e centre research - amis dusi-r presentation june 2014

Dr. Steve WeatherbeeeCenter Research

steve@ecenterresearch.com

Financial contribution fromAvec le financement de

Key System Benefits

Increase organizational efficiency

Target treatment to client needs

Monitor client progress

Improve care coordination

Monitor program effectiveness

Generate quarterly/annual reports

Increase Organizational Efficiency

Common system functions

Web based anytime access/any device

One source record for each client

Common client information

Consistent format of information

Customize to meet Centre data needs

Target Treatment to Client Needs

Standardized intake protocol

Validated multivariate assessment

Mental health and addiction combined

Culturally relevant (adaptation in progress)

Treatment Planning Tool (coming soon)

Monitor Client Progress

Follow up assessment

Progress monitoring reports

Case notes / Client files

Adapt treatment plan / review impact

After care monitoring

Improve Care Coordination

Common referral process

Electronic sharing of key information

Transfer/sharing of client records

Continuity of care (inpatient-outpatient-aftercare)

Early detection of relapse

Monitor Program Effectiveness

Aggregate client outcomes data

Real-time reporting

Advanced filtering

Guide improvement decisions

Generate Quarterly/Annual Reports

Real-time analytics

Instant report generation

Accommodate different funding sources

AMIS System Navigation

AMIS Design - Flexible

Support - HelpDesk

Menus - Tools

Tabs - Grids - Action buttons

Advanced Reporting – Filters

AMIS System Demo

Client records – demographics-settings

Assessments - Forms - Reports

Referral functions

Monitoring client progress

Reviewing program effectiveness

Location settings

Instant quarterly and annual reports

Drug Use Screening Inventory (DUSI-R)

STEP 1 STEP 2 STEP 3

DQS

SHORTFORM

DUSI-R

3 Minutes 7 Minutes 20 Minutes

TIME

RESOURCES MANAGEMENT

The DUSI-R Quick Screen (DQS)

• Three age-versions of the DUSI-R Quick Screen severity of substance use AND RELATED PROBLEMS during early, middle and late adolescence.

Two Indexes

• Substance Use Involvement Index and

• Problem severity Index

Substance Use Involvement Index

Problem Severity Index

DQS Instant Screening Results

Drug Use Screening Inventory (DUSI-R)

Basic Scales (problem severity 0 – 100%)

Substance Use Family System

Behavior Problems School Performance

Health Status Work Adjustment

Psychiatric Disturbance Peer Affiliation

Social Skills Leisure/Recreation

Drug Use Screening Inventory

Overall Problem Density Score 0-100%

+6 Ancillary Scales• Anxiety• Depression• ADHD• SUD• CD• Violence Proneness

DOMAIN 1ASubstance Topology

• Type of Substances

• Frequency

DOMAIN 1BSubstance Use Consequences

• Motivation (craving) (1)

• Tolerance (2)

• Loss of Control (3,16)

• Social Disruption (6,24)

– Legal

– Injury

– Emotion

• Dependence (12, 18)

DOMAIN 2Behavior Patterns

• Dysregulation (28,23,25,28,29,30,31)

• Social isolation (26,34,35)

• Interpersonal hypersensivity

– Anger (17,27)

– Aggression (19,20,27,32)

DOMAIN 3Health Status

Frequent health problems associated with

substance use and psychiatric disorder

• Disease (46,47)

•Injury (39)

•Illness (41,42,43,44,46,47)

•HIV Risk (45)

DOMAIN 4Mental Health Disorder

• Antisociality (49,50,51)

• ADHD (52,53,54,55)

• Affect (D&A) (56-64, 67)

• Paranoia (63-66)

• Mania (68)

DOMAIN 5Social Competence

• Relationship formation (71,72,73,77,82,83)

• Assertive (73,74,79)

• Help seeking (75)

• Refusal (76,80)

• Compliment acceptance (81)

DOMAIN 6Family System

• Substance use (55,86)

• Antisociality (87)

• Dyadic interactions quality (Dysfunction)

• Conflict (88,93)

• Cohesion (89)

• Engagement/investment (90,92,94,95,96,97)

• Boundaries/rules (91)

• Threats (98)

DOMAIN 7School Problems

• Likes school (100)

• Performance/grades (101,102,103,104)

• Compliance (103,106,108,112,118)

• Adjustment (110,111,119)

• Dropout risk (105)

• Perceived danger (113)

DOMAIN 8Work Adjustment

• Firing (122, 125, 128)

• Interpersonal Adjustment (121,124,127,129)

• Job seeking skills (125)

• Illegal Work (126)

DOMAIN 9Peer Relationships

• Peer drug use/dealing (132,133,139,140)

• Non-drug antisociality (134,136,138,141)

• Older friends (137)

• Gang (142)

• Adjustment problems (143,144,145)

DOMAIN 10Leisure and Recreation

• Active activities (147,151,158)

• Passive activities (149,152)

• Adult supervision (148,150)

• Boredom (153)

• Solitary activity (154,156)

Why use the DUSI-R?

