1. As an Assignment for Relapse Prevention and Intervention
Treatment Plan:
David Schmidt
SueAnn Land
3/1/2013
Instructor: Stephanie Kehoe

2. TABLE OF CONTENTS
Scenario .................................................................................................... 1
Statement of the Problem ....................................................................... 2
Short-Term Objectives ........................................................................... 3
Long-Term Objectives ............................................................................ 6
Measurement Criteria............................................................................. 8
Target Dates ........................................................................................... 11
Relapse Prevention Strategies .............................................................. 13
Support Groups ....................................................................................................................................... 13
Behavioural Interventions ....................................................................................................................... 13
Cognitive Interventions ........................................................................................................................... 13
Medications ............................................................................................................................................. 15
Skills Training ......................................................................................................................................... 15
Counselling ............................................................................................................................................. 16
Action Plans ............................................................................................................................................ 18
Homework ............................................................................................................................................... 19
Self-Monitoring Goal Setting .................................................................................................................. 20
Schedule of Completed ADAT Questionnaires .................................. 21
Scoring the BASIS-32 .............................................................................................................................. 23
Scoring the Drug Taking Confidence Questionnaire (DTCQ) for Alcohol and Drugs .......................... 24
Scoring the Perceived Social Support (PSS)........................................................................................... 25
Bibliography........................................................................................... 26

3. Scenario
David Schmidt is a 38 year old male who is originally from Hazleton,
Pennsylvania. He is a Canadian citizen, and he relinquished his U.S.
citizenship in 2002. David is a university graduate with a Bachelor’s Degree
in English. In 2000, he was a journalist writing for the Outer Banks Sentinel,
a local newspaper in Manteo, North Carolina when he signed up to cover a
local carnival and its inhabitants. During his time researching as an active
employee of the carnival, he encountered a female named “Torchy” who was
a methamphetamine addict, using intravenously. They formed a romantic
relationship and he began to use “recreationally” with her. Torchy died of an
overdose on 3/26/2006. From that point, David said he went downhill.
He was brought into the Withdrawal Management Site (Detox) by the
Sudbury Regional Police on 12/19/2012 because he was intoxicated on
alcohol and found to be wandering in Bell Park, reported by a concerned
jogger. When confronted, David initially said he was looking for ducks to
feed (it was -28° outside that day); and then admitted that he had nowhere to
go and had been visiting a friend who no longer wished him to return to their
place of residence. He was cooperative with the police and there are no
further legal issues as he came of his own volition.
During the initial interview, David admitted that he also used “crystal” and
lifted his sleeves to show the track marks. He appeared exhausted and stated
that he wanted to “crash here for a bit” and then discuss his treatment options.
He was admitted to treatment the same evening.
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4. Statement of the Problem
David is currently homeless and has no relatives or friends in Sudbury
with which to stay. He did not sleep for the first two days of detox.
Finally, he slept for approximately 12 hours. On the third evening of
detox he was noticed to be conversing with himself and he began to
“spar” boxing-style with an unknown, unseen person. He was agitated
and claimed that this person, “Charles” was watching him. He would
not specify why. It was agreed by the staff that a psychiatric consult
would be wise as the behaviour could be either methamphetamine-
induced psychosis while in withdrawal or possibly an unknown mental
illness. Methamphetamine addicts often report hearing voices and have
other types of hallucinations. (Hanson & Fleming, 2013)
David will be given the CAGE, MAST, and ADAT questionnaires
over the next two weeks. We will research to see if there is a psychiatric
issue and if there is what treatment facility will be available with the
appropriate staff to address both the addiction and the mental illness.
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5. Short-Term Objectives
CAGE/MAST and ADAT Questionnaires
The CAGE and MAST questionnaires were completed on 12/20/12.
Both indicated that David has alcohol dependence. Because of the
incident on the 22nd, we are requesting that David undergo a
psychiatric assessment before further assessment. The holidays are
preventing that happening until the 26th.
Appointment on 12/26/2012 at Kirkwood with Dr. Soloman Nisaa.
