RUNNING HEAD: DIAGNOSTIC INTERVIEW MARCELLA

Diagnostic Interview : Marcella

Unit 5 Assignment
Kaplan University
Helen Farel

RUNNING HEAD: DIAGNOSTIC INTERVIEW MARCELLA

Identifying Information:
Marcella Johnson is a 15-year-old bi-racial (Caucasian and African American) female,
who has been referred to my office by Dr. Frazier, the attending psychiatrist at Crozer Hospital
in Upland, Pennsylvania. Marcellas referral comes following her attempt to commit suicide with
prescription pain medication. Dr. Frazier has requested that my office provide a diagnostic
interview, screening, evaluation, and assessment along with recommendations and suggestions
for further evaluation and treatment.
Method of Interview:
I met with Marcella Johnson on November 14, 2014 to complete the referral for a
diagnostic interview, screening, evaluation and assessment. Marcella provided her family
history, medical history, and social background.
Family history:
Marcella is being raised by her grandparents with little or no input from her mother.
Bethany, (Marcellas mother) has never been married and has raised Marcella as a single mother
since her birth.
Substance abuse history:
Marcellas grandparents both drank alcohol throughout their adult life and experimented
with various other drugs as well. Her stepfather uses marijuana on a daily basis because he feels
it helps with the pain of a previous back injury. Bethany developed a substance use problem at
the age of 14 that rapidly progressed after her father killed himself.
Direct/Indirect messages:

RUNNING HEAD: DIAGNOSTIC INTERVIEW MARCELLA

Children and teenagers are very impressionable and learn from what they see. If they see
their parents doing things they think they can do them as well. The messages that Marcella may
have received are my grandparents and mother have all used drugs so therefore its fine for me
to use them too.
Education/Employment history:
Marcella is a full-time high school student and has not had any type of employment at the
present time, but she has done some babysitting. Marcella did well academically in elementary
school and part of junior high, but for the last four years her grades have been steadily declining.
Social history:
Marcella can name only two friends and states that she does not like people so having
only two friends is fine with her.
Substance abuse history:
Marcella reports that she has used alcohol a few times with her friends and has also used
alcohol on special occasions at family gatherings. She stated that her suicide attempt was the first
time that she used prescription pain pills or any non-prescribed drugs.
Significant risk factors involving relationship with family:
When asking Marcella about her relationship with her family members she stated that she
never had a father and she isnt sure if her mother even knew who her father was. She also stated
that he has never been a part of her life. She bluntly states that she hasnt had a mother for the
past few years as well. She describes her grandmother as the only one who would care if she had
succeeded in her suicide attempt.

RUNNING HEAD: DIAGNOSTIC INTERVIEW MARCELLA

Risk/Protective factors:
Numerous variables have been identified that help ascertain which individuals are prone to
abuse drugs. The components that are coupled with the more prominent potential for drug abuse
are known as risk factors and those coupled with the least potential for abuse are known as
protective factors. (NIDA, 2003, p. 6). Risk factors can influence drug use in many ways. The
more risks the teenager is subject to the more prone he or she is to abuse drugs. (NIDA, 2003, p.
7). If there is a family history of substance abuse the teenager is at risk of drug abuse as well.
Protective factors can decrease the effect of some risk factors, for example, parental backing and
support, can diminish the impact of the risks of having substance abusing peers. (NIDA, 2003, p.
7). Some risk factors that could have influence on Marcella are:

Substance abuse among parents.

Positive family attitudes toward drug use

Poor attachment with parents.

Family conflict and disruption.

Early substance use.

Social difficulties.

Association with drug using peers.

Academic failure.

Low commitment to school.

(NIDA, 2003, p. 6)

Some protective factors that could lessen the impact of a few of the risk factors are:

Positive physical development.

Family connectedness (attachment & bonding with grandmother)

RUNNING HEAD: DIAGNOSTIC INTERVIEW MARCELLA

Living in a stable home (grandparents)

Supportive relationship with family (grandmother)

(NIDA, 2003, p. 6)

Other relevant factors:

Other risk factors frequently identify with the nature of connections outside of the family,
for example in their schools with their educators and in the community. Difficulties in these
settings can be significant to the teenagers emotional, cognitive and social improvement. A
percentage of the risk factors are academic failure and poor coping skills. (NIDA, 2003, p. 9).
Other factors that could influence the teenager to start using drugs are the availability of the
substance and the belief that drug use is generally tolerated. (NIDA, 2003, p. 9).
After speaking with Marcella and obtaining the information needed about her family
history, medical history, and social background, I felt the need to go further with her and
implement the CRAFFT screening interview. The CRAFFT is a behavioral health screening
tool for the use with children under the age of 21. (CeSAR, 2009, p. 1). The CRAFFT was
developed to screen adolescents who are at a high risk for alcohol and other drug use disorders.
(CeSAR, 2009, p. 1). It is a brief effective screening tool intended to assess whether a more
extended discussion about the context of use, recurrence, and other risks and consequences is
needed. (CeSAR, 2009, p.1). To begin the screening using the CRAFFT you ask the adolescent
to answer the first three screening questions honestly and tell him/her that their answers will be
kept confidential. (CeSAR, 2009, p. 1). If the adolescent gives a yes answer to one of the
three screening questions you then move on and ask the remaining six questions and if they
answer yes to two or more of the six questions, further assessment needs to be done. (CeSAR,
2209, p. 1). Marcella did answer one of the first three questions with a yes answer, so I moved on

