This form is a required document in clients file adult programs must utilize the asi addiction severity index lite adolescent programs must utilize the yai youth assessment index note. It is the first step in the development of a patient profile for. The addiction severity index is a relatively brief, semistructured interview designed to provide important information about aspects of a patients life which may contribute to hisher substance abuse syndrome. Addictions severity index fill out and sign printable.
Asilite im going to ask you some questions about your alcohol and other drug use and any problems you may have had in these areas. The asi form is completed for each client admitted or readmitted after one year. Addiction severity index 5th edition dens clinicaltraining version a. The international journal of the addictions, 262, 219226. The 5th edition addiction severity index asi is a semistructured interview designed to provide important information about aspects of a clients life which may contribute to her substance abuse problem. Addiction severity indexmultimedia version hazelden. Teen addiction severity index tasi brief description the tasi is a semistructured interview that was developed to fill the need for a reliable, valid, and standardized instrument for a periodic evaluation of adolescent substance abuse. Items with an asterisk are cumulative and should be rephrased at introducing the asi.
The asi form will provide a comprehensive, overall understanding of all aspects of the patients existence in order to properly. Quick guide on how to complete addiction severity index lite. Reproductions supplied by edrs are the best that can be made. Addiction severity index, 5th edition boston university. Make plenty of comments if another person reads this asi, they should have a. Addiction severity index an overview sciencedirect topics. The asi is a semistructured instrument used in facetoface interviews conducted by clinicians, researchers or trained technicians. The way to complete the addiction severity index form on the internet. This instrument is an interview process that assesses history, frequency. Unpublished manual, 2011 mclellan at, luborsky l, obrien cp, woody ge. Source mclellan at, kushner h, metzger d, peters r, smith i, grissom g, pettinati h, argerious m. It is important that a clients current address is set so that the client contact information is current in the system and any autogenerated letters will be mailed to the correct address. Asimv addiction severity index multimedia version is the electronic version of the traditional paper and penciladministered asi.
Reliabilitymd validity in three centers, journal of nervous and mental disease, 1985. Asi addiction severity index lite and yai youth assessment. The addiction severity index asi is one of the most widely used tools for the assessment of substance userelated problems. Asimv addiction severity index multimedia version is the electronic version of the traditional paperand penciladministered. The asi is a semistructured interview designed to address seven potential problem areas in.
Developed by mclellan and coworkers in 1981, the asi has been translated into seventeen languages japanese, french, spanish, german, dutch, and russian among them and was. Addiction severity index reference substance abuse management system appendix c, page 1 addiction severity index last updated. The advanced tools of the editor will guide you through the editable pdf template. Mclellan, at, luborsky, l, woody, ge, obrien cp 1980. Clinicians all over the world use the asi to get a better. Use the quick search and powerful cloud editor to generate a correct addiction severity index 5th edition. The addiction severity index asi is a standardized semistructured interview used to assess the severity of problems. If you do not currently have adobe acrobat reader installed on your computer, you will need to download it first.
The addiction severity index asi is a clinicalresearch instrument which has been in wide use during the past 6 years to assess the treatment problems found in alcohol and drugabusing patients. Reproductions supplied by edrs are the best that can be. Medical, employmentsupport status, alcohol, drug, legal, familysocial, and psychiatric. Instructions for downloading instruments and manuals.
This interview is particularly useful for gathering detailed information consistent with a psychosocial report. The interview is based on the idea that addiction to drugs or alcohol is best considered in terms of the life events that preceded, occurred at the same time as, or resulted from. The interview forms, a comprehensive test manual and other user information are. Associate professor of psychiatry alcohol research center university of connecticut health center school of medicine 263 farmington avenue farmington, ct. Skilled manual usually having had training baker, barber, brakeperson, chef, electrician, fireman, machinist, mechanic. This tool serves as a guidance instrument in treatment planning.
Bhimv asimv addiction severity indexmultimedia version. The addiction severity index lite asi lite adapted from. Ever 0 no 1 yes age 1st past month 0 no 1 yes other 11 months 0 no 1 yes 1. Reliability of the addiction severity index selfreport form. The addiction severity index asi is one of the most widely used tools for the assessment of. Supplementary administration manual for the expanded female version of the addiction severity index asi instrument the asif. The addiction severity index asi provides a general overview of substanceabuse problems rather than a focus on one particular area 200 questions on 7 subscales. In a study of male veterans, a preliminary evaluation of the asi has indicated reliability and validity.
