Workshops for Good

Intervention Nation

ASSESSMENTS

  IS YOUR LOVED ONE STRUGGLING WITH ADDICTION?
ARE YOU AT YOUR BOTTOM?

 

If you would like to have yourself or a loved one considered for a FREE Intervention, please complete the assessment form below. The information you provide will be submitted directly to the intervention team at Intelligent Intervention for further assessment in relation to your LIVE consultation which will likely be scheduled within 7 to 14 days of your submission of this form. Your information will not be seen by anyone outside the walls of Intelligent Interventions but by submitting this information, you give Intelligent Interventions the right to use the information for sole purposes in connection with the intervention, and you acknowledge that you may not receive an immediate response from this submission(up to 14 days) and might not be chosen for the Intervention scholarship.

 

IF YOU BELIEVE THAT THE SITUATION YOU DESCRIBE BELOW REQUIRES
URGENT ATTENTION CONTACT AN APPROPRIATE CARE PROVIDER OR CALL 911.

 

Please use discretion when talking about and with whom you are talking to about your decision to initiate this process. Also, please remember that intervention works most effectively when as few individuals as possible are aware of the event. Discretion is recommended especially the addict and those choosing not to participate in the solution.

 

PLEASE DO NOT INCLUDE THE ADDICT'S CONTACT NUMBERS OR EMAIL ADDRESS IN YOUR APPLICATION.

 

 

I'm inviting you to complete this INTERVENTION SERVICES SUBMISSION FORM.

Go here to complete this form

Identifying a problem is always the first step in working towards a solution. This is especially true in the case of substance abuse. The insight and experience of skilled intervention specialists combined with the use of state-of-the art assessment tools provides a clear and reliable picture of an individual’s involvement with alcohol, drugs co-dependent behavior or other substances. Often this is an eye opening experience for both clients and their loved ones, providing a powerful and irrefutable case for the pursuit of sobriety

Addiction "Diagnoses"

Alcoholism - Definitions Two opposing views of alcohol and alcoholism

Alcohol & Drug Addiction - Self Diagnosis

Questions to help you determine if you have an alcohol or drug problem

From Johns Hopkins

Alcohol & Drug Addiction - Other Person Diagnosis

Questions to help you determine if a relaive or friend has an alcohol or drug problem

Computer or Internet Addiction - Self Diagnosis

Questions to help you determine if you have a computer or internet addiction

From the National Counseling Center

Compulsive Gambling / Gambling Addiction - Self Diagnosis

Questions to help you determine if you are a compulsive gambler

From Gamblers Anonymous

 

Alcohol & Drug Addiction - Self Diagnosis

 

Ask yourself the following questions:

  • Do you lose time from work due to drinking or drug use?

  • Is drinking or drug use making your home life unhappy?

  • Do you drink or use drugs because you are shy with other people?

  • Is drinking or drug use affecting your reputation?

  • Have you gotten into financial difficulties as a result of drinking or drug use?

  • Do you turn to lower companions and an inferior environment when drinking or using drugs?

  • Does your drinking or drug use make you careless of your family's welfare?

  • Has your ambition decreased since drinking or using drugs?

  • Do you crave a drink or drugs at a definite time daily?

  • Do you want a drink or drugs the next morning?

  • Does drinking or using drugs cause you to have difficulty in sleeping?

  • Has your efficiency decreased since drinking or using drugs?

  • Is drinking or using drugs jeopardizing your job or business?

  • Do you drink or use drugs to escape from worries or trouble?

  • Do you drink or use drugs alone?

  • Have you ever had a complete loss of memory as a result of drinking or drug use?

  • Has your physician ever treated you for drinking or drug use?

  • Do you drink or use drugs to build up your self-confidence?

  • Have you ever been to a hospital or institution on account of drinking or drug use?

 

A Yes to three or more questions indicate abuse or addiction is present and corrective steps need to be taken.

Alcohol & Drug Addiction - Other Person Diagnosis

If you think you may be affected by a friend, co-worker, or family member with an alcohol or other drug problem, the following test can help you determine if your suspicions are founded.

 

Answer each question with a "yes" or "no."

 

Ask yourself the following questions:

  • Are you afraid to be around the person when he or she is drinking or using drugs because of the possibility of verbal or physical abuse?

  • Do you lose time from work due to drinking or drug use?

  • Is drinking or drug use making your home life unhappy?

  • Do you drink or use drugs because you are shy with other people?

  • Is drinking or drug use affecting your reputation?

  • Have you gotten into financial difficulties as a result of drinking or drug use?

  • Do you turn to lower companions and an inferior environment when drinking or using drugs?

  • Does your drinking or drug use make you careless of your family's welfare?

  • Has your ambition decreased since drinking or using drugs?

  • Do you crave a drink or drugs at a definite time daily?

  • Do you want a drink or drugs the next morning?

  • Does drinking or using drugs cause you to have difficulty in sleeping?

  • Has your efficiency decreased since drinking or using drugs?

  • Is drinking or using drugs jeopardizing your job or business?

  • Do you drink or use drugs to escape from worries or trouble?

  • Do you drink or use drugs alone?

  • Have you ever had a complete loss of memory as a result of drinking or drug use?

  • Has your physician ever treated you for drinking or drug use?

  • Do you drink or use drugs to build up your self-confidence?

  • Have you ever been to a hospital or institution on account of drinking or drug use?

 

A Yes to three or more questions indicate abuse or addiction is present and corrective steps need to be taken.


Computer / Internet Addiction - Self Diagnosis

Ten Symptoms of Computer Addiction

 

  • A demonstrated "loss of control" when trying to stop or limit the amount of time on the computer. (Breaking promises to self or others. Promising to quit or cut down and not being able to do so)

  • Being dishonest or minimizing the extent of the time you stay on the computer, or covering up or being dishonest about what activities you participate in when on the computer.

  • Negative consequences experienced by the computer user or his/her friends or family as a direct result of time or activities spent on the computer.

  • Participation in high risk or normally unacceptable behaviors when using the computer. Compromising your morals and values based on the opportunity to remain anonymous and protected on the computer. (a good test for this is to ask yourself if your spouse, partner or family would approve of what you were doing on the computer)

  • An overdeveloped sense of importance for the computer in ones life. Defending your right to use the computer as much as desired, regardless of the fact that people in your life are feeling left out and neglected. (denial of the problem and justification; not being able to hear or feel what the other people are saying regarding your computer behavior)

  • Mixed feelings of euphoria (a "rush"), combined with feelings of guilt brought on by either the inordinate amount of time spent on the computer or the abnormal behavior acted out while using the computer.

  • Feelings of depression or anxiety when something or someone shortens your time or interrupts your plans to use the computer.

  • Preoccupation with the computer and computer activities when you are not using the computer (thinking about the computer and its activities when doing something else; i.e. having a family dinner, working on project deadline etc.)

  • Finding yourself using the computer at times when you are feeling uncomfortable, irritated, or sad about something happening in your life. ( feeling uncomfortable in your relationship, so you will self medicate and "hide out" on the computer) Using time on the computer to become externally focused outside yourself as a way to avoid facing what is happening in your life, and avoiding feeling the appropriate feelings inside yourself. (self medicating)

  • Experiencing financial concerns or problems in your life as a result of money being spent on computer hardware, computer on-line charges, or any other costs associated with computers. (Spending money on computer related items which should have been allocated to other normal living expenses)

 

If you said yes to one question, you may have a problem with computer addiction.

If you said yes to two questions, there is a good chance you do have a problem with computer addiction.

If you answered yes to three or more, you are demonstrating a pattern of behavior which would suggest that you are addicted to your computer and/or the activities on it.



Compulsive Gambling / Gambling Addiction - Self Diagnosis

 

Gamblers Anonymous offers the following questions to anyone who may have a gambling problem. These questions are provided to help the individual decide if he or she is a compulsive gambler and wants to stop gambling.

 

TWENTY QUESTIONS

 

  • Did you every lose time from work or school due to gambling?

  • Has gambling ever made your home life unhappy?

  • Did gambling affect your reputation?

  • Have you ever felt remorse after gambling?

  • Did you ever gamble to get money with which to pay debts or otherwise solve financial difficulties?

  • Did gambling cause a decrease in your ambition or efficiency?

  • After losing did you feel you must return as soon as possible and win back your losses?

