riskandneeds.com - Substance Abuse Questionnaire (SAQ) -----------------------------

The Substance Abuse Questionnaire (SAQ) is an adult substance (alcohol and other drugs) abuse assessment instrument or test that also assesses aggressiveness, resistance and stress handling abilities. The SAQ has 153 items, takes 25 to 30 minutes to administer and reports are available on-site within 2½ minutes of test data input. The SAQ is an adult (male and female) automated (computer-scored) self-administered test. The SAQ has six measures or scales: 1. Truthfulness Scale, 2. Alcohol Scale, 3. Drugs Scale, 4. Aggressiveness Scale, 5. Resistance Scale and 6. Stress Coping Abilities Scale.

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The SAQ is much more than just a test for alcohol and drug use or abuse. It also measures client truthfulness when tested along with client aggressiveness, resistance and stress handling abilities. Many of these important behaviors are missed by other tests.

A concise, objective and standardized assessment instrument that provides substance (alcohol and other drugs) use and abuse information along with other attitudinal, behavioral and stress handling abilities is rare. When identifying substance use/abuse, it's very important to know if the client was being truthful. And, from a supervisory and counseling/treatment perspective, it's equally important to establish how aggressive and resistant the client will be. When screening patients, defendants and probationers, it facilitates intervention and outcome to identify the presence of established emotional and mental health problems. When a client scores at or above the 90^th percentile on the Stress Coping Abilities Scale, that client very likely has a serious emotional/mental health problem and should be referred for a comprehensive psychological evaluation, diagnosis and treatment plan. Obviously, all clients don't have serious problems, yet you need to screen the clients in your program to identify those that do.

At one sitting of approximately 30 minutes' duration, staff can acquire a vast amount of important and helpful information. As noted earlier, early problem identification facilitates timely intervention, referral and treatment outcome. An example SAQ report is presented at the end of this webpage. To go directly to this report, click on this SAQ Example Report link.

Screening and assessment instruments filter out individuals with problems that may require referral for more comprehensive evaluation, appropriately respond to different levels of supervision, or benefit from different types of counseling and treatment programs. This filtering systems works as follows:

Reference to the above table shows that a problem is not identified until a scale score is at or above the 70^th percentile. These risk range percentiles are based upon the many defendants, probationers and patients that have completed the SAQ. This procedure is fair and avoids extremes such as over-identification and under-identification of problems.

Using the above table for reference (contingent upon adopted policy), 11% of the people screened (Severe Problem) could be referred for evaluation, treatment or additional services. In this example, 89% of the people screened would not be referred for additional (and often unnecessary, as well as expensive) services.

Savings (dollars) would be large with no compromises in clients receiving appropriate evaluation and/or treatment services. Indeed, it is likely that more clients would receive help. Without a screening program, there is usually more risk of over or under-utilization of additional professional services.

SAQ test booklets are provided free. These booklets contain 153 items and are written at a 5^th to 6^th grade reading level. If a person can read the newspaper, they can read the SAQ.

In brief, SAQ reports summarize the client's self-report history, explain what attained scores mean and offer specific score-related recommendations.

Within 2½ minutes of test data entry, automated (computer-scored) 3-page reports are printed on-site. These reports summarize a lot of information in an easily understood format. For example, reports include an SAQ profile (graph), which summarizes all scale scores at a glance. Also included are scale scores, an explanation of what each score means and specific score-related recommendations. In addition, significant items (direct admissions) are highlighted, and answers to a built-in interview (last sequence of items) are presented. Emphasis is placed on having meaningful reports that are easily understood and helpful.

An example SAQ report is presented at the end of this webpage. To go directly to this report, click on the SAQ Example Report link.

The SAQ has a proprietary built-in database that insures inclusion of administered SAQ tests in a confidential (no names) manner. SAQ reliability, validity and accuracy statistics are reported in the document titled "SAQ: An Inventory of Scientific Findings." Annual database analysis further demonstrates that SAQ scales have high reliability and validity coefficients.

For example, interscale consistencies (coefficient alphas) for SAQ scales are reported in the following table for 3,184 clients tested with the SAQ. This is one among many samples.

All SAQ scales have alpha coefficients well above the professionally accepted standard of .75 and are highly reliable. And, all coefficient alphas are significant at the p<.001 level.

Early validity studies used criterion measures and were validated with other tests like the Minnesota Multiphasic Personality Inventory (MMPI) L-Scale and F-Scale, 16PF, SAQ-Adult Probation III, Defendant Questionnaire, Taylor Manifest Anxiety, etc. Much of this research is summarized in the document titled "SAQ: An Inventory of Scientific Findings." Subsequently database analysis based studies further support SAQ reliability, validity and accuracy. To review a research study involving 3,184 clients click on the SAQ Research Study link.

The SAQ is available in Windows format. Windows diskettes require a one-time setup procedure after which SAQ data (25 or 50 tests) diskettes are used to score and print reports.

Training manuals are provided free, and new test users can be walked through these procedures over Risk & Needs Assessment, Inc.'s (Risk & Needs) telephone line.

