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Global Appraisal of Individual Needs

From Wikipedia, the free encyclopedia

Global Appraisal of Individual Needs
Purposerespond to the needs of substance abuse treatment

The Global Appraisal of Individual Needs (GAIN) is a family of evidence-based instruments used to assist clinicians with diagnosis, placement, and treatment planning. The GAIN is used with both adolescents and adults in all kinds of treatment programs, including outpatient, intensive outpatient, partial hospitalization, methadone, short-term residential, long-term residential, therapeutic community, and correctional programs.[1]

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Transcription

Did you ever ponder the value of the company you work for, the civil service you consult or the association you make donations to? Not in the financial sense. No. The question is: Are those organizations valuable for society at large? And hereby valuable for you? To answer those questions, the University of St.Gallen developed a unique approach of Public Value. Its novelty is to embed management concepts, like Shareholder Value, Customer Value, Sustainability, Corporate Social Responsibility, Shared Value and Stakeholder Value within society as a whole. The concept of Public Value has its foundations in the idea that we humans are social animals. We are virtually interacting with each other all the time: Together, within a group and in large organizations: Companies, the public service and unions and associations build the ecosystem in which we live. That’s why scholarship sees organizations as “productive social systems ”. However, companies and organizations aren’t just places where social interaction happens. They produce goods and services; they create jobs, pay taxes and social contributions, carry out legally fixed performance mandates and unions and associations perform important tasks for our civil society. Thereby, organizations deeply impact our living environments, push or hold back progress and coin our attitudes towards society – not least also through advertising. They constitute – as sociologists like to say – a reproduction mechanism of society with all its values, rules and norms. Simply put: Organizations make society and thus generate Public Value. But, what exactly is Public Value? Public Value means value creation towards the common good. That is, the added value and benefit of an organization for the wellbeing of each individual and the general public – in other words the common good. It represents the values and norms, which shape our way of living together and which everybody benefits from. Effects that go beyond mere economic transactions and that affect our living conditions, are understood as negative or positive externalities by economists. Accordingly, organizations may destroy or create common good. This, however, depends on one’s perspective. That’s why the concept of common good or Public Value is unique: It is all about looking at organizations from the point of view of society. But how can we evaluate an organization from the standpoint of society? Psychology comes in handy here. It found four stable, basic human needs that build the motivational and emotional backbone for the evaluation of Public Value: one: Each of us would like to understand the surrounding world and to have a target-oriented effect on it. Two: Each of us seeks recognition as a human being. Three: Each of us strives for sound social relationships. and four: each of us looks for positive and enjoyable experiences. These four elements result for every individual in a distinct pattern of needs, which organizations touch and influence with their performances and behaviors. Let’s wrap it up: The concept of Public Value does not understand the value creation that an organization seeks to generate as mere material thing, but also as a motivational and emotional one that is anchored in our awareness. So, it is all about the images in our minds. But is this interesting for managers and politicians? Yes. Various organizations think about their contribution to the common good through their core businesses or performance mandate. Fresenius Medical Care, for example, wanted to know the social appraisal of of their dialysis clinics. Swiss insurance company Mobiliar analyzed the potential effects of a corporate acquisition on their Public Value. The Football club FC Bayern Munich examined the challenges of its growth strategy for its Public Value. And the German Federal Employment Agency – one of Europe’s biggest civil services – tried to find out which contribution to the common good legitimizes its reason of being. Now, how exactly were these organizations able to measure their contribution to the common good? The University of St.Gallen developed two methods to analyze Public Value. Both focus on the four basic human needs. One: The Public Value Scorecard. Two: The Public Value Atlas. The Public Value Scorecard focuses on five questions: one: Is it profitable? Two: Is it useful? Three: Is it decent? Four: Is it politically acceptable? And five: Is it a positive experience? Keeping these five questions in mind when making management decisions allows us to think beyond the profitability of the company and take into account the four basic human needs. Not everything always fits neatly, however. A management’s initiative for example, could be profitable and useful, but at the same time neither decent nor politically acceptable. It also may be legal, but not legitimate yet. The second method is termed the Public Value Atlas. In this case, the general public is directly asked what Public Value an organization creates. Similar to customer surveys it is possible to gather management information at the heartbeat of society. An organization is able to better understand for what it is esteemed for and for what it isn’t; if its actions are perceived as legitimate and if its efforts have a positive impact on the public. “This is all about advertising and political marketing!”, you say? At the core of the Public Value Atlas lays the assumption that sooner or later, empty promises won’t hold. Public Value is what the public values. Put simply: Public Value is a matter of attitude. And the attitude of all of us determines how valuable the activity of an organization is. The Public Value approach tells us that an organization always acts meaningfully, whenever it gets appreciated by the public and thus whenever it contributes to a functioning society. It helps to scrutinize management decisions against their compatibility with the common good. It fosters a new understanding of value creation that combines hard and soft factors. and it makes it possible to evaluate the performance of an organization in a new way. Public Value matters for all of us: management, society and you.

History

The GAIN was developed to respond to the needs of substance abuse treatment personnel who are faced with the demands of assessing, documenting, treating, and monitoring clients. Researchers, clinicians, policymakers, and behavioral healthcare agencies worked to design assessment tools that could produce methodical data for mapping onto the Diagnostic and Statistical Manual of Mental Disorders (DSM) for diagnosis and the American Society of Addiction Medicine (ASAM) Patient Placement Criteria for placement, while following The Joint Commission (TJC) [formerly the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)] for integrating assessments into treatment plans.[2] Since its inception in 1993, application of the GAIN has expanded to thousands of users at agencies across the United States, Canada and several other countries.[3]

Family of assessments

  • GAIN Initial (GAIN-I) – a comprehensive standardized assessment that can be used for treatment placement and planning, outcome monitoring, economic analysis, program planning, and supporting motivational interviewing.[1]
  • GAIN Monitoring 90 Days (GAIN-M90) – a subset of the GAIN-I used for quarterly follow-up to measure changes in participants throughout their treatment.[2]
  • GAIN-Q3 – The GAIN-Q3 includes three separate versions that screen for the recency and frequency of behavior and service utilization in nine areas. Successive versions provide additional information, such as a six-item measure of life satisfaction or supplemental modules to collect information on reasons and readiness to change.[4]
  • GAIN Short Screener (GAIN-SS) – a screener, not used for diagnosis or level of care placement, that quickly identifies clients likely to have mental health disorders, issues with crime/violence, and issues with substance use. The GAIN-SS is typically self-administered.[1]

All these assessments can be used to generate reports to aid in diagnosis and treatment planning.[1]

Content

The GAIN-I has sections covering background, substance use, physical health, risk behaviors and disease prevention, mental and emotional health, environment and living situation, legal, and vocational. Within these sections are questions that address problems, services, client attitudes and beliefs, and the client's desire for services.[1] Information on symptoms, which is used for diagnosis, is collected if the behavior has occurred in the last year. Information on behaviors, which is used for treatment monitoring, is collected if the same behavior occurred within the last 90 days. The items are combined into over 100 scales Scale (social sciences) and subscales that can be used for DSM-IV–based diagnoses,[5] ASAM-based level-of-care placement,[6] TJC-based treatment planning,[7] and Drug Outcome Monitoring Study-based outcome monitoring.[8] The GAIN also includes items that support most state and federal reporting requirements, which compare to community samples from the National Survey of Drug Use and Health (NSDUH [formerly the National Household Survey on Drug Abuse (NHSDA)]).[9] As biopsychosocial assessments, The GAIN-I and GAIN-SS provide measures over four main categories of emotional and behavioral health problems—internalizing, externalizing, substance, and crime/violence. Among these categories are numerous scales and indices, which have demonstrated good reliability and internal consistency in studies.[10]

Response to criticism

The GAIN has been criticized for not having scales to assess response style. Critics say these face-valid questions are vulnerable to faked responses from participants.[11] Although it would be impossible for interviewers to ensure that participants always provide genuine responses to questions, the benefit of semi-structured assessments, like the GAIN, is that they allow the interviewer to clarify participant responses. Additionally, helping participants understand how their responses will be used in specific areas of their treatment may encourage them to be truthful. The GAIN-I includes ratings at the end of each section that allow an interviewer to record whether a participant seemed to be doing some estimating, whether they did not understand the questions, whether they were in denial about the severity of a problem or whether they were misrepresenting information. These ratings can be used as flags to communicate problem areas to clinicians and can also assist in treatment planning.[12]

Notes

  1. ^ a b c d e [1], Cormier, G., Jackson-Gilfort, A., Godley, S.H., Hervis, O.E., Parks, G.A., Savery, P., Triplett, E. (2008). Evidence-Based Practice for Adolescent Substance Abuse: A Primer for Providers and Families, p. 10, accessed 2011-01-11.
  2. ^ a b Dennis, M. L., White, M., Titus, J. C., & Unsicker, M. S. (2008). Global Appraisal of Individual Needs: Administration Guide for the GAIN and Related Measures (Version 5). Bloomington, IL: Chestnut Health Systems, [2][permanent dead link] accessed 2011-29-04.
  3. ^ Dennis, M.L. (2010). Global Appraisal of Individual Needs (GAIN): Global Appraisal of Individual Needs (GAIN): A Standardized Biopsychosocial Assessment Tool Archived 12 December 2010 at the Wayback Machine accessed 2011-01-11.
  4. ^ Titus, J. C., Feeney, T., Smith, D. C., Rivers, T. L., Kelly, L. L., & Dennis, M. D. (2012). GAIN-Q3 3.1: Administration, clinical interpretation, and brief intervention. Normal, IL: Chestnut Health Systems,[3][permanent dead link] accessed 2011-29-04.
  5. ^ American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (DSM-IV-TR) (4th rev. ed.). Washington, DC: American Psychiatric Association
  6. ^ American Society of Addiction Medicine (ASAM). (2001). Patient placement criteria for the treatment for substance-related disorders (2nd rev. ed.). Chevy Chase, MD: American Society of Addiction Medicine.
  7. ^ Joint Commission on Accreditation of Healthcare. (2002). Accreditation manual for mental health, chemical dependency, and mental retardation/developmental disabilities services: Vol. 1. Standards. Oakbrook Terrace, IL: Author.
  8. ^ Dennis, M. L., Scott, C. K, Godley, M. D., & Funk, R. (1999). Comparisons of adolescents and adults by ASAM profile using GAIN data from the Drug Outcome Monitoring Study (DOMS): Preliminary data tables. Bloomington, IL: Chestnut Health Systems, [4] Archived 12 December 2010 at the Wayback Machine accessed 2011-01-11.
  9. ^ Office of Applied Statistics (OAS). (1996). National Household Survey on Drug Abuse (NHSDA): Main findings (DHHS Publication No. (SMA) 96-3085). Rockville, MD: Substance Abuse and Mental Health Services Administration.
  10. ^ Dennis, M.L., Chan, Y., & Funk, R. (2006). Development and validation of the GAIN Short Screener (GSS) for internalizing, externalizing and substance use disorders and crime/violence problems among adolescents and adults. The American Journal on Addictions, 15, 80–91.
  11. ^ Rogers, R. (2008) Clinical Assessment of Malingering and Deception. New York, NY: The Guilford Press
  12. ^ Titus, J.C., Unsicker, J.I., White, M.K., Dennis, M.L., Feeney, T. (2008). Global Appraisal of Individual Needs: Frequently Asked Questions (FAQ) (Version 5). Bloomington, IL: Chestnut Health Systems, [5] Archived 12 December 2010 at the Wayback Machine accessed 2011-01-11.

External links

This page was last edited on 3 February 2022, at 10:20
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