Program Guide April 2005

Transcription

1 Program Guide April Needham Street, Suite 100 Newton, MA

2 Inflexxion, Inc. 320 Needham Street, Suite 100 Newton, MA These materials are protected under federal copyright laws; they are not to be reproduced by any electronic, mechanical, or other means, including storage or retrieval systems, for any use, except with the express written permission of Inflexxion, Inc. Handouts 1-39 Copyright 2003 Hazelden Foundation are excerpted from Time-Effective Treatment: A Best Practices Manual for Substance Abuse Professionals. Reprinted by permission of Hazelden Foundation, Center City, MN. To order, call or see

3 Table of Contents Introduction.3 Getting Started System Requirements.4, 31 Installation.5 Computer Settings Screen Appearance.6 Font Setting.6 Screen Savers/Scheduled Programs. 7 Audio/Video.7 Copying CD (audio/video) to Hard Drive. 7 Word 2000, 2002, Program Description General Description Administering the ASI-MV Program Features Save & Return / Closing Program.12 Changing client ID / Password Protection.13 ASI-MV 5 Outputs Narrative Report (ReportWriter).14 Consistency of Response Summary.16 Question & Answer Report.16 Brief Screening Report.17 Domestic Violence & Sexual Abuse Summary.17 Action Plan Summary...18 Client Placement Worksheet...19 Outcome Comparison Worksheet...19 Utilization Report.19 Treatment Matching Guidelines...20 Client Worksheets & Handouts...20 Certificate of Completion.21 Backup/Restore.22 Research-Related.23 Clinical Support Terminology / Domains Introducing the ASI-MV 5 to Clients Treatment Planning Program Limitations Buy ASI-MV 5 Uses Troubleshooting Tips Customer Care ASI-MV 5 Computer Checklist Appendix A Certificate of Completion blank Consistency of Response Summary Sample Brief Screening Report Sample Domestic Violence & Sexual Abuse Report Sample

4 3 Introduction Addiction Severity Index Multimedia Version 5 ASI-MV 5 ASI-MV 5 is an interactive CD-ROM program that allows for client self-administration of the widely used ASI. Clients, regardless of education level, reading ability and prior computer experience, can easily use this program and, because it requires no staff or training time to administer, the ASI-MV can be given for a fraction of the cost of the interviewer version. ASI-MV is an engaging audio and video program that guides clients through a series of on-screen offices in which they meet with virtual interviewers. Questions and answer options are presented verbally as well as written on the screen, so that clients need not be literate to self-administer the ASI. Upon completion, reports are immediately available for staff members. In clinical studies, the ASI-MV has proven to have excellent reliability and validity (Butler et al, 2001). It can save treatment centers money, ensure standardization, and become an indispensable part of substance abuse treatment and outcome planning. Research findings appear in: Butler, S. F., et al. (2001). Initial validation of a computer-administered addiction severity index: The ASI-MV. Psychology of Addictive Behaviors, Vol. 15, No. 1, New Features in ASI-MV 5 Instruments: - ASI-MV - ASI-MV Spanish - ASI-MV Lite - ASI-MV Follow-up - ASI-MV CJ (Criminal Justice) Reports: - Narrative Reports - Brief Screening Summary - Client Placement Worksheet (ASAM Dimensions) - Domestic Violence & Sexual Assault Summary - Key Clusters & Problem Lists (treatment planning assistance) - Client Feedback Form Tools: - Treatment Matching Guidelines - Client Worksheets & Handouts

5 4 Getting Started System Requirements for ASI-MV 5 Supported & Recommended Specifications Operating Systems (Supported) Windows 2000 (Service Pack 6 recommended) and Windows XP (Service Pack 1 or 2) Software Applications Microsoft Word * 2000; 2002; and 2003 * MUST be installed BEFORE ASI-MV 5 System Performance 64 MB RAM (128 MB preferred for optimal performance) 15 MB free hard drive space 166 MHz processor Hardware & Peripherals Sound Card Color VGA Monitor CD-ROM player Speakers (headphones optional preferred for laptops) Mouse** Printer (color ink jet recommended) ** It is suggested that laptops running the ASI-MV 5 also have an external mouse for clients to use.

6 5 Getting Started Installation ASI-MV 5 Installation in 10 minutes Some ASI-MV customers will be installing over previous versions of the program. Do not uninstall earlier versions. Once the new version is installed please consult the Backup/Restore section to merge your data. 1. Insert ASI-MV CD-ROM into the CD drive. 2. Double-click My Computer icon on your desktop. 3. Double-click on the CD drive that reads ASI-MV5. 4. Double-click on the SETUPASIMV5.exe icon. 5. Click Yes to install the program. 6. Click Next at the ASI-MV Welcome screen. 7. Click Next at the Destination Directory screen. 8. Click Finish to end installation. The ASI-MV 5 program is now loaded on your computer. Some systems may require you to restart for new settings to take affect. If you are prompted to restart, please do so before continuing. 9. The ASI-MV5 icon will now be located on your computer desktop. Double-click this icon to open the program (If the icon does not appear on your desktop, go to C:\Program Files\ASIMV5 and right click on the icon and choose send shortcut to desktop). Your Administrator Password: Please see the Computer Settings section on the following pages for important details regarding the program before administering to clients.