David’s appointment revealed that he has had paranoid ideations
long before the use of methamphetamine. He spoke of entering the
military at age 19 (1993) and being “voluntarily released” during boot
camp. He was training and became convinced that the other soldiers
in his troop had turned against him and were “hunting” him. He made
references to the video game, “The Third World War” (Wikipedia, 2012)
and began calling them by nicknames he associated with his video and
on-line playing group. He was interviewed by the staff psychiatrist
and it was advised that he seek treatment. He declined at that time
(1993) and there was not sufficient cause to hold him against his will.
He was released from military service, instead.
Dr. Nisaa prescribed a beginning dosage of Geodon (Ziprasidone) at
20 mgs. twice a day with food. (NIH Publication No. 08-3929, Revised 2008)
David was given an initial intramuscular dosage of Geodon on
12/22/12 at the emergency room at Health Sciences North.
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6. (Micromedex™, Cerner Multum™, Wolters Kluwer™ and others, 2013) The drug did
not show any adverse side effects and was prescribed as initial
treatment for schizophrenia. David is scheduled for on-going weekly
appointments with Dr. Nisaa until he finds residential treatment.
Group Therapy
David has been participating in group at the detox and initially he
was a reluctant participant – very quiet and shy. It was noted that he
was a carnival barker in his addiction. He said that the psychotic
episode on 12/22/12 scared him quite a bit. David expressed anger
several days during group therapy and would often isolate afterward.
Anger management was recommended.
Anger Management
David has been an active participant in the Anger Management
course offered the week of 12/31/12–1/4/13. He came to class
prepared with his homework. During anger management, he said that
his head hurt and frequently got headaches. At the time, it was
thought to be acute withdrawal and possibly emotional symptoms.
David’s blood pressure was taken and it was 150/95. At this time it
was inconclusive as to whether the new dosage of Geodon was
responsible. He will be examined again by Dr. Nisaa on 12/28/12 to
determine if he is not reacting well to the Geodon. (Micromedex™, Cerner
Multum™, Wolters Kluwer™ and others, 2013)
David’s anger issues began in early childhood with a physically,
emotionally and verbally abusive parent (father). They carried over
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7. into his relationships with women, most notably Torchy. David talked
about physically abusing her and expressed guilt and remorse. He had
to leave the group on the afternoon of 1/2/2013 because he was
overcome with emotion. David met with an individual counsellor at
that time.
Early Psychosis Intervention Program
David was not eligible for the Early Psychosis Intervention Program
at Health Sciences North because he was 38 years old. The program
is for the ages of 16-35 years old. (Health Sciences North, 2011)
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8. Long-Term Objectives
AA/NA Groups
David attended Alcoholics Anonymous and Narcotics Anonymous
meetings while he was in treatment both on-site and off-site. He
found a temporary sponsor and began to work, immediately, on the
first three steps admitting powerlessness, recognizing the insanity of
addiction, and beginning the process of faith in power greater than
himself. It is recommended that he continue in a 12-step program –
whether that is AA or NA.
Treatment at Homewood
David was accepted into treatment at Homewood on January 7,
2013. He was entered into the IMAP (Integrated Mood and Anxiety
Program) and will be treated for a period of 8 weeks. Per their
request, he was sent with a 21-day supply of both Geodon and
Lisinopril. (Homewood Health Centre, 2012) His medications will be
monitored by staff. David’s stay is in a ward bed provided by OHIP.
Upon release, David has agreed that his medical records will be made
available to the community health team responsible for monitoring his
medications and continuing education/relapse prevention. (Homewood
Health Centre, 2012)
Concurrent Disorders Program
David’s projected discharge date from Homewood is March 4,
2013. He said that he wants to return to Sudbury. Because the
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9. Concurrent Disorders service is for discharge planning and transitional
case management for patients from Sudbury, they will be the ones
doing the follow up treatment for David. (Health Sciences North, 2011)
ACTT I and ACTT II
There is a possibility that David will be referred to either the ACTI
or the ACTII team upon the determination of the Concurrent
Disorders Clinic. Usually, ACTT I and ACTT II are reserved for
patients who require “client-centered highly individualized treatment,
support and rehabilitation to people suffering from schizophrenia,
schizo-affective or bipolar illness. The individuals served are adults
(16 years or older) with the highest intensity of need due to complex,
long-term, persistent symptoms.” (Health Sciences North, 2011)
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10. Measurement Criteria
David’s MAST Test is recorded here and his comments are listed and
italicized. They were handwritten on the original.
