Decisions to use tools within TANF agencies may depend in part upon the skills and training of staff. Because TANF staff do not generally have advanced training, or expertise in barrier identification, TANF agencies often rely on specialists employed by partner agencies to further the identification process. Partner agency staff frequently possess greater expertise and formal training regarding barrier identification, and are able to utilize a wider range of validated tools to uncover unobserved barriers to employment. For example, therapists might use the Beck Depression Inventory-II (BDI-II), the Minnesota Multiphasic Personality Inventory (MMPI), or an intelligence test in their efforts to diagnose a mental health problem or disability. Addiction counselors employed by substance abuse partners may use additional tools developed to determine the extent of a substance abuse problem and the appropriate treatment.
In Montgomery County, Kansas, Regional Alcohol and Drug Assessment Center (RADAC) assessors use the Michigan Alcohol Screening Test (MAST) and the Kansas Client Placement Criteria (KCPC).21 The MAST is a simple self-scoring test. This twenty-five question tool inquires not only about an individual’s drinking habits, but also about any history of mental illness. After the MAST, the RADAC assessors administer the automated KCPC. This state-developed tool requires approximately an hour to complete and is conducted through an interview with responses recorded on a laptop computer. Questions on the KCPC range from the client’s employment history, to household members’ histories of substance abuse or mental health problems. Scoring the assessment and interpreting the results requires the application of clinical knowledge by a substance abