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According to week two, it is clear that the assessment tools used in psychotherapy have two primary purposes. The first purpose is to measure the illness and diagnose clients while the second purpose is to evaluate a client’s response to treatment. There are different types of assessment tools, but in this discussion, I have selected Patient Stress Questionnaire.
The psychometric properties of the Patient Stress Questionnaire as the selected assessment tool
Patient Stress Questionnaire refers to the tool employed in primary care settings to help in screening for the behavioral health symptoms. The instrument was adapted from the PHQ-9, AUDIT, GAD-7, and PC-PTSD. Patient Stress Questionnaire is made up of a list of items that efficiently help in identifying the potential behavioral health problems. The tool is a 24-item behavioral health screening tool which is composed of a collection of twelve (12) separate “ultra-brief” screening tools to offer a preliminary mental health and addiction diagnosis. The PHQ-9 is made up of 9 items which represent the criterion symptoms for DSM 5 major depressive disorder. These have questions related to how much sign has bothered the client based on the scale such as “not at all,” “nearly every day,” and “several days”. The GAD-7 is made up of seven items with the response similar to PHQ-9 and scored as a continuous variable from 0 to 21 (Kroenke et al. 2016).
When it is appropriate to use Patient Stress Questionnaire
The tool is used when the client is suspected to have depression and anxiety. Several well-validated measures can be used to assess depression and anxiety as separate domains (Flückiger et al 2016), but the advantage of Patient Stress Questionnaire is that it is a measure that offers a single composite score for both the depression and anxiety (Kroenke et al. 2016). The tool is used in assessing depressive symptoms among patients having conditions such as aphasia. The tool is applicable for measuring perceived stress (Laures-Gore et al. 2017).
Furthermore, theoretical and empiric evidence of overarching psychological construct that compromise of distinct but related dimensions of anxiety and depression. Therefore, the intercorrelation between depression and anxiety makes Patient Stress Questionnaire attractive as it provides a composite score.
Based on the efficacy of Patient Stress Questionnaire in evaluating psychopharmacologic medications, psychopharmacological medications aim to manage behavior, stabilize mood, or to treat psychiatric disorders and their associated symptoms. On the other hand, Patient Stress Questionnaire is used to screen for these behavioral health symptoms and therefore, can be used to determine whether the symptoms are reducing or not based on the psychopharmacological medications. The tool can be used to self-report symptoms and to identify persistent symptoms of anxiety disorders and even monitor the treatment in clinical practice (Rose & Devine, 2014).
Kroenke, K., Wu, J., Yu, Z., Bair, M. J., Kean, J., Stump, T., & Monahan, P. O. (January 01, 2016). Patient Health Questionnaire Anxiety and Depression Scale: Initial Validation in Three Clinical Trials. Psychosomatic Medicine, 78, 6.
Laures-Gore, J. S., Farina, M., Moore, E., & Russell, S. (January 01, 2017). Stress and depression scales in aphasia: Relation between the aphasia depression rating scale, stroke aphasia depression questionnaire-10, and the perceived stress scale. Topics in Stroke Rehabilitation, 24, 2, 114-118.
Rose, M., & Devine, J. (January 01, 2014). Assessment of patient-reported symptoms of anxiety. Dialogues in Clinical Neuroscience, 16, 2, 197-211.
Flückiger, C., Forrer, L., Schnider, B., Bättig, I., Bodenmann, G., & Zinbarg, R. E. (January 01, 2016). A Single-blinded, Randomized Clinical Trial of How to Implement an Evidence-based Treatment for Generalized Anxiety Disorder [IMPLEMENT] — Effects of Three Different Strategies of Impleme
psychometric properties of the Screening, brief intervention, and referral to treatment (SBIRT) tool
The SBIRT grant program was developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) which provided either brief intervention/treatment or referred to appropriate services for individuals who use alcohol or psychoactive substances, not including tobacco that may not meet criteria for a substance use disorder (Aldridge, Linford, & Bray, 2017). It begins with a pre-assessment screening which briefly explores substance use. If a positive pre-screen is evident, the provider should move to the Alcohol use disorders identification test (AUDIT) and/or the Drug abuse screening test (DAST) for more thorough assessment. If positive brief intervention or treatment is advised (“Clinician Tools – SBIRT for Substance Abuse,” n.d.). According to Yong, et al. as part of their systematic review, it is unclear whether it is beneficial to utilize brief interventions as part of the SBIRT screened individuals who were not seeking treatment at the time of assessment (2014). Evaluation of this project indicated that the program was positively correlated with decreased alcohol and/or substance use in this population. However, it is unclear whether other factors were key (Aldridge et al., 2017). It was noted however that participants had significantly lower reports of substance use one month after intervention. However limitations in study design may have impacted the reported results (Aldridge et al., 2017).
Explain when it is appropriate to use SBIRT with clients
Each client should be assessed using a pre-assessment screening tool yearly. If positive, the client should be assessed using the AUDIT or DAST tools as indicated above (“Clinician Tools – SBIRT for Substance Abuse,” n.d.)
Is the SBIRT tool appropriate to evaluate the efficacy of psychopharmacologic medications
The SBIRT protocol moves to brief intervention or brief treatment as appropriate. These interventions are focused on psychological treatments 5-60 minutes in length (“Clinician Tools – SBIRT for Substance Abuse,” n.d.) As such, they would not be involving psychopharmacological substances, at least initially it would not be appropriate for evaluation of medication effectiveness.
Aldridge, A., Linford, R., & Bray, J. (2017). Substance use outcomes of patients served by a large US implementation of Screening, Brief Intervention and Referral to Treatment (SBIRT). Addiction, 112, 43–53. https://doi.org/10.1111/add.13651
Clinician Tools – SBIRT for Substance Abuse. (n.d.). Retrieved September 5, 2018, from http://www.sbirt.care/tools.aspx
Young, M. M., Stevens, A., Galipeau, J., Pirie, T., Garritty, C., Singh, K., … Moher, D. (2014). Effectiveness of brief interventions as part of the Screening, Brief Intervention and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances: a systematic review. Systematic Reviews, 3, 50. https://doi.org/10.1186/2046-4053-3-50
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