Frequently Asked Questions
- How do you interpret the Supplemental Addiction Measure (SAM)?
- How do you interpret the slope of the line formed by the scale scores?
- My client wants to get his driver’s license back. He reports abstaining from alcohol for over a year. Should I have him complete the SASSI for a lifetime or for the past year?
- Should I use the SASSI or the BADDS?
- A client admits to a severe issue with gambling...although her Face Valid scales are low, the SASSI finds a high probability of dependence. Does this confirm a gambling addiction?
- Is it acceptable to read the SASSI to a client who is illiterate or blind?
- How accurate is the SASSI?
- Is the SASSI-3 accurate for older adults?
- Will SASSI stand up in court?
- Does the SASSI command high credibility in the court?
- Does the SASSI identify those with substance use disorders specifically, or does it classify as test positive anyone who may have another psychiatric disorder or problems in adjustment and functioning?
- What happens if the SASSI results are subpoenaed?
- How well utilized is the SASSI among courts?
How do you interpret the Supplemental Addiction Measure (SAM)?
SAM scores are used in the Decision Rules to increase the accuracy of other subscales. Interpretation of the SAM is not a function of its use.
How do you interpret the slope of the line formed by the scale scores?
Although some clinicians draw on ‘anecdotal’ reports to predict behavior patterns based on the slope of the line, this practice is not supported by SASSI data and is discouraged. Individual subscales may be interpreted with caution only as directed by the SASSI User’s Guide.
My client wants to get his driver’s license back. He reports abstaining from alcohol for over a year. Should I have him complete the SASSI for a lifetime or for the past year?
Either is acceptable. Your client and the court should be made aware that the SASSI cannot determine if a client is currently drinking. The Face Valid items may show no drinking during the past year, but the subtle scales reflect personality traits that do not change quickly. For instance, someone who is in recovery for an extended period of time will more than likely still show as having a high probability of a substance use disorder.
Another option is to administer the Behaviors & Attitudes Drinking & Driving Scale (BADDS) to determine the extent to which your client may be at risk for drinking & driving.
Should I use the SASSI or the BADDS?
If your objective is to identify those who are likely to have a substance use disorder, screening instruments such as the adult, adolescent, or Spanish SASSI measures can assist you to this end. If your goal is to identify more specifically those who are likely to engage in impaired driving behaviors, or if your goal is to evaluate the effectiveness of an impaired driving intervention, the BADDS is a highly valuable tool.
A client admits to a severe issue with gambling. She is taking several prescribed medications for chronic illnesses. Although her Face Valid scales are low, the SASSI finds a high probability of dependence. Does this confirm a gambling addiction?
No. The SASSI should not be used to determine whether or not someone has a gambling addiction. However, there does appear to be a high probability that the client has a substance use issue and further exploration into her prescription drug use would be appropriate. For instance, does the client take only prescribed medications in quantities approved and overseen by a single physician?
Is it acceptable to read the SASSI to a client who is illiterate or blind?
Occasionally reading the questionnaire to a client is acceptable. However, we do strongly recommend that clinicians take advantage of our professionally read CD and/or audiotape. Using the professional CD or audiotape will ensure that the questions are read to the client in a way that would not interfere with the accuracy of the responses.
How accurate is the SASSI?
The Adult SASSI-3 and Adolescent SASSI-A2 have an overall empirically tested accuracy of 94 percent. Validation research on the Spanish SASSI indicates an overall accuracy rate of 84%
When should I administer the Adolescent SASSI (SASSI-A2) vs. the Adult SASSI (SASSI-3)?
The Adolescent SASSI (SASSI-A2) should be used with youth between the age of 12 and 18 years. Exceptions can be made. For example, it may be appropriate to administer the SASSI-3 (adult version) to a 17 year old who no longer lives with his/her parents and is full self-supporting. On the other hand, the SASSI-A2 may be more appropriate to use with an 18 year old in high school who is still dependent on his or her parents.
Is the SASSI-3 accurate for older adults?
Yes. Validation research on the SASSI-3 found no variance in accuracy between adults 60 years or older versus the general adult population.
Will SASSI stand up in court?
If you mean will the judge always agree with the results of SASSI-3 decision rules, we actually hope not. The SASSI-3 is a highly accurate screening instrument but does not agree with clinical judgment 100% of the time. In 6% of cases of adults with diagnosed substance use disorders, the SASSI screening results will likely fail to identify the disorder (i.e., the SASSI-3 demonstrated 94% sensitivity in validation research). Similarly, in 6% of adults diagnosed by clinician as NOT having a substance use disorder, the SASSI-3 decision rules are likely to indicate a high probability of them having a substance use disorder (i.e., 94% specificity). This is why we encourage counselors to use their judgment and other information from interviews with the individual and family members when possible, as well as other information on treatment and court records when formulating their diagnoses. The SASSI does not yield a clinical diagnosis but rather a screening result that can be used as one piece of information when conducting clinical diagnostic evaluations
Does the SASSI command high credibility in the court?
Yes. One reason is the accuracy of the screening results (overall accuracy of 94%; 94% sensitivity and specificity). One important part of this credibility is that many other screening measures deliberately set their cutoff scores very low in order to maximize sensitivity of their instruments, often at the cost of misidentifying those without substance use disorders as test positive (i.e., low specificity). In contrast, one goal in developing the SASSI-3 decision rules was to balance the false positive and false negative error rates.
Does the SASSI identify those with substance use disorders specifically, or does it classify as test positive anyone who may have another psychiatric disorder or problems in adjustment and functioning?
Another reason the SASSI-3 has high credibility is that while other screening instruments may misidentify individuals with emotional problems as if they were alcoholic or drug addicted, the SASSI was developed to not confuse general maladjustment with substance dependence. Research on the SASSI-3 has found that patients who are receiving clinical services but who do not have alcohol or drug problems are correctly identified as non substance dependent at the same level of accuracy as other individuals with neither substance nor psychiatric problems (i.e., the SASSI-3 accuracy in classifying those diagnosed as not having a substance use disorder in three types of service settings did not differ significantly: General Psychiatric Hospitals, 91%, Vocational Rehabilitation, 96%; Sex offender treatment program, 95%). Research has also shown the accuracy of the SASSI-3 to be unaffected by wide variations in clients levels of adjustment and functioning.
What happens if the SASSI results are subpoenaed?
Counselors who have their diagnoses, including test results subpoenaed by defense attorneys have told us that they often offer instead to loan the attorney a copy of the SASSI manual. Frequently the attorney will review the manual and successfully convince their client to plea bargain rather than try to challenge the diagnosis.
How well utilized is the SASSI among courts?
The SASSI is not only accepted, but is actually required in a sizeable number of courts. For example, we are aware of five states that require everyone arrested for a DUI (DWI) to be given a SASSI and Behaviors & Attitudes Drinking & Driving Scale (BADDS) as part of the evaluation. Other examples of government mandated administrations occur in areas such as detention and correctional facilities, and probation departments.