Dr. Steve Weatherbee eCenter Research

steve@ecenterresearch.com

Financial contribution fromAvec le financement de

Key System Benefits ü  Increase organizational efficiency

ü  Target treatment to client needs

ü  Monitor client progress

ü  Improve care coordination

ü  Monitor program effectiveness

ü  Generate quarterly/annual reports

Increase Organizational Efficiency

ü  Common system functions

ü  Web based anytime access/any device

ü  One source record for each client

ü  Common client information

ü  Consistent format of information

ü  Customize to meet Centre data needs

Target Treatment to Client Needs

ü  Standardized intake protocol

ü  Validated multivariate assessment

ü  Mental health and addiction combined

ü  Culturally relevant (adaptation in progress)

ü  Treatment Planning Tool (coming soon)

Monitor Client Progress ü  Follow up assessment

ü  Progress monitoring reports

ü  Case notes / Client files

ü  Adapt treatment plan / review impact

ü  After care monitoring

Improve Care Coordination ü  Common referral process

ü  Electronic sharing of key information

ü  Transfer/sharing of client records

ü  Continuity of care (inpatient-outpatient-aftercare)

ü  Early detection of relapse

Monitor Program Effectiveness

ü  Aggregate client outcomes data

ü  Real-time reporting

ü  Advanced filtering

ü  Guide improvement decisions

Generate Quarterly/Annual Reports ü  Real-time analytics

ü  Instant report generation

ü  Accommodate different funding sources

AMIS System Navigation

ü  AMIS Design - Flexible

ü  Support - HelpDesk

ü  Menus - Tools

ü  Tabs - Grids - Action buttons

ü  Advanced Reporting – Filters

AMIS System Demo

ü  Client records – demographics-settings

ü  Assessments - Forms - Reports

ü  Referral functions

ü  Monitoring client progress

ü  Reviewing program effectiveness

ü  Location settings

ü  Instant quarterly and annual reports

Drug  Use  Screening  Inventory    (DUSI-­‐R)  

STEP  1   STEP  2   STEP  3  

DQS  

SHORTFORM  

DUSI-­‐R  

3  Minutes   7  Minutes   20  Minutes  

TIME  

RESOURCES  MANAGEMENT  

The  DUSI-­‐R  Quick  Screen  (DQS)  •  Three  age-­‐versions  of  the  DUSI-­‐R  Quick  Screen    severity  of  substance  use  AND  RELATED  PROBLEMS  during  early,  middle  and  late  adolescence.  

Two  Indexes  •  Substance  Use  Involvement  Index  and    •  Problem  severity  Index  

Substance Use Involvement Index

Problem Severity Index

DQS Instant Screening Results

Drug  Use  Screening  Inventory  (DUSI-­‐R)    

Basic  Scales  (problem  severity  0  –  100%)  

 Substance  Use      Family  System  Behavior  Problems    School  Performance  Health  Status      Work  Adjustment  Psychiatric  Disturbance  Peer  AffiliaVon  Social  Skills      Leisure/RecreaVon    

Drug  Use  Screening  Inventory  

Overall  Problem  Density  Score    0-­‐100%    

+6  Ancillary  Scales  • Anxiety  • Depression  • ADHD  • SUD  • CD  • Violence  Proneness  

DOMAIN  1A  Substance  Topology  

•  Type of Substances •  Frequency

DOMAIN  1B  Substance  Use  Consequences  

•  Motivation (craving) (1) •  Tolerance (2) •  Loss of Control (3,16) •  Social Disruption (6,24)

– Legal – Injury – Emotion

• Dependence (12, 18)

DOMAIN  2  Behavior  PaHerns  

•  Dysregulation (28,23,25,28,29,30,31) •  Social isolation (26,34,35) •  Interpersonal hypersensivity

–  Anger (17,27) –  Aggression (19,20,27,32)

DOMAIN  3  Health  Status  

Frequent health problems associated with substance use and psychiatric disorder

•  Disease (46,47) • Injury (39) • Illness (41,42,43,44,46,47) • HIV Risk (45)

DOMAIN  4  Mental  Health  Disorder    

•  Antisociality (49,50,51) •  ADHD (52,53,54,55) •  Affect (D&A) (56-64, 67) •  Paranoia (63-66) •  Mania (68)

DOMAIN  5  Social  Competence  

•  Relationship formation (71,72,73,77,82,83) •  Assertive (73,74,79) •  Help seeking (75) •  Refusal (76,80) •  Compliment acceptance (81)

DOMAIN  6  Family  System  

•  Substance use (55,86) •  Antisociality (87) •  Dyadic interactions quality (Dysfunction) •  Conflict (88,93) •  Cohesion (89) •  Engagement/investment (90,92,94,95,96,97) •  Boundaries/rules (91) •  Threats (98)