1. Comprehensive

• 16 scales

2. Efficient

• 20 minutes to administer, and immediate automatic scoring

3. Pragmatic

• measures problems that can be resolved

4. Ranks Problems Severity on a Common Metric of 0-100%

• intervention can be tailored to the magnitude of each problem

5. Improves Staff Decision Making

• Treatment plan, monitor change, relapse prevention

Why use the DUSI-R?

6. Resources Management

• Informs resource needed for prevention and treatment

7. Outcomes Monitoring

• Tracking client’s progress

8. Program Evaluation

• Document magnitude of benefit and cost-effectiveness.

9. Client Motivation/Engagement

• Form partnership with client to catalyze empowerment

10. Brief, Short, and Full Versions are available

Prioritizing Intervention Modalities

Monitoring Patient Response to Tx

Patient Response to Tx

Tx Plan Adaptation –

Changing Needs/Priorities

Post–Treatment Gains Sustained,

Monitor Risk for Relapse

Population Profile – Multivariate

Needs

Population Profile – Substance Use

Population Profile –

Substance Use Reduction

Population Profile – Mental Health

Population Profile – Adverse

Outcomes

Population Profile – Reduction of

Likelihood of Disorder by age 19, 22

Population Profile – Reduction of Risk

for Adverse Outcomes

Through technology,

patient-centered clinical practice

and case management are

efficiently coordinated

by the DUSI-R

Publications

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deviation in temperament traits. British Journal of Addictions, 85, 1501-1504.

Tarter, R. & Hegedus, A.M. (1991). The Drug Use Screening Inventory: Its application in the evaluation and treatment of alcohol and

drug abuse. Alcohol Health and Research World, 15, 65-75.

Tarter, R., Laird, S., & Bukstein, O. (1991). Multivariate comparison of adolescent offspring of substance abuse parents: Community

and treatment samples. Journal of Substance Abuse, 3, 301-306

Tarter, R.E. (1991). Prevention of Drug Abuse: Theory and Application. The American Journal on Addictions, 1(1), 2-20.

Tarter, R., Moss, H., Arria, A., & Mezzich, A., Vanyukov, M. (1992). Psychiatric diagnosis of alcoholism: Critique and reformulation.

Alcoholism: Clinical and Experimental Research, 16, 106-116.

Mezzich, A., Tarter, R., Hsieh-Y-C, & Fuhrman, A. (1992). Substance abuse in female adolescents: Association between age of

menarche and chronological age. The American Journal on Addictions, 1, 217-221.

Tarter, R., Laird, S., Bukstein, O., & Kaminer, Y. (1992). Validation of the adolescent Drug Use Screening Inventory: Preliminary

Findings. Psychology of Addictive Behaviors, 6, 233-236.

Mezzich, A., Tarter, R., Kirisci, L., Clark, D., Bukstein, O., & Martin, C. (1993). Subtypes of early age onset alcoholism. Alcoholism:

Clinical and Experimental Research, 17, 767-770.

Tarter, R., Kirisci, L., Hegedus, A., Mezzich, A., & Vanyukov, M. (1994). Heterogeneity of adolescent alcoholism. Annals of the New

York Academy of Sciences, 708, 172-180.

Tarter, R. (1994). Rediscovering opportunities in the emerging health services environment. Journal of Clinical Psychology, 50,

111-113.

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Counseling, Vol. 1, Lesson 1, Professional Achievement Services.

Mezzich, A., Tarter, R., Hsieh, H-C, & Moss, H. (1994). Platelet Monoamine Oxidase and temperament and personality in adolescent

female substance abusers. Personality and Individual Differences, 16, 417-424.

Tarter, R., & Vanyukov, M. (1994). Alcoholism: A developmental disorder. Journal of Consulting & Clinical Psychology, 62, 1096-

1107.

Tarter, R., Mezzich, A., Kirisci, L., & Kaczynksi, N. (1994). Reliability of the Drug Use Screening Inventory among adolescent

alcoholics. Journal of Adolescent Substance Abuse, 3, 25-36.

Kirisci, L., Tarter, R., Tse-Chi, H. (1994). Fitting a two-parameter logistic item response model to clarify the psychometric properties of

the drug use screening inventory for adolescent alcohol and drug abuse. Alcoholism: Clinical and Experimental Research, 18,

1335-1341.

Mezzich, A., Moss, H., Tarter, R., Wolfenstein, M., Hsieh, Y-C, & Mauss, R. (1994). Gender differences in the pattern and progression

of substance abuse in conduct disordered adolescents. American Journal on Addictions, 3, 289-295.

Tarter, R., Mezzich, A., Hsieh, Y-C, & parks, M. (1995). Cognitive capacities in female adolescent substance abusers: Association with

severity of drug abuse. Drug and Alcohol Dependence, 39, 15-21.

Mezzich, A., Tarter, R., Kirisci, L., Hsieh, Y-C., & Grimm, M. (1995). Coping capacity in female adolescent substance abusers.

Addictive Behaviors, 20, 181-185.

