Screening, Assessment, and Evaluation
What this domain tests
This domain separates three tasks candidates often blur: screening (brief, standardized, decides whether a fuller look is needed), assessment (ongoing multi-method data gathering for treatment planning), and evaluation (a formal diagnostic or forensic opinion produced by a qualified clinician). Expect questions on instrument choice, level-of-care justification, and the limits of what you may conclude.
Core rules
- Use validated, normed tools and record instrument, version, date, and score: TCU Drug Screen V, GAIN-SS, AUDIT, DAST-10, ASI, PHQ-9, GAD-7.
- DSM-5-TR substance use disorder = 2 or more of 11 criteria in 12 months; 2-3 mild, 4-5 moderate, 6 or more severe. Intoxication, withdrawal, and remission are separate specifiers.
- ASAM Criteria six dimensions drive placement: withdrawal/intoxication risk, biomedical, psychiatric/cognitive, readiness to change, relapse potential, recovery environment.
- Risk-need-responsivity: match intensity to actuarial risk (e.g., LSI-R), target criminogenic needs, adapt to literacy, culture, language, and learning style.
- Underreporting is the norm in justice settings. Corroborate with records, collateral contacts, and objective testing, using written consent.
Worked example
A man on probation scores high on the TCU Drug Screen and says, "I only smoke weed." Reasoning: that is a positive screen, not a diagnosis. Administer the ASI and a structured DSM-5-TR interview, review the presentence report, and order urine creatinine to detect dilution. If he meets six criteria for severe stimulant use disorder and Dimension 1 shows no withdrawal risk, the defensible conclusion is severe SUD with residential placement plus psychiatric consultation, not "in denial."
Traps
Treating a screen as a diagnosis; ignoring reading level; skipping collateral data; missing withdrawal risk that requires medical management; writing forensic opinions outside your scope.