DOMAIN  7  School  Problems  

•  Likes school (100) •  Performance/grades (101,102,103,104) •  Compliance (103,106,108,112,118) •  Adjustment (110,111,119) •  Dropout risk (105) •  Perceived danger (113)

DOMAIN  8  Work  Adjustment  

•  Firing (122, 125, 128) •  Interpersonal Adjustment (121,124,127,129) •  Job seeking skills (125) •  Illegal Work (126)

DOMAIN  9  Peer  RelaWonships  

•  Peer drug use/dealing (132,133,139,140) •  Non-drug antisociality (134,136,138,141) •  Older friends (137) •  Gang (142) •  Adjustment problems (143,144,145)

DOMAIN  10  Leisure  and  RecreaWon  

•  Active activities (147,151,158) •  Passive activities (149,152) •  Adult supervision (148,150) •  Boredom (153) •  Solitary activity (154,156)

Why  use  the  DUSI-­‐R?  

1.  Comprehensive •  16 scales

2.  Efficient •  20 minutes to administer, and immediate automatic scoring

3.  Pragmatic •  measures problems that can be resolved

4.  Ranks Problems Severity on a Common Metric of 0-100% •  intervention can be tailored to the magnitude of each problem

5.  Improves Staff Decision Making •  Treatment plan, monitor change, relapse prevention

Why  use  the  DUSI-­‐R?  

6.  Resources Management •  Informs resource needed for prevention and treatment

7.  Outcomes Monitoring •  Tracking client’s progress

8.  Program Evaluation •  Document magnitude of benefit and cost-effectiveness.

9.  Client Motivation/Engagement •  Form partnership with client to catalyze empowerment

10.  Brief, Short, and Full Versions are available

Prioritizing Intervention Modalities

Monitoring Patient Response to Tx

Patient Response to Tx

Tx Plan Adaptation – Changing Needs/Priorities

Post–Treatment Gains Sustained, Monitor Risk for Relapse

Population Profile – Multivariate Needs

Population Profile – Substance Use

Population Profile – Substance Use Reduction

Population Profile – Mental Health

Population Profile – Adverse Outcomes

Population Profile – Reduction of Likelihood of Disorder by age 19, 22

Population Profile – Reduction of Risk for Adverse Outcomes

Through technology, patient-centered clinical practice and case management are efficiently coordinated by the DUSI-R

Publications Tarter, R.E. (1990). Evaluation and treatment of adolescent substance abuse: A decision tree method. American Journal of Drug

and Alcohol Abuse, 16(1,2), 1-46. Tarter, R., Laird, S., Kabene, M., Bukstein, O., Kaminer, Y. (1990). Drug abuse severity in adolescents is associated with magnitude of

deviation in temperament traits. British Journal of Addictions, 85, 1501-1504. Tarter, R. & Hegedus, A.M. (1991). The Drug Use Screening Inventory: Its application in the evaluation and treatment of alcohol and

drug abuse. Alcohol Health and Research World, 15, 65-75. Tarter, R., Laird, S., & Bukstein, O. (1991). Multivariate comparison of adolescent offspring of substance abuse parents: Community

and treatment samples. Journal of Substance Abuse, 3, 301-306 Tarter, R.E. (1991). Prevention of Drug Abuse: Theory and Application. The American Journal on Addictions, 1(1), 2-20. Tarter, R., Moss, H., Arria, A., & Mezzich, A., Vanyukov, M. (1992). Psychiatric diagnosis of alcoholism: Critique and reformulation.

Alcoholism: Clinical and Experimental Research, 16, 106-116. Mezzich, A., Tarter, R., Hsieh-Y-C, & Fuhrman, A. (1992). Substance abuse in female adolescents: Association between age of

menarche and chronological age. The American Journal on Addictions, 1, 217-221. Tarter, R., Laird, S., Bukstein, O., & Kaminer, Y. (1992). Validation of the adolescent Drug Use Screening Inventory: Preliminary

Findings. Psychology of Addictive Behaviors, 6, 233-236. Mezzich, A., Tarter, R., Kirisci, L., Clark, D., Bukstein, O., & Martin, C. (1993). Subtypes of early age onset alcoholism. Alcoholism:

Clinical and Experimental Research, 17, 767-770. Tarter, R., Kirisci, L., Hegedus, A., Mezzich, A., & Vanyukov, M. (1994). Heterogeneity of adolescent alcoholism. Annals of the New

York Academy of Sciences, 708, 172-180. Tarter, R. (1994). Rediscovering opportunities in the emerging health services environment. Journal of Clinical Psychology, 50,

