How to Coach Yourself and Others Empowering Coaching And Crisis Interventions | Page 169
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Other Screening tools:
TCUDS II
The Texas Christian University Drug Screen II (TCUDS II) is a 15-item, self-administered substance abuse
screening tool that requires 5–10 minutes to complete. It is based in part on Diagnostic Interview Schedule and
refers toDiagnostic and Statistical Manual of Mental Disorders, 4 th Edition, Text Revision (DSM-IVTR; American Psychiatric Association [APA] 2000a) criteria for substance abuse and dependence. TCUDS II is
used widely in criminal justice settings. It has good reliability. (Knight 2002; Knight et al. 2002). This screen,
along with related instruments, is available at www.ibr.tcu.edu.
CAGE
CAGE (Ewing 1984) asks about lifetime alcohol or drug consumption. Each “yes” response receives 1 point,
and the cutoff point (the score that makes the test results positive) is either 1 or 2. Two “yes” answers results in
a very small false-positive rate and the clinician will be less likely to identify clients as potentially having a
substance use disorder when they do not. However, the higher cutoff of 2 points decreases the sensitivity of
CAGE for women—that is, increases the likelihood that some women who are at risk for a substance problem
will receive a negative screening score (i.e., it increases the false-negative rate).
Note: It is recommended that a cutoff score of 1 be employed in screening for women. This measure has also
been translated and tested for Hispanic/Latina populations.
A common criticism of the CAGE is that it is not gender-sensitive—that is, women who have problems
associated with alcohol use are less likely than male counterparts to screen positive when this instrument is
used. One study of more than 1,000 women found that asking simple questions about frequency and quantity of
drinking, coupled with a question about binge drinking, was better than the CAGE in detecting alcohol
problems among women (Waterson and Murray-Lyon 1988).
The CAGE is “relatively insensitive” with Caucasian females, yet Bradley and colleagues report that it “has
performed adequately in predominantly black populations of women” (1998c, p. 170). Johnson and Hughes
(2005) conclude that CAGE has similar reliability and concurrent validity among women of different sexual
orientations. The CAGE-AID (CAGE Adapted to Include Drugs) modifies the CAGE questions for use in
screening for drugs other than alcohol. This version of the CAGE shows promise in identifying pregnant, lowincome women at risk for heavier drug use (Midanik et al. 1998).
Substance Abuse Screening and Assessment Among Women
How screenings and assessments are conducted is as important as the information gathered. Screening
and assessment are often the initial contact between a woman and the treatment system. They can either
help build a trusting relationship or create a deterrent to engaging in further services.
Self-administered tools may be more likely to elicit honest answers; this is especially true regarding
questions related to drug and alcohol use.
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