The MAST Test (About.com, 2013)
Patient Name: David Schmidt Date: 12/20/2012
Counsellor Name: SueAnn Land Program #: 888
The MAST Test is a simple, self-scoring test that helps assess if you have a drinking problem.
Answer yes or no to the following questions:
1. Do you feel you are a normal drinker? ("normal" is defined as drinking as much or less than
most other people)
___ Yes _X_ No
2. Have you ever awakened the morning after drinking the night before and found that you could
not remember a part of the evening?
_X_ Yes ___ No
3. Does any near relative or close friend ever worry or complain about your drinking?
___ Yes _X_ No (I don’t have any close friends anymore.)
4. Can you stop drinking without difficulty after one or two drinks?
_X_ Yes ___ No (I didn’t have problems with the alcohol as much as I did with the crystal.)
5. Do you ever feel guilty about your drinking?
___ Yes _X_ No (The only one I’m hurting is me, right?)
6. Have you ever attended a meeting of Alcoholics Anonymous (AA)?
___ Yes _X_ No (I think AA is a con job for Jesus.)
7. Have you ever gotten into physical fights when drinking?
_X_ Yes ___ No
8. Has drinking ever created problems between you and a near relative or close friend?
___ Yes _X_ No (Like I said, no friends…no problem.)
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11. 9. Has any family member or close friend gone to anyone for help about your drinking?
___ Yes _X_ No
10. Have you ever lost friends because of your drinking?
___ Yes _X_ No (Okay… maybe a yes.)
11. Have you ever gotten into trouble at work because of drinking?
_X_ Yes ___ No (I got fired from the Show for being passed out when it opened.)
12. Have you ever lost a job because of drinking?
_X_ Yes ___ No (See above.)
13. Have you ever neglected your obligations, family, or work for two or more days in a row
because you were drinking?
_X_ Yes ___ No (Isn’t this the same question?)
14. Do you drink before noon fairly often?
___ Yes _X_ No (I’m still asleep, if I’m sleeping.)
15. Have you ever been told you have liver trouble, such as cirrhosis?
___ Yes _X_ No
16. After heavy drinking, have you ever had delirium tremens (DTs), severe shaking, visual or
auditory (hearing) hallucinations?
_X_ Yes ___ No (I hear things all the time, especially when Buddy is around. He doesn’t
know when to shut up.)
17. Have you ever gone to anyone for help about your drinking?
___ Yes _X_ No
18. Have you ever been hospitalized because of drinking?
___ Yes _X_ No
19. Has your drinking ever resulted in your being hospitalized in a psychiatric ward?
___ Yes _X_ No (I am NOT crazy, I just have a problem with bumping crystal.)
20. Have you ever gone to any doctor, social worker, clergyman, or mental health clinic for help
with any emotional problem in which drinking was part of the problem?
_X_ Yes ___ No (I went to a Padre one time when we were in Kearney, New Jersey. He
was cool.)
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12. 21. Have you been arrested more than once for driving under the influence of alcohol?
___ Yes _X_ No (Never been arrested; but the cops brought me here.)
22. Have you ever been arrested, or detained by an official for a few hours, because of other
behaviour while drinking?
_X_ Yes ___ No (See above.)
Scoring the MAST Test
Score one point if you answered "no" to the following questions: 1 or 4. Score one point if you
answered "yes" to the following questions: 2, 3, 5 through 22. A total score of six or more
indicates hazardous drinking or alcohol dependence and further evaluation by a healthcare
professional is recommended.
David scored a 9 on his MAST test, indicating a drinking dependence.
The CAGE Questionnaire (Mulhauser, 2012)
Patient Name: David Schmidt Date: 12/20/2012
Counsellor Name: SueAnn Land Program #: 888
1. Have you ever felt you should cut down on your drinking?
_X_ Yes ___ No
2. Have people annoyed you by criticising your drinking?
_X_ Yes ___ No
3. Have you ever felt bad or guilty about your drinking?
_X_ Yes ___ No
4. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a
hangover (eye-opener)?