111-113. Tarter, R. (1994). Integrative approach for the evaluation & treatment of alcohol and drug abuse. In Directions of Rehabilitation

Counseling, Vol. 1, Lesson 1, Professional Achievement Services. Mezzich, A., Tarter, R., Hsieh, H-C, & Moss, H. (1994). Platelet Monoamine Oxidase and temperament and personality in adolescent

female substance abusers. Personality and Individual Differences, 16, 417-424. Tarter, R., & Vanyukov, M. (1994). Alcoholism: A developmental disorder. Journal of Consulting & Clinical Psychology, 62,

1096-1107. Tarter, R., Mezzich, A., Kirisci, L., & Kaczynksi, N. (1994). Reliability of the Drug Use Screening Inventory among adolescent

alcoholics. Journal of Adolescent Substance Abuse, 3, 25-36. Kirisci, L., Tarter, R., Tse-Chi, H. (1994). Fitting a two-parameter logistic item response model to clarify the psychometric properties of

the drug use screening inventory for adolescent alcohol and drug abuse. Alcoholism: Clinical and Experimental Research, 18, 1335-1341.

Mezzich, A., Moss, H., Tarter, R., Wolfenstein, M., Hsieh, Y-C, & Mauss, R. (1994). Gender differences in the pattern and progression of substance abuse in conduct disordered adolescents. American Journal on Addictions, 3, 289-295.

Tarter, R., Mezzich, A., Hsieh, Y-C, & parks, M. (1995). Cognitive capacities in female adolescent substance abusers: Association with severity of drug abuse. Drug and Alcohol Dependence, 39, 15-21.

Mezzich, A., Tarter, R., Kirisci, L., Hsieh, Y-C., & Grimm, M. (1995). Coping capacity in female adolescent substance abusers. Addictive Behaviors, 20, 181-185.

Tarter, R. (1995). Genetics and primary prevention of drug and alcohol abuse. The International Journal of Addictions, 30, 1479-1484.

Tarter, R. (1995). Rationale and Method of Client-Treatment Matching. The Counselor. Kirisci, L., Mezzich, A., Tarter, R. (1995). Norms and sensitivity of the Adolescent Version of the Drug Use Screening Inventory.

Addictive Behaviors, 20, 149-157. Tarter, R., Mezzich, A., Hsieh, Y-C, & parks, M. (1995). Cognitive capacities in female adolescent substance abusers: Association with

severity of drug abuse. Drug and Alcohol Dependence, 39, 15-21. Mezzich, A., Tarter, R., Kirisci, L., Hsieh, Y-C., & Grimm, M. (1995). Coping capacity in female adolescent substance abusers.

Addictive Behaviors, 20, 181-185. Tarter, R. (1995). Genetics and primary prevention of drug and alcohol abuse. The International Journal of Addictions, 30,

1479-1484. Tarter, R. (1995). Rationale and Method of Client-Treatment Matching. The Counselor. Tarter, R., Kirisci, L., & Mezzich, A. (1996). The Drug Use Screening Inventory: School Adjustment Correlates of Substance Abuse.

Measurement and Evaluation in Counseling and Development, 29, 25-34. Nespor, K., Csemy, L., & Pernicova, H. (1996). Comprehensive school based prevention including peer programmes. Alkoholizmus a

Drogove Zavislosti (Protialkoholicky Obzor, 31, 13-21. Tarter, R., & Kirisci, L. (1997). The Drug Use Screening Inventory for Adults: Psychometric Structure and Discriminative Sensitivity.

American Journal of Drug and Alcohol Abuse, 23, 207-219. Tarter, R., & Kirisci, L. (1997). Multivariate typology of adolescents with alcohol use disorder. American Journal on Addictions, 6,

150-158. Tarter, R., Kirisci, L., & Clark, D. (1997). Alcohol Use Disorder Among Adolescents: Impact of paternal alcoholism on drinking behavior,

drinking motivation and consequences. Alcoholism: Clinical and Experimental Research, 21, 171-178. Moss, H., Bonicatto, S., Kirisci, L., Girardelli, A., & Murrelle, L. (1998). Substance abuse and associated psychosocial problems among

Argentina adolescents: sex heterogeneity and familial transmission. Drug and Alcohol Dependence, 52, 221-230. De Micheli, D. & Formigoni, M. (2000). Screening of drug use in a teenage Brazilian sample using the Drug Use Screening Inventory

(DUSI). Addictive Behaviors, 25(5), 683-691. Tarter, R., & Kirisci, L. (2001). Validity of the Drug Use Screening Inventory for predicting DSM-III-R substance use disorder. Journal of

Child and Adolescent Substance Abuse, 10, 45-53.