Tarter, R. (1995). Genetics and primary prevention of drug and alcohol abuse. The International Journal of Addictions, 30, 1479-

1484.

Tarter, R. (1995). Rationale and Method of Client-Treatment Matching. The Counselor.

Kirisci, L., Mezzich, A., Tarter, R. (1995). Norms and sensitivity of the Adolescent Version of the Drug Use Screening Inventory.

Addictive Behaviors, 20, 149-157.

Tarter, R., Mezzich, A., Hsieh, Y-C, & parks, M. (1995). Cognitive capacities in female adolescent substance abusers: Association with

severity of drug abuse. Drug and Alcohol Dependence, 39, 15-21.

Mezzich, A., Tarter, R., Kirisci, L., Hsieh, Y-C., & Grimm, M. (1995). Coping capacity in female adolescent substance abusers.

Addictive Behaviors, 20, 181-185.

Tarter, R. (1995). Genetics and primary prevention of drug and alcohol abuse. The International Journal of Addictions, 30, 1479-

1484.

Tarter, R. (1995). Rationale and Method of Client-Treatment Matching. The Counselor.

Tarter, R., Kirisci, L., & Mezzich, A. (1996). The Drug Use Screening Inventory: School Adjustment Correlates of Substance Abuse.

Measurement and Evaluation in Counseling and Development, 29, 25-34.

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Tarter, R., & Kirisci, L. (1997). The Drug Use Screening Inventory for Adults: Psychometric Structure and Discriminative Sensitivity.

American Journal of Drug and Alcohol Abuse, 23, 207-219.

Tarter, R., & Kirisci, L. (1997). Multivariate typology of adolescents with alcohol use disorder. American Journal on Addictions, 6,

150-158.

Tarter, R., Kirisci, L., & Clark, D. (1997). Alcohol Use Disorder Among Adolescents: Impact of paternal alcoholism on drinking behavior,

drinking motivation and consequences. Alcoholism: Clinical and Experimental Research, 21, 171-178.

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Argentina adolescents: sex heterogeneity and familial transmission. Drug and Alcohol Dependence, 52, 221-230.

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(DUSI). Addictive Behaviors, 25(5), 683-691.

Tarter, R., & Kirisci, L. (2001). Validity of the Drug Use Screening Inventory for predicting DSM-III-R substance use disorder. Journal

of Child and Adolescent Substance Abuse, 10, 45-53.

Tarter, R., Kirisci, L., Vanyukov, M., Cornelius, J., Pajer, K., Shoal, G., & Giancola, P. (2002). Predicting Adolescent Violence: Impact

of Family History, Substance Use, Psychiatric History, and Social Adjustment. American Journal of Psychiatry, 159, 1541-1547.

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Masters of Health Sciences, Auckland University, Auckland, New Zealand.

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Central American and the Dominican Republic. Rev Panam Salud Publica, 11(2), 76-82.

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adolescents. Addictive Behaviors, 28, 1419-1429.

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community twin sample. Twin Research, 6, 490-496.

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childhood predicts early age onset of substance use disorder. American Journal of Psychiatry, 160, 1078-1085.

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Rican adolescents. Drug and Alcohol Dependence, 76, 37-44.

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adolescent sample. Addictive Behaviors, 29, 627-638.

Tarter, R., Kirisci, L., Habeych, M., Reynolds, M., & Vanyukov, M. (2004). Neurobehavior disinhibition in childhood predisposes boys to

substance use disorder by young adulthood: direct and mediated etiologic pathways. Drug and Alcohol Dependence, 73, 121-132.

Kirisci, L., Vanyukov, M., & Tarter, R. (2005). Detection of youth at high risk for substance use disorder: A Longitudinal Study.

Psychology of Addictive Behaviors, 19, 243-252.

Tarter, R., Vanyukov, M., Kirisci, L., Reynolds, M., & Clark, D. (2006). Predictors of marijuana use in adolescents before and after licit

drug use. Examination of the gateway hypothesis. American Journal of Psychiatry, 163, 2134-2140.

Tarter, R., Kirisci, L., Feske, U., & Vanyukov, M. (2007). Modeling the pathways linking childhood hyperactivity and substance use

disorder in young adulthood. Psychology of Addictive Behaviors, 21, 266-271.

Kirisci, L., Tarter, R., Mezzich, A., & Reynolds, M. (2008). Screening current and future diagnosis of psychiatric disorder using the

revised Drug Use Screening Inventory. American Journal of Drug and Alcohol Abuse, 34, 653-665.

Kirisci, L., Tarter, R., & Reynolds, M. (2009). The Violence Proneness Scale predicts outcomes associated with substance abuse.

American Journal on Addictions, 18, 173-177

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Screening Inventory in a Brazillian sample of adolescents. American Journal of Addictions, 19, 364-367.

Kirisci, L., Reynolds, M., & Tarter, R. (2013). Quick screen to detect current substance use disorder in adolescents and likelihood of

disorder. Drug and Alcohol Dependence, 128, 116-122.