The Truth About Chemical
Information you need to know before making your appointment.
If you've been
ordered by the courts to get a chemical health assessment (or chemical
health evaluation), or requested by your employer, or out of your own
personal concern, there are things you must know when
seeking a chemical health evaluation in order to avoid a
misdiagnosis and inappropriate recommendation which could
lead to negative outcomes effecting you for years (financial,
professional, legal, etc.).
Chemical health assessments are also
known as chemical health evaluations, chemical dependency assessments,
alcohol and drug assessments and
more. Many places provide chemical health
assessments: hospitals, treatment centers, government agencies, and
private, independent chemical health evaluators.
Below are four things you should know
before scheduling an appointment for your chemical assessment.
I was contacted by an
individual who felt he had been misdiagnosed. He wanted another
assessment to serve as a second opinion. The original diagnosis
was Chemically Dependent with the recommendation that he
complete an outpatient treatment program. As a
result of this assessment he was out of work (no pay and no benefits -
except COBRA) until he completed an outpatient treatment program.
Issue #1 - No
collateral contacts were made as part of the first evaluation.
Issue #2 - I
completed an evaluation for this client with the client reporting
occasional drug use (marijuana once every four to six months).
Upon completion of the evaluation, including collateral contacts, I
found nothing (according to the mandated diagnostic criteria for
problem pattern use) to indicate dependency issues. This
person may have been making a few bad decisions which caused some
problems, but he was not Chemically Dependent.
important if someone is diagnosed with patterns consistent with chemical
dependence or chemical abuse, they receive the proper
referral and help they need.
It's equally important for a person to be diagnosed correctly with a
proper recommendation provided. As in the case above, the
misdiagnosis cost this person his livelihood.
#1. How Experienced is the Evaluator?
Do they have a license to conduct
chemical health evaluations? Is the person conducting the evaluation
fresh out of school? How many years have they been conducting
assessments? Choose an experienced evaluator who has worked with
many clients through a broad spectrum of situations. Evaluators who
have limited experience or have only worked in one area of service may
not be your best choice to serve your needs.
Note: Interviewing skills are imperative
to the assessment process and the correct diagnosis. An
experienced, skilled interviewer starts with a clean slate and asks
appropriate questions in order to gather enough information to
thoroughly understand the client's history and current
situation. An evaluator's interview with you should consist
of much more than simply reading questions from a standard form.
For example, an evaluator at a treatment center may utilize an
assessment tool for determining level of care for treatment
services. This type of assessment tool may not be appropriate for
all clients since not all clients need treatment services. A
skilled, experienced evaluator understands there are limitations to
these types of tools and will ask additional qualifying questions in
order to thoroughly understand a client’s situation and make
It is also important that the evaluator
understands the client's legal right to the least restrictive diagnosis
as mandated by law through DSM-IV-TR* criteria concerning diagnosis and
#2. What's Included
in an Evaluation and How Much Time Does It Take?
Where does the
interview take place? It's critical that the interview is conducted
during a face-to-face confidential meeting, in a private setting in
order to assess a client appropriately.
The evaluation consists of an in-depth
interview which takes about 2 hours. It takes time to conduct a
quality interview and to understand and document your whole
story. Your chemical use will be
reviewed along with the impact of that use on your
daily life and relationships during the interview.
Collateral information should be
gathered during the interview. You will be asked to bring in
names and contact information of people who you know and know your
situation. They will serve as your collateral contacts to provide
additional information in the evaluation process. There may be a
few situations where collateral contacts aren't necessary, but that's
the rare exception, not the rule.
A woman called me for advice. She
recently completed a chemical health evaluation conducted by another
evaluator. She had received a DUI (her first) and wanted an
independent assessment completed prior to going to court. The
diagnosis from the evaluation was Alcohol Abuse and the
recommendation was a 12 hour education course to support her
Issue #1 - The recommendation included in
the original evaluation wasn't appropriate for the diagnosis.
Issue #2 - The summary provided to the
client was brief and didn't offer any information or explanation as to
the reason for the diagnostic impression.
Issue #3 - I completed an evaluation for
this client and I found nothing to substantiate the diagnosis of Alcohol
The damaging effects from a misdiagnosis
can be hard to correct.
#3. What Will You Be Receiving After the
information should provide more than one or two brief
paragraphs. You should receive a detailed summary of the
evaluation with the diagnosis and recommendations The summary should
provide specific, documented, itemized information which justifies the
diagnosis and clearly communicates to the client how and why the
clinician arrived at their diagnostic impression.
I prefer to
present my evaluations in a narrative format. This format allows the
flexibility to present the client's situation and my findings in a
manner that is detailed, thorough and understandable. This format
has proven to be very effective for my clients, particularly in
providing supportive information for a client's court case.
is the Cost?
The average cost is
$250.00. What's more important than cost is the value of the
service provided. Receiving the wrong service at a low price
can end up being very costly to you. Make sure you are receiving
the right service at the right price.
If a person is seeking chemical dependency services and
needs public funding to pay for the treatment, the State of Minnesota
provides financial help to those who qualify. More information
can be found here.