7 6 Getting Started Computer Settings Screen Appearance For optimal performance, the computer s settings should be set to 800x600 or 1024x768. Check the current settings on your computer in the control panel and adjust if necessary. Changing the Display Settings: 1. Click on Start in the lower left toolbar 2. Scroll up and select Settings and then select Control Panel 3. Double-click on Display 4. Click on the Settings tab 5. Move the arrow under Screen Area to the left or right depending on current setting until it is set at either 1028x768 or 800x To save settings or to simply close window if settings are already correct click OK and close all open windows by clicking on the X in the upper right corner of window. 7. You may be prompted to restart the computer for new settings to take affect. If prompted to do so, restart your computer now. Font Size Should the display settings appear incorrect when running the program (for example, pictures and/or buttons are not aligned) please check your display settings to ensure your computer is displaying at 96 dpi. Setting the Font Size: 1. Click on Start in the lower left toolbar 2. Scroll up and select Settings and then select Control Panel 3. Double-click on Display 4. Click on the Settings tab 5. Click on the Advanced button 6. Set Display/Font Size to Normal size - 96 dpi 7. To save settings or to simply close window if settings are already correct click OK and close all open windows by clicking on the X in the upper right corner of window. 8. You may be prompted to restart the computer for new settings to take affect. If prompted to do so, restart your computer now.

8 7 Getting Started Screen Savers & Scheduled Programs Some ASI-MV users have experienced problems with audio and/or video playback on computers running screen savers, anti-virus software, and/or scheduled programs (for example, system scans). If you encounter similar problems please try temporarily disabling these programs while administering the ASI- MV. Remember to enable them when the ASI-MV is complete. For further clarification, or to report problems, contact Inflexxion Customer Care toll-free at Audio & Video As specified in System Requirements (page 3), a sound card is required for the ASI-MV program. Without one the audio and video files will not play and the program will display an error message. If you are experiencing any problems with the audio or video and are not sure if you have a sound card please consult the documentation that came with your computer. If you are having problems with audio or video and are sure that it is not sound card-related, check your computer connections to: 1) make sure that external speakers are both plugged into the system as well as to electrical outlets; 2) make sure that headphones if applicable are plugged in correctly; and 3) make sure that volume is turned up. If you cannot resolve the sound problem or are having any problems with video playback, please contact Inflexxion Customer Care for assistance, toll-free at Copying the ASI-MV 5 to Hard Drive The ASI-MV 5 CD-ROM contains the audio and video files needed to run the program and must be in the computer s CD drive when administering the ASI-MV. If you do not want to use the CD each time or are experiencing audio and/or video playback problems you may want to copy these files to your computer s hard drive. Doing so will eliminate the need to use the ASI-MV CD and will also improve program performance. Before beginning, verify that the ASI-MV 5 CD-ROM is in the CD drive. 1. Double-click the ASI-MV5 icon located on your computer desktop. 2. Enter your Administrator Password Click on the Administration button 4. Click on Screen Setup 5. Click on ASIMV-v5 Directory This will copy all the ASI-MV audio and video files to the hard drive and you will not need the CD-ROM in the CD player to run the program.

9 8 Getting Started Microsoft Word Settings (versions ) The Client Narrative, Question & Answer, Brief Screening and Domestic Violence & Sexual Abuse Reports all contain macros. Microsoft Word security settings must be set accordingly to ensure that reports generate. Before running any of the above reports for the first time, settings may need to be adjusted. Setting Macros Security 1. Open Microsoft Word and select Tools from the toolbar 2. Select Macros 3. Select Security 4. Set Security Level to Medium by clicking on the radio button 5. Click OK to close menu and close the Word program. Settings are now adjusted for all ASI-MV reports.

10 9 Program Description General Description The ASI-MV 5 is a self-administered, multimedia interview that consists of seven sections or domains: 1. Medical 2. Education & Employment 3. Alcohol 1 4. Drug 5. Legal 6. Family & Social 7. Psychological The program s video narrators, George and Angela, introduce the program as well as each domain and reappear throughout to provide positive feedback to the client. Each domain has its own video interviewer, appropriate for the section (i.e., doctor for Medical; lawyer for Legal, etc.), who introduces the topic and provides voiceovers for the questions within. Questions and answers are read aloud within the ASI-MV so that a client need not be literate to use the program. Answer options also blink or flash when read so that it is clear which option is being read. Repeat and Back buttons on each screen allow a client to repeat the question and answers as well as change answers when necessary on previous screens. NOTE: Clients may only change answers in the domain/section that they are currently working in. It is not possible to go back to another domain/section to change answers. While previous experience with a computer is not necessary for a client to successfully use the program, manipulating the mouse may be difficult at first for some users. It is suggested that a staff person sit with the client through at least the General section to show him or her how to point and click when necessary. Depending on a client s reading ability as well as previous computer experience with a mouse, as noted above completion of the ASI-MV should take approximately 45 minutes. At the conclusion of the program, the client will be presented with the option to print a Certificate of Completion. Inflexxion has found that this certificate is an important component of the program the clients respond very favorably to them and encourages facilities to print them for their clients. If you are unable to print the certificate, a blank copy is included at the end of this Program Guide for you to copy and distribute as needed. 1 The Alcohol and Drug Domains have been combined into one section within the program. Separate scores are still generated for Alcohol and Drug.

