Overview of ASI Training

Advanced courses focus on enhancing those skills as well as how to use ASI data for making patient placement decisions, treatment planning and outcomes monitoring.

Administrators and Supervisor Course focuses on the knowledge and skills supervisors and administrators must have to successfully implement and monitor the use of the ASI and how to use the data collected for treatment planning and delivery as well as monitoring of clinician performance.

ASI and Patient Placement Criteria course provides a review of the strengths and weaknesses of the ASI as it relates to making patient placement decisions. Course includes an introduction and overview of Uniform Patient Placement Criteria (UPPC), i.e., The American Society of Addiction Medicines (ASAM) Patient Placement Criteria, its dimensions of assessment and how the ASI is best used in conjunction with ASAM criteria to make placement decisions.

All courses will include the presentation of case vignettes drawn from our clinical experiences that reflect real world clinical/administrative situations. These cases will be presented in both print and video formats.

The Addiction Severity Index is in its 5th edition and the training curriculum has been revised over time to meet the changing needs of the addictions field. The initial training on the ASI was primarily designed for, and used by, researchers, research assistants and technicians. In response to increasing popularity of the instrument and its use of by counselors and clinicians, the training was revised to incorporate more relevant content to counselors and to meet the varied and diverse learning styles of this group. Aside from adding more clinically relevant content, the format of the workshop itself is much more experiential and skills focused. ASI courses have continued to evolve as a result of ongoing collaborative efforts between researchers, clinicians, master trainers and course participants.

Master ASI Trainers, Thomas H. Coyne MSW, and Ron Jackson MSW are responsible for the clinically relevant changes and inclusion of experiential exercises in the curriculum and for the workshops increased popularity among practitioners in the field.

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Competency Based Training and Methods

Competency measures are methods or procedures used to determine how proficient individuals are in the proper use of various tools, protocols, and the like. Competency measures are widely used in business, industrial, and academic settings.

We currently use a number of competency measures to determine various dimensions of performance. Some strictly measure content knowledge of the ASI instrument; some measure the ability to properly code an ASI, while others measure the ability to properly conduct an ASI interview.

The ASI Quiz (measures content knowledge and coding ability)
The ASI quiz consists of questions covering all sections of the ASI; it can be completed in 20 - 30 minutes, and results in a maximum score of 100. It presupposes that a person has been properly trained on the use of the ASI. This quiz has been refined and updated based on years of use. See Products and Services.

Videotape Coding Exercise (measures coding ability)
These exercises use videotaped ASI interviews produced by colleagues in our own organization, in which a skilled trainer / researcher interviews a “patient” (role-played by another staff person). While watching the videotaped ASI interview, the viewer uses a blank ASI instrument to code all sections of the ASI. The viewer’s coded ASI is then compared to the properly coded ASI that corresponds to the videotaped interview. The videotaped interview lasts approximately 45 -60 minutes. The videotapes and more qualitative review of the coded ASI with individual feedback is also available for purchase. See Products and Services .

Individualized Quality Assurance (Q.A.) Audit of Interviewer Skills (measures content knowledge, coding ability and interviewing skills)
An individualized Q.A. audit consists of a simulated interview designed to measure the proper use of the ASI. It is usually conducted on the telephone. A staff member role-plays a patient, using a scripted text, and a recording sheet designed to capture impressions on interviewing style, definitions of terms, use of pertinent probes and the like. At the completion of the simulated interview, the staff person compares the interviewer’s coded responses to the standardized coded ASI, and provides verbal feedback. The audit process lasts approximately 90 minutes and yields rich, qualitative and quantitative information that the ASI interviewer can utilize to improve proficiency. Q.A. Audits are also available for purchase. See Products and Services.

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Standard Two-Day ASI Training

The Addiction Severity Index (ASI) is a structured clinical interview that can be used for evaluating a client’s need for treatment for Drug, Alcohol, Medical, Employment/Social Support, Family/Social Relationships, Legal and Psychiatric Problems. It has been used for treatment planning, outcome studies and overall program evaluation. This two-day training will provide workers with the knowledge, skills and support materials required to use the ASI effectively in their clinical settings. All attendees will be evaluated upon completion of the training.

