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S.M.A.R.T. Treatment Planning

A look at how the S.M.A.R.T. Treatment Planning products were created illustrates the close cooperation required by the Blending Initiative. The initiative brings together researchers supported by the National Institute on Drug Abuse (NIDA) and trainers from SAMHSA’s Addiction Technology Transfer Centers (ATTCs) to get research findings into the hands of practitioners.

With NIDA support, researcher A. Thomas McLellan, Ph.D., founder and Chief Executive Officer of the Treatment Research Institute (TRI) in Philadelphia, PA, and his colleagues developed the Addiction Severity Index (ASI) in 1980. The ASI helps addiction counselors systematically collect information about seven areas of patients’ lives, including alcohol and drug use, medical and psychiatric problems, employment, legal issues, and family and social relationships.

In addition to giving clinicians a framework for gathering information about all aspects of a client’s life, the ASI also provides objective data that both clinicians and researchers can readily understand.

“The substance abuse field has never had something like a blood pressure rating, where you could say, ‘This client is 130 over 80,’ ” explained Deni Carise, Ph.D., TRI’s Director of Treatment Systems Research. “We basically had descriptive things like, ‘This person drinks far too much,’ or ‘This person drinks a lot,’ or ‘This person’s a heavy drinker.’ You can’t tell which person drinks more than the others.”

By now, most clinicians use the ASI to assess substance use treatment disorders. Yet these professionals don’t always make the most of the data generated by the tool, viewing it merely as required paperwork. “People often do the assessment, throw it in the chart, and close the file,” said Dr. Carise.

The ASI Blending Team hopes to make the assessment tool more broadly accessible and understandable, so that it can be used to maximum advantage. The team consists of Dr. McLellan, Dr. Carise, and Meghan Love on the science side and three ATTC representatives on the technology-transfer side.

Aimed at addiction counselors and their supervisors, the S.M.A.R.T. Treatment Planning curriculum explains how to use the ASI for clinical purposes, and in particular, treatment planning. “The curriculum walks people through the process of collecting information about patients’ problems and then using that information as the building blocks of a treatment plan,” explained ASI Blending Team Chair Richard T. Spence, Ph.D., Director of the Gulf Coast ATTC in Austin, TX.

After developing and piloting the curriculum, the blending team conducted a “training of trainers” session. The ATTCs are now developing a cadre of trainers who can offer the training, said Dr. Spence, noting that the ATTC national office maintains a list of available trainers around the country.

The curriculum for S.M.A.R.T. Treatment Planning: Utilizing the Addiction Severity Index (ASI): Making Required Data Collection Useful can be accessed at www.nattc.org/aboutUs/blendingInitiative/
blendingteams.htm#asi.