Speaker A
he I appreciate your participation in intake so far I want to change to a new section if that's okay with you and this section is on substance use is that an area you feel comfortable discussing sure all right so are there any
A role-play intake demo by Dr. Todd Grande showing a clinician assessing a client's alcohol and marijuana use, frequency, functional impact, and family history.
Key Takeaways
- Structured substance use assessment examines quantity, frequency, functional impact, and attempts to reduce use.
- Client's alcohol and cannabis use is linked to job stress and occupational consequences such as tardiness.
- Interpersonal harm and guilt are important clinical indicators to assess alongside consumption patterns.
- Family history of alcohol problems is a relevant risk factor to document in intake.
What the video covers
- Clinician opens the substance use section of an intake interview with a client role-play.
- Client reports drinking about three 16-oz beers daily over roughly two hours, with more on weekends.
- Alcohol use is described as a way to unwind after work, but has led to a fight with friends and lateness to work.
- Client has used marijuana since starting college about two years ago, mostly on weekends and sometimes before bed to ease anxiety.
- Marijuana use has also contributed to morning difficulties and late arrivals at work, prompting boss irritation.
- Client previously cut back alcohol to one or two beers but resumed heavier drinking when job stress increased.
- Family criticism of drinking and client guilt about upsetting his mother and arguments with friends are explored.
- Morning drinking or use to steady nerves or ease hangovers occurs occasionally on weekends.
- Past use includes one-time ecstasy use and brief cigarette smoking in high school.
- Family history includes a grandfather reported by the mother to have been an alcoholic.
Full Transcript — Download SRT & Markdown
Speaker A
substances that you currently use um I drink a bit can you tell me how often you drink uh I guess it's it's more than a bit I uh I would say I have probably three drinks a day and what are
Speaker A
you drinking um beer you know what size um the bottles so I think there's there's 16 ounces three bottles of beer a day yeah and how much time uh does does it take you to consume those uh probably a couple of
Speaker A
hours so every day three beers in in about two hours yeah does that do anything to you in terms of your mood or feelings um it just kind of helps me unwind after a long day of work relaxes
Speaker A
me um so it's relaxing for you yeah has it ever gotten you into any type of trouble uh there was one time that I uh my my friends and I kind of got into a fight after I had been
Speaker A
drinking um and we almost stopped talking because of it but we were able to uh work it out but I almost I've almost lost friends over it before all right is there any other areas where it might disrupt
Speaker A
functioning um sometimes it's hard to get up and get to work the next morning after I've had if I drink it like later in the day um it's hard to get up and get to work on time the next morning so I've been late
Speaker A
a couple of times too all so three three bottles of beer pretty much every day pretty much every day Prett much every day has there ever been a time when uh you've consumed more or less a particular day um not typically during
Speaker A
the week but I'll sometimes I'll drink more on the weekends um I maybe drink um like my normal like three in a couple of hours and then maybe three three or four hours later I'll have a couple more you have a few more
Speaker A
yeah and how long have you been drinking alcohol I guess I started when I was around 17 17 yeah was now you mentioned beer have you ever consumed any other type of alcohol um I've tried wine and shots before but
Speaker A
I always kind of just gravitate more towards the beer back toward beer yeah any other substances that you use currently um on on the weekends every once in a while I'll I'll smoke some pot um with my friends like Saturday
Speaker A
night that's pretty much just weekends um sometimes during the week um like before I go to sleep I'll have a joint just um it helps my anxiety and my worries before I go to bed all right when did you first start using
Speaker A
marijuana uh that was probably a couple years ago when I first started college about two years ago yeah and on the weekends sometimes other times yeah um actually I guess it's it's more on the weekends but I would say maybe every
Speaker A
other day during the week so mostly on the weekends occasionally during the week has it ever led to any trouble or change in functioning um not I mean on the weekends no cuz I don't really have anywhere to be but
Speaker A
um sometimes during the week if I if I again kind of like the alcohol if I smoke it too late again it's hard to get up in the morning and get to work on time and my boss is really starting to
Speaker A
get irritated with me with how often I've been late not that I'm like super late but I'm late enough have you ever tried to cut down on the substance use alcohol orij um I've tried to cut back on the alcohol
Speaker A
before um about a year ago I tried um I was looking uh started when I started this job that I have now um I tried to cut back when I first started mhm um and I was able to get down to like two one
Speaker A
or two beers instead of three um but then the job got stressful and I got comfortable I guess and started drinking more again so you think perhaps the alcohol use is connected to the stress with your job I yeah I would say it's
Speaker A
definitely connected all right have you ever been annoyed by people that perhaps criticize is your substance use yeah my family can be critical of they don't really know about the marijuana but they can be critical of my alcohol
Speaker A
use all right and that bothers you yeah have you ever felt bad or guilty about your substance use my I felt guilty um with my mom because it upsets her so much sometimes like I'll feel guilty about how my sub
Speaker A
abuse upsets her um but and some I feel bad like if I have a fight with my friends if I'm drunk um I'll feel bad the next day um about getting into an argument with them CU it's usually over something
Speaker A
silly all right have you ever had to drink or use drugs first thing in the morning to steady your nerves or to uh lessen the effects of a hangover um I would say on the not during the week but on the weekends when
Speaker A
I'll drink a little bit more sometimes I'll have like as just a little bit um like if I drink Saturday night I'll have a little bit Sunday morning to just get going in the morning so on occasion that
Speaker A
happens yeah I wouldn't say it's often but on occasion so alcohol and marijuana two substances you currently use can you tell me about substances you used in the past um at a party one time I tried Ecstasy but I I didn't like like it and
Speaker A
I ended up not really hanging out with those people anymore so it it wasn't an issue so just the one time yeah just the one time all right um in high school my friends um a lot of my friends were
Speaker A
smokers so um I smoke cigarettes but it kind of it just made me feel sick and um I didn't really like it very much it didn't really do anything for me so that didn't last long she discontinued yeah
Speaker A
that didn't last long at all all right any other substances or just those two um just those two that I'm currently using and then um just the smoking and the um ecstasy previously all right do you have a family history of substance
Speaker A
use um my grandfather um my mom claims that my uh grandfather was an alcoholic any other history no not that I'm aware of at least before I move to the next section of the intake while we're still talking about
Speaker A
substance use is there anything else you want to add any other comments you want to make about this section I think so I think that covers it does that cover pretty well yeah all right I appreciate you answering these questions and if
Speaker A
you're okay I'm going to move from this section and move to the next section the intake okay
Topics:substance use assessmentintake interviewalcohol usecannabis useclinical role-playmotivational interviewingfamily historyaddiction assessmentcounseling trainingTodd Grande
