Review the Intake Assessment Form. Create a fictional history of an inmate or offender who has an alcohol or substance abuse disorder to use for this assignm
Review the Intake Assessment Form.
Create a fictional history of an inmate or offender who has an alcohol or substance abuse disorder to use for this assignment.
APA 7th Edition: The Basics of APA In-text Citations | Scribbr ????
Here are examples of models:
– The Social Learning Model
– The Biopsychosocial Model
– The Community-Based Prevention Model
– The Harm Reduction Model
– The Trauma-Informed Care Model
Various models of substance abuse prevention, intervention, and rehabilitation are available for the delivery of support services for justice-involved individuals with addiction and substance abuse issues. It is important to understand how and when these various models can be applied to various diverse populations. Much information about a client’s situation can be obtained through intake interviews with the client. In this assignment, you will explore the types of information you can learn about your client through an intake interview, and discover how to apply substance abuse prevention, intervention, and rehabilitation models to such a situation.
Create a 1,200 word paper
Include An Introduction and Conclusion
You should:
- Describe the inmate or offender with an alcohol or substance abuse disorder who is seeking treatment at your correctional facility (e.g., prison, jail, parole, probation, or diversion). 200 words
- Describe this inmate or offender’s life experience through their initiation of substance use, prior treatment, and any periods of sobriety. 200 words
- Describe and analyze at least 2 models of substance abuse prevention, intervention, and/or rehabilitation that could be used in the delivery of support services for this client. 200 words
- Outline the treatment strategies you are proposing for the inmate or offender. 200 words
- Identify 2 treatment goals you will work on with the inmate or offender. 200 words
Include 2 references.
Format any citations in your presentation according to APA guidelines.
CPSS/420 v2
Intake Assessment Form
CPSS/420 v2
Page 2 of 2
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Intake Assessment Form
Intake Instructions
Intake staff shall review each completed intake assessment completed for each program participant. The intake assessment may help identify a program participant’s treatment needs, but it is the responsibility of staff to gather additional information in the following areas: Social supports, economic resources (including health insurance or Medicaid availability), the program participant’s family history, education, employment history, criminal history, legal status, medical history, alcohol use and other drug use history, and finally previous treatment programs.
Intake assessments should include the evaluation of substance use disorders; the evaluation of alcohol use disorders, and the assessment of treatment needs. This information is utilized to create client driven, clinically supported treatment plans that are SMART (Specific, Measurable, Attainable, Realist and Timelined)
Client Information
Client’s First Name:
Client’s Last Name:
Date of Birth:
Insurance Type:
Client’s Preferred Name:
Admission Date:
Emergency Contact Information
Emergency Contact:
Relationship:
Contact Address (Street, City, State, Zip):
Contact Phone Number:
Release for Emergency Contact obtained for this time period:
Personal Information
Sex Assigned at Birth
Mention ‘Yes’ against what is relevant:
Male:
Female:
Intersex:
Gender queer:
Gender non-conforming:
Male to female:
Female to male:
Other (Specify):
Unknown or declined to state:
Gender Identity
Mention ‘Yes’ against what is relevant:
Male:
Female:
Intersex:
Gender queer:
Gender non-conforming:
Male to female:
Female to male:
Other:
Unknown or declined to state:
Pronoun Preferred
Mention ‘Yes’ against what is relevant:
Him:
Her:
They:
Other:
Unknown:
Referral Reason
Why has the client been referred?
Treatment counselor:
Alcohol and Drug History
Fill in appropriate details for each.
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Check if ever used: |
Age at first use: |
None or denies |
Current Use |
Current Abuse |
Current Dependence |
In Recovery |
Client-perceived Problem? Write Y or N |
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Alcohol |
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Amphetamines (Speed/Uppers, etc.) |
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Cocaine/Crack |
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Opiates (Heroin, Oxy, Methadone, Suboxone) |
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Hallucinogens (LSD, Mushrooms, Ecstasy, Molly) |
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Sleeping pills, Benzos, Valium, or similar |
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PSP (Phencyclidine) or Designer Drugs (GHB) |
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Inhalants (paint, gas, glue, aerosols) |
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Marijuana, Hashish. DABS |
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Tobacco, nicotine, vaping, chew |
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Caffeine (energy drinks, sodas, coffee, etc.) |
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Over the counter |
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Other substances |
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Complimentary alternative medication |
Previous Drug and/or Alcohol Treatment History:
|
Type of Previous Recovery Treatment (Inpatient, Outpatient, Residential, Detoxification) |
Name of Previous Treatment Facility |
Dates of Previous Treatment |
Treatment Completed (Yes or No) |
Medical History:
|
Medical Provider |
Name: |
Phone #: |
Last Date of Service: |
|
Primary Physician: |
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Other medical provider(s) |
Date records requested:
From whom, if applicable:
Relevant Medical History
General Info:
Baseline weight:
Weight changes:
BP:
Mention ‘Yes’ wherever relevant
|
Condition |
Cardiovascular |
Respiratory |
Genital, urinary, bladder |
Gastro-intestinal bowel |
Nervous system |
Musculoskeletal |
Gyneco logy |
Skin |
Endocrine |
|
Chest pain |
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Hypertension |
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Hypotension |
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Palpitation |
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Smoking |
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Bronchitis |
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Asthma |
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COPD |
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COVID |
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Incontinence |
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Nocturia |
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UTI |
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Retention |
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Urgency |
