What are the requirements and changes?
The revisions to Standard CTS.03.01.09 consist of the following:
Revised element of performance (EP) 1 that requires organizations to use a standardized tool or instrument to monitor an individual’s progress
New EP 2 that requires organizations to analyze the data generated by this activity and use the results to inform the individual’s goals and objectives as needed
Revised EP 2, renumbered as EP 3, that requires organizations to use their data to evaluate outcomes of care, treatment, or services provided to the population(s) they serve
Treatment Planning With Brief Addiction Monitor Assessments
Brief addiction monitor assessments, or BAM, can help by:
- Determining the patient’s strengths
- Indicating the presence of a problem
- Providing evidence of goal achievement by measuring progress on objectives.
- Targeting and measuring the effectiveness of interventions for specific deficiencies in the patient’s lifestyle.
“Enhanced precision and consistency in disease assessment, tracking, and treatment to achieve optimal outcomes”
In the past 30 days (or 7 days if it’s a follow-up), how many days have you felt depressed, anxious, angry or very upset throughout most of the day?
In the past 30 days (or 7 days if it’s a follow-up), how many days did you drink ANY alcohol?
The Measurement-Based Care Approach
All clients in treatment for SUD receive a baseline BAM upon admission to the program.
The baseline data and feedback (MET) session inform treatment planning.
Follow-up BAMs are administered repeatedly throughout the client’s course of treatment, typically every 30 days, just prior to treatment plan reviews, and at the transition between levels of care.
The follow-up data and feedback sessions inform adaptive treatment efforts. Follow-up BAMs also may be administered as a mechanism of outreach, via MET, to out-of-treatment clients.
Treatment Planning and the BAM: Interventions Based on Items
Specific items to attend to, and suggested referrals, include:
- #1 (health), refer to primary care
- #3 (mood), proceed to further assessment, i.e., suicide risk, and confer with MH Treatment Coordinator
- #5,6,7 (heavy alcohol use, any drug use, specific drug use), any reported use warrants discussion with the client to consider adjusting treatment (e.g., a higher level of care or changing modality)
- #8 (craving), consider medicinal adjuncts, i.e., naltrexone, acamprosate.
- #14 (adequate income), consider CWT, HUD-VASH, vocational counseling.
- #16 (social support), consider adding network support
- #17 (satisfaction with progress), warrants discussion of modifications or supplements to treatment
Note: Examining scores from individual items as described above is the most clinically relevant use of this measure. Composite scoring is supplementary and very preliminary. It is based on clinical judgment rather than empirical data.
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