TPC-Journal-V6-Issue2

The Professional Counselor /Volume 6, Issue 2 124 Procedure and Materials The procedures involved here were approved by the sponsoring institution’s Institutional Review Board and the data collection sites, and were consistent with the American Counseling Association’s Code of Ethics (2014). Three licensed counselors who had completed two graduate courses in testing and assessment conducted standardized interviewing and administered SASSI-3s. All three counselors completed training in SUD interviewing and SASSI-3 administration and scoring prior to the study’s beginning. All persons receiving treatment at sites 1 and 2 were asked to participate. A total of 117 of the 118 (99.2%) persons at site 1 and 61 of the 64 (95.3%) persons at site 2 agreed to participate. Sixty-three of 79 students (79.8%) enrolled in one of three separate undergraduate counseling courses agreed to participate. Each participant met individually with a researcher who used the structured SUD questionnaire to conduct an interview and administered the SASSI-3. The SASSI-3s were scored and interpreted by a fourth researcher who had no knowledge of the interviewing researchers’ diagnostic impressions. For quality control purposes, the senior author reviewed the SASSI-3 scoring and questionnaire results. Instruments Structured Substance Use Disorder Questionnaire . At present, no structured guide or screen exists that was developed and normed using the current DSM-5 SUD criteria. To ensure that the counselors were uniform in their substance use interviews and that their interviews were consistent with the DSM-5 criteria, we designed a 22-item questionnaire to determine whether participants would meet criteria for a DSM-5 SUD. This questionnaire was based on the 11 criteria for an SUD from the DSM-5 (APA, 2013). These items were yes/no questions corresponding to the criteria for an SUD and were divided into two sections. The first 11 items applied to alcohol use and the second 11 items applied to the use of other drugs. Consistent with the DSM-5 ’s SUD section, participants who responded “yes” to two or more items in either section met criteria for a DSM-5 substance use disorder. Endorsement of two items in the first section indicated the participant met criteria for an SUD involving alcohol use; endorsement of two items in the second section indicated the participant met criteria for an SUD involving other drugs. Severity of the SUD was based on decision rules provided in the DSM-5 : 2–3 symptoms indicated a mild SUD, 4–5 symptoms indicated a moderate SUD, and 6 or more symptoms indicated a severe SUD (APA, 2013). Counselors clarified the meaning of items as needed. No distinction was made between different types of drug use (marijuana, cocaine, etc.) because the SASSI-3 does not do so. The internal consistency estimates for the alcohol and other drug use sections were high ( α = .94 and α = .97, respectively). Data Analysis The authors used two methods of statistical analysis. Cohen’s kappa was used to measure the agreement between the two dichotomous DSM-5 SUD diagnosis variables (i.e., met criteria or not) and the overall score on the SASSI-3 (high probability of substance dependence disorder/ low probability). Cohen’s kappa also was used to compare the DSM-5 diagnosis of either an SUD involving alcohol or one involving other drug use to the score on the SASSI-3 subscale 1 (FVA) or subscale 2 (FVOD), respectively. It was then used to measure agreement between the DSM-5 SUD diagnosis and the scores on subscales 3–9 on the SASSI-3. The value of the kappa is between 0 and 1 and is divided into 5 levels of agreement: .01 to .20 signifies slight agreement; .21 to .40 fair; .41 to .60 moderate; .61 to .80 substantial; and .81 to .99 near perfect agreement (Landis & Koch, 1977). Unlike the kappa, ROC curve analysis is used with continuous variables. ROC analysis allows one