11 10 Program Description Administering the ASI-MV 5 1. Double-click the ASI-MV 5 icon in the Start menu to start the program. 2. At the Password screen type in the Administrator Password and then click Enter. 3. Select Run ASI-MV at the Administrator screen. 4. Enter client s information at the Intake screen. If the client does not have, or does not want to use his or her Social Security number please enter Click Enter to begin program. NOTE: Once you enter your facility information in the Facility fields it will be saved for future administrations. 5. You will then be presented with the Introductory screen and the client can click anywhere on the screen to begin the program. Inflexxion suggests that a staff person sit with the client through the first section, the demographic section, to ensure that the client is comfortable with the mouse and understands how to answer questions and advance to the following questions/sections.

12 11 Program Description 6. When the client has completed the seven 2 ASI-MV sections he or she will be presented with the option of printing or not printing a personalized Certificate of Completion. NOTE: There is only one opportunity to print this certificate for each client and Inflexxion suggests doing so. Facilities using the ASI-MV program have found that overwhelmingly, clients enjoy receiving the certificate. If you are unable to print the certificate, a blank copy is included in Appendix A of this Program Guide for you to copy and distribute as needed. The ASI-MV 5 is now complete. Staff may now open the ASI-MV to generate and view reports for this client as beginning on page The Alcohol and Drug Domains have been combined into one section within the program. Separate scores are still generated for Alcohol and Drug.

13 12 Program Features Save & Return Because the ASI-MV 5 uses a Microsoft Access database to store program data, client data is saved throughout the administration of the program automatically. In the event that the program closes either because of a system failure or by a client s own desire to stop ASI-MV data are saved. The client may continue where he or she left off when the program is started again within seven days. To restart the program and continue, the administering staff person should open the ASI-MV and select the Start ASI-MV button. This will open a screen that lists the number of clients that have not completed the program. Once a client name is selected there are the following options: Restart the program where the client left off Start a new ASI-MV for a new client Deactivate an incomplete client record Back to the Administration Screen NOTE: Because of time sensitive 30 day questions, any incomplete client records will be deactivated automatically from the program after 7 days. Deactivated clients will only produce Question & Answer Reports. See page 15 for details. Selecting Restart the program will then open a confirmation screen showing the ASI-MV video narrators, George and Angela. Staff will be presented with the last question answered and they can choose to start at this screen or restart from the beginning. The client will then be brought to the appropriate section of the program. Closing Program If a client needs to stop the program during an administration, staff may shut it down by double-clicking on the small gray box in the bottom left corner of the screen and clicking Yes when prompted. As discussed above, when the program is restarted the client s name will appear in the list of incomplete records.

14 13 Program Features Changing Client ID To change a client ID in the program, select the List of Clients button from the Administrator screen. Select the client whose ID you would like to change. Click on the Change Client ID button. Select Yes on the confirmation popup window. Assign a new ID and close. The ID number is now changed and will be reflected in all outputs generated from this point forward. Password Protection The ASI-MV requires password entries at various points in the program to protect sensitive client data. The password is always Enter this code when opening the program, enter this code when generating reports (except for the Utilization Report), and enter this code to open reports that have already been generated.

15 14 Program Features ASI-MV 5 Outputs Narrative Report (ReportWriter) The ReportWriter is an application that uses macros to transfer those data gathered during the ASI-MV administration into a Microsoft Word template to produce a password protected Narrative Report. The Narrative Report contains the following information: Severity & Composite Score tables Domain summaries Detailed drug and alcohol use history Psychiatric risk table Summary of the most severe domains Score Discrepancy Table DSM IV Diagnosis Template (for clinician completion, if desired) Consistency of Response Summary Generating the Narrative Report: 1. Open the ASI-MV program and enter the 1235 password 2. Select Reports on the Administration screen 3. Select Narrative Report from the Reports screen 4. Select the type of report you wish 5. Enter the password when prompted 6. Select Enable Macros when prompted (If you do not get the Macros box please consult the Microsoft Word settings section) 7. Select the client s name from the drop down list and click Generate

16 15 Program Features Depending on which version of Microsoft Word the computer is running, as well as its processing speed, this process may take anywhere from 10 to 60 seconds to complete. It will be saved automatically using client name and date and time for the file name to your computer s hard drive. You may print the document as you would any Microsoft Word document once it has generated. NOTE: The Report will automatically be saved to C:\ Programs \ ASIMV5 \Reports As with any Microsoft Word document, the Narrative Report may be edited 3 and saved in any location once generated the computer s hard drive, network drive, or floppy disk drive. The generated report may be opened on any computer running Microsoft Word. To access generated reports in their default save location: 1. Double-click on My Computer to open 2. Double-click on C drive hard drive 3. Double-click on Program Files 4. Double-click on ASI-MV5 5. Double-click on Reports folder. All generated Narrative Reports are saved in this location by default during generation. Once you have generated a client s report, you may simply go to the above location to retrieve it, edit it, and/or move it to another location. You will be prompted to enter the password when opening generated reports. NOTE: Once a report has been edited you want to open it using the above process. Using the ASI-MV Narrative Report button will generate another, non edited, copy of a client s report. Editing Narrative Reports Once the Narrative Report is generated in Word on your computer screen, you can edit it, add data and include your clinical impressions. In fact, after each domain you are prompted to do so, such as this example in Alcohol and Drug. Clinician Impressions/Information (e.g. more specifics on current alcohol/drug use amounts and patterns, problems with past sobriety attempts, problems with past treatment episodes and attitude about wanting help at this time.): Remember to click on the Save icon in Microsoft Word or Edit/Save on the toolbar to save any changes that you make to the document after it generates (e.g., clinical comments). If you are prompted to save changes to ReportWriter v5_1.doc when closing Microsoft Word, please select NO. Saving changes to the template document/application may corrupt your report. 3 The Composite and Severity Score table within the report may not be edited. These scores are locked.