___ Yes _X_ No
Two “yes” responses indicate that the possibility of alcoholism should be investigated further.
David had three “yes” responses on his CAGE questionnaire,
indicating a drinking dependence.
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13. Target Dates
Date Treatment Event Comments
December 19, 2012 Entered Detox Brought by Sudbury
Regional Police. No
charges pending.
December 20, 2012 CAGE & MAST Alcohol dependence
questionnaires recognized
completed
December 22, 2012 Clinical Notes – Possible psychotic
Patient Health episode. Referred to Dr.
Concern Solomon Nisaa. Seen at
ER and given Geodon.
December 23-24, 48-Hour Psychiatric Observation – Gonorrhoea
2012 Hold at Health was discovered and
Sciences North – treated.
Kirkwood Site
December 25, 2012 Detox Client released back to
Withdrawal Management
Services
December 26, 2012 Psychiatric Appt. Appt. with Dr. Nisaa.
Was confirmed that
episode on 12/22/12 was
not singular. Possible
schizophrenia.
December 27, 2012 Begins Group Group Therapy at Detox
Therapy
December 28, 2012 HSF, PSS, TEQ, AC, Forms have been
DTCQ-8 (for alcohol completed and are
and drugs), DHQ, attached.
BASIS-32 and
SOCRATES
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14. Date Treatment Event Comments
December 28, 2012 Psychiatric Consult Appt. with Dr. Nisaa to
see if headache was
associated with Geodon.
High blood pressure
diagnosed and medicated
with 5 mgs. of Lisinopril
daily.
December 29, 2012 Clinical Profile Form Form has been completed
and is attached.
Week of December Anger Management Attended
31, 2012 through
January 4, 2013
January 7, 2013 Homewood Entry into Residential
Treatment
March 4, 2013 Projected Date of End of the 8-Week
Release from Treatment at IMAP
Homewood
March 5, 2013 Concurrent Disorders Treatment Plan to be
Clinic continued under the care
of Health Sciences North
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15. Relapse Prevention Strategies
Support Groups
David reported that he enjoyed the Saturday 10:30 a.m. AA
meeting at the Kirkwood site. While this is an institutional meeting,
and considered to be a Special Interest Group in AA, it is serving for
the time being as a temporary home group for David. It is
recommended for him to begin the 90 meetings in 90 days process
when he is released from treatment.
David has declined to find an NA group stating that he found his
comfort level in AA, even with the addiction to methamphetamine.
This concerned staff a bit – but it is his decision. It was recommended
that if it becomes an issue, NA needs to be looked at again.
Behavioural Interventions
Staff feels that the week of Anger Management at the Withdrawal
Management Site and the week(s) of the related program at
Homewood will be sufficient for David at this time. Should any
aggression or behavioural problems be noted, he will be immediately
referred back into an anger management program as a requirement for
continuing care. This will be monitored by the Concurrent Disorders
Clinic.
Cognitive Interventions
David had several cognitive distortions. (Renee Spencer, 2010) One of
them was the repeated statement “I have no friends.” In that statement
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16. he was confirming to himself that he was not worthy of having
friends. We did cognitive restructuring with the substitution of the
words, “I am in the process of forming new friendships that will
benefit my recovery.” Another one was “I killed Torchy.” He
repeated that several times when he talked about Torchy’s overdose. I
asked him if he actually put the needle in her arm and gave her the
“bump.” He responded that he was not around at the time it happened
but that it was his supply or crystal that she used and that they had
been fighting at the time. We talked about this over the course of
several one-on-one and group sessions. He began to say, instead: “I
feel guilty that I wasn’t there when Torchy overdosed.” It is still a sad
statement, but it is more in line with what actually happens when
David speaks of her death. He is beginning to accept that Torchy’s
overdose was not his doing.
We have not worked on his on-going hallucinations of “Charles.”
The administration of Geodon is relatively new and I am deferring to
the psychiatrists to treat his diagnosed schizophrenia because I do not
feel anywhere near qualified to do anything other than acknowledge to
David that Charles is present and divert the conversation back to
David and what’s happening with David.
David also gets agitated when other people are “in his space.” He
does not like close human contact and it is because he feels threatened
by people. I asked him if he thinks that I am going to hurt him. He
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17. replied that he didn’t. I countered with, “do you suppose there are
others who would be near you and have no desire to harm you?” He
said, “They are not you” and we let the subject drop. I can’t tell if the
paranoia is feeding this statement; but I do not wish to agitate him
further.
He is beginning to understand that the cognitive distortion begins
with a negative statement and that he can replace it with a positive
statement. Further, that it is a part of the disease of addiction that
negative precedes positive and the behavioural modification is that he
consciously begins to differentiate the two before he opens his mouth
to speak.
Medications
Geodon 20 mgs. 2 times a day w/food (schizophrenia) –
prescribed on 12/22/12 and renewed on 12/26/12 by Dr. Soloman
Nisaa.
Lisinopril 5 mgs. 1 time a day (blood pressure) – began on
12/28/12 due to frequent headaches, prescribed by Dr. Soloman
Nisaa.
Skills Training
While at Homewood, David will participate in communication
skills, anger management; and leisure, lifestyle balance and
relationship workshops. He also has the choice to participate in
workshops for self-esteem, art therapy, psychodrama and process
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18. groups. There are also recreational and leisure activities. All of these
are small group settings (to avoid anxiety) and range from 6 to 12
participants. (Homewood Health Centre, 2013)
Counselling
To counsel David, I chose two methods. The Matrix Model,
because I felt that with David’s low self-esteem and paranoia, rather
than a confrontational approach, he needed to be nurtured and
coached. “Over 2,500 methamphetamine addicts have been treated
with The Matrix Model. The Matrix Model is an evidence-based
outpatient treatment program with over 20 years of research and
development. It is proven effective in the treatment of
methamphetamine addicts.” (Obert, Rawson, McCann, & Ling, 2013) I also
chose Supportive-Expressive Psychotherapy because David has issues
with interpersonal relationships with people and feels that he is “better
off” alone rather than with a group of friends or family to support him.
“Expressive Supportive Therapy incorporates three fundamental
approaches: emotional expression, social support and cognitive
management skills. Some of the features of supportive therapy are to
create a state of gratification in the session, relieve pressure on the
patient to talk, provide non-interpretive interventions, focus on
conscious processes, engage in structured problem solving, provide
guidance and advice, and offer praise.” (Deluca-Waack, 2004, p. 437)
SueAnn Land Page 16

19. The Matrix Model – Even though it is an outpatient treatment
plan, we began the therapy while David was inpatient in preparation
for his return to Sudbury and his discharge planning with the
Concurrent Disorders Team. I have included an example of a Matrix
session in the homework section of this treatment plan.
Supportive-Expressive Psychotherapy – We used supportive
listening in group sessions at detox. It was not a “hot-seat”
environment and the patients were allowed to express themselves
without criticism. When dissent occurred in the group, the patients
were encouraged to express themselves in “I feel” statements instead
of “you made me” statements. We discussed problem situations that
might lead them to relapse like people, places and things. Then we
discussed how to confront rather than avoid uncomfortable situations
like having to excuse yourself if someone was using around you or
offering you drugs or alcohol. We discussed the support of a 12-step
program and how to interact with fellow members. We talked about
relationships with the opposite (or same) sex and how to give yourself
the opportunity of “no, thank you.” Gratitude lists were introduced
and David’s list is included in his homework assignment section.