RUNNING HEAD: DIAGNOSTIC INTERVIEW MARCELLA

to asking her the remaining six questions, all of which she answered with a no. With that being
the case I do not feel that Marcella needs any further assessment for a substance use problem. I
would however like to discuss an assessment test that I would have used in the event that
Marcella did need further assessment for alcohol use. Since her attempted suicide with pain pills
was a onetime event, I do not feel that she needs further assessment in that area.
If I felt that Marcella needed further assessment for an alcohol use disorder I would have
implemented the Adolescent Drinking Index (ADI) to determine if Marcella did indeed have an
alcohol use disorder and to determine how severe it is. The Adolescent Drinking Index (ADI) is
a twenty four item rating scale that measures the severity of drinking problems in adolescents. It
has been used for adolescents in schools, substance use programs and also for adolescents who
are under evaluation for psychological problems. It is used to identify those adolescents who are
in need of further evaluation and it helps with their treatment planning. (Arizona Dept. of Health,
n.d. para. #1). The ADI is a self-administered paper and pencil test that takes approximately five
minutes to complete. (Arizona Dept. of Health, n.d. para. #1)
I may have also implemented the Personal Experience Screening Questionnaire (PESQ)
if I had felt that Marcella had a substance use problem as well. The Personal Experience
Questionnaire (PESQ) is a brief screener expected to help service providers make fitting
referrals. It is particularly helpful in school, detention centers, medical clinics and other settings
where everyday screening is the goal instead of a detailed evaluation. The problem severity
index measures the degree to which the adolescent is mentally and behaviorally involved with
the psychoactive agent. The psychosocial items evaluate individual and ecological issues
frequently connected with adolescent substance use. Also the drug use history shows age of

RUNNING HEAD: DIAGNOSTIC INTERVIEW MARCELLA

onset and how regularly over the last twelve months the adolescent has used alcohol or
psychoactive substances. (Psychpress, 2014, para. #1).
After performing the CRAFFT screening interview, the Adolescent Drinking Index
(ADI), the Personal Experience Screening Questionnaire (PESQ) and reviewing the DSM-5
criteria for substance use disorders, I am unable to diagnose Marcella with any substance use
disorders at this time, due to the fact that she does not meet any of the criteria on the DSM-5 for
an alcohol use disorder. Even though Marcella has used alcohol in the past on special occasions
she is not using it every day, therefore I feel that she does not need any further assessment. Also
her attempted suicide with prescription pain medications was the one and only time that she has
used any type of psychoactive substance, and does not meet any of the DSM-5 criteria for a
substance use disorder.

RUNNING HEAD: DIAGNOSTIC INTERVIEW MARCELLA

References
Adolescent Substance Abuse Screening Instruments. Attachment A. Retrieved from
www.azdhs.gov/bhs/guidance/catsu_attach_a.pdf
American Psychiatric Association. (2005). Substance-Related and addictive disorders. Retrieved
from www.dsm5.org/Documents/Substance%20use%20Disorder20Fact%20sheet.pdf
CeASAR (The Center for Adolescent Substance Abuse Research (2009). The CRAFFT
Screening Tool.
Retrieved from www.ceasar-boston.org/CRAFFT/pdf/CRAFFTEnglish.pdf
Miller, W.R., Forcehimes, A. A., & Zweben, A., (2011). Treating Addiction. A guide for
professionals. New York, NY: Guilford.
National Institute on Drug Abuse. (n.d.). Risk and protective factors. Retrieved from
www.drugabuse.gov/sites/default/files/preventingdruguse_2.pdf
PsychPress (2014). Psychological test materials. Personal Experience Screening Questionnaire.
Retrieved from
www.paychpress.com/psychometric/product-page.asp?ProductID=3940#expand

RUNNING HEAD: DIAGNOSTIC INTERVIEW MARCELLA

RUNNING HEAD: DIAGNOSTIC INTERVIEW MARCELLA

10

RUNNING HEAD: DIAGNOSTIC INTERVIEW MARCELLA

11

RUNNING HEAD: DIAGNOSTIC INTERVIEW MARCELLA

12