17 16 Program Features Consistency of Response Summary The ASI-MV has a built-in consistency check of 27 pairs of questions, which, if not answered the same way, suggest a client may misunderstand or be deceiving the program. Located at the end of the Narrative Report, the Consistency of Response Summary details questions and answers that did not correspond correctly during the ASI-MV interview and may suggest client confusion, inaccuracy or deception. These questions should be part of a counselor/clinician follow-up. Please see Appendix B for sample. Checking Psychiatric Risk In addition to your face-to-face assessment of clients mental status, the ASI-MV provides you with valuable information about their self-reported risk factors. It is recommended at a minimum that clinicians review the Psychiatric Risk Questions immediately after an ASI-MV is completed and take appropriate action, if indicated. Psychiatric Risk Questions Listed below, are twelve questions of the Psychiatric Status section along with Mr. Client s answers to them. This gives the clinician important information, which may require immediate face-to-face intervention or follow-up if answered YES. In the past 30 days, have you had times when you heard voices or saw things that other people couldn t see and hear? Other times in your life? In the past 30 days, have you had times when you had trouble controlling your temper or violent behavior? Other times in your life? In the past 30 days, have you seriously considered a plan for killing yourself? Other times in your life? In the past 30 days, have you attempted suicide or tried to kill yourself? Other times in your life? Have you had trouble thinking clearly today? Have you had trouble concentrating today? Have you been hearing voices today? No No No No No No No No Not at all Not at all Not at all Question & Answer Report The Question & Answer Report details each question in the ASI-MV, the answers available for each question, and the client s response to each question. The report also shows the questions a client skipped. As with the Narrative Report described above, this report is created using a Microsoft Word template and is automatically saved by client name and date and time during generation. This report is also saved in the default location noted above, but can be saved in another location and/or moved to another computer provided it is running Microsoft Word.

18 17 Program Features Generating the Question & Answer Report: 1. Open the ASI-MV program and enter the password 2. Select Reports on the Administration screen 3. Select Question & Answer Report from the Reports screen 4. Enter the password when prompted 5. Select Enable Macros when prompted (If you do not get the Macros box please consult the Microsoft Word settings section) 6. Select the client s name from the drop down list and click Generate Simply close Microsoft Word when you are finished working with the report. Brief Screening Report The Brief Screening Report is a single page summary of key elements of a client s ASI-MV responses, including answers that may indicate potential psychiatric risk. It can be used to assist staff in deciding whether or not to refer for a full evaluation. This report is created using Microsoft Word and is automatically saved by client name and date and time during generation. This report is also saved in the default location noted in the Narrative Report description, but can be saved in another location and/or moved to another computer provided it is running Microsoft Word. Generating the Brief Screening Report: 1. Open the ASI-MV program and enter the password 2. Select Reports on the Administration screen 3. Select Brief Screening Report from the Reports screen 4. Enter the password when prompted 5. Select Enable Macros when prompted If you do not get the Macros box please consult the Microsoft Word settings section. 6. Select the client s name from the drop down list and click Generate Domestic Violence & Sexual Assault Screening Summary The Domestic Violence & Sexual Assault Screening Summary is a single page summary of key elements of ASI-MV responses that may be useful indicators of domestic violence and/or sexual assault. This document was proposed by the Division of Domestic Violence & Sexual Assault Services of the Oklahoma Department of Mental Health and Substance Abuse. This report is created using Microsoft Word and is automatically saved by client name and date and time during generation. This report is also saved in the default location noted in the Narrative Report description, but can be saved in another location and/or moved to another computer provided it is running Microsoft Word.

19 18 Program Features Generating the Domestic Violence & Sexual Assault Screening Summary: 1. Open the ASI-MV program and enter the password 2. Select Reports on the Administration screen 3. Select Domestic Violence & Sexual Assault Screening Summary from the Reports screen 4. Enter the password when prompted 5. Select Enable Macros when prompted If you do not get the Macros box please consult the Microsoft Word settings section. 6. Select the client s name from the drop down list and click Generate Action Plan Summary The Action Plan Summary presents data extracted from the ASI-MV, across all domains, and arranges it in a useful manner for assistance with treatment planning including Problem Lists and the following Key Clusters: Client s Perception of problems Client s Motivation to get help for problems Possible Psychiatric Risks Potential Strengths / Supports Recovery Environment Assets & Liabilities The summary also includes a Client Feedback Sheet with ASI-MV severity ratings and the definitions of each domain, which the clinician can offer clients, a blank Treatment Planning Form or template, and a sheet listing the Client Handouts and Worksheets. Generating the Action Plan Summary: 1. Open the ASI-MV program and enter the password 2. Select Reports on the Administration screen 3. Select Action Plan Summary from the Reports screen 4. Enter the password when prompted 5. Select Enable Macros when prompted (If you do not get the Macros box please consult the Microsoft Word settings section) 6. Select the client s name from the drop down list and click Generate

20 19 Program Features Client Placement Worksheet The Client Placement Worksheet contains the six dimensions of the ASAM Patient Placement Criteria. It is populated with data from the ASI-MV within each dimension and the clinician is prompted to add further information and rate the Risk of each dimension. This tool is intended to assist with effective client placement. Generating the Client Placement Worksheet: 1. Open the ASI-MV program and enter the password 2. Select Reports on the Administration screen 3. Select Client Placement Worksheet from the Reports screen 4. Enter the password when prompted 5. Select Enable Macros when prompted (If you do not get the Macros box please consult the Microsoft Word settings section) 6. Select the client s name from the drop down list and click Generate Outcome Comparison Worksheet The Outcome Comparison Worksheet is used for comparing ASI-MV Composite Scores to track progress and outcome. The worksheet is populated with current ASI-MV composite Scores and clinicians can enter the previous scores they wish to compare. Generating the Client Placement Worksheet: 1. Open the ASI-MV program and enter the password 2. Select Reports on the Administration screen 3. Select Outcome Comparison Worksheet from the Reports screen 4. Enter the password when prompted 5. Select Enable Macros when prompted (If you do not get the Macros box please consult the Microsoft Word settings section) 6. Select the client s name from the drop down list and click Generate Utilization Report The Utilization Report produces frequencies of aggregate, anonymous, demographic and clinical ASI- MV data from each computer running the program and NOT all computers running the program. The report is searchable by time period year, month, week and day so that a user may look at changes in client population over different periods. For example, a user may want to compare clients from January of 2004 to those in March of These reports may not be saved, but may be printed for reference.

21 20 Program Features To generate a Utilization Report: 1. Open the ASI-MV program and enter the password 2. Select Reports on the Administration Screen 3. Select Utilization Report on the Reports screen 4. Choose the time period you would like to look at on the calendar buttons 5. Click on the Print button Close the Utilization Report window by clicking on the X in the upper right corner. Treatment Matching Guidelines The Treatment Matching Guidelines provide information to clinicians on key issues, further assessment, intervention considerations and resources, in order to most effectively respond to deficit areas in each domain of the ASI-MV. It includes guidelines for using the principles of Stages of Change and Motivational Enhancement. Generating the Treatment Matching Guidelines: 1. Open the ASI-MV program and enter the password 2. Select Reports on the Administration screen 3. Select Tool Box from the Reports screen 4. Select Treatment Matching Guidelines Client Worksheets & Handouts Client Worksheets and Handouts are tools a clinician can print and distribute for client education and homework. These resources are used with the express written permission of Hazelden Publishing and Education Services. Handouts 1-39 Copyright 2003 Hazelden Foundation are excerpted from Time-Effective Treatment: A Best Practices Manual for Substance Abuse Professionals. Reprinted by permission of Hazelden Foundation, Center City, MN. To order, call or see Generating the Client Worksheets & Handouts: 1. Open the ASI-MV program and enter the password 2. Select Reports on the Administration screen 3. Select Tool Box from the Reports screen 4. Select Client Worksheets and Handouts

22 21 Program Features Certificate of Completion At the conclusion of the ASI-MV program, clients are presented with option of printing a personalized Certificate of Completion. This certificate announces that they have successfully completed the AS-MV. Inflexxion has learned that the certificate is very important to most clients, and some clinicians have reported that their clients feel a sense of accomplishment at completing the assessment. Inflexxion encourages facilities to print these certificates whenever possible since the option is only available at the conclusion of each assessment. If you are unable to print the certificate, a blank copy is included in Appendix A of this Program Guide for you to copy and distribute as needed.

23 22 Program Features Backup & Restore Backup Each time the program is closed, a backup copy of the ASI-MV Microsoft Access database is automatically saved on the computer s hard drive. To locate these files: 1. Double-click on My Computer 2. Double-click on C drive hard drive 3. Double-click on Program Files 4. Double-click on ASI-MV5 5. Double-click on Database folder 6. Double-click on Backup folder Backup databases are stored in this folder. If your computer is not running Microsoft Access you may see the Microsoft Windows icon rather than the Microsoft Access icon. These backup files may also be saved to other locations such as network drives and/or floppy disks. While the program automatically saves a copy of the database whenever it is closed, it is also possible to manually backup the data either to the computer s hard drive or to a floppy disk. NOTE: To save to a floppy disk, make sure to insert a disk prior to beginning the Backup/Restore function. To backup database manually: 1. Open ASI-MV and enter password 2. Select Backup/Restore button on Administrator screen 3. Under Step 1 on the Backup screen select Backup 4. Under Step 2 on the Backup screen choose your backup location hard drive, network drive, floppy disk drive, etc. 5. Under Step 3 on the Backup screen choose Start. 6. When backup is complete you will receive an Operation Successful message You may close the program at this point as backup is complete. If you receive an error message during any part of this process please contact Inflexxion Customer Care toll-free at