Tarter, R., Kirisci, L., Vanyukov, M., Cornelius, J., Pajer, K., Shoal, G., & Giancola, P. (2002). Predicting Adolescent Violence: Impact of Family History, Substance Use, Psychiatric History, and Social Adjustment. American Journal of Psychiatry, 159, 1541-1547.

Andrade, L. (2002). Factors of Acculturative Stress as Predictors of Substance Use in Latino Youth. Unpublished Doctoral Dissertation, Alliant International University, California School of Professional Psychology (Fresno Campus), Fresno, California.

De Micheli, D., & Formigoni, M. (2002). Are reasons for the first use of drugs and family circumstances predictors of future use patterns? Addictive Behaviors, 27, 87-100.

De Micheli, D., & Formigoni, M. (2002). Psychometric properties of the Brazilian version of DUSI (Drug Use Screening Inventory). Alcoholism: Clinical and Experimental Research, 26, 1523-1528.

Dolan, G. (2002). The Drug Use Screening Inventory – Revised (DUSI-R). It’s validity in a New Zealand Context. Dissertation for Masters of Health Sciences, Auckland University, Auckland, New Zealand.

Vittetoe, K., Lopez, M.F. Delva, J., Wagner, F., & Anthony, J. (2002). Behavioral problems and tobacco use among adolescents in Central American and the Dominican Republic. Rev Panam Salud Publica, 11(2), 76-82.

Aytaclar, S., Erkiram, M., Kirisci, L., & Tarter, R. (2003). Substance abuse and associated psychosocial risk factors among Turkish male adolescents. Addictive Behaviors, 28, 1419-1429.

Siewert, E., Stallings, M., & Hewitt, J. (2003). Genetic and environmental analysis of behavioral risk factors for adolescent drug use in a community twin sample. Twin Research, 6, 490-496.

Tarter, R., Kirisci, L., Mezzich, A., Cornelius, J., Pajer, K., Vanyukov, M., Gardner, W., & Clark, D. (2003). Neurobehavior disinhibition in childhood predicts early age onset of substance use disorder. American Journal of Psychiatry, 160, 1078-1085.

De Micheli, D., Lucia, M., & Formigoni, O.S. (2004) Drug use by Brazilian students: Associations with family, psychosocial, health, demographic and behavioral characteristics. Society for the Study of Addiction, 10.111, 1360-0443.

Obando, P., Kliewer, W., Murrelle, L., & Svikis, D. (2004). The comorbidity of substance abuse and depressive symptoms in Costa Rican adolescents. Drug and Alcohol Dependence, 76, 37-44.

Siewert, S., Stallings, M., Hewitt, J. (2004). Factor structure and concurrent validity of the Drug Use Screening Inventory in a community adolescent sample. Addictive Behaviors, 29, 627-638.

Tarter, R., Kirisci, L., Habeych, M., Reynolds, M., & Vanyukov, M. (2004). Neurobehavior disinhibition in childhood predisposes boys to substance use disorder by young adulthood: direct and mediated etiologic pathways. Drug and Alcohol Dependence, 73, 121-132.

Kirisci, L., Vanyukov, M., & Tarter, R. (2005). Detection of youth at high risk for substance use disorder: A Longitudinal Study. Psychology of Addictive Behaviors, 19, 243-252.

Tarter, R., Vanyukov, M., Kirisci, L., Reynolds, M., & Clark, D. (2006). Predictors of marijuana use in adolescents before and after licit drug use. Examination of the gateway hypothesis. American Journal of Psychiatry, 163, 2134-2140.

Tarter, R., Kirisci, L., Feske, U., & Vanyukov, M. (2007). Modeling the pathways linking childhood hyperactivity and substance use disorder in young adulthood. Psychology of Addictive Behaviors, 21, 266-271.

Kirisci, L., Tarter, R., Mezzich, A., & Reynolds, M. (2008). Screening current and future diagnosis of psychiatric disorder using the revised Drug Use Screening Inventory. American Journal of Drug and Alcohol Abuse, 34, 653-665.

Kirisci, L., Tarter, R., & Reynolds, M. (2009). The Violence Proneness Scale predicts outcomes associated with substance abuse. American Journal on Addictions, 18, 173-177

Fidalgo, T.M., Tarter, R., daSilveira, E.D., Kirisci, L., daSilveira, D.X. (2010). Validation of a short version of the revised Drug Use Screening Inventory in a Brazillian sample of adolescents. American Journal of Addictions, 19, 364-367.

Kirisci, L., Reynolds, M., & Tarter, R. (2013). Quick screen to detect current substance use disorder in adolescents and likelihood of disorder. Drug and Alcohol Dependence, 128, 116-122.