  • After a win did you have a strong urge to return and win more?

  • Did you often gamble until your last dollar was gone?

  • Did you ever borrow to finance your gambling?

  • Have you ever sold anything to finance gambling?

  • Were you reluctant to use "gambling money" for normal expenditures?

  • Did gambling make you careless of the welfare of your family?

  • Did you ever gamble longer than you had planned?

  • Have you ever gambled to escape worry or trouble?

  • Have you ever committed, or considered committing, an illegal act to finance gambling?

  • Did gambling cause you to have difficulty in sleeping?

  • Do arguments, disappointments or frustrations create within you an urge to gamble?

  • Did you ever have an urge to celebrate any good fortune by a few hours of gambling?

  • Have you ever considered self destruction as a result of your gambling?

Most compulsive gamblers will answer yes to at least seven of these questions.

Typical Characteristics of Co-dependent People

A SELF-INVENTORY — Take this test



Directions: Place a number from 1 to 4 in the space

before each question to indicate the degree of your response.

 

1=Never
2=Occasionally
3=Frequently
4=Almost Always

__ 1. I tend to assume responsibility for others' feelings and/or behavior.

__ 2. I have difficulty in identifying my feelings - happy, angry, scared, sad, etc.

__ 3. I have difficulty expressing my feelings.

__ 4. I tend to fear or worry how others may respond to my feelings or behaviors of others.

__ 5. I minimize problems or deny the truth about the feelings or behaviors of others.

__ 6. I have difficulty in forming or maintaining close relationships.

__ 7. I am afraid of rejection.

__ 8. I am a perfectionist and judge myself harshly.

__ 9. I have difficulty making decisions.

__ 10. I tend to be reactive to others rather than to act on my own.

__ 11. I tend to put other people's wants and needs first.

__ 12. I tend to value the opinion of others more than my own.

__ 13. My feelings of worth come from outside myself, through the opinions of other people or from activities that seem to validate my worth.

__ 14. I find it difficult to be vulnerable and ask for help.

__ 15. I deal with issues of control by attempting to always be in control, or the opposite, by being careful never to be in a position of responsibility.

__ 16. I am extremely loyal to others, even when the loyalty is unjustified.

__ 17. I tend to view the situation with "all or nothing" thinking.

__ 18. I have a high tolerance for inconsistency and mixed messages.

__ 19. I have emotional crisis and chaos in my life.

__ 20. I tend to find relationships in which I feel "needed" and attempt to keep it that way.



Scoring: Add the numbers to get a total score.
Use the following ranges to help interpret your level of co-dependency.

 

60-80: A very high degree of co-dependent patterns

40-59: A high degree of co-dependent patterns
30-39: Some degree of co-dependent patterns
20-29: A few co-dependent patterns

 

 

At Intelligent Interventions, we firmly believe that in order to provide the most appropriate counseling services, a proper assessment is one of the most important parts of the process. A comprehensive and thorough assessment is vital in the development of an individualized Treatment Plan.  We will spend as much time as needed to acquire all of the relevant information from the individual and family in order to first determine whether or not we can be of maximum assistance and support in your situation.  If it is established that all parties believe that can help, the assessment will lay the groundwork for the Treatment Plan.  Assessment is ongoing through the treatment process because individuals and dynamics change as the family and individual change.  The initial assessment can take anywhere from one to three hours and is based on a bio-psycho-social approach. Studies have shown that an assessment comprised of biological, psychological and social factors can provide the most comprehensive picture of an individual and their family. Everyone involved has different perspective on what THEIR reality of the situation consists of. If possible, it is important for us to speak with all of the people who are involved in the process of counseling or other treatment related services.

An accurate assessment is never just as simple as “how much are they drinking or what are they using and how much?”  There are many contributing factors to why the individual and the family are in their current situation.  It is our job to ask the right questions, get the right information and share that information with you.  Once we have developed an inclusive and collaborative assessment, we will begin to develop an individualized plan for the individual and family.

Intelligent Interventions believes in utilizing various resources in the treatment profession. If we do not believe after completing our assessment that we can provide the necessary treatment support, we will provide you with referrals to fellow professionals may be more adept to your specific needs

  

Un-dependent Communities

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