24 23 Program Features Restore In the event that you need to reinstall the program or move data to another machine, the Restore feature allows for you to restore the most recent database saved. This could be an automatic backup or a manual backup as noted in the Backup section. To restore data: 1. Open ASI-MV and enter password 2. Select Backup/Restore button on Administrator screen 3. Under Step 1 on the Backup screen select Restore 4. Under Step 2 on the Backup screen choose the location of your backup database hard drive, network drive, floppy disk drive, etc. 5. Under Step 3 on the Backup screen choose Start. 6. When restore is complete you will receive an Operation Successful message NOTE: When restoring a backup database, you will lose the ASI-MV uses currently licensed to your machine. Please note the number of uses remaining BEFORE restoring data. This information may be found on the Administrator screen. This screen will show the number of uses licensed to your machine and the number of uses available. The number of uses available may be replaced by calling Inflexxion Customer Care toll-free at You may close the program at this point as restore is complete. If you receive an error message during any part of this process please contact Inflexxion Customer Care. Research Related The ASI-MV program has a data export feature that allows data gathered in the Microsoft Access database to be exported into a comma deliminated text file for importation into Microsoft Excel and/or statistical software programs. This text file output exports variable labels for the record set (matched to Dr. Tom McLellan s Addiction Severity Index 5 th Edition variables) and each record in the database. To export data: 1. Open ASI-MV and enter password 2. Select Backup/Restore button on Administrator screen 3. Under Step 1 on the Backup screen select Export to Data File 4. Under Step 2 on the Backup screen you will see the default save location for this file: the ASI-MV5 folder on your hard drive. 5. Under Step 3 on the Backup screen choose Start. 6. A pop-up box will appear asking if you want to include personal

25 24 Program Features identifiers in this output (i.e., name, social security number, etc.). You may select Yes or No. At this point, if this file already exists you will be prompted to replace it. 7. When backup is complete you will receive an Operation Successful message Each time you export a data file the file will append to reflect additional ASI-MV records. You may close the program at this point as restore is complete. If you receive an error message during any part of this process please contact Inflexxion Customer Care. To import this file into Excel: 1. Open Microsoft Excel 2. Select Data on the toolbar 3. Select Get External Data 4. Select Import Text File 5. Locate the text file on your computer in the Import Text File box 6. Under Step 1 on the Import Text Import Wizard Window select Delimited and select Next 7. Under Step 2 on the Import Text Import Wizard Window check Comma under Delimiters and uncheck Tab. Select Next 8. Under Step 3 on the Import Text Import Wizard Window click Finish 9. Select OK on the Import Data pop-up box

26 25 Clinical Support Report Terminology This support is primarily for clinicians who want to know such things as how to present the ASI-MV to clients and how to use the Severity Ratings and Composite Scores. Severity Ratings are the clinical summary scores most commonly used by clinicians. They are useful for identifying problem areas that may need attention. These ratings are clinically meaningful and are often used for treatment planning. Severity Ratings are normally not used for research or outcome evaluation because they factor in client responses to "lifetime" questions, which should not change in subsequent administrations. Composite Scores are generated from a number of items in each Domain that refer to the client's behavior, mostly within the last 30 days (not "lifetime"). Therefore, Composite Scores are useful for measuring change in problem status and can be effectively used in research and outcome evaluation. NOTE: Questions that are skipped may make it difficult for the ASI-MV to provide an accurate picture of the clients problems. Skipping questions may also result in some domain Severity Ratings and Composite Scores to not generate. If there is no Severity Rating or Composite Score generated for a Domain, the clinician can go over the questions in that Domain with the client in a face-to-face meeting. Perception Scores are generated in each domain from the client s answer to the question, In the past 30 days, how troubled or bothered have you been by alcohol problems (or drug, medical, employment legal, family, social, or psychological problems). The answer options are: 0 = Not at all; 1 = Slightly; 2 = Moderately; 3 = Considerably; 4 = Extremely. Motivation Scores are generated in each domain from the client s answer to the question, How important is it to you now to receive treatment for alcohol problems (or drug, medical, employment legal, family, social, or psychological problems). The answer options are: 0 = Not at all; 1 = Slightly; 2 = Moderately; 3 = Considerably; 4 = Extremely. Domains There are six sections or destinations to which the client is guided after the main introduction 4. Each section offers a slightly different virtual environment designed to make the interview experience less redundant and boring to the client. However, the basic structure of the question and answer interface remains consistent throughout all seven domains. The domains and associated questions are derived from the content of the standard ASI interview. The seven domains are: Medical Status: These questions ask about hospitalizations, chronic medical problems, medications and perceptions of illness. The purpose is to identify medical problems that need attention. Clients rate their level of concern for these medical problems in the last 30 days, and how important it is to get treatment for them now. 4 The Alcohol and Drug Domains have been combined into one section within the program. Separate scores are still generated for Alcohol and Drug.

27 26 Clinical Support Employment/Support Status: These questions collect information on occupation, employment status and means of support. The purpose is to establish clients' level of concern over employment problems and how important they feel it is to get counseling for these problems now. Alcohol Use: These questions ask about alcohol use and treatment. Clients are asked about their use and asked to indicate their level of concern over their use. Clients are also asked how important receiving treatment or counseling is at this time. Drug Use: These questions ask about drug use and treatment. Clients are asked about their use of a range of substances and to indicate their level of concern over their use. Clients are also asked how important receiving treatment or counseling is at this time. Legal Status: These questions ask about arrests, convictions and incarceration for a variety of illegal activities. Clients are asked to indicate their level of concern over legal problems, such as arrests, charges and convictions. Clients also rate how important it is for them to receive counseling or referral for these problems now. Family/Social Relationships: These questions collect information on marital status, living arrangements and social relationships. Clients are also asked about their satisfaction in these areas and if treatment or counseling is desired. Psychiatric Status: These questions ask about the occurrence of psychological or emotional problems such as depression, anxiety, psychotic symptoms and suicidal ideation. Clients are asked about inpatient and outpatient treatment for pthese problems, as well as psychiatric medications. Clients are also asked about the level of their concern over psychiatric problems and whether treatment or counseling is desired. Introducing the ASI-MV to Clients Asking clients to use computers to enter information about themselves may be difficult for some counselors and staff. Some worry that it might be too impersonal, or not confidential enough. There are also concerns that clients may not know how to use a computer mouse, or may be afraid of failure. In clinical trials with clients representing a broad range of population demographics, Inflexxion found that: Client acceptance of the ASI-MV and the computer was very high; Clients found the program engaging and easy to use; Clinicians were able to spend more face-to-face counseling time with clients and less data gathering. As with any assessment, there will always be some clients who will not or cannot take the ASI-MV. However, the following tips may be helpful when introducing the client to the ASI-MV: Explain that all clients are asked to take this questionnaire.

