Before completing this assignment, watch the ASAM Level of Care mini-lecture.
ASAM Mini-Lecture
As you watch, pay attention to the purpose of the different levels of care and how client needs, risks, strengths, and functioning influence placement decisions.
You will also receive a separate mini-lecture explaining how to appropriately use AI for this assignment.
🧠 Use the SAME Client
You must use the client you selected for Assignment One.
Do not create a new client.
Do not add information that was not provided.
Remember:
DON'T ADD INFORMATION.
If information is missing, identify that information as something you would want to assess before making a final recommendation.
PART I — Your Clinical Picture
Briefly summarize the client's current situation.
Focus on the information that is most important for determining level of care.
Consider:
- Substance use
- Frequency and severity
- Previous treatment
- Previous periods of abstinence
- Withdrawal concerns
- Medical needs
- Mental health needs
- Motivation
- Recovery environment
- Family/social support
- Legal involvement
- Employment
- Current functioning
- Strengths and barriers
PART II — The Six ASAM Dimensions
Use the six ASAM dimensions to organize your thinking.
Dimension 1
Acute Intoxication and/or Withdrawal Potential
What information do you have?
What concerns, if any, are present?
What additional information would you need?
Dimension 2
Biomedical Conditions and Complications
What do you know about the client's physical health?
Are there concerns that could affect treatment?
Dimension 3
Emotional, Behavioral, or Cognitive Conditions and Complications
What mental health or behavioral concerns are present?
Are there concerns that may require additional assessment or referral?
Dimension 4
Readiness to Change
Where does the client appear to be in relation to change?
What does the client say they want?
Are there differences between what the client wants and what others want for them?
Dimension 5
Relapse, Continued Use, or Continued Problem Potential
What information suggests risk for continued use?
What previous patterns or consequences are relevant?
What strengths might reduce risk?
Dimension 6
Recovery/Living Environment
What is the client's current environment?
What supports are present?
What barriers or risks exist?
PART III — Your Level of Care Recommendation
Based on the information available, identify the ASAM Level of Care you believe is most appropriate.
Then explain why.
Your explanation should connect your recommendation to the client's needs rather than simply saying:
“I think this client needs Level ___.”
Use evidence from your assessment.
🤖 PART IV — Use AI as a Clinical Thinking Partner
Now you will use AI to challenge your clinical reasoning.
The purpose of using AI is not to have AI make the decision for you.
You are the counselor.
You make the initial clinical determination.
AI is being used as a tool to help you look at the case from another perspective.
Step 1 — Make Your Own Recommendation First
Before using AI, complete Parts I–III based on your own understanding of the client and the ASAM dimensions.
Record your initial level-of-care recommendation.
Step 2 — Ask AI to Review Your Reasoning
You may use an AI tool to review your assessment and ASAM reasoning.
You might ask questions such as:
“Review my ASAM assessment and identify areas where my reasoning may be incomplete.”
or:
“Based only on the information provided in this case, what questions should I reconsider when determining level of care?”
or:
“Challenge my reasoning about this client's ASAM placement. What might I be overlooking?”
Do not ask AI to invent information about the client.
AI should work only with the information provided in the case.
Step 3 — Evaluate the AI Response
AI is not automatically correct.
Read its response critically.
Identify:
- Something AI identified that you had overlooked.
- Something you agreed with.
- Something you disagreed with or questioned.
- Whether AI added information that was not actually present in the case.
Remember:
AI can make assumptions too.
This is another opportunity to practice:
DON'T ADD INFORMATION.If AI assumes something that isn't in the case, recognize that as a problem rather than accepting it as fact.
Step 4 — Reconsider Your Recommendation
After reviewing the AI response, decide whether your original ASAM recommendation:
- stayed the same,
- changed,
- or became more nuanced.
Explain why.
You do not have to change your answer simply because AI suggested something different.
In fact, defending your original clinical reasoning may be the better answer if you can explain why.
PART V — What Are You Still Missing?
This is important.
A good counselor recognizes when there isn't enough information.
Identify at least three pieces of information you would want to obtain before making or finalizing your recommendation.
Remember:
Missing information is different from negative information.