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20. Action Plans
Time Monday Tuesday Wednesday Thursday Friday Saturday Sunday
7-8 a.m. Hot Hot Hot Hot Hot Hot No
Breakfast Breakfast Breakfast Breakfast Breakfast Breakfast Breakfast
8:30 a.m. Group Alcoholism Group Addiction Group Hellos & Free Time
Therapy Education Therapy Education Therapy Goodbyes
9:45 a.m. Break Break Break Break Break Break Break
10 a.m. Nutritional Physician Yoga/ Psychiatric Tai Chi/ Art & Family
Workshop Appts. Aerobics Appts. Chi Dong Handiwork Time
Noon Lunch Lunch Lunch Lunch Lunch Lunch Lunch
12: 45 p.m. Break Break Break Break Break Break Break
1 p.m. Pet Group Music Group Small Walk at Family
Therapy Therapy Therapy Therapy Group Bell Park Time
Workshops
3 p.m. Home- ADAT Home-work ADAT Home-work Relapse Home-work
work CAGE Quiet time CAGE Quiet time Prevention Quiet time
Quiet time MAST MAST
Interviews Interviews
5:30 p.m. Supper Supper Supper Supper Supper Supper Supper
6:30 p.m. Break Break Break Break Break Break Break
7:00 p.m. AA NA AA NA AA NA AA
Meeting Meeting Meeting Meeting Meeting Meeting Meeting
On-Site On-Site On-Site On-Site Off-Site Off-Site On-Site
9 p.m. Free Time Spirituality Free Time Client Free Time Free After the
and Lead Time Family
Meditation Group Goes Home
Workshop Therapy Group
11 p.m. Lights out Lights out Lights out Lights out Lights out Lights out Lights out
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21. Homework
Gratitude List – by David Schmidt dated 1/29/2012
1. I am grateful that Charles is here with me because I am frightened.
2. I am grateful for my counsellor, SueAnn, because I can talk to her
and I don’t feel weird.
3. I am grateful for Dr. Nisaa because I don’t like him, particularly,
but I he talked with me about Charles and about seeing and hearing
things that other people don’t. He told me it is a part of my brain
chemistry and it can be controlled.
4. I am grateful not to have to find crystal.
5. I am grateful that the shakes are starting to go away.
Matrix Section Homework
Alcohol the Legal Drug Handout – completed 1/3/2013
Boredom Handout – completed 1/4/2013
Work & Recovery Handout – completed 1/4/2013
Be Smart, Not Strong Handout – completed 1/4/2013
The Matrix homework that David filled out can be found following
the completed ADAT forms at the end of this treatment plan.
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22. Self-Monitoring Goal Setting
“My counsellor told me that it was okay to dream and to begin to
build a life for myself without drugs and alcohol. At first I thought
she was kidding me and just trying to con me into something I may or
may not want to do. I mean, I wanted to quit using – but I didn’t
know if I wanted to stay sober. She explained to me that there is a
difference between dry and sober. Dry means I quit using and don’t
change anything else. Sober means I quit using and keep working
toward a healthier life. Healthier meaning that I need to go to AA
meetings, get a sponsor and work the steps. I’m a smart guy, I can
usually do things all by myself and it bothers me that I’ve gotten so
low that I have to ask for help and continue asking for help.
Truthfully, I just don’t know what else to do. This treatment plan they
have for me looks long. Eight weeks of treatment in Homewood –
that’s a long time. But I’ve been told that it’s a nice area and the
people are good. I won’t be “locked up.” I’m afraid about the
schizophrenia and I’ve never taken medication for it so I don’t know if
Charles will go away. He’s been with me for a long, long time. Even
before I started the crystal and lost Torchy. I don’t know if I want to
lose him too. We’ll see. I really like the AA meetings and the NA
meetings are okay, too, although I’ll probably just to go AA. SueAnn
says that I have to take it “one day a time” and for right now, I’m
willing to do that.” – David Schmidt (1/5/2013)
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23. Schedule of Completed ADAT Questionnaires
Form Date Score
Completed
