Evaluations

Evaluations are the tool therapists use to determine the level of treatment appropriate for a particular clients need.  For addicts and family members evals can answer the questions, Is there really a problem, and just how big is it?

Evaluations can also serve as a guide to what an addict should be working on next and what form of treatment would be appropriate. Having traveled the path of recovery and studied the process of addiction, we can help you work on what needs to be worked on, when it needs to be worked on.  That is something addicts don’t do very well on their own.  That direction will reduce the recovery period significantly.

For addicts, there is a “blindness” that comes with using that keeps them from seeing how much trouble they are in.  I sometimes use the following metaphor to gauge how the client assesses his situation.  I ask, How sick do you think you are?  Do you have:

  • A cold
  • Pneumonia
  • Pneumonia with complications.
  • Pneumonia with life threatening complications.
  • Are you in need of life support.

The addict’s assessment is very often quite different than my own.

Participating in an evaluation or assessment can bring clarity for the addict and family concerning addiction, and give direction for seeking healing.  Please use the dialogue box below to request an evaluation.

Professional Criteria for Evaluations

In the professional clinical world, evaluations are used to determine the level of care needed by a particular client.  Counselors are guided by the American Psychiatric Association’s DMS IV for diagnostic standards.  We begin by looking for difficulty in controlling use, does one drink or hit lead to another and another.  And secondly is there use despite negative consequences.  Do you continue to use despite trouble with the law, family or work.

A diagnosis of abuse would result from meeting one of the four following criteria.

1. Continued use despite social or interpersonal problems.  2.  Repeated use that causes problems (failure to meet obligations) at work school or home.  3.  Repeated use in physically hazardous situations (driving under the influence).  4.  Legal problems arising from your use.

An abuse diagnosis usually results in treatment recommendations ranging from 8 -52 hours over one day to 26 weeks.  In court mandated situations mandatory self-help meetings like AA or NA might also be required.

A dependence (addiction) diagnosis would be appropriate for any client that met 3 of the following criteria.

Tolerance. Has your use of drugs, alcohol or sexual acting out increased over time?  Do you need to use more to get the same high?

Withdrawal. When you stop using, have you ever experienced physical or emotional withdrawal? Have you had any of the following symptoms: irritability, anxiety, shakes, sweats, nausea, or vomiting?

Difficulty controlling your use. Do you sometimes use more or for a longer time than you would like? Do you sometimes drink to get drunk? Are you progressively spending more time using your drug of choice, or acting out sexually?

Negative consequences. Have you continued to use even though there have been negative consequences to your mood, self-esteem, health, job, or family?

Neglecting or postponing activities. Have you ever put off or reduced social, recreational, work, or household activities because of your use?

Spending significant time or emotional energy. Have you spent a significant amount of time obtaining, using, concealing, planning, or recovering from your use? Have you spend a lot of time thinking about using? Have you ever concealed or minimized your use? Have you ever thought of schemes to avoid getting caught?

Desire to cut down. Have you sometimes thought about cutting down or controlling your use? Have you ever made unsuccessful attempts to cut down or control your use? (Addictions and recovery. org)

If you meet three of the above criteria your diagnosis would be dependence. You would be labeled an addict.  Your treatment might be in-patient or intensive outpatient.  Inpatient programs last from several weeks to months depending on the program and need.  Typically intensive outpatient programs meet 2-3 times a week for 6-9 hours.  Treatment would probably last for 3-24 months.  (State requirements vary greatly and local requirements should be researched.)

Evaluations at Waterfall Counseling are conducted electronically using skype, telephone or email.  They are accomplished in two parts.  One is a background questionaire which we will email to you that helps you describe your situation.  When we receive the questionaire back we will contact you to complete the evaluation.

To arrange for your evaluation, please use the contact box below:

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