Screening and Intake
Screening is the front door of the treatment continuum: a brief, standardized process that decides whether a fuller assessment is warranted. Know the distinction between screening (quick, broad, rules in or out) and assessment (comprehensive, diagnostic, drives the treatment plan). Candidates should recognize validated instruments (e.g., AUDIT, DAST, CAGE, PHQ-9, GAD-7) as screening tools, not diagnostic verdicts, and understand that a positive screen triggers referral for full assessment rather than immediate placement in a program.
Intake covers eligibility determination, informed consent, confidentiality and its limits, insurance and payment, program rules, and initial risk screening (withdrawal risk, suicide risk, medical urgency). Traps: questions that treat a screening cutoff as a diagnosis; confusing eligibility criteria with clinical criteria; and forgetting that a client who is intoxicated or in acute withdrawal needs medical evaluation before psychosocial intake. Another common trap is documentation timing-intake data must be recorded contemporaneously and accurately.
Rule of thumb: screen to decide whether to assess; assess to decide what to treat. If a stem says 'the counselor's first action,' look for the least invasive, most appropriate next step-usually clarifying information or arranging full assessment, not jumping to treatment.
Worked example: A client scores 18 on the AUDIT at intake. The correct next step is to complete a comprehensive assessment and evaluate withdrawal and safety risk-not to enroll him in a 28-day program based on the score alone.