RESEARCH AND DEVELOPMENT BRINGS THE ASI TO WORLDWIDE PRACTICE
The ASI debuted at a time when science was increasingly understanding addiction as a disease process, one both complicated by and causing complications in multiple areas of patients’ life functioning. In 1975, with funding from NIDA, McLellan and his team undertook an intensive research and development process for a new assessment instrument that would both propel further inquiry into these processes and also have practical use for treatment providers. In 1977, the team released the first working model of the ASI and, in 1980 after several validation studies, the instrument was formally adopted.
The ASI transformed the field by standardizing assessment of all patients across all dimensions of their functioning. In research, the ASI became a mainstay of scientific analysis. Its collection of retrospective functional data (past 30 days) gave scientists empirical data to analyze change over time. Later, in the mid 1980s when elected officials and taxpayers began demanding more accountability for their treatment dollars, the ASI and other instruments gave birth to standardized evaluation of patient progress during treatment, post-treatment outcome evaluation and ultimately, to data-driven improvements in treatment performance.
Today, the ASI is the most widely used assessment instrument in the field of addictions. It is now in its fifth version, the ASI-V5, and a sixth is under development. Many state governments and federal agencies require the ASI as part of their evaluation procedures. It has been translated into 18 languages, including French, Spanish and other versions developed by the World Health Organization.
Derivative instruments include the Clinical/Training Version, ASI-CTV and the ASI-Lite, a shorter version, designed to be administered in 30 minutes or less. A culturally sensitive version developed for the Native American population of North Dakota, the ASI-ND/NAV, is also now available.
The Treatment Services Review (TSR) was developed in 1982 by Dr. McLellan and his colleagues as a companion to the ASI. The TSR is administered at various intervals during treatment to measure the amount and duration of services corresponding to each of the ASI problem domains. It serves both an auditing function to ensure that services called for in the treatment plan are in fact being rendered, as well as a scientific tool in identifying the operative treatment ingredients contributing to patient outcomes.
The ASI has proven of great value in learning how to tailor treatment to better meet the needs of patients, allocate resources, and inform public health policy. As the needs of our nation’s policy makers, researchers and practitioners continue to evolve, the ASI will serve as the common metric ensuring that the clinical information obtained will be valid and reliable.
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