Critique of Substance-Use Interview

This essay critically evaluates a patient assessment interview for a young substance abuse patient and recognizes and analyzes the elements in detail and recognizes any errors if present.

Running head: CRITIQUE OF SUBSTANCE-USE INTERVIEW
Critique of substance-use interview
Name of the student:
Name of the university:
Author note:

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CRITIQUE OF SUBSTANCE-USE INTERVIEW
Table of Contents
Introduction:..............................................................................................................................2
The interviewer’s initial contact with the interviewee:.............................................................2
The level of rapport and respect:...............................................................................................3
Interviewee’s readiness to change:............................................................................................4
Identification of impact of substance use on health:.................................................................5
Identification of impact of substance use on lifestyle:..............................................................6
Impact of stressors:....................................................................................................................7
Overall engagement:..................................................................................................................7
Conclusion:................................................................................................................................8
References:................................................................................................................................9

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Introduction:
Considering the statistical data available for Australian demographics, the percentage of
drug and alcohol abuse among adolescents has enhanced to 13% in the last decade. Hence, there
is a varied range of different programs and strategies in place for both preventing and improving
the state of the youth under the grasp of substance abuse (Crits-Christoph et al., 2012). Dual
Diagnosis Directive by the Victorian Government is one of the most remarkable innovative
addition to the present improvement among the substance abuse victims in the Victoria.
Assessment is one impactful element of the dual diagnosis procedure and any error or
misinterpretation in the patient assessment interview can not only lead to misdiagnosis, but a
behavioural error can agitate the patient and defeat the entire purpose of the interview (Cooper et
al., 2012). This essay will attempt to explore and critically evaluate a patient assessment
interview for a young substance abuse patient and be able to recognize and analyse the elements
in detail and recognize any errors if present.
The interviewer’s initial contact with the interviewee:
As mentioned by Le Berre et al. (2012), therapeutic engagement is a fundamental
requirement of the relationship between the patient and the interviewer. If the communication
approach, tone of voice, even the gesture of the interviewer offends the patient, it will restrict
establishment of a mutually respectful between the patient and interview and can even agitate the
patient which will restrict him or her from having the comfort or confidence to open up to the
interviewer with their issues. As per the Australian guidelines for the interviewing, it is very
important for the health care professional to undertake a warm and respectful attitude towards the

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patient. In this case, the interviewer has not undertaken a very warm approach and has not been
engaged in easy conversation with the patient which is undoubtedly one of the key requirements
of the effective communication needed for the psychosocial assessment of patients (Vancampfort
et al., 2014).
The level of rapport and respect:
It is crucial to maintain a warm and casual rapport with the substance abuse victim to
ensure communication comfort for the interviewer and the patient. As mentioned in the
guidelines for successful ASSIST interview by Sahealth.sa.gov.au (2018), it is crucial for the
assessor to adequately introduce him or herself along with their professional role and the need
for undertaken this assessment interview. Informed consent is a very important aspect while
undertaking any care activity with a patient. As mentioned by Cooper et al (2012), non-
judgmental open approach to communication and informed consent is considered to be respectful
for the patient. In this case, the interviewer has started the communication with the patient with
the fact his mother is concerned about him and has asked personal question without attempting to
build a rapport with him with small talk. Along with that the interviewer also failed to initiate the
interview with the mandatory confidentiality policy and informed consent either. Hence, it can
be stated that the interviewer failed to establish rapport with the patient, however, the interviewer
has successfully taken a respectful attitude towards the patient.
Interviewee’s readiness to change:
As mentioned by Connors, DiClemente, Velasquez and Donovan (2013), with respect to
the substance abuse, readiness to change present in a patient has a huge impact on the

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behavioural modifications that the health care worker is able to implement. On a more
elaborative note, recovery from an addiction habit would require implementation of varied range
of changes in the lifestyle, hence readiness to change in the patient will determine the exact kind
of referrals that can be provided to the patient (Lewis, Dana & Blevins, 2014). As the interview
progressed, the interviewer had exhibited patience, perseverance and compassion interrogating
the patient regarding the negative impact of smoking cannabis excessively. This subtle technique
had been successful and the interviewer could assess that there had been considerable readiness
for change in the patient. Gavin only appeared confused and agitated experiencing the early signs
of psychosis. Interviewer convinced Gavin to slowly limit and eventually stop smoking cannabis
to be able to regain control of his life and prioritize his health needs.
Identification of impact of substance use on health:
One of the most key requirements of a substance abuse assessment interview is to explore
and evaluate the impact of the prolonged substance used on the health and wellbeing factors of
the patients. The referral of the substance abuse victim to different health professionals for
psychotherapeutic treatment or intervention will depend on the exact need of the patient
associated with the high degree of impact that the substance abuse has been successful in
facilitating in the life of the patient affecting his health and wellbeing status. In this case as
illustrated by Barnett, Sussman, Smith, Rohrbach and Spruijt-Metz (2012), while assessing the
impact of the substance abuse on the victim the interview mistake a non-judgmental
compassionate empathetic and yet inquisitors approach to help the patient to get comfortable and
be able to explore the extent of the impact that the substance abuse have facilitated in his or her
life. In the most cases the impact of substance abuse in centred around not just the physical and

