Assessment strategies and instruments in dd

Abstract

The aim of this chapter is to provide the reader of a strategy to decide which instruments to use in case of dual disorder. Depending on the level in the diagnostic process, distinction should be made between the need for screening and than further assessment. Then, several instruments are presented for the screening of substance use or abuse in general psychiatric context and for the screening of comorbidity in treatment context of substance use disorders. Instruments should cover a number of criteria such as reliability and validity, relative easy training and-in a European context-availability in several languages. Once the screening is able to confirm a suspected diagnosis, rating scales and structured interviews are recommended. In case of substance use disorder, the instruments should be multidimensional and sometimes substance specific. To assess comorbidity, comprehensive clinical experience is basic, beside the use of structured and standardized instruments and rating scales, in order to reduce sources of error. It is concluded that more standardization of the diagnostic process needs to be taken for the future of empirical research in psychiatry to advantage consistency and comparability of data across studies. Next to the need of more standardization of the diagnostic process, standard use of instruments in clinical practice could also enhance communication and alliance between patient and therapist. By incorporating patient and therapist ratings in the assessment process, clinical usefulness, personal relevance, and meaningfulness to the patient could be enhanced.