This document provides instructions for completing an assessment of a client named Cheyenne using the ASI-Lite template. It explains that the template collects information on general demographics, employment/support status, substance use history, legal issues, family/social relationships, and psychiatric history. For each section, the interviewer should collect relevant details from the client interview and note any contradictions or important issues in the comments section. The goal is to understand the severity of the client's substance use disorder and make an appropriate treatment recommendation.

1. Benchmark Assignment—Risk and Quality Management Paper
Imagine you are a quality leader for a health care organization,
and you have been asked to create a document for new
employees to introduce the basic concepts of risk and quality
management.
Write a 1,050- to 1,400-word paper in which you address the
following:
· Explain basic concepts of quality improvement in the health
care industry.
· Explain the concepts of risk and quality management in the
health care industry.
· Analyze the information needed for decision-making processes
in risk and quality management in the health care industry.
· Analyze 4 risk- and quality-management tools used in the
health care industry by considering the following:
· What are the risk and quality management tools used in health
care?
· What is the purpose of each tool?
· What are the advantages and disadvantages of the tools
selected?
· Explain challenges in making risk- and quality-management
decisions in the health care industry.
Cite at least 4 peer- reviewed, scholarly, or similar references.
Format your paper according to APA guidelines.
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2. Cheyenne Scenario
Hi, my name’s Cheyenne and I’m a 32-year-old woman. I teach
middle school science.
I’ll just tell you what you already know. I was arrested for
drunk driving last weekend for
the second time this year, well… ever, really.
For me to get my license back, I had to come to this
appointment today. Then, I have to
complete whatever treatment you suggest. Can you believe it?
The judge took my
license for a whole year this time, but I think that if I do well,
he might reconsider.
But, listen, I don’t have a drinking problem…not really. I know
that it’s a problem when I
keep getting caught, but I remember from my DUI intervention
class that women have
more sensitive systems. I think that’s all it is with me. I only
had a few drinks at the bar
before driving. I’m sure I was there a long time, at least several
hours, so I thought I was
okay to drive.
I hope this isn’t going to be a problem for me and my job. I
teach science and I’ve been
at the same school since I started teaching 10 years ago. I need
my job because I’m a

3. single mom and I’m raising two children. They spend half the
week with me and half
with their father. I never drink…well only a little…when they
are home though. Their
father doesn’t pay child support, so I’m always stressed about
money. So, I have to be
careful about not losing my job, you know?
And now, I should be really careful because I took five sick
days in the last 3 weeks. I
just wasn’t feeling good enough to face my students. They’re
driving me crazy — I’ve
never had such an undisciplined group of students. It seems like
all my students this
year are disrespectful, rude, and careless in their work. They
don’t even bother to pay
attention during lab assignments and that is the best part of
taking science classes. I
asked my principal for help. BIG MISTAKE. He told me to “get
it together” and so, I’m
avoiding him now.
In fact, it is their fault that I am in this mess! At the beginning
of this year, a bunch of us
decided to go out on Fridays after work. We needed to blow off
some steam before
ending the week. Most of them stay for a drink and then go
home to their families.
However, a few of us stay later and have a few more drinks. I
try to get home when my
children get home; I have them on Friday nights every other
week. On the weeks when
they are with their father, I just stay out till everyone else heads
home. Probably, I drink

4. five drinks during that time. It’s not as bad as it sounds because
I am there for about 3
hours.
After a few weeks of doing this, I started buying wine and
vodka to keep at home. It was
getting expensive paying for those drinks on Friday. I still go
out with my friends, but I
only buy one drink and then order soda water. Occasionally, I
just add vodka that I bring
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from home and boy, does it save money! I admit that I never
bought alcohol to keep at
home before.
I feel like such an adult. When I get home from work, I have a
drink or two to relax. I like
it — I feel grown up and it helps settle my mind before I have
to grade student work. I
forget how inadequate I feel at work after a few drinks. Plus, I
think it helps my students
get better grades because I don’t care as much!
If I had to guess and am truly honest with myself, I probably
drink three to four drinks a