Proprietary SAQ diskettes contains 25 or 50 test applications. These 3½" diskettes score, interpret and print reports on-site. Once an SAQ account is established, ordered diskettes are mailed to users. Approximately 97% of orders are filled the same day they are received. When all test applications on a data (25 or 50) diskette are used, that diskette is returned to Risk & Needs where the demographics and test data are downloaded into the SAQ database for subsequent analysis.

The proprietary "delete names" program is activated by the test users with a few keystrokes to delete all client names from the diskette before it is returned to Risk & Needs. Deleting all client names insures protection of each client's confidentiality and compliance with HIPAA (federal regulation 45 C.F.R. 164.501).

The SAQ system contains a proprietary database. Earlier, it was noted that all SAQ used diskettes are returned to Risk & Needs, and the test data is downloaded into the cumulative SAQ database. This database allows ongoing research and testing program summary features that were not possible before. Ongoing research insures quality control. Annual testing program summaries provide for program self-evaluation. And, database analysis and annual testing program summaries are provided free.

In summary, all returned SAQ diskettes' test data is centrally filed at Risk & Needs' offices in the SAQ database. This database has many advantages. Database analysis permits ongoing cost efficient research that includes scale alpha coefficients, ANOVA, frequency distributions, correlations, cross-tab statistics along with reliability, validity and accuracy determinations. A research study can be reviewed by clicking on the SAQ Research Study link.

Risk & Needs can access each of its tests' built-in databases for statistical analysis and summarization of all tests administered in a year. Annual Summary Reports are prepared for state, department, agency and even some individual providers -- at no cost to them. These reports are provided as a professional courtesy to large volume test users. Summary reports include demographics, court-history when relevant, and test statistics (reliability, validity and accuracy). Has anyone offered to summarize your testing program? Annually? At no additional cost to you? Minimum testing volume for annual reports is 350 tests. There is no maximum limit. Risk & Needs' annual reports range in size from 350 tests to over 55,000 tests annually. An example Annual Summary Report can be viewed by clicking on this Annual Summary Report link.

The SAQ is to be used in conjunction with experienced staff judgment. When available, court records and counseling or treatment records should be reviewed. Experienced staff should also interview the client. For these reasons, the following statement is contained in each SAQ report: "SAQ reports are confidential and are considered working hypotheses. No diagnosis or decision should be based solely upon SAQ results. The SAQ is to be used in conjunction with experienced staff judgment."

Truthfulness Scale: Identifies denial, problem minimization and faking. It is now clear that many probationers attempt to minimize their problems. A Truthfulness Scale is now a necessary component in contemporary probationer tests. The SAQ's Truthfulness Scale has been validated with the Minnesota Multiphasic Personality Inventory (MMPI), polygraph exams, other tests, experienced staff judgment and truthfulness studies. The Truthfulness Scale has been demonstrated to be reliable, valid and accurate. In some respects, the SAQ's Truthfulness Scale is similar to the MMPI's L and F-Scales. It consists of a number of items that most people agree or disagree with.

Truth-Corrected Scores: Have proven to be very important for assessment accuracy. The proprietary truth correction program is comparable to the MMPI's K-Scale correction. The SAQ's Truthfulness Scale has been correlated with the 5 other scales. The Truth Correction equation then converts raw scores to Truth-Corrected scores. Truth-Corrected scores are more accurate than raw scores. Raw scores reflect what the client wants you to know. Truth-Corrected scores reveal what the client is trying to hide.

Aggressiveness Scale: Is often defined in terms of punitive behavior. And, we are familiar with the aggressive-frustration hypothesis that postulates aggressive behavior is largely a response to frustration. The Aggressiveness Scale refers to a person's ranking on an outgoing to assaultive behavior scale. High risk scores on the Aggressiveness Scale manifest strong self-assertiveness, social dominance and a tendency toward hostility.

Resistance Scale: Measures defensiveness, non-compliance and oppositional behavior. This scale score varies directly with the client's attitude, feelings and outlook. This scale also measures defensiveness, resistance to help and uncooperativeness. Some people resist help; whereas, others accept it.

Stress Coping Abilities Scale: Measures how well the probationer handles stress, tension and pressure. How well a person manages stress can effect their adjustment and mental health. We now know that stress exacerbates emotional and mental health problems. This scale is a non-introversive way to screen established (diagnosable) mental health problems. A probationer scoring at or above the 90^th percentile on the Stress Coping Abilities Scale should be referred for a more comprehensive evaluation and diagnosis. This important area of inquiry is missed by other probationer screening tests.

More than just another alcohol or drug test. In addition to alcohol and drugs, the SAQ assesses other important areas of inquiry like truthfulness, denial and faking, aggressiveness and stress coping abilities. The SAQ is specifically designed for substance abuse assessment. It provides the information needed for understanding probationer attitudes and behavior.

