IC&RC CCJP cheat sheet

Screening is a brief, low-cost triage step (e.g., AUDIT, DAST-10, TCU Drug Screen) that flags probable need for fuller assessment; it is not diagnostic and a positive screen alone never establishes a substance use disorder.

Assessment is multidimensional: ASAM Criteria six dimensions cover intoxication/withdrawal risk, biomedical conditions, psychiatric/emotional status, readiness to change, relapse potential, and recovery living environment.

Use standardized, validated instruments with known cut scores and report them as measured (e.g., AUDIT-10 score 8-15 = hazardous drinking range; 16+ = high risk) rather than paraphrasing them loosely.

Criminal justice referrals often require a biopsychosocial history, collateral contacts (probation/parole, family), and records review; document consent before contacting collaterals.

Legal status matters: pending charges, sentencing dates, and diversion conditions shape urgency and assessment scope; ask directly and record dates.

Validity threats include underreporting due to legal consequences, malingering, and recall bias; triangulate self-report with records, collateral, and urinalysis.

Risk assessment must document suicide risk, withdrawal risk, overdose history, and violence risk; these drive immediate placement decisions.

Diagnosis should follow DSM-5-TR criteria for substance use disorders (11 criteria, severity by count: 2-3 mild, 4-5 moderate, 6+ severe) plus remission specifiers.

ASAM level of care is determined by matching the six dimensions to intensity: e.g., Level 1 outpatient, Level 2.1 intensive outpatient, Level 2.5 partial hospitalization, Level 3 residential, Level 4 medically managed inpatient.

Treatment plans should be individualized, measurable, time-bound, and tied to assessment findings; each problem statement links to goals, objectives, and interventions.

Use SMART objectives: specific, measurable, achievable, relevant, and time-bound; progress is documented against each objective.

Confidentiality rules under 42 CFR Part 2 restrict disclosure of substance use disorder records more strictly than HIPAA; written consent must specify recipient, purpose, and expiration.

Case management functions include linkage, coordination, monitoring, advocacy, and documentation; a release of information is required before cross-agency coordination.

Court-ordered treatment must be integrated with the treatment plan; documentation should address compliance with court conditions while preserving clinical judgment.

Aftercare and continuing care planning begins at intake; discharge planning should address housing, transportation, employment, and recovery supports.

Documentation should be contemporaneous, objective, and behaviorally specific; avoid conclusory labels such as 'manipulative' without supporting observations.

Motivational interviewing core elements: open questions, affirmations, reflective listening, summaries (OARS); the spirit is collaboration, acceptance, compassion, and evocation.

Change talk (desire, ability, reason, need, commitment) is reinforced; sustain talk is reflected without argument; the righting reflex (arguing for change) is counterproductive.

Stages of change: precontemplation, contemplation, preparation, action, maintenance, and relapse; interventions are matched to the stage.

Relapse prevention uses high-risk situation identification, coping skills, and a lapse-management plan; a lapse is not automatically a full relapse.

Crisis intervention priorities: ensure immediate safety, de-escalate, assess suicide and violence risk, mobilize supports, and arrange follow-up before ending contact.

Suicide risk assessment should document ideation, plan, intent, means, prior attempts, and protective factors; means restriction is a key intervention.

Withdrawal management: alcohol and benzodiazepine withdrawal can be life-threatening and require medical management; opioid withdrawal is generally not life-threatening but is distressing.

Overdose response includes naloxone administration, calling emergency services, and rescue breathing; Good Samaritan laws may protect the caller in many jurisdictions.

Education should be matched to health literacy, language, and culture; use teach-back to confirm understanding.

Family education covers the biopsychosocial model of addiction, relapse as a process, enabling behaviors, and boundary setting.

Community education includes prevention science: risk and protective factors, and evidence-based prevention strategies such as environmental and policy approaches.

Prevention frameworks: universal, selective, and indicated prevention, matched to population risk.

Stigma reduction requires person-first language ('person with a substance use disorder') and avoiding terms like 'addict' or 'clean/dirty'.

Confidentiality limits apply to family education: no disclosure of client information without consent, except as permitted by law.

Community resources include mutual-help groups (AA, NA, SMART Recovery), peer recovery support, and harm reduction services such as syringe exchange and naloxone distribution.

Education about medication for opioid use disorder (buprenorphine, methadone, naltrexone) should correct the misconception that medication is not 'real' recovery.

Informed consent requires disclosure of the nature of services, risks, benefits, alternatives, confidentiality limits, and the right to withdraw.

Mandatory reporting duties vary by jurisdiction and typically cover suspected child abuse or neglect; know the local statute and reporting timeline.

Duty to warn/protect may apply when a client poses a serious threat to an identifiable person; follow jurisdiction-specific law and consult supervision.

Dual relationships should be avoided when they risk exploitation or impaired objectivity; bartering and personal relationships require careful evaluation.

Scope of practice: only perform services within training and licensure; refer or consult when outside competence.

Boundaries include no sexual relationships with clients, no exploitation, and careful management of gifts, self-disclosure, and social media contact.

Record retention and release follow legal and ethical standards; clients generally have a right to access their records, subject to exceptions.

Continuing education, supervision, and consultation are professional obligations; ethical decision-making models help resolve dilemmas systematically.

Drug courts and diversion programs combine judicial supervision with treatment; participants typically face regular status hearings, drug testing, and phased incentives and sanctions.

Therapeutic jurisprudence holds that legal rules and procedures can affect participants' psychological well-being; collaboration between court and treatment staff is central.

Roles must remain distinct: treatment staff report clinical information, while courts make legal decisions; avoid becoming an agent of law enforcement.

Confidentiality in justice settings requires written consent for disclosure; 42 CFR Part 2 applies to federally assisted SUD programs.

Advocacy includes educating justice partners about evidence-based treatment, medication for opioid use disorder, and the harms of stigma.

Sanctions and incentives should be graduated and predictable; research supports swift, certain, and fair responses.

Reentry planning addresses housing, employment, transportation, documentation, and continuity of care to reduce recidivism.

Collaboration includes probation/parole, courts, corrections, law enforcement, and community providers; memoranda of understanding clarify roles and information sharing.