This is the only standardized, proven and effective format for the delivery of the Two-day Basic ASI course. The effectiveness of this format in producing trainees that are knowledgeable about the ASI content and about ASI interviewing techniques was recently validated again in a NIDA funded study. Course Format includes didactic presentations with small and large group exercises, role-plays and discussion. Presentation of case vignettes drawn from our clinical experiences that reflect “real world” clinical/administrative situations. These cases will be presented in both print and video formats.

Course attendees receive a participant’s package, which includes all the necessary ASI support materials for continued use and application of the instrument. This two-day course has been delivered successfully around the country to thousands of addiction treatment professionals.

Goal / Educational Competencies

The goal of this workshop is to develop and/or enhance interviewer competencies in correctly utilizing the Addiction Severity Index, a standardized screening and assessment instrument.

Objectives:

• Identify and understand the specific intention of each question asked in the ASI.
• Phrase each question in the most efficient way while remaining flexible enough to adapt the instrument to make it more gender, cultural and population sensitive.
• Verify patient/client self-report through the use of cross checking.
• Understand the importance of the use of additional probes (questions) to augment information provided by the client.
• Consistently apply the correct numerical codes in response to client answers.
• Utilize the severity rating procedure.
• Begin to develop an understanding of the functionality of the data collected using the ASI for treatment planning and making patient placement decisions.

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Standard One Day ASI Training

The one-day training is actually an abridged version of the standard 2-day training, consisting of an introduction to the ASI, followed by select item explanation of the rationale, coding rules, and conventions documented in the ASI Manual and User’s Guide. To cover all the material in a single day, discussions are limited. However, a role-play exercise is included.

The major difference between the one-day and the two-day is that there is, obviously, half as much time. Therefore we’ve had to design the one day training in such a way that we would attempt to achieve many of the same objectives as the two day but do so differently.

There is select item explanation regarding the more difficult items in each section of the ASI, not each item as is done in the two-day training. There is reduced opportunity and time for role plays, discussion and the modeling of probing and rephrasing.

Therefore, we have identified the critical questions in each section that need explanation, modeling and rephrasing.

The reduced time in the one-day impacts upon the amount of knowledge attained and the development of skills. We would like to impress upon participants the importance of studying the questions not covered during the one day, reviewing again the ones that were, using the ASI manual and practicing the administration of the instrument.

Course attendees receive a participant’s package, which includes all the necessary ASI support materials for continued use and application of the instrument.

While this one-day training does exist and is offered, evaluations have shown that two-day training participants do better regarding their knowledge of and skills in administering the ASI. This one-day training could be combined with the ASI training on tape package as a means to reinforce knowledge attained and maintain coding and rating consistency over time. See ASI Training on Tape

Goal / Educational Competencies

The goal of this workshop is to develop and/or enhance interviewer competencies in correctly utilizing the Addiction Severity Index, a standardized screening and assessment instrument .

Objectives:

• Identify and understand the specific intention of each question asked in the ASI
• Phrase each question in the most efficient way while remaining flexible enough to adapt the instrument to make it more gender, cultural and population sensitive.
• Verify information through the use of cross checking.
• Understand the importance of the use of additional probes (questions) to augment information provided by the client.
• Consistently apply the correct numerical codes in response to client answers.
• Utilize the severity rating procedure.
• Begin to develop an understanding of the functionality of the data collected using the ASI for treatment planning and making patient placement decisions.

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Standard One-Day Booster Session

It is unrealistic to expect that all participants go back to their agencies and implement new knowledge and skills without encountering problems. Participants often have requested the need for an additional day to practice and review what was learned in the standard two-day training and to ask questions about coding issues that have arisen. This booster session allows for that extra day of review in which participants can discuss problems they encountered taking the training to practice.

The Booster Session was designed to follow a standard two-day, one-day, or a distance learning training using the ASI Training on Tape. Booster sessions have been utilized all over the country and follow a similar format as the two-day training. The booster session utilizes the same exercises, procedures and similar materials but focuses on the evaluation and application of skills that participants had only minimally practiced in the Basic two-day training. In this standardized booster training there is more emphasis on evaluation and enhancement of interviewing skills and addressing problems participants may have had in administering the instrument correctly. Overall it is much more experiential with increased utilization of materials and exercises.