On line resource center for the addiction severity index addiction severity index 5th edition clinical training version a. Associate professor of psychiatry alcohol research center university of connecticut health center school of medicine 263 farmington avenue farmington, ct 060302103. Addiction severity index, 5th edition clinicaltraining version a. Provide opportunities to practice incorporating the addiction severity index information in treatment planning and documentation activities through use of the addiction severity index narrative report and case examples. Since treatment programs need to complete a number of data collection forms on each patient admitted to. The bhimv behavioral health index multimedia version is an online, client selfadministered comprehensive behavioral health assessment tool which provides an overview of the clients functioning in multiple. In a study of male veterans, a preliminary evaluation of the asi has indicated reliability and validit.
How to complete the addiction severity form on the web. Followup asilite addiction severity index lite ataq addiction treatment attitudes questionnaire abq addictive behaviors questionnaire arsw adjective rating scale for withdrawal aais adolescent alcohol involvement scale aceq aaeq adolescent cannabis expectancies questionnaire adolescent alcohol. The advanced tools of the editor will lead you through the editable pdf template. A guide to training and supervising asi interviews. It also includes summary composite scores calculated for each of seven problem areas medical, employment, alcohol, drug, legal, family and social, and psychiatric.
Addiction severity index asi is an assessment tool widely used in the evaluation of substance abuse treatment. Download the addiction severity index form, which is often used by psychiatrists for the purpose of a more in depth patient evaluation with regard to the level of severity of addiction and addictive behaviors. New items were added in existing sections to assess route of drug administration. Asi manual united nations office on drugs and crime. Regular article validation of the addiction severity index.
It is the first step in the development of a patient profile for subsequent use by clinical and research staffs. Addiction severity index 5th edition fill and sign. We will ask you questions in seven potential problem areas. An improved diagnostic instrument for substance abuse patients. It is free of charge and will quickly install on your computer by going to. The uwasi is a modified version of the asi developed by ernst and grant that includes all. Aug 16, 2005 please indicate on the registration form the type of special accommodations, if any, you require.
The fifth edition of the addiction severity index, journal of substance abuse. Items with an asterisk are cumulative and should be. Enter your official identification and contact details. Babor alcohol research center university of connecticut, farmington, ct.
Stop the interview if the client misrepresents two or more sections. The addiction severity index asi is a brief, approximately one hour partly structured interview that is used to analyze the vital aspects of a persons life that may lead to drug and alcohol abuse. Addiction severity index form pdf fill out and sign. Addiction severity index form pdf fill out and sign printable pdf. Use our detailed instructions to fill out and e sign.
Addictions severity index fill out and sign printable pdf. Addiction severity index asi brief description target populations administrative issues the asi is a semistructured interview designed to address seven potential problem areas in substanceabusing patients. This paper discusses the rationale for the design of the tasi and presents a preliminary study indicating satisfactory interrater reliability of the rating scale. Note the instruction for each question and answer the questions accordingly. Reliability and convergent validity were assessed among 95 inpatient adolescent participants. The addiction severity index, lite version asilite is a shortened version of the addiction severity index asi. The alcohol, smoking and substance involvement screening test. After the questions have been asked and answered interviewer must provide a. A semistructured interview for adults administered by a clinician addressing seven potential problem areas among persons with substance use disorders including medical status, employment and support, drug use, alcohol use, legal status, familysocial status and psychiatric status. Conversion and validation of the teenaddiction severity. The asi is a multidimentional structured interview introduced by dr. Addiction severity index asi addiction severity index asi brief description target populations administrative issues the asi is a semistructured interview designed to address seven potential problem areas in substanceabusing patients. Addiction severity index lite cf clinicaltraining version thomas mclellan, ph. This study converted the teen addiction severity index tasi into selfreport formats using internet net and interactive voice response ivr automatedtelephone technologies.
The asilite contains 22 fewer questions than the asi, and omits items relating to severity ratings, and a family history grid. The addiction severity index asi is 12 years old and has been revised to include a new section on family history of alcohol, drug, and psychiatric problems. Vista mental health mh addiction severity index multimedia version asimv installation and user guide for patch ys5. Introduce and explain the seven potential problem areas. Course limitations this is not a course on administering, scoring, or understanding the addiction severity index. Addiction severity index asi this is a semistructured interview designed to provide important information about aspects of the life of patients that may contribute to their substanceabuse problems. An improved diagnostic evaluation instrument for substance abuse patients. European addiction severity european monitoring centre. Addiction severity index this tool will tell us more about you such as the areas of need you have that brought you to this agency and how we can help you. I would like to remind you that the information you give me. Programme on substance abuse world health organization 1211 geneva, switzerland or thomas f. Tool patient age administration screening and diagnosis of. Items with an asterisk are cumulative and should be rephrased at followup. The teen addiction severity index tasi training workshop.
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