Three ways to give the SAQ. The SAQ can be administered in three different ways: 1. Paper-pencil test booklet format is the most popular testing procedure. SAQ English and Spanish test booklets are available. 2. SAQ tests can be given directly on the computer screen. Some probation departments dedicate computers for SAQ testing. And, 3. Human voice audio in English and Spanish. This approach involves a computer, a headset and the probationer uses the up-down arrow keys. As the client goes from question to answer with the arrow keys, each question and answer is highlighted on the monitor (screen) and simultaneously read to the client. The three administration modes are discussed in the "SAQ: Orientation and Training Manual." Each test administration mode has advantages and some limitations. Risk & Needs offers these three testing modes so test users can select the administration mode that is optimally suited to their needs.

Reading Impaired Assessment. Reading impaired probationers represent 20+ percent of probationers tested. This represents a serious problem to many other probationer tests. In contrast, Risk & Needs has developed an alternative for dealing with this problem, i.e., a short form of the SAQ and "human voice audio."

Human Voice Audio: Presentation of the SAQ in English and Spanish helps overcome many reading and cultural difference issues. A probationer's passive vocabulary is often greater than their active (or spoken) vocabulary. Hearing items read out loud often helps reduce both cultural and communication problems. This human voice audio administration requires a computer, earphones and simple instructions regarding how to operate the up-down arrow keys on the computer keyboard.

Confidentiality: Risk & Needs encourages test users to delete probationers' names from diskettes before they are returned to Risk & Needs. Once probationer names are deleted, they are gone and cannot be retrieved. Deleting probationer names does not delete demographics or test data, which is downloaded into the SAQ database for subsequent analysis. This proprietary name deletion procedure involves a few keystrokes and insures client confidentiality and compliance with HIPAA (federal regulation 45 C.F.R. 164.501).

Test Data Input Verification: Allows the person that inputs test data from the answer sheet into the computer to verify the accuracy of their data input. In brief, test data is input twice, and any inconsistencies between the first and second data entries are highlighted until corrected. When the first and second data entries match or are the same, staff can continue. This proprietary Test Data Input Verification procedure is optional, yet it is strongly recommended by Risk & Needs.

Inventory of Scientific Findings: Much of the SAQ research has been gathered together in one document titled "SAQ: An Inventory of Scientific Findings." This document summarizes SAQ research chronologically -- as the studies were completed. This innovative chronological reporting format was established largely because of the SAQ database, which permits annual database analysis of all tests administered. It also allows the reader to observe the evolution of the SAQ into its current state-of-the-art position.

Staff Training: Risk & Needs' staff is available to participate in SAQ training programs conducted by probation departments, courts and assessment agencies in the United States. Risk & Needs typically participates in 4-hour or 6-hour SAQ training sessions. This training can include hands-on computer scoring, as desired. Risk & Needs gives attendees certificates attesting to training.

Staff training is also provided on Fridays at Risk & Needs' Phoenix offices from 8:30 a.m. to 11:30 a.m. or from 1:30 p.m. to 4:30 p.m. These training sessions are free. To participate, contact Risk & Needs at least ten days in advance. Participation is on a first call, first scheduled basis.

Scale Interpretation: There are several levels of scale interpretation ranging from viewing the SAQ as a self-report to interpreting scale elevations and scale interrelationships. This discussion is presented on the SAQ-Adult Probation III webpage.

Test Unit Fee (Cost): SAQ cost information can be reviewed by clicking on the Test Unit Fee (Cost) link. There is only the one cost or charge, and that is the test unit fee. Everything else is included at no additional cost to the test user. This includes test booklets, answer sheets, training manuals, upgrades, ongoing database research, annual summary testing reports, staff training, and support services. Do not be misled by some test publishers' à la carte pricing like separate costs for each test administration as well as for each of the test-related items listed above. Instead of asking for the test administration cost, ask for the total cost involved in using a test. We believe Risk & Needs' one test unit fee is very affordable.

Free Examination Kit: A 1-test demonstration diskette is available on a 30-day cost free basis. Demo diskettes are in Windows format. The Examination Kit includes a 1-test demo diskette, installation CD (with instructions), test booklet, answer sheet and some descriptive materials. Risk & Needs Assessment, Inc. does want the test booklet and diskette returned within 30 days.

If you are selecting a substance abuse assessment instrument, the following Comparison Checklist should prove helpful. This checklist itemizes important assessment and screening qualities. The "Other" column represents any other test you might want to compare to the SAQ.

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The SAQ example three-page report can be available on-site within 2½ minutes of data entry. SAQ reports contain a lot of information and are highly individualized. The SAQ profile summarizes SAQ scale scores at a glance. SAQ scale paragraphs give the client's attained score, explain what that score means and present specific score-related recommendations. Significant items represent direct admissions or unusual answers. And, the "Multiple Choice" section presents the client's answers, with all their biases, to the last sequence of multiple choice (items #143 to 153) items.

Substance Abuse Questionnaire (SAQ) report summarizes the clients scale scores, explains what each score means and makes ASAM compatible recommendations. It highlights significant items (direct admissions), sets forth Multiple Choice (items 143 to 153), answers and provides space for staff observations and recommendations.

Additional information can be provided upon request by writing:
Risk & Needs Assessment, Inc.
P.O. Box 44828
Phoenix, Arizona 85064-4828.

Our telephone number is (602) 234-3506
Our fax number is (602) 266-8227
and our e-mail address is sheryl@riskandneeds.com.