Health Screening (HSF) 12/28/12 N/A
Treatment Entry Questionnaire (TEQ) 12/28/12 60
Personal Drinking Questionnaire 12/28/12 Recognition
(SOCRATES 8A) – 33
Ambivalence
–8
Taking Steps
– 33
Personal Drug Use Questionnaire 12/28/12 Recognition
(SOCRATES 8D) – 33
Ambivalence
–8
Taking Steps
– 34
SOCRATES-8 Profile Sheet 12/28/12 Recognition
– Medium
Ambivalence
– Very Low
Taking Steps
– Medium-
High
Psychoactive Drug History Questionnaire 12/28/12 N/A
(DHQ)
Behaviour and Symptom Identification 12/28/12 (See Page 22
Scale (BASIS-32) for scoring)
Adverse Consequences of Substance Use 12/28/12 N/A
(AC)
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24. Form Date Score
Completed
Drug Taking Confidence Questionnaire 12/28/12 300 total or
(DTCQ-8) for Alcohol 38% average
(See Page 23
for Detailed
Scoring)
Drug Taking Confidence Questionnaire 12/28/12 340 total or
(DTCQ-8) for Drugs 43% average
See Page 23
for Detailed
Scoring
Perceived Social Support (PSS) 12/28/12 Family – 1
Friends – 1
See Page 24
for Detailed
Scoring
Clinical Profile Form 12/28/12 N/A
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25. Scoring the BASIS-32
(AMHOCN, 2013)
Color
Question Answer Code
1 4 Relation to self/others
2 0 Items 7, 8, 10, 11, 12, 14,and 15
3 4 Score 3.7
4 0 Depression/anxiety
5 0 Items 6, 9, 17, 18, 19 and 20
6 4 Score 3.8
7 0 Daily living/role functioning
8 3 Items 1, (2, 3, 4*), 5, 13, 16, 21 and 32
9 4 Score 4.0
10 4 Impulsive/addictive behaviour
11 3 Items 25, 26, 28, 29, 30 and 31
12 4 Score 3.6
13 0 Psychosis
14 4 Items 22, 23, 24 and 27
15 4 Score 3.3
16 4 BASIS-32
17 4 Score 2.9
18 4
19 3 *highest # of these 3 answers
20 4
21 4
22 4
23 4
24 2
25 3
26 0
27 0
28 4
29 4
30 4
31 3
32 4
2.90625 Average
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26. Scoring the Drug Taking Confidence Questionnaire (DTCQ) for
Alcohol and Drugs
(Centre for Addiction and Mental Health, 2010, p. 156)
DTCQ-8 for Alcohol DTCQ-8 for Drugs
DTCQ-8 DTCQ=8
Alcohol Drugs
Question Score Question Score
1 0 1 0
2 0 2 100
3 60 3 40
4 0 4 0
5 0 5 20
6 40 6 80
7 100 7 100
8 100 8 0
Average 38 Average 43
Total 300 Total 340
120
DTCQ-8 Alcohol Score
DTCQ=8 Drugs Score
100
80
60
40
20
0
1 2 3 4 5 6 7 8
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27. Scoring the Perceived Social Support (PSS)
(Centre for Addiction and Mental Health, 2010, p. 187)
Family Question Score Key
Don't
1 Know 0 Yes
2 Yes 0 No
3 No 0 Yes
Don't
4 Know 0 Yes
5 No 0 Yes
6 No 0 Yes
7 No 1 No
Friends Question Score Key
Don't
1 Know 0 Yes
2 Yes 0 No
3 No 0 Yes
Don't
4 Know 0 Yes
Don't
5 Know 0 Yes
6 No 0 Yes
7 No 1 No
David insists that he no longer has any family or friends support and
he is quite alone in this world. It is my hope that he decides to revise
his answer later in treatment, if possible. At the time of this test,
12/29/12 – his answers are recorded. He has a score of 1 for family
and 1 for friends.
SueAnn Land Page 25

28. Bibliography
About.com. (2013). MAST Test - The Michigan Alcohol Screening Test: Measures Lifetime Drinking
Problems. Retrieved from About.com: http://alcoholism.about.com/od/tests/a/mast.htm
AMHOCN. (2013). Behavourial and Symptom Identification Scale (BASIS-32_. Retrieved from Australian
Mental Health Outcomes and Classification Network:
http://amhocn.org/static/files/assets/662692f0/Behavioural_and_Symptom_Identification_Scale.pdf
Centre for Addiction and Mental Health. (2010). Scoring the Drug Taking Confidence Questionnaire
(DTCQ). Retrieved from Admission and Discharge Criteria and Assessment Tools Manual (Revised):
http://www.camh.net/Publications/Resources_for_Professionals/ADAT/index.html
Centre for Addiction and Mental Health. (2010). Scoring the Perceived Social Support Form. Retrieved
from Admission ad Discharge Criteria and Assessment Tools Manual (Revised):
http://www.camh.net/Publications/Resources_for_Professionals/ADAT/index.html
Deluca-Waack, J. L. (Ed.). (2004). Handbook of Group Counselling and Psychotherapy. Thousand Oaks,
California: Sage Publications, Inc.