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mental health outcomes, the impact extends towards the social, financial and spiritual well-being
status of the addict as well. Hence, while assessing the impact of the substance abuse on the
victim, it is crucial for the interviewer to assess all the mentioned aspects as well. Here he
assessed the impact of the abuse on his sleep patterns and activities of daily living, which
discovered that he has disturbed sleep patterns and personal hygiene due to his psychotic
symptoms. The impact of substance in his behaviour was also accurately addressed or assessed
in the interview which needs to be commended. Although, the approach taken by the interviewer
could have been more compassionate and empathetic which could have avoided irritation or
agitation in Gavin (Smith et al., 2012).
Identification of impact of substance use on lifestyle:
As well as health and wellbeing status, the impact of substance abuse is very high on the
lifestyle and living conditions of the patient as well. Addiction alters behavioural patterns,
choices, judgment and decision making abilities of an abuse victim. As discussed by Bachman,
Wadsworth, O'Malley, Johnston and Schulenberg, (2013), the impact of substance abuse is also
high on the financial and educational life of the victim, often a substance abuse victim surpasses
even the sense off appetite in severe cases of dependability on drugs. Here, the interviewer had
started with assessing the impact of his addiction in his TAFE course, in which his progress was
significantly threatened due to his psychotic symptoms such as delusions and hallucinations;
which indicates the addiction affecting his education and in turn his career. Along with that, the
financial impact of the substance abuse has also been discussed where the patient stated he
spends $100 a week on cannabis which is affecting his financial stability. Hence, the addiction is

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affecting his financial stability as well which undoubtedly has a significant impact on his
lifestyle deteriorating it every day.
Impact of stressors:
External stressors can also have a deliberating impact on the lifestyle of a substance
abuse victim and can even facilitate higher substance abuse as well. As illustrated by Konings et
al. (2012), it is crucial for the interviewer that is assessing a particular substance abuse patient to
identify the evidence of any stress or that can have a delimiting impact on the patient's lifestyle
and substance abuse. In this case, ASSIST framework has a very elaborate questionnaire
assessing each of the different substance abuse possibilities involving different drugs, alcohol
and tobacco. This illustrative framework has been successfully explored by the interviewer
which helped him discover his concerning drug habits involving tobacco, alcohol and cannabis.
Furthermore, the interviewer had also been pressing with the intention to discover any stressor
facilitating his addiction to cannabis. It was discovered that inability to focus and lack of
motivation and self-worth acted as stressors, however there was need for more extensive efforts
to explore the origin and exact impact of the stressors.
Overall engagement:
With respect to overall engagement, the interviewer had been attentive, focused and calm
throughout the interview. He had a very perseverant and patient yet effective communication
approach for the patient which helped calm him and give him a sense of comfort so that he can

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freely share his issues. Even when the patient got agitated the interviewer was very calm and
apologetic in handling an agitated patient which is a key professional trait for a psychiatric
counsellor. Hence, it can be considered that the overall engagement and competence of the
interviewer was sufficiently, although his approach had been very professional and distant, and
he could have incorporated more empathetic or compassionate approach (Grady, 2015).
Conclusion:
On a concluding note, substance abuse can be considered as one of the greatest threats or
dangers associated with the health and welfare of the youth. The percentage of young adults or
adolescents associated with some or the other form of substance abuse has enhanced drastically.
This assessment had been an excellent opportunity for understanding the effectiveness of patient
assessment interview for substance abuse and how the impact of interviewer assessment and how
to conduct it successfully to analyse the effectiveness of the interview to adequately explore the
exact issues.

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References:
ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) :: SA Health. (2018).
Retrieved from
http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/
clinical+resources/professional+development/
drug+and+alcohol+training+and+development/
assist+alcohol+smoking+and+substance+involvement+screening+test
Bachman, J. G., Wadsworth, K. N., O'Malley, P. M., Johnston, L. D., & Schulenberg, J. E.
(2013). Smoking, drinking, and drug use in young adulthood: The impacts of new
freedoms and new responsibilities. Psychology Press. Retrieved from
https://books.google.co.in/books?
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08qxUU0t0o0gq8V64VG0hRY
Barnett, E., Sussman, S., Smith, C., Rohrbach, L. A., & Spruijt-Metz, D. (2012). Motivational
interviewing for adolescent substance use: A review of the literature. Addictive
behaviors, 37(12), 1325-1334. Doi: 10.1016/j.addbeh.2012.07.001
Bettmann, J. E., Russell, K. C., & Parry, K. J. (2013). How substance abuse recovery skills,
readiness to change and symptom reduction impact change processes in wilderness
therapy participants. Journal of Child and Family Studies, 22(8), 1039-1050. Retrieved
from https://link.springer.com/article/10.1007/s10826-012-9665-2

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Connors, G. J., DiClemente, C. C., Velasquez, M. M., & Donovan, D. M. (2013). Substance
abuse treatment and the stages of change: Selecting and planning interventions. Guilford
Press. Retrieved from https://books.google.co.in/books?
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%20abuse%20interviewer&f=false
Cooper, L. A., Roter, D. L., Carson, K. A., Beach, M. C., Sabin, J. A., Greenwald, A. G., & Inui,
T. S. (2012). The associations of clinicians’ implicit attitudes about race with medical
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Grady, C. (2015). Enduring and emerging challenges of informed consent. New England Journal
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Konings, M., Stefanis, N., Kuepper, R., De Graaf, R., Ten Have, M., Van Os, J., ... & Henquet,
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Le Berre, A. P., Vabret, F., Cauvin, C., Pinon, K., Allain, P., Pitel, A. L., ... & Beaunieux, H.
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