If the case doesn't tell you something, don't assume the answer.
⭐ Counselor Challenge
Imagine that Jordan says:
“I don't need treatment. I just need to finish probation.”
How might you respond without arguing with the client?
Write 2–3 sentences demonstrating your authentic counselor voice.
🤖 AI Reflection
Briefly respond to the following:
1. What did AI help you see that you had not considered?
2. Did AI make any assumptions that were not supported by the case?
3. Did your ASAM recommendation change after using AI?
If it changed, explain why.
If it did not change, explain why you remained confident in your original recommendation.
4. What did you learn about using AI as a clinical thinking tool?
⚠️ AI Expectations
For this assignment, AI use is required.
However, AI does not replace your clinical reasoning.
You are responsible for:
- The information you submit.
- Your ASAM reasoning.
- Your final level-of-care recommendation.
- Identifying unsupported assumptions.
- Evaluating the accuracy of AI's response.
Do not allow AI to create facts about the client.
Do not simply copy and paste an AI-generated ASAM assessment and submit it as your own clinical reasoning.
Your job is to think first, use AI second, evaluate third, and make your own final decision.
Submission
Submit one document containing:
- Clinical summary
- Six ASAM dimensions
- Initial level-of-care recommendation
- AI review/challenge
- Your evaluation of the AI response
- Final level-of-care recommendation
- Missing information
- Counselor Challenge response
- AI reflection
Final Reminder
You are the counselor.
AI is the tool.
Use it to ask better questions, challenge your thinking, and identify gaps—but you are responsible for the clinical reasoning.
CASE STUDY: JORDANJordan is a 29-year-old adult who was referred to substance use treatment by probation following a conviction for possession of a controlled substance.
Jordan is currently on probation and has been ordered to complete a substance use assessment and follow treatment recommendations.
Jordan reports that they began using alcohol regularly at approximately age 18.
Jordan reports that alcohol use increased after the death of a close friend when Jordan was 22.
At age 23, Jordan reports beginning to use cocaine recreationally with friends.
Jordan states that cocaine use initially occurred approximately once or twice a month.
Over the past two years, cocaine use has increased.
Jordan reports using cocaine approximately two to three times per week during periods when it is available.
Jordan reports that alcohol is usually used at the same time.
Jordan states:
“I don't think I have a problem with alcohol. The cocaine is what got me into trouble.”
Jordan reports that there have been several occasions when they intended to use cocaine once but continued using longer than planned.
Jordan reports spending more money than intended on cocaine.
Jordan states that they have missed work because of being awake late using substances.
Jordan reports that their partner has complained about their substance use.
Jordan and their partner have been together for approximately four years.
They currently live together.
Jordan reports that the relationship has become “pretty tense” since the legal charges.
Jordan has one child, age 6, from a previous relationship.
Jordan reports seeing the child on weekends.
Jordan states that the child's other parent is “always threatening to take me back to court.”
Jordan reports that their probation officer requires them to attend treatment and submit to drug testing.
Jordan reports being worried about failing a drug test.
Jordan states:
“My PO is just waiting for me to mess up.”
Jordan reports that they completed a substance use treatment program approximately three years ago.
Jordan reports maintaining abstinence from cocaine for approximately six months following that treatment episode.
Jordan states that they returned to cocaine use after reconnecting with several friends who were using.
Jordan reports that they have never participated in residential treatment.
Jordan reports no current prescription medications.
Jordan reports no significant medical conditions.
Jordan reports experiencing periods of anxiety and difficulty sleeping.
Jordan has never received a formal mental health diagnosis.
Jordan reports that their mother has a history of problematic alcohol use.
Jordan reports that their father has not been involved in their life since Jordan was approximately 10 years old.
Jordan completed high school.
Jordan is currently employed full-time in a warehouse.
Jordan reports that employment has been “mostly okay,” although they received a written warning after missing work following a night of substance use.
Jordan reports that they would like to keep their job.
Jordan identifies their sister as someone they can depend on.
Jordan states:
“I don't want to go back to jail.”
When asked what they would like to get out of treatment, Jordan responds:
“I just want to get through probation and get everybody off my back.”