Screening and Assessment in Addiction Treatment

assessment in rehab reflection in water


There are two familiar terms in the addiction treatment field – “screening”  and “assessment”. But do most people seeking treatment know the differences between these two processes? Or why screening and assessment are so important to the diagnosis and development of specific treatment recommendations? Screening, and assessment can also enhance positive recovery outcomes.


What is Screening and Assessment

Screening occurs when someone who is seeking help for their addiction makes that first call. They are evaluated for the presence of a problem with alcohol and/or drugs. The outcome of the screening process is usually a simple “yes” or “no.” An assessment is a more detailed process for defining the nature of a substance problem. An assessment is used to diagnose substance use disorders (SUDs), co-occurring disorders, and to develop specific treatment recommendations such as residential or outpatient treatment.

The Nuts & Bolts of Assessment

The assessments done at Sanford are performed by master’s level therapists. They explore the whole person’s life, with emphasis on their preferences and priorities. Some of the questions are:

  • What has worked for you in the past when you have tried to change your lifestyle and/or behaviors?
  • What is the history of your substance use?
  • Is there a history of alcohol of drug use in the family?
  • Mental health history and emotional concerns?
  • Physical health history and medication use?
  • Are their cultural, ethnic or spiritual matters to consider?
  • What are your relationship issues with significant others, children, and parents?
  • And what are the reasons you are seeking help?


Thoughtful consideration is given to each individual’s strengths and resources as well as potential opportunities to secure support from family, friends, and community. And all information gathered in an assessment is highly confidential and protected by HIPAA and federal confidentiality regulations. Furthermore, the interviewing strategy is non-judgmental and focused particularly on a person’s most significant and valued accomplishments, strengths, gifts and natural talents.


We also use tests and inventories for client assessments

We also use tests and inventories during assessments to help determine the level of care needed for treatment. These inventories are short, with mostly “true” or “false” or “yes” or “no” answers. Moreover, we look for inventories that have specific profiles for women or men.


We undergo all of the formal and professional procedures in gathering information. We also recognize the power of simple, direct questions when working with our clients. I often just ask, “What happened? What do you think would be helpful?” and “Tell me about the real you.The person you know you are inside. Not the one caught up in this addiction.”


an assessment is a reflection - lotus water


Who Are You?

Gathering pieces of information throughout treatment is all part of the continuing assessment process. At Sanford we are ever searching for the answer to the question, “Who are you?” Discovering this is not so much looking for an answer, but teaching our clients a process. We teach them to stay in recovery and to acknowledge their true core. We help them accept all their feelings, not just the socially acceptable ones. And we help them make decisions about their deepest values and meanings.


For the women of Sanford House at Cherry Street …

It is interesting to note that after a lifetime of work, the brilliant psychoanalyst Sigmund Freud declared he didn’t know what women wanted. (Perhaps he didn’t have the proper assessment tools!) However, over 150 years ago journalist and female activist Margaret Fuller was able to assess and define women in a way that stands the test of time. She wrote,“What a woman needs is not as a woman to act or rule, but as a nature to grow, as an intellect to discern, as a soul to live freely and unimpeded to unfold such powers as are given to her.”


This too, is the gift of recovery…

Sanford House Addiction Treatment Centers



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Marilyn Spiller is a viral writer, recovery coach, and recovery advocate. She is the Marketing Director at Sanford, responsible for written and creative content, website design, new media, promotions, subscriber outreach, and SEO. Excursions Magazine is a particular source of pride; it serves a wide range of readers, and “excursion” has become part of the company vernacular, describing Sanford’s signature experiential outings for those in treatment. She also developed and hosts the podcast Anatomy of Addiction and is Vice President of the Board of JACK Mental Health Advocacy.