Addiction Counseling


Assessment of addictions is frequently complicated by the presence of
other mental health issues. In our course, the term used for this
phenomenon is co-occurring disorders. Scholarly literature may also
refer to the combination of addiction and mental health issues as dual
diagnosis (Lewis, 2014). This concept will be an integral part of your
Assessment of Addiction and Co-occurring Disorders assignment in Unit
5. The assessment of addiction depends upon the definition that was
established in Unit 3 and will build upon knowledge of assessment of
mental health issues.
Assessment forms the basis of treatment planning. An accurate
assessment of both addiction and co-occurring disorders supports the
level of care and treatment approaches selected. Assessments can
include clinical interviews with the client and structured assessment
tools such as those outlined in Table 4.1 of the course text (Lewis,
2014, pp. 61–62). Each type of assessment has limitations in the
accuracy of the data gathered, whether this is due to the client’s
ability or willingness to provide an accurate reflection of his or her
use or whether the assessment tool has inherent limits in its
reliability and validity. By considering both types of assessment and
any opportunities for collecting data from family or other relevant
sources, the data can suggest important patterns that could help
support an assessment of the level of severity.
Lewis, T. (2014). Substance abuse and addiction treatment: Practical
application of counseling theory. Upper Saddle River, NJ: Pearson.
To successfully complete this learning unit, you will be expected to:
1. Apply diagnostic criteria using the current DSM to assess patterns
of substance use addictive behaviors.
2. Apply current American Society of Addiction Medicine (ASAM)
criteria for levels of care.

Learning Activities Studies
Use your Substance Abuse and Addiction Treatment text to read the
• Chapter 4, “Assessment, Diagnosis, and Treatment Planning,” pages
Use the library to read the following section of the DSM–5:
• Substance-Related and Addictive Disorders, pages 481–589.

Internet Readings
Click the links below to complete the following from the Substance
Abuse and Mental Health Services Administration, Center for Substance
Abuse Treatment (SAMHSA/CSAT):
• In Substance Abuse: Clinical Issues in Intensive Outpatient
Treatment (Treatment Improvement Protocol [TIP] Series, No. 47), read
Chapter 3. “Intensive Outpatient Treatment and the Continuum of Care.”
• In Substance Abuse Treatment for Persons with Co-occurring
Disorders (Treatment Improvement Protocol [TIP] Series, No. 42), read:

o Chapter 4: “Assessment.”
o Appendix H: “Screening Instruments.”

Unit 4 Discussion 1: 1 page needed with minimum of 250 words and 2
DSM-5 and Diagnosis
Review a specific addiction listed in the DSM-5 and address what the
relevant differential diagnosis would need to rule out. Note what
assessments are needed to rule out other mental health or medical
disorders that might be present with similar concerns or symptoms.
What assessments would help support determining the level of severity?

Unit 4 Discussion 2: 1 page needed with minimum of 250 words and 2
Comparing Assessment Tools for Addiction
Using the Case of Michael presented in the Lewis text (on pages
10–12), evaluate a substance abuse screening assessment tool listed
in the CSAT TIP 42, Appendix H: “Screening Instruments.” How would
that tool provide useful information to help assess the appropriate
level of care according to the American Society of Addiction Medicine
(ASAM) criteria? (See CSAT TIP 47, Chapter 3: “Intensive Outpatient
Treatment and the Continuum of Care.”) What would need to be
considered in using the selected assessment if Michael was not born in
the United States and only had a limited command of English?


Co-occurring disorders usually have symptoms that predate the other. The co-occurring conditions tend to exacerbate the other, making accurate diagnosis difficult.  It is impossible to extricate the symptoms that are caused by one symptom from the other. In such cases, ruling out differential diagnosis is important to understand the exact cause of the condition. A good example is alcoholism and depression (Duric, Clayton, Leong& Yuan, 2016). These two conditions tend to occur making it difficult to know whether the clientis suffering from Alcohol Use Disorder (AUD) or Major Depression Depressive Disorder. In the diagnosis of Major Depressive Disorder, the symptoms of the condition should be confirmed if they are not attributed to substance abuse like alcoholism.