5. night. It’s not much since I drink it over a few hours and never
feel real drunk. In fact,
that was why I got arrested. I didn’t feel drunk at all and that
was after four margaritas!
Maybe I drink a lot because my parents did. In fact, my mother
was a real alcoholic.
That’s how I know that I’m not. She was never able to keep a
job; in fact, she was
barely sober each day when my brothers and I got home from
school. I was so angry
with her, you know. There were so many school events that she
missed.
On the weekends, my father used to drink with her. They had
parties at the house that
lasted all weekend long. It was awful! I couldn’t get my
homework done and they
smoked weed. Ewwww! That smelled awful and just made them
all even more wasted.
I’m nothing like them — I just like to have a drink or two to
forget the awfulness in my
life.
I don’t know what to expect since I haven’t been in treatment
before — well, just DUI
intervention. Am I going to have be with….drug users? I’ve
never taken any drugs at all,
not even in college. I really don’t need to be with people who
are going to jail or who
use, you know, the hard drugs.
I mean, I guess that I need some help. I’m smart enough to
know that being arrested for
drunk driving twice in a year means I must have some problems.
I think that if you can

6. just teach me to maybe reduce my drinking and not drive, I’ll be
fine. Yeah, I’ll be good
then. Being arrested is no fun, I promise you that. I had never
been arrested before this
year.
Okay, so I’ll do whatever you tell me so that I can end this
nightmare. Who knows,
maybe I’ll figure out a way to stop fighting with my kids and
their father. They keep
telling me that I’m a horrible mother because of the arrests.
They’re not even willing to
listen to me anymore. At least, I get to see the kids still. The
judge warned that if they
had been younger, I would’ve lost custody. Since they both
drive, I guess it’s different. I
just want to end this nightmare!
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Assignment Template | Unit 3
TEMPLATE SECTION EXPLANATIONS
Below are explanations of each of the sections on the ASI-Lite
template that you will
complete. Remember this information when you write your
short summaries under each

7. section of the template. The template follows the explanations
below.
General Information
You will find this type of section on every assessment form.
The information in this
section is important to help you create a profile of the client, to
get contact information,
and to understand “who” you client is through demographic
information. Complete this
section using information from the client interview or if the
data is missing, make it up.
You will find that the questions in this section are
straightforward to answer.
Employment/Support Status
The information that you collect in this area helps with
determining the severity of the
addiction disorder. Clients who have moderate to severe
disorders will report significant
issues in this section. It is important to know if your client has a
driver’s license or
reliable transportation because without it, he/she will find it
difficult to come to
appointments. If information is not included in the audio
interview, you may make it up.
The information in this section will be used with information in
other sections to
determine the severity rating and placement recommendation of
the substance use
disorder. For example, a client who cannot keep a job and
spends most of her day
getting, using, and recovering from drug use would have a
severe diagnosis (compared
to mild or moderate).

8. Alcohol/Drugs
The information collected in this section is critical to making a
substance use specific
diagnosis. You will note the types of drugs used, frequency,
amount, combinations, and
anything else related to drug/alcohol use history.
Legal Status
This information is important to know for practical purposes. It
helps to identify level of
use if the client reports that it is her “fifth DUI” conviction or
first arrest. You will also
learn if the client is court-mandated (this means your agency
needs to bill differently). Of
course, it also helps you to understand the level of involvement
that the client has with
the judicial system.
Family/Social Relationships
This information in this section helps to identify the client’s
role in the family. If the client
lives alone, social relationships will be important to explore as
a form of primary support.
Often, family members or close friends will be concerned about
the client. The client
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might show frustration with others thinking that he/she has a

9. problem. It is also
important to know if the quality of those relationships.
Psychiatric Status
While your agency will likely not enroll clients, who have
severe mental health disorders,
it is important to assess the client’s current status. Clients in
crisis often suffer from
mental health symptoms and those require treatment. This
section is already completed
for you on your template, but consider the information when
making a diagnosis and
placement recommendation.
****
TEMPLATE INSTRUCTIONS
Remember: This is an interview, not a test
If a response is already provided, use it in your overall analysis.
If the client did not give
a response for a question, you can make it up. Use that
information in your analysis too.
Interviewer Instructions
1. Leave no blanks
2. Make plenty of comments (if another person reads this ASI,
he or she should

10. have a relatively complete picture of the client's perceptions of
his/her problems).
3. When writing comments in the summary area at the end of
each section, please
write the question number.
****
TEMPLATE
General Information
Date of Admission: 1/23 /2017 Date of
Interview: ____________
Gender: Male
Female
Transgender
Name: Cheyenne Smith-Jones
Address: 123 Main Street Madison, WI, 53703
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Telephone Number: (414) 343-9948
How long have you lived at this address? Years ____ Months
_____
Date of birth: (Month/Day/Year)
What race do you consider yourself?
White (not Hispanic) Hispanic-Mexican
Black (not Hispanic) Hispanic-Puerto Rican
American Indian Hispanic-Cuban
Alaskan Native Other Hispanic
Asian/Pacific
Do you have a religious preference?
Protestant
Catholic
Jewish
Islamic
Other
None
Have you been in a controlled environment in the past 30 days?
No
Jail
Alcohol/Drug Treat.
Medical Treatment

12. Psychiatric Treatment
Other: ______________
How many days (approximately)? __________
Employment/Support Status
Level of education completed (indicate the highest level
achieved):
GED = 12 years
High School Diploma
Training or Technical education. Area of specialization:
______________
College completed. Degree and major
_________________
Some college
Do you have a valid driver's license? YES NO
Do you have an automobile available? YES NO
Does not require ownership, only requires availability on a
regular basis.
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13. How long was your longest full time job (does not necessarily
mean most recent job)?
Years ____ Months ______
Full time = 35+ hours weekly;
Usual (or last) occupation? (specify)
______________________________
Does someone contribute the majority of your support? YES
NO
Usual employment pattern, past three years?
Full time (35+ hours) Service
Part time (regular hours) Retired/Disability
Part time (irregular hours) Unemployed
Student In controlled environment
How troubled or bothered have you been by these employment
problems in the past 30
days? ___________________
How important to you now is counseling for these employment
problems?
_____________________
Employment/Support Comments
Include any information that was interesting: The client might
mention that she started
college, but ended drinking too much to complete her degree.
Note client’s strengths
too.
_____________________________________________________
_________________

14. _____________________________________________________
_________________
_____________________________________________________
_________________
Alcohol/Drugs
Route of Administration Types:
Oral
Nasal
Smoking
Non-IV injection
IV
Past 30 Days Admin- indicate the route of administration
Alcohol (any use at all) # of times in the last 30 days _____
Alcohol (to intoxication) # of times in the last 30 days _____
Heroin # of times in the last 30 days _____
Methadone # of times in the last 30 days _____
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Other Opiates # of times in the last 30 days _____
Barbiturates/Sedatives # of times in the last 30 days _____

15. Cocaine # of times in the last 30 days _____
Amphetamines # of times in the last 30 days _____
Cannabis # of times in the last 30 days _____
Hallucinogens # of times in the last 30 days _____
Inhalants # of times in the last 30 days _____
More than 1 substance per day # of times in the last 30 days
_____
How many times in your life have you been treated for:
Alcohol use: ______ Drug use: _____
Include detoxification, halfway houses, in/outpatient
counseling, and AA or NA (if
3+ meetings within one month period).
How many of these were detox only:
Alcohol: _______ Drugs: _____
How much money would you say you spent during the past 30
days on:
Alcohol: _______ Drugs: _____
How many days have you been treated as an outpatient for
alcohol or drugs in the past
30 days? (Include AA/NA): ___________________
How many days in the past 30 have you experienced alcohol
problems: ____
How troubled or bothered have you been in the past 30 days by
these alcohol problems:
____________________________

16. How important to you now is treatment for these alcohol
problems:
____________________
How many days in the past 30 have you experienced drug
problems: ____
How troubled or bothered have you been in the past 30 days by
these drug problems?
___________________________
How important to you now is treatment for these drug
problems? ______________
Alcohol/Drugs Comments
Include any contradictions or important notes that relate to the
client’s substance use.
_____________________________________________________
_________________
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_____________________________________________________
_________________
_____________________________________________________

17. _________________
Legal Status
Was this admission prompted or suggested by the criminal
justice system?
YES NO
Are you on parole or probation? Note duration and level in
comments. YES NO
_____________________________________________________
_________________
_____________________________________________________
_________________
_____________________________________________________
_________________
How many of these charges resulted in convictions? _____
Convictions include fines, probation, incarcerations, suspended
sentences, and guilty
pleas should be noted in comments area.
_____________________________________________________
_________________
_____________________________________________________
_________________
_____________________________________________________
_________________

18. Legal Comments
Include anything that the client stated that was important.
_____________________________________________________
_________________
_____________________________________________________
_________________
_____________________________________________________
_________________
Family/Social Relationships
Marital Status:
Married
Remarried
Widowed
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Separated
Divorced
Never Married

