settings, as well as assessments of incarcerated individuals within federal, state, city, and county correctional facilities. One key element towards reducing recidivism and reoffending, is that individuals receive treatment for substance use disorders (SUD’s) while in the correctional system. While SUD is not the only contributing factor to criminality, it does significantly increase the likelihood of legal infraction and violations, placing these individuals at a higher risk of re-offending. Thus, identifying SUD as early as possible helps provide tailored treatment to those who need it, while simultaneously reducing the risk of future legal difficulties. Now in its fourth iteration (SASSI-4), this article discusses the SASSI screening tools’ utility with criminal offenders and serving clinical needs, and reviews a case study of a young male’s clinical evaluation while incarcerated. Results For this case study, we reviewed the SASSI-4 screening results of a 24-year-old male whom we will call "Bryon". Bryon was in his 4th week of detention at a local mid-western jail in the United States. He was arrested after turning himself in for a prior domestic violence offense committed while under the influence of alcohol and for which he had fled the state. Bryon had one prior arrest (for receiving stolen property, which he subsequently traded for drugs). The intake counselor conducting Bryon’s assessment had been meeting with him at the jail for several weeks. The court was particularly interested in determining the level of risk that Bryon would again flee the area. Conclusion This case presents us with a good example of the value of early identification of substance use disorder, and potential problems in criminal justice settings. Bryon's SASSI results clearly demonstrate a well-established pattern of substance misuse that will require relatively intensive intervention. Therefore, he may be a solid candidate for diversion into an alcohol and drug treatment program as a way of reducing the risk of future offenses.
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