It is recommended that the Booster Session Course be taken 30 - 45 days after the Basic One or Two Day ASI Courses. This booster session has also been utilized by agencies that have already received training in order to evaluate interviewer competencies and provide a refresher on coding conventions and rating practices. See ASI Training on Tape

ASI Training on Tape

The videotape series, which was originally designed as a self-training, is essentially an abbreviated version of the standard 2-day training workshop.

More specifically, Training on Tape provides a didactic presentation of introductory information regarding the development and usefulness of the ASI, followed with a detailed presentation on appropriate administration and coding of the ASI interview on a section-by-section basis.

The ASI Training on Tape package can be bought separately or with competency evaluation services as part of a comprehensive long distance learning program. See Products and Services

There is a great need for continuously available, standardized ASI training package that is up-to-date and cost efficient. The following are several reasons contributing to the need for such a training package.

It is burdensome for a treatment program to relieve clinical staff, en masse, from regular responsibilities to attend a 2-day ASI training workshop. What happens traditionally in our field and all over the country is that treatment providers will send one or two staff to an ASI workshop. It is then expected that these individuals will then train the remainder of the staff upon their return to the treatment program.

We can tell you from years of experience that this is one of the biggest mistakes a program director, supervisor or administrators can make and absolutely the wrong way to go about training staff. However it is better than no training at all. The result is the ongoing perpetuation of misinformation about why and how the instrument is to be used.

Agencies may need only 1 or a few people to be trained in the use of the ASI, and there are no inexpensive options for this purpose continuously available on a national basis. In this situation the tapes can be bought as part of our distance learning training program.

Standard and up-to-date training and materials are not always provided by the trainers or organizations that currently conduct ASI training in the field.

Ron Jackson and I have traveled to over 43 states and done hundreds of ASI trainings for thousands of practitioners. We have heard hundreds of times from participants who thought they were trained correctly in how to use the ASI, that in fact they were not trained correctly at all and didn’t even receive any support materials as part of their training experience, not even the ASI Question by Question Manual.

High turnover of substance abuse treatment providers requires that ongoing training options be available and affordable.

If half your staff leaves six months after the ASI training and booster session, how do you get the new staff trained in a cost efficient and effective manner? You use the ASI Training Tapes along with the facilitators guide with some assistance from the staff that was trained and is currently using the instrument correctly.

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Advanced Course For Clinicians

The standard ASI courses in our curriculum are designed to give counselors and other clinical staff basic interviewing skills, the competence to convey the intent of each of the ASI questions to patients and the skills to correctly interpret the answers to their ASI and questions. While these skills are essential, they are not adequate for counselors to use the collected information in their every day assessment, treatment planning and delivery. In the Advanced Course, we begin with those who have the basic skills to collect accurate information, and focus on how this information can and should be used to develop sound placement decisions and treatment plans. This course is only recommended for those who have had the standard ASI course and or the ASI Booster Session.

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Training for Supervisors, Program Directors and Administrators

While it is obviously critical to teach ASI skills to those who will actually administer the instruments, we have found that it is as essential to provide administrators and clinical supervisors with training in: 1) how to maintain reliability and consistency of the information, 2) how to incorporate the collected information into standard clinical decision making and management of clinical policy at the program level, 3) how to develop efficient quality assurance and outcome monitoring procedures that use the collected data that complements the ongoing clinical practice within the program. Included will be strategies and techniques used to supervise, monitor correct use, maintain interviewer competencies, maintain interviewer inter-rater reliability, maintain the reliability of the data collection process, and to utilize the data collected for developing outcome based programming. This is the major focus of this course and those administrators who complete it will be in a better position to actually implement and utilize the data that will be collected.

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ASI & Uniform Patient Placement Criteria’s (i.e., ASAM)

The Goals of this workshop are to develop an understanding of Uniform Patient Placement Criteria, i.e., the American Society of Addiction Medicine’s Patient Placement Criteria I & II, and an understanding of PPC criteria in general and its role in the assessment, placement and treatment of substance abuse and it’s related disorders. In addition and most importantly is for participants to understand the relationship and functionality of the Addiction Severity Index as it relates to assessment and making level of care decisions using patient Placement Criteria and in treatment planning. Mr. Coyne and Jackson have had extensive experience over the years providing training that provides a crosswalk between the ASI and ASAM PPC I & II. This is currently the only course of its kind currently being offered regarding the use of the ASI and Uniform Patient Placement Criteria.