28 27 Clinical Support Assure them that information gathered is confidential, as is the rest of the information in their file. Tell them the ASI-MV is an interview they complete on a computer that will talk them through each section. It will present them with videos of people who will guide them through the program and that any time they need a question repeated, they can click the Repeat button; Ask if they would like some help in learning how to use the mouse. Explain that they will be presented with mostly multiple-choice questions and will be asked to select the best answer. After answering each question, they must click the "Enter" button at the bottom of each screen. Explain that the interview asks questions in different areas: medical; legal, employment; family/social; alcohol/drugs; and psychological. Emphasize that this assessment will provide an overall view of problem areas as these may relate to their use/abuse of alcohol/drugs. Tell them that for each of the areas, they will be asked how serious they feel the problems are and whether they want help with those problems. Tell them that some of the questions may not apply, or may sound unusual, but "please bear with the program and answer as best you can." You may find it useful to tell clients that some people find answering questions on the computer is more comfortable than with a counselor. Emphasize that they should make a real effort to answer all questions. QUESTIONS THAT ARE SKIPPED MAY MAKE IT DIFFICULT FOR THE ASSESSMENT TO PROVIDE AN ACCURATE PICTURE OF THE PROBLEMS WITH WHICH THEY ARE STRUGGLING. SKIPPING QUESTIONS MAY ALSO RESULT IN SOME DOMAIN SEVERITY RATINGS AND COMPOSITE SCORES NOT GENERATING. If there is no Severity Rating or Composite Score generated for a Domain, the clinician can go over the questions in that Domain with the client in a face-to-face meeting.

29 28 Clinical Support Treatment Planning As stated above, Severity Ratings can assist clinicians with treatment planning. High Domain ratings help clinicians target those deficit areas for intervention. It is understood that most substance abuse treatment settings do not have vocational or legal resources. However, an effective treatment plan would address how a client could access those needed resources. The following are samples of treatment plans in different problem areas. These samples are adapted from the National Institute on Drug Abuse publication, "Assessing Client Needs Using the ASI: A Handbook for Program Administrators" (NIH Publication No , 1993, page 15): 1. Medical: "Refer to medical clinic for evaluation and treatment. Provide HIV counseling and encourage testing." 2. Employment: "Reassess after medical and psychiatric treatments have begun," or "Gather more history to identify reasons why client cannot hold a job. Refer to vocational rehabilitation program." 3. Alcohol Use: "Initiate alcohol counseling, refer to AA and support AA attendance" 4. Drug Use: "Client abstinent, continue counseling," or "No action" 5. Illegal Activity: "Refer to legal aid for consultation," or "Talk with lawyer to clarify legal requirements of Driving While Intoxicated conviction" 6. Family/Social: "Refer to social worker for evaluation of family problems and recommendations for treatment" 7. Psychiatric: "Refer to psychiatrist for evaluation and recommendations for treatment," or "Re-evaluate for emergence of depression after alcohol counseling is underway" Program Limitations The ASI-MV has been developed for use with adults seeking substance abuse treatment and is not designed for use with adolescents or children. There are a number of other assessment tools for adolescents. As with any assessment or intervention, there may be some clients for which the ASI-MV is not suitable. Clinicians need to determine if a client's current mental status is appropriate for sitting down for an extended session at a computer. If the client is disorganized, agitated, intoxicated or otherwise not in an appropriate state of mind to take the ASI-MV, alternative assessment approaches will be necessary. NOTE: The ASI-MV is intended to be a significant part of a complete psychosocial evaluation, however, by itself, it is not a complete psychosocial evaluation.

30 29 Buying ASI-MV Uses Each ASI-MV CD-ROM is shipped with 5 free administrations, or uses of the ASI-MV already loaded. To purchase additional uses, to purchase an Unlimited Use site license, or to unlock uses already purchased, please select the Buy ASI-MV Uses button on the Administrator Screen and call Inflexxion Customer Care toll-free at the new uses or the site license term will be added to your computer by exchanging numbers over the telephone. When you call for more uses of the program you will need to read the Inflexxion Customer Care Representative the 15-digit serial number showing on your Buy ASI-MV Uses screen. It is important that you include all characters in the serial number: dashes, commas, etc. if applicable. NOTE: Because there is some confusion between some letters and numbers, it is helpful to remember that all letters are lower case numbers are larger (e.g., o is a letter and 0 is the number zero; l is a letter, i is a letter and 1 is a number). Once you have read the serial number you will be given a code to enter in the Purchase Key field. Enter this code and select Enter to record your new uses. Because not all facilities have telephones in the same area as the computers, you may record the serial number and enter the Purchase Key code at another time you do not need to physically be in front of the computer when you call to purchase uses. Purchase Key codes expire after 24 hours, however, so it is important that you enter this code before the end of the day.