Hanson, D. G., & Fleming, P. (2013). Mental Illness: The Challenge of Dual Diagnosis. (S. L. Services,
Producer) Retrieved from http://learn.genetics.utah.edu/content/addiction/issues/mentalillness.html
Health Sciences North. (2011). ACTT I and ACTT II -- Psychosocial Research Team. Retrieved from Health
Sciences North: Mental Health & Addictions:
http://www.hsnsudbury.ca/portalen/ProgramsandServices/MentalHealthAddictions/tabid/560/Default.
aspx
Health Sciences North. (2011). Early Psychosis Intervention Program: Psychosocial Research Team.
Retrieved from Health Sciences North: Mental Health & Addictions:
http://www.hsnsudbury.ca/portalen/ProgramsandServices/MentalHealthAddictions/tabid/560/Default.
aspx
Health Sciences North. (2011). Mental Health & Addictions: Concurrent Disorders. Retrieved from Health
Sciences North:
http://www.hsnsudbury.ca/portalen/ProgramsandServices/MentalHealthAddictions/tabid/560/Default.
aspx
Homewood Health Centre. (2013). FAQ - Integrated Mood and Anxiety Program (IMAP). Retrieved from
Homewood Health Centre: http://homewood.org/programs-and-services/integrated-mood-and-
anxiety/frequently-asked-questions-imap
SueAnn Land Page 26

29. Homewood Health Centre. (2012, September). Planning for Your Stay at Homewood: An Admission
Booklet. Retrieved from Homewood Health Centre: http://homewood.org/wp-
content/uploads/2011/11/Admission-Booklet-Sept-2012.pdf
Homewood Health Centre. (2012, January 30). Statement of Information Practices. Retrieved from
Homewood Health Centre: http://homewood.org/wp-
content/uploads/2011/11/StatementOfInformationPractices.pdf
Micromedex™, Cerner Multum™, Wolters Kluwer™ and others. (2013, February). Drug Interactions
Between Geodon and Lisinopril. Retrieved from Drugs.com: http://www.drugs.com/drug-interactions/
Micromedex™, Cerner Multum™, Wolters Kluwer™ and others. (2013, February). Indications and Usage
for Geodon. Retrieved from Drugs.com: http://www.drugs.com/pro/geodon.html
Mulhauser, D. G. (2012, June 27). Welcome to the CAGE Questionnaire: A Screening Test for Alcohol
Dependence. Retrieved from Counselling Resource Mental Health Library Psychological Self-Tests and
Quizzes: http://counsellingresource.com/lib/quizzes/drug
NIH Publication No. 08-3929. (Revised 2008). What Medications are Used to Treat Schizophrenia?
Retrieved from The National Institute of Mental Health:
http://www.nimh.nih.gov/health/publications/mental-health-medications/what-medications-are-used-
to-treat-schizophrenia.shtml
Obert, M. M., Rawson, P. R., McCann, M. M., & Ling, M. W. (2013). The Matrix Model: Intensive
Outpatient Alcohol and Drug Treatment, A 16-Week Individualized Program. Retrieved from Hazelden
Family of Products: http://www.hazelden.org/web/public/matrixfamily.page
Renee Spencer, P. M. (2010, January). Clinical Examples of CBT: Cognitive Intervention. Retrieved from
CBT or Psychodynamic Therapy? An Information Resource About CBT and Psychodynamic Therapy:
http://cbtvspsychodynamic.com/CBTexamples.html
Wikipedia. (2012, November 26). The Third World War - Video Game. Retrieved from Wikipedia:
http://en.wikipedia.org/wiki/The_Third_World_War_(video_game)
SueAnn Land Page 27