CONTENTS

About This Course

Table of Contents

1. Introduction to the Issues
2. Understanding Alcohol Abuse
3. Understanding Violence Against Women
4. Alcohol and Domestic Violence
5. Alcohol, Sexual Assault, and Rape
6. Prevention and Early Intervention
7. Screening and Assessment
8. Diagnosis and Treatment
9. Legal and Ethical Issues

Supplements
Fact Sheets
Videos
Resources

Silence Hurts
Alcohol Abuse and Violence Against Women

Module Content Objectives Introduction General Screening For Domestic Violence and Sexual Assault -- Domestic Violence Screening Statements -- Additional Statements of Support Addressing Alcohol Abuse With Domestic Violence Clients -- Screening Instruments for Alcohol Use -- Assessments For Alcohol Use -- Talking About Alcohol Abuse -- Supporting Sobriety Assessing Violence for Women in Alcohol Treatment -- Domestic Violence Screening -- Domestic Violence Assessment Tips Addressing Alcohol Abuse With Men in Treatment For Violence -- Alcohol Screening -- Alcohol Assessment Addressing Domestic Violence With Men in Alcohol Treatment -- Abuse Screening -- Timing for Batterer Intervention/Relapse Prevention Child Maltreatment and Abuse Psychiatric Comorbidities -- Dual Diagnosis Safety Planning Summary of Module References Module 7 Quiz

Screening Instruments for Alcohol Use

Many instruments are available for screening. Screening questions can be asked through an in-person interview, a written questionnaire, a computerized questionnaire, or a telephone interview. Any positive responses should lead to further questions about consequences. Alcohol screening in clinical practice should be consistent with other screening procedures in place.

In some settings, screening instruments are given as self-report questionnaires, with instructions for the patient to discuss the meaning of the results with his or her health care provider. Not all patients can read well enough to complete questionnaires.

CAGE

The CAGE questionnaire,¹¹ which has been validated, is one of the most well-known, widely used alcohol screens. It consists of four questions, which can be self-administered-even by those with low reading skills-and can be modified to screen for use of other drugs.

The CAGE can be administered formally or informally as part of the intake process or when alcohol problems are suspected. Positive responses on the CAGE are for lifetime problems, not current problems. Before administering the CAGE or any other screen, it is important to confirm that the person does currently drink alcohol and that positive responses relate to problems experienced recently, usually within the past year.

AUDIT

The Alcohol Use Disorders Identification Test (AUDIT) has been validated cross-culturally. Because there are few culturally sensitive screening instruments, the AUDIT may prove useful for identifying alcohol problems among ethnic minority groups. Laboratory tests generally are used only to supplement screening tests.^12,13

The Michigan Alcohol Screening Test (MAST)

The MAST is one of the most widely used tools for alcohol abuse. The measure is a 25-item questionnaire designed to provide a rapid and effective screening for lifetime alcohol-related problems and alcoholism. The MAST has been used in many settings and with varied populations.

The Short Michigan Alcohol Screening Test (S-MAST)

The Short Michigan Alcohol Screening Test (S-MAST) is aimed at identifying individuals with alcohol abuse or alcoholism. This shorter version has been adapted from the longer MAST.

Additional Alcohol Screening Tools

In addition, instruments are available for determining quantity and frequency of alcohol consumption. Typical screening questions can be used to screen for alcohol use. Assessment and followup screening questions on alcohol use provide greater detail about drinking patterns. These questions provide greater specificity about drinking and are not prone to underreporting errors when patients have to report their average consumption over time. These questions can be used to track a patient's alcohol use.

Screening For Depression and Other Health Conditions

Although two or more positive responses are indicative of an alcohol problem, a positive response to any one of the questions should prompt further exploration. The Goldberg Depression Questionnaire and The Center for Epidemiological Studies Depression Scale can help supplement alcohol screening to determine whether depression is also present.

The Health Screening Survey addresses a range of health issues including physical activity, smoking, and nutrition.