Mr. Coyne has been working collaboratively for several years now on the development and training of a computerized version that integrates both the ASI and Uniform Patient Placement Criteria Dimensions to assist practitioners in making placement decisions. This has been valuable experience both in the application of the placement criteria and in developing standardized ways of training that application in state treatment systems. He most recently has delivered training in six states on the topic. The trainings have al been well received with participants reporting an increased understanding and appreciation for the information collected in the ASI.

Currently there is no proven and effective standardized course that has been shown to produce trainees qualified to use the American Society of Addiction Medicine’s (ASAM) Patient Placement Criteria I or II. The American Society of Addiction Medicine and the original developers of the ASAM criteria agree that there is a great need to develop and test such a curriculum. We believe this workshop achieves the necessary goals needed to equip practitioners with the knowledge and skills required to use Uniform Patient Placement Criteria in making Patient Placement Decisions.

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Training of Facilitators

There continues to be a growing need for the increased availability of cost efficient training in the use of the Addiction Severity Index (ASI). Train the Trainer Programs (TOT’s) unless properly implemented do not provide states and agencies with the infrastructure necessary to continue to provide ASI Training on an as needed basis. Learning to become and ASI trainer or any topic trainer is not an overnight process that is accomplished by attending any two-day training.

Recognizing this we have developed Training of Facilitator Program (TOF). This TOF program allows the individual facilitator to focus on the facilitation of the training and achieving the goals and objectives of the course.

Anyone who facilitates these trainings on a regular basis, is in fact learning each time they do so. This process in and of itself prepares the individual over time to do more of the training themselves and rely less and less on the tapes.

The Training on Tape Series, in conjunction with ASI Interview tapes and the User Guide provides all the necessary information and materials to facilitate an ASI workshop. The User's Guide along with the set of videotapes and interviewer tape(s) has been designed to serve as a flexible resource for those who wish to learn about and use the ASI correctly. The entire package provides a number of training options to select from to best meet existing needs.

ASITRAINING.com staff are currently the only experienced staff in providing training of facilitators.

The ASI Training on Tape package can be bought separately or with competency evaluation services as part of a comprehensive distance-learning program. See Products and Services - ASI Training Tapes

Training of Trainers

There are many reasons for the failure of this otherwise successful model to disseminate information and build infrastructure and capacity to provide ASI training on demand.

Organizations interested in TOT’s who either due to time or fiscal restraints are unable to commit to the completion of the full TOT process, including evaluation of all participants are strongly encouraged to use the Training of Facilitators (TOF’s) as the first step of any TOT process.

Distance Learning and the ASI

ASITRAINING.com offers distance learning on the correct administration and application of the Addiction severity Index. Distance Learning includes the use of ASI Training on Tape in conjunction with a host of competency evaluation and consultation services provided by our Master Trainers.

All participants will be evaluated using scientifically developed competency measures and procedures. These evaluation and consultation services will be available via telephone as well as on line @ ASITRAINING.com.

Users of the ASI distance learning service have reported that the individual evaluation and feedback regarding their specific knowledge and skills in administering the ASI was most helpful. It was an opportunity for specific feedback that is often not available during traditional training workshops.

ASI Computerized Software Training

ASI software has been developed with extensive consultation from the developers of the Addiction Severity Index, Thomas McLellan Ph.D., his clinical and research staff and from practitioners and program directors from around the country. The response to the software, its ease of use, interface, narrative bio-psycho-social and reporting capabilities has been overwhelming positive.

ASI TRAINING.com trainers will provide ASI training in conjunction with ASI Software training. There are several companies that provide ASI software products. ASI TRAINING.com staff has used software from the three leading providers of computerized software for the ASI. It is our opinion based on over 20 years of experience as well as feedback from clinicians and Administrators around the country that the best software currently available is that developed. (In conjuction with Dr. A. Thomas Mc.Lellan and his Staff, call us for more information on this software and how to obtain it.)

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