The Michigan Alcoholism Screening Test
The Michigan Alcoholism Screening Test (MAST) is a renowned screening tool that came into existence in 1971. MAST is ranked among the oldest screening tools, and it has specifically been constructed in order to be used among members of the public to help identify dependent drinkers. There are varying types of MAST screening tools that can either be self-administered or be dispensed by trained individuals through interviews. Different types of MAST screening tools are usually measured through a scored scale system that usually comprise of 25 questions that are usually administered to the concerned clients (John, 2004). Most questions in this tool mainly operate in the past tense and they usually concentrate on the various problems that the client may have faced throughout his/her lifetime. This indicates that the tool does not concern itself with the various problems that the client may currently be facing or even shown signs of, and as such, the tool cannot be able to detect alcohol-related problems in their early stages. The type of extended questioning adopted while using this tool is however beneficial since it allows the person conducting the screening test to accomplish a great deal of the assessment process as well as build a strong rapport with the client when conducting the screening test (Carol, 1994). A MAST screening tool can also take the form of a MAST-G screening tool, which is a type of alcohol screening tool that is usually used to screen alcohol-related issues affecting geriatric clients that mainly include the elderly people. The MAST-G tool usually contains twenty-four rather than twenty-five questions and it as well contains an underlying question that mainly focuses on the concept of sensitivity and reliability when dealing with geriatric clients. a MAST tool can as well take the form of a Brief MAST tool, which mainly takes a shorter form of alcohol screen tool and usually contains ten rather than 25 questions. A Short-MAST tool, which is similar to the Brief MAST tool but comprises of thirteen questions, can equally be used to screen alcohol-related issues (Paizza, 2012). Another important version of the MAST screening tools is the Short-MAST-G screening tool, which is the type of a short screening tool containing ten questions and is usually administered on the geriatric clients. The choice of the type of MAST screening tool used in any given assessment is usually dependent on the decision as well as the predictions made by the screener particularly when there is a specific tool that can be used to screen the case in question. The screener, who in this can refers to a highly trained individual, makes the ultimate decision pertaining to the specific tool that he/she needs to use depending on forecasted accuracy, sensitivity and reliability (Carol, 1994).
Assessing alcohol related problem using MAST
The Michigan Alcoholism Screening Test (MAST) is the ultimate choice screening tool that was used to assess the ultimate alcohol related problem that the concerned client could be involved in. since I am a trained and licensed addiction counselor at the Western Montana Addiction Services, I decided to use this tool with my fiancée, Holly Metzger, so I could gather a great deal of information during the assessment while on the other hand observing sensitivity. Findings of this assessment however indicated that the client did not have any apparent problem related to alcoholism. She reported to perceive herself as a normal drinker since she drank as much or even less than what most people do. She also stated that she has never woken up the morning after taking alcohol and found that she could not remember any part of various events that may have taken place in the evening. None of the client’s relatives or friends has ever been concerned or even complained about her drinking. She also reported that she can easily stop drinking even after having one or two drinks. The client reported that she does feel guilty for drinking and has never been in the assembly of Alcoholics Anonymous. She further stated that she has never engaged in any physical battle when drinking and has never created problems with friends of relatives. None of her friends or relatives has ever attempted to seek for any type of assistance because of her drinking and never lost a close friend because of drinking. The client further reported that she has never had any problems at work nor has she ever lost employment because of engage in drinking. The client has never absconded her work and family duties and obligations even for a single day because of drinking. The client does not engage in drinking before noon. She has never been diagnosed of any Liver problem like cirrhosis. She has never had delirium tremens, extreme tremors or audio and visual hallucinations. The client has never sought for assistance nor has she ever been admitted in hospital because of drinking. She stated that her drinking has never resulted to her admission in a psychiatric ward. She further reported to have never sought assistance from a medical professional, a community worker or a clergyman because of various drinking-related emotional problems. The client reported to have never been arrested for driving while drunk, neither has she ever been arrested for engaging in other ill behaviors while drinking.
Although there are various other screening tools that could be used for this assessment, the MAST screening instrument was specifically chosen because it could allow the screener to undertake an effective screening of various lifetime challenges related to alcoholism. Since this instrument has previously been successfully used in a wide variety of settings, the screener was quite certain that it could be used productively with a fiancée and render reliable results. The instrument could as well allow the screener to assess the social, family and work-related problems that may often be associated with drinking (John, 2004). MAST could also allow the screener to observe sensitivity since he could only restrain himself to the standardized questions contained in the scored scale system. The client could easily understand the instrument thereby ensuring that he gave precise hence reliable responses. The screener could also be able to easily score the various responses provided thereby being able to decide whether further assessment could be required (Cheryl, 1997).
The instrument exhibited major strengths and limitations, and these could significantly influence the overall outcomes drawn from the assessment. Among the major strengths exhibited by this tool is that it could be used to assess the severity of alcohol dependence, which would in return help to determine the most appropriate treatment approach that could be recommended for the client. The tool is equally important as it helps to assess the various social, family and work-related problems that could result from heavy drinking (Paizza, 2012). The tool can also be used to screen alcohol-related problems affecting the general population, which indicates that it can be administered to any type of client and render productive results. The instrument is also dependent of quantity and frequency, which allows the screener to ask questions that are realistic in real-world. The instrument however has certain limitations that can affect the reliability of overall results obtained. The length of the test, which mainly includes the number of questions contained in test, limits its applicability in a busy healthcare office or an emergency hospital environment. The instrument equally concentrates on lifetime rather than current alcohol-related problems, which means that it can only detect past problems and cannot detect current problems in their early stages (Thurber, 2002).