31 30 Troubleshooting Tips If you experience any problems with audio or video playback, please refer to the Computer Settings - Audio/Video section of the manual for tips. If the computer running the ASI-MV is in a public space, it is suggested that facilities equip it with headphones for client privacy given the personal nature of some of the questions. Please ensure that printer connections are well established so that the Certificate of Completion may be printed for clients. There is only one opportunity to print the certificate at the end of the program and printer problems may result in a client s inability to receive one. If a facility would like extra (blank) copies of certificates to distribute to clients in case of printer problems, please request them using the Inflexxion toll-free number. Facilities may also white out a client s name on an existing certificate and photocopy for additional clients. If you are unable to find a client in the Narrative Report list, verify that the client did in fact finish the program. Reports are not generated for unfinished assessments. Data may be found in the Question & Answer report, however. Customer Care Please consult the ASI-MV Computer Checklist (page 35) prior to reporting technical problems. This will allow Inflexxion Customer Care to identify and fix reported problems in a timelier manner. For assistance with any part of this program or to purchase additional uses please contact Inflexxion Customer Care toll-free at Inflexxion business hours are 9 am to 5 pm (EST) Monday through Friday. For calls after 5 pm, please leave a message on the Customer Care voic and someone will get back to you the following business day. For clinical-related and/or sales questions, please contact: Al Villapiano, Ed.D. Lisa Morrison, BSW Vice President of Clinical Development, ASI-MV Account Executive Substance Abuse Ext. 258 Ext. 222 lmorrison@inflexxion.com avillapiano@inflexxion.com For Customer Care and/or Technical Support questions please contact: Kristin Coffey Technology Manager Substance Abuse Ext. 268 kcoffey@inflexxion.com

32 31 Troubleshooting ASI-MV 5 Computer Checklist The following items should be checked if the ASI-MV does not operate correctly. Any configuration that does not meet the minimum configuration (page 3) might cause audio/video problems or cause the computer to freeze because the ASI-MV is a multimedia presentation that uses considerable system resources. Type of Computer The ASI-MV will operate on any computer that is running at the minimum configuration listed below. There are some computers that use special configurations (EMachine or some clones) that can cause problems (usually associated with shared memory with the video card). These systems must be specially configured, as discussed below, to operate the ASI-MV correctly. Operating System and Service Pack The ASI-MV is designed to operate on, Windows 2000 (Service Pack 6 recommended) and Windows XP (Service Pack 1 or 2) Additional Software Needed The ASI-MV requires Microsoft Word 2000; 2002; or 2003 to generate the reports and other outputs. Word MUST be installed BEFORE installing ASI-MV 5 Amount of Memory (RAM) on the Computer Generally, the ASI-MV will run on any computer that meets the memory standards for the Windows operation system. It is recommended, however, that a minimum of 128 MB of memory be available for the program to run at its optimal performance. Free Space on Hard Drives The ASI-MV system requires less than 15 MB of space on the hard drive. However, as the database grows, free memory must be available to accommodate the database. This could grow to many hundreds of MBs depending on the number of cases run on the computer. In addition, inasmuch as the computer uses free space on the hard drive for virtual memory, there should be as much as 700 MB free for that purpose. Total Number of MB for Virtual Memory Usually the operating system sets the space required for virtual memory. However, in some instances (e.g., shared memory configurations), the user must reset the virtual memory manually. Tests have shown that the ASI-MV will operate with the minimum/maximum set to 350/650 MB. This can usually be set in the Performance area of the system specification in the Control Panel. Type of Video Card, Audio Card & the Amount of Memory on the Card The ASI-MV utilizes considerable resources for video and audio because it is a multimedia presentation. System specifications will define these parameters. Service Packs The Windows operating system generally is installed with a number of standard libraries that are required to operate most applications. The ASI-MV utilizes some of these libraries. If your computer did not have a standard installation, some of these required libraries might not be present. To account for this, the ASI-MV has included a number of these libraries in the installation package. However, if the ASI-MV does not operate correctly, please call Inflexxion Customer Care for assistance in identifying and acquiring missing or outdated libraries. Disk Defragmentation Performance will suffer if the disk is highly fragmented. Each of the operating systems has a defragmentation tool in the systems utilities. This process should be done on a regular basis.

33 32 Troubleshooting ASI-MV 5 Computer Checklist The following checklist should be filled out for each item discussed below. Each of these items may be found by clicking on the Start button on the bottom toolbar and selecting Settings then Control Panel. Choose System in the Control Panel window to display computer settings. Computer Specifications Type of Computer (please note the model & make of computer e.g., Dell 8200 series) Operating System/Service Pack (e.g., Windows 2000, Service Pack 2) Microsoft Word Version* (e.g., Word 2000) Memory Hard Drive Free Space Virtual Memory Video & Audio Card/Memory ASI-MV Build Number ** * To find version of Microsoft Word, open Word program, select Help and About Microsoft Word. **To find ASI-MV build number, open program and look for number on Password Screen in upper-right corner.

34 Appendix 33 A ASI-MV 5 Program Guide