Saturday, December 28, 2013

drug and alcohol evaluations

Welcome to the first post on this Blog site.  The purpose of the Blogs is to provide information to current and potential new clients in need of drug and alcohol evaluations.  I hope the reading is helpful and relieves some concerns that inevitably come with court ordered requirements.  I'll start with the most important questions:

  • What are drug and alcohol evaluations?  The evaluation consists of an assessment and a report that explains the findings of that assessment.  So what is an assessment? A trained and certified or licensed professional meets with a client.  After some intake paperwork a client may be given some brief questionnaires if the evaluation is limited to substance use and a personal interview.  The counselor may use a printed or computer version of an interview and writes in the answers.  Many questions ask about specific drugs, lifestyle problems that are common among people with substance abuse.  Some of the questionnaires are straight forward, while others may have questions to try to detect if someone answers in a way to make themselves look really good.  It is important to be honest with the answers to get a valid score.  After the professional has sufficient information, a report is written for the court or whoever needs that evaluation--sometimes social services will request these.
  • Who gets ordered and why?  This varies a bit, but mainly I get clients from out of state, in particular Arizona that had a misdemeanor while on vacation. With first infractions, the court often orders a drug and alcohol evaluation and for the defendant to follow through with any recommendation.  Often clients will be referred by a judge or mediator from Family Court, often as a result of custody dispute. It is very common for parents to accuse each other of wrongdoings including drug and alcohol abuse. A judge or mediator cannot take the time to find out who is saying the truth or how bad the drug and alcohol use really is, so they refer out.  Some people come to an appointment confused, saying "I'm not an alcoholic, so why do I have an evaluation done?"  Most people think an evaluation is exclusively for people with advanced alcoholism or addiction, however for court orders, they may also serve to clear up the mutual accusations, detect early signs of abuse and bring more clarity in how to best proceed with a case.  An evaluation can and should offer solutions if a substance use disorder is in fact detected, and this set of solutions would be in the written portion and the client should be made aware of course.  Cases where children are removed from the home may also require evaluations, here the social workers may want to be sure the children can be placed back with the parents or if the parents need to go through a treatment program before that is the case. These cases can be challenging because of the family trauma and distrust in the person conducting the evaluations. Unfortunately, some clients in states of anxiety, fear of being judged and fear of consequences may be very apprehensive.  Many are also unaware how their drug and alcohol use IS actually impacting other family members and IS creating problems but may try to present that there are NO problems. Typically the apprehension and inconsistencies raise flags, making it much more challenging to assist the client through the evaluation.  Unfortunately, an evaluator may not be in the position to tell a client not to worry, just tell the truth since they cannot guarantee that the results lead to satisfactory outcomes. The decisions are in the hands of the courts.  Typically though, keeping the family unit together is a big priority these days, if an evaluation confirms a presence of a substance use disorder, that can be a good thing when the parent agrees to treatment!
  • PRICES:  if you look through the internet and make some phone calls, you might get some very, very different price ranges, buyer beware!  Some agencies might get funding and that would explain how they can do so much work for under 100 dollars, but typically in the Ventura area, many charge around 400-500 dollars, or even more.  Some may charge less but may require that you complete a treatment program--for people that don't need an intensive treatment program, this is often confusing. This may simply be that they called a treatment program that uses the assessment procedure to determine if you need inpatient treatment or if their outpatient treatment is sufficient.  They may not have the time or resources to only do court evaluations.  Also when you call around, you may want to know that some programs only do a brief "screening": intake paperwork, a questionnaire and brief interview, again to determine what level of care you might need, not enough information of what a judge or social worker might want/need. Having a solid, thorough evaluation might seem expensive, but may reduce continued arguing in court and leave a judge wondering.
  • What would a recommendation say?  A counselor's job is also to try and assess what "level of care" is best based on the information given.  There are tools we use to help us make decisions that are not too drastic.  Best case scenario could say that there were not enough findings to show the client has a current substance abuse disorder, yet a counselor cannot say this 100%, so we use careful language. Worst case scenario, I stop in the middle of the assessment and call an ambulance to take you to the closest hospital as I see you are going through withdrawal or DT's and they are life threatening--but this is very unlikely and the recommendation would state that intensive treatment is recommended.  Even if the results show a substance use disorder, this does not mean parents don't get visitation or their children back.  If the clients follow through with the recommendations, depending on the situation, visitations might continue.  If a client does not follow through, supervised visitation or even therapeutic visitation might be ordered.  For criminal cases, a judge might decide to allow treatment rather than jail time.  In summary, an evaluation does not determine the outcome, that is still up to a judge, they might help the judge, district attorney or your lawyer negotiate terms.
I hope this was helpful, it is a long blog hoping to answer a lot of questions people may not get answered when they ask in court.  I have seen letters to courts by therapist saying something like "My client is not an alcoholic, I have seen him/her for three years"--while a therapist might mean well, a judge may not consider such a letter as enough evidence, in particular not knowing what expertise in addictions that particular therapist has.  Hence, the going to someone that specializes in the field of substance abuse might really pay off in the long run.  For more information please visit aspiracounseling.com.