19. Are you satisfied with this situation? YES
INDIFFERENT NO
Satisfied = generally liking the situation.
Usual living arrangements (past 3 years): Choose arrangements
most representative of
the past 3 years.
With sexual partner & children With friends
With sexual partner alone Alone
With children alone Controlled Environment
With parents No stable arrangement
With family
Are you satisfied with these arrangements? YES
INDIFFERENT NO
Do you live with anyone who:
Has a current alcohol problem? YES NO
Uses non-prescribed drugs? YES NO
With whom do you spend most of your free time?
Family
Friends
Alone
Family/Social Comments
Include important information.
_____________________________________________________
_________________

20. _____________________________________________________
_________________
_____________________________________________________
_________________
Psychiatric Status
*assume that this part of the form was completed by a licensed
mental health
professional.
How many times have you been treated for any psychological or
emotional
problems:
In a hospital or inpatient setting? * 12/2/2015 after an argument
with her ex-husband,
threatened suicide and was admitted for evaluation- 3 days then
released.
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Outpatient/private patient? *saw a psychiatrist for treatment of
mild depression (not
formerly diagnosed with depressive disorder though).
12/2/2015- 12/5/2016

21. Enter diagnosis in comments if known.
*Client reported that she did not think that she had a diagnosis,
but also thought that
she did not need to see a psychiatrist.
For Items P8-10, Patient can have been under the influence of
alcohol/drugs.
Experienced trouble controlling violent behavior including
episodes of rage, or violence?
Client stated that she becomes violent when drinking only if her
ex-husband calls her.
She stated that this is worse after she has been drinking.
Experienced serious thoughts of suicide? Patient seriously
considered a plan for taking
his/her life.
Client was hospitalized on 12/2/2015 for suicidal threat/ideation
and was held for three
days before release. Client does not remember much about this
incident. Client is not
currently suicidal or homicidal.
Attempted suicide?
Client threatened to swallow pills on 12/2/2015 which resulted
in involuntary
hospitalization. Client reported that she has not felt suicidal
since that incident. It should
be noted that client was subsequently prescribed anti-
depressants (though she cannot
recall which ones) for a year.
Psychiatric Status Comments
When client described psychiatric treatment, her responses were
vague. It sounds as if
she did not see the psychiatrist more than a few times. Client
reported that she only

22. remembers meeting with him four or five times in the year that
she saw him for medical
management check-ups. She cannot recall which drugs she was
prescribed. *NOTE*
we have consent to contact the psychiatrist (see client file).
Client spoke openly about her suicide threat. Prior to the threat,
the client reported that
she considered suicide for a month or so. When asked about the
precipitating event, the
client reported that her ex-husband called to make sure that she
was home so that the
divorce papers could be delivered. Client reported that she did
not want the divorce.
Client would not discuss the relationship further.
Date of Interview: How long have you lived at this address
Years: Months: Other: How many days approximately: Training
or Technical education Area of specialization: College
completed Degree and major: Years: Months_2: Usual or last
occupation specify: days: How important to you now is
counseling for these employment problems: too 1: too 2: too 3:
of times in the last 30 days: of times in the last 30 days_2: of
times in the last 30 days_3: of times in the last 30 days_4: of
times in the last 30 days_5: of times in the last 30 days_6: of
times in the last 30 days_7: of times in the last 30 days_8: of
times in the last 30 days_9: of times in the last 30 days_10: of
times in the last 30 days_11: of times in the last 30 days_12:
Alcohol use: Drug use: Alcohol: Drugs: Alcohol_2: Drugs_2: 30
days Include AANA: How many days in the past 30 have you
experienced alcohol problems: How troubled or bothered have
you been in the past 30 days by these alcohol problems: How
important to you now is treatment for these alcohol problems:

23. How many days in the past 30 have you experienced drug
problems: How troubled or bothered have you been in the past
30 days by these drug problems: How important to you now is
treatment for these drug problems: Include any contradictions or
important notes that relate to the clients substance use: 1: 2:
Are you on parole or probation Note duration and level in
comments 1: Are you on parole or probation Note duration and
level in comments 2: Are you on parole or probation Note
duration and level in comments 3: How many of these charges
resulted in convictions: pleas should be noted in comments area
1: pleas should be noted in comments area 2: pleas should be
noted in comments area 3: Include anything that the client
stated that was important 1: Include anything that the client
stated that was important 2: Include anything that the client
stated that was important 3: Include important information 1:
Include important information 2: Include important information
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