Asi Questions

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COMMONLY ASKED QUESTIONS ABOUT THE ASI The Interview Format - Does It Have to be an Interview? This is perhaps the most often asked question regarding the ASI. In the search for faster and easier methods of collecting data many clinicians and researchers have asked for a self-administered (either by computer or paper and pencil) version of the instrument. We have not sanctioned the use of a self-administered version for several reasons. First, we have tested the reliability and validity of the severity ratings by having raters use just the information that has been collected on the form - without the interview. This has resulted in very poor estimates of problem severity and essentially no concurrent reliability. Second, we have been sensitive to problems of illiteracy among segments of the substance abusing population. Even among the literate there are problems of attention, interest and comprehension that are especially relevant to this population. Finally, since the instrument is often used as part of the initial clinical evaluation, it has been our philosophy that it is important to have interpersonal contact for at least one part of that initial evaluation. We see this as simply being polite and supportive to a patient with problems. We have seen no convincing demonstration that the interview format produces worse (less reliable or valid) information than other methods of administration and we have found that particularly among some segments of the substance abusing population (eg. the psychiatrically ill, elderly, confused and physically sick) the interview format may be the only viable method for insuring understanding of the questions asked. Particularly in the clinical situation, the general demeanor or "feel" of a patient is poorly captured without person-to-person contact and this can be an important additional source of information for clinical staff. There are of course many useful, valid and reliable self-administered instruments appropriate for the substance abuse population. For example, we have routinely used selfadministered questionnaires and other instruments with very satisfactory results (eg. Beck Depression Inventory, MAST, SCL-90, etc.) but these are usually very focussed instruments that have achieved validity and consistency by asking numerous questions related to a single theme (eg. depression, alcohol abuse, etc.). The ASI is purposely broadly focussed for the purposes outlined above, and we have not been successful in creating a viable self-administered instrument that can efficiently collect the range of information sought by the ASI. Thus, it should be clear that at this writing there is no reliable or valid version of the ASI that is self-administered and there is currently no plan for developing this format for the instrument. We would of course be persuaded by comparative data from a reliable, valid and useful self-administered version of the ASI and this is an open invitation to interested parties. Role of the Interviewer - What are the qualifications needed for an ASI interviewer? Having indicated the importance of the interview process it follows that the most important part of the ASI is the interviewer who collects the information. The interviewer is not simply the recorder of a series of subjective statements. The interviewer is responsible for the integrity of the information collected and must be willing to repeat, paraphrase and probe until he/she is satisfied that the patient understands the question and that the answer reflects the best judgment of the patient, consistent with the intent of the question. It must be emphasized that the interviewer must understand the intent of each question. This is very important since despite the range of situations and unusual answers that we have described in the manual, a new exception or previously unheard of situation occurs virtually each week. Thus, ASI interviewers should not expect to find answers in the workbook to all of the unusual...
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