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Treatment Planning M.A.T.R.S.: Evidence from Research

What is the ASI?
The ASI is one of the most reliable and valid measurements of the nature and severity of client problems, and it identifies potential problems in six domain areas: medical status, employment and support, alcohol and drug use, legal status, family/social status, and psychiatric status.

Why use the ASI?

• ASI’s semi-structured interview format allos the counselor to gather required information.
• Helps the client and counselor identify problems and agree on goals, objectives, and interventions.
• Provides information useful in justifying the need for continued services.
• Gives the basis for documentation and discharge planning.
• Addresses the third principle outlined in the Principles of Drug Addiction Treatment: A Research-Based Guide – “to be effective, treatment must address the individual’s drug use and any associated medical, psychological, social, vocational, and legal problems” (NIDA, 1999, p.1).
• Retention in treatment improves when services are matched to a client’s problems. Clients “whose problems are identified at admission and then receive services that are matched to those problems, stay in treatment longer” (Carise et al., 2004; Hser, Polinsky, Maglione, & Anglin, 1999; Kosten et al., 1987; McLellan et al., 1999).

Using the ASI to Develop a Treatment Plan
Treatment planning begins during the assessment process, and the “union” of treatment planning and assessment is a natural process. The six problem domains (listed above) help support the importance of viewing clients and their problems from a biopsychosocial perspective, and allow the “marrying” of the assessment treatment planning processes, resulting in a guide that addresses specific client needs.

How the ASI can be used by Program Directors

• Identifies types of client problems not addressed by in-house services
• Quantifies the severity of client problems or needs over time
• Provides a quantifiable measure of program success
• Documents unmet client service needs
• Includes data needed in reports for TEDS, CARF, JCAHO, grants management, managed care, and other stakeholders

Article of Interest

The Addiction Severity Index at 25: origins, contributions and transitions.
Am J Addict. 2006 Mar-Apr;15(2):113-24.
Thomas McLellan A, Cacciola JC, Alterman AI, Rikoon SH, Carise D.
The Treatment Research Institute, Philadelphia, Pennsylvania, USA.

Abstract: "The Addiction Severity Index (ASI) is a multi-dimensional interview used to measure the substance use, health, and social problems of those with alcohol and other drug problems, both at admission to treatment and subsequently at follow-up contacts. This article first discusses the conceptual and practical importance of the ASI's multi-dimensional approach to measuring addiction severity, as illustrated by two case presentations. The second section of the paper reviews how this measurement approach has led to some important findings regarding the prediction and measurement of addiction treatment effectiveness. The third section describes the historical and practical considerations that have changed the instrument over time, details the problems with the instrument, and describes our efforts to correct those problems with the ASI-6. Finally, some recent ASI data collected from over 8,400 patients admitted to a nationally representative sample of U.S. addiction treatment programs are presented."

For additional resources highlighting research related to buprenorphine treatment, please see the "Other Resources" section.