The use of this instrument has enabled the screener to identify a great deal of his capacity to effectively use this instrument to assess various alcohol-related problems. In order for the screener to be able to effectively use this instrument, he started by identifying the main goal for undertaking the exercise, which was to detect any alcohol-related problems. In this regard, the screener targeted someone whose alcohol problem may not have yet been addressed so as to be able to decide the subsequent intervention measures that could be employed to address any alcohol related-problems. Through this instrument, the screener was thus capable of setting a platform for further assessments so as to determine the need for subsequent interventions. The screener’s ability to use instrument was equally exhibited by his great ability to observe a great deal of sensitivity since he did not ask questions that were outside the scored scale system (Cheryl, 1997). This ensured that he could easily protect his basic relationship with the client mainly because she was only participating in screening test on voluntary basis to help him test his instrument. The ability to use the instrument can as well be measured in the screener’s ability to analyze as well as interpret the results thereby being able to identify his client as someone who does not have any apparent problem associated with alcoholism (Thurber, 2002).
The screener further realized that understanding as well as communicating assessment results with the client would be an easy task. This is particularly because the screener had a personal relationship with the client, and as such, he would easily identify the easiest and most appropriate way to notify her of the screening results. The ease at which the screening results could be communicated was further enhanced by the fact that the screener could step by step engage the client in the assessment exercise so as to ensure that he could easily understand how he came up with the ultimate conclusion relating to problems related to his drinking. The fact that the screener had ranked the client as having no apparent alcohol-related problem further enabled him to easily inform the client of her ineligibility for admission or referral for treatment (Paizza, 2012). The screener further observed that he had an effective ability to communicate the screening results to other professionals. The screener was for example able to maintain the integrity of his professional relationship with the client by ensuring that he could only release the screening results to professionals that were licensed as well as qualified to interpret the data. He thus contacted those professionals that had signed a form of consent with the client’s legal representatives to ensure that they could give accurate interpretation of the screening results while on the other hand maintaining a high degree of integrity (Cheryl, 1997). He was equally able to contact his colleagues to ensure that they had not engaged in a professional relationship with his client. This was particularly important since professional ethics demand that addiction professionals should not engage in a professional relationship, which includes offering professional services to clients that are already in another relationship with their fellow professionals. He was also able to significantly cooperate with other professionals to ensure that he could obtain as well as provide important information unless he could be constrained by professional ethics (John, 2004).
There is enough evidence that significant ethical issues can emerge from using the MAST screening instrument in this test given the type of personal relationship that the screener has with his client. Using the MAST screening instrument may infringe the client’s privacy, which may ultimately bleach the intimate relationship that she has with the screener. Administration of the screening questionnaire for example demands that the client exposes her personal habits and lifestyle, and this may greatly affect the level of affection that the screener has for the client. The need to share the screening results with other professionals can also interfere with the individual’s confidentiality, thereby exposing her to issues of social stigmatization and alienation (Cheryl, 1997). The intimate relationship that the screener has with the client can as well inhibit him from conducting the screening test in a professional manner. This is especially because the screener may opt to refrain from asking intimidating questions that the client might not be comfortable responding to. In order to enhance efficiency in using this instrument, the screener should seek to conduct the screening activity in a professional manner without being restricted by personal factors that include intimacy. The screener should also observe issues of confidentiality to protect the client’s privacy. Further training should also be obtained so as to obtain skills on how the instrument can be administered to an intimate partner without interfering with their basic relationship (Thurber, 2002).
In conclusion, the Michigan Alcoholism Screening Test has proven to be an important screening tool that can help the screener to obtain relevant information relating to different problems linked to alcoholism. The need to obtain reliable information while maintaining a high degree of confidentiality and sensitivity saw the screener engaging his fiancée on voluntary basis to be able to gather valid information relating to alcoholism. The instrument proved to have major strengths and limitations that demanded that the screener would have to observe a high degree of professionalism to be able to obtain quality results. Further training should however be obtained to ensure that the screener would gain skills on how to remain professional, enhance confidentiality and remain sensitive.
Carol, S. (1994). Prevalence of Alcoholism and Drug Abuse among Female AFDC Recipients, Journal of Health and Social Work, 19(1):69-99
Cheryl, C. (1997). Breif Screening Instruments for Alcoholism, Journal of Alcohol Health & Research World, 21(4):69-88.
John, L. et al. (2004). The Michigan Alcoholism Screening Test (MAST): A Statistical Validation Analysis, Journal of Measurement and Evaluation in Counseling and Development, 36(4):22-56.
Paizza, L et al. (2012). The Substance Abuse Subtle Screening Inventory-3 and Stages of Change: A Screening Validity Study, Journal of Addictions & Offender Counseling, 33(2):71-103.
Thurber, S et al. (2002). An Adolescent Version of the Michigan Alcoholism Screening Test, Journal of Adolescence, 37(148):45-67.