Assessment and referral of children and young people with alcohol problems

Assessment and referral of children and young people

• if alcohol misuse is identified as a potential problem, with potential physical, psychological, educational or social consequences, in children and young people aged 10-17 years, conduct an initial brief assessment to assess:
  • the duration and severity of the alcohol misuse (the standard adult threshold on the AUDIT for referral and intervention should be lowered for young people aged 10-16 years because of the more harmful effects of a given level of alcohol consumption in this population) any associated health and social problems
  • the potential need for assisted withdrawal
• refer all children and young people aged 10-15 years to a specialist child and adolescent mental health service (CAMHS) for a comprehensive assessment of their needs, if their alcohol misuse is associated with physical, psychological, educational and social problems and/or comorbid drug misuse
  
  
• when considering referral to CAMHS for young people aged 16-17 years who misuse alcohol, use the same referral criteria as for adults
  
  
• a comprehensive assessment for children and young people (supported if possible by additional information from a parent or carer) should assess multiple areas of need, be structured around a clinical interview using a validated clinical tool (such as the Adolescent Diagnostic Interview [ADI] or the Teen Addiction Severity Index [T ASI]), and cover the following areas:
  • consumption, dependence features and patterns of drinking
  • comorbid substance misuse (consumption and dependence features) and associated problems
  • mental and physical health problems
  • peer relationships and social and family functioning
  • developmental and cognitive needs, and educational attainment and attendance
  • history of abuse and trauma
  • risk to self and others
  • readiness to change and belief in the ability to change
  • obtaining consent to treatment
  • developing a care plan and risk management plan.

Reference:

• 1) NICE (February 2011). Alcohol-use disorders - Diagnosis, assessment and management of harmful drinking and alcohol dependence