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Assignment 2: Mental Status Plan

You are a newly recruited intern counselor at a correctional facility where Michael was committed for 18 months for the conviction of burglary. Upon arrest, Michael tested positive for marijuana and heroin.  You are assigned Michael’s case. You review his case history and discuss it with your supervisor in detail. You then decide to draw up a list of 15–20 questions to ask Michael to assess the areas of need that his treatment plan should address. Before you ask him the questions you decide to get input from your supervisor. Devise an assessment and interview plan.  Include what assessment screen tool, as discussed in the module lecture, you have chosen to use during the assessment. Be sure to explore the screening tools link which has a listing of over 15 different screening tools in the module lecture.  Your questions must cover his psychosocial history and include a rationale for each question included.

Case information on Michael:

  • 50 years old
  • 5 prior convictions of: disorderly conduct, attempted burglary, drug possession, driving under the influence and receiving stolen property.
  • Michael has never been treated for addiction

Be sure to include the following items in your report:

    1. A review of the case.
    2. Details of your assessment plan: What areas of need your treatment plan should address, specific instruments selected, along with reasons for selecting them.
    3. In your interview plan include a summary of the components of the MSE and at least 15 additional questions to assess the client’s psychosocial history.
    4. A rationale for selecting each question in the interview.
    5. Justify your ideas by using appropriate examples and references from text, appropriate professional field-related Web sites.
    6. Answer the questions in a logical, organized manner.

Your report should be at least 3 pages long. Remember to include a cover page and reference page, and to support your arguments with information drawn from the online content, the textbook, and other credible, scholarly sources to substantiate the points you are making.  Apply APA standards for writing and citations to your work.

Please include 5 references

Assignment 2 Grading Criteria Maximum Points
Provided a summary of the components of a mental status examination. 20
Included a brief review of case information. 5
Selected instruments and specified why the particular instruments were selected in terms of validity and applicability. 25
Provided an interview plan which included components of the MSE and at least 15 questions to ask Michael during the assessment with rationale for each question. 30
Wrote in a clear, concise, and organized manner; demonstrated ethical scholarship in accurate representation and attribution of sources, displayed accurate spelling, grammar, and punctuation. 20
Total: 100

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  • Module 2 online lectures
  • From the assigned textbook, Drugs, Society and Criminal Justice, read:
    • Fundamentals of Drug-taking Behavior
    • Opioids: Opium, Heroin, and Prescription Pain Medications
    • Cocaine and Methamphetamine
    • Performance Enhancing Drugs and Drug-Screening Tests

Online couse info

Assessment Process

During this process, the counselor, together with the client, determines the nature and causes of substance abuse problems in the client’s life that need attention. They also identify the resources and support systems to treat the client for these problems. The information is gathered through an intake interview along with the client’s psychosocial history. In the next lecture topic, we will discuss in detail an intake interview and psychosocial history.

During the assessment process, information about the client is collected from various sources such as the client’s self statements and past records. An expert analyzes and evaluates the information gathered and then develops a treatment plan for the client.

The assessment process begins with identifying risk factors. A risk factor is an event that brings substance abusers to the attention of the people concerned about them. An example of such an event is a husband arrested for beating his wife and referred for treatment by a court. Another example is a soccer player who tests positive for cocaine and is referred to treatment by his coach. The risk factors in these examples are wife-beating and testing positive for cocaine. After a risk factor is identified, a brief screening is conducted. After the screening, an appropriate intervention is suggested for the abusers.

In addition to an intake interview, there are also standardized instruments of assessment. Let’s look at them.

An assessment tool widely used to assess the client’s problem for alcohol and other addictions is the Addiction Severity Index (ASI).

Addiction Severity Index

The Addiction Severity Index was developed in the year 1980 by TRI Executive Director, A. Thomas McLellan in collaboration with the University of Pennsylvania’s Center for the Studies of Addiction. ASI is a standardized assessment instrument that helps match a problem of a client with an appropriate treatment. It is designed to be administered in the form of a semistructured interview in approximately one hour or less. It is a widely used measure of assessment in both research and clinical practice. The ASI shows a high level of internal consistency and reliability and good convergence with other measures of substance abuse. According to the ASI, a practitioner should address an addiction by focusing on the issues that contribute to or result from the addiction.

ASI assesses severity of problems in the domains of a client’s life that are commonly associated with drug use: medical symptoms, employment and self-support, drug and alcohol use, legal status, family history, family and social relationships, and psychiatric symptoms. Based on the information such as client response, data from physical exams, lab reports, and psychological test results, ASI helps develop a severity profile for a client by assigning a severity score. This score indicates the degree of patient problems on a 10-point scale, from 0 to 9, in each of the seven problem areas. The composite scores of the seven problem areas are then used to summarize the changes in client status.

It is important to note there is an adolescent version of the ASI.  This version assesses chemical use, school status, employment/support, family relationships, peer/social relationships, legal status (involvement with criminal justice program), and psychiatric status.

To view the T-ASI click here:


In substance abuse, diagnosis is the “art of confirmation of a substance abuse or dependency from its signs and symptoms.” A professional can better communicate a client’s problem by referring to a specific diagnosis to describe the problem.
Diagnosis has two main goals:

    • To Help the Counselor Have an Understanding of the Diagnostic Categories: A common diagnostic framework that forensic clinicians and other professions use is the Diagnostic and Statistical Manual of Mental Disorders. Developed by the American Psychiatric Association, DSMoutlines strict criteria for the clinical diagnosis of It provides a clear description of diagnostic categories to diagnose, communicate about, and treat people with various mental disorders. We will discuss in detail about this instrument in this week’s lecture topic “Substance Disorder.”
  • To Determine Treatment for the Client: Diagnosis identifies a client’s problems, goals, and objectives, facilitating designing a treatment plan for the client.

As mentioned earlier, a part of the assessment process and probably the most important component is the intake interview. Let’s look at it in detail.

Using the navigation on the left, please proceed to the next page.
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The intake interview is an event of primary verbal communication between a client and an expert to elucidate the characteristic patterns of the client, particularly the patterns for which a client requires help.

Psychosocial interview is an important form of intake interview. The use of well-designed psychosocial interviews and questionnaires helps understand the problem of a client. A psychosocial interview is conducted in the form of a face-to-face interview with the client.

The Mental Status Examination (MSE) is a formal structured assessment of the client’s behavioral and cognitive functioning. It includes descriptions of the client’s appearance and general behavior, level of consciousness and attentiveness, motor and speech activity, mood and affect, thought and perception, attitude and insight, and, finally, higher cognitive abilities.


Screening is a process to identify the presence of a problem and the need for further evaluation, if there is a reason for concern. Screening should be conducted throughout client contact in a treatment program such as during detention, pretrial, probation, incarceration, parole or aftercare, and revocation hearings. During this process, particular attention is paid to key information such as types of substances abused, event that precipitated the use, frequency of use, amount of ingestion, and behavior during and after the ingestion.

Screening Tools

There are a number of screening tools that a counselor can use to help in assessment and diagnosis.  Factors such as age impact the screen tool selected.  Let’s discuss the two commonly used screening tools in the treatment of substance abuse.  It is important to remember there are many screen tools available,

Although a number of studies were conducted to test the reliability of this instrument, the results were mixed. Wolford conducted a study on people with severe mental illnesses to compare different instruments for screening. Although CAGE was found to be better than other approaches such as clinical variables, laboratory tests, and collateral reports, it yielded only a modest 60.9 percent sensitivity and 69.5 percent specificity. CAGE includes information related to lifetime rather than current substance abuse problems, which might be considered as its limiting factor. For best results, CAGE should be used in conjunction with other assessment tools such as an intake interview.

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One of the oldest and widely used tools for screening is MAST. The tool was developed by Melvin L. Selzer in 1971 to assess if the client has a drinking problem. MAST is a 24-item, self-report inventory of common signs and symptoms of a variety of problems resulting from alcohol abuse. Let’s look at the MAST questionnaire:

MAST Questionnaire

The MAST questionnaire comprises questions about the various aspects of alcohol consumption. The client answers each question in yes or no.

The total score helps evaluate the absence or the existence of excessive alcohol consumption.

Scoring Pattern

  • Question 1: One point if the answer is no and no point if the answer is yes.
  • Question 2: One point if the answer is yes and no point if the answer is no.
  • Question 3: One point if the answer is yes and no point if the answer is no.
  • Question 4: One point if the answer is no and no point if the answer is yes.
  • Question 5: One point if the answer is yes and no point if the answer is no.
  • Question 6: One point if the answer is yes and no point if the answer is no.
  • Question 7 to 17 and 19 to 22: One point if the answer is yes and no point if the answer is no.
  • Question 18: Five points for each Delirium Tremens
  • Question 23 and 24: Two points for each arrest

The score

  • Between 0 and 3 indicates low risks.
  • Between 4 and 9 indicates high risks. Addiction to alcohol is likely.
  • Greater than 9 indicates alcoholism.

A limitation of MAST is that adolescents seem to score higher than adults, which can be misleading. In addition, the tool helps to detect alcohol abuse only and not drug-related abuses. The tool also does not detect binge drinking. For best results, MAST should be used in conjunction with an intake interview.