title: Use of sexual risk assessment and feedback at intake to promote counselor awareness of subsequent client risk behavior during early treatment.
abstract: BACKGROUND
  Sexual risk is an important, oft-neglected area in addiction treatment.
  
  
  OBJECTIVE
  This report examines computerized sexual risk assessment and client feedback at intake as means of enhancing counselor awareness of client risk behavior during early treatment, as well as any clinical impact of that counselor awareness.
  
  
  METHODS
  In 2009-2011, new clients at both opiate treatment and drug-free treatment programs endorsed in a computer-assisted assessment at intake 90-day retrospective indices for: being sexually active, having multiple partners, having sex under drug influence, and inconsistently using condoms. Clients were randomly assigned in a 2:1 ratio to receive or not receive a personal feedback report, and those receiving a report chose if a counselor copy was also distributed. Ninety days later, retained clients (N = 79) repeated the assessment and their counselors concurrently reported perceptions of recent client risk behavior.
  
  
  RESULTS
  Based on client reports, pretreatment risk behaviors were prevalent among men and women and remained so during treatment. A general linear model revealed greater counselor awareness of subsequent client risk behavior with mutual distribution of intake feedback reports to client and counselor, and at the opiate treatment program. A repeated-measures analysis of variance indicated that counselor awareness did not predict change in temporally stable patterns of sexual risk behavior. CONCLUSIONS/IMPORTANCE: Findings document that computerized intake assessment of sexual risk and mutually distributed feedback reports prompt greater counselor awareness of clients' subsequent risk behavior. Future research is needed to determine how best to prepare counselors to use such awareness to effectively prompt risk reduction in routine care.
authors.affiliation: 1Alcohol and Drug Abuse Institute, University of Washington, Seattle, Washington, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Hartzler
authors.forename: Blair
authors.initials: B
authors.lastname: Beadnell
authors.forename: Donald A
authors.initials: DA
authors.lastname: Calsyn
mesh_terms: D000328:Adult; D001364:Awareness; D017280:Condoms; D003376:Counseling; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000523:psychology / Q000628:therapy*; D015995:Prevalence; D018570:Risk Assessment; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D012747:Sexual Partners / Q000523:psychology
keywords: assessment; feedback report; sexual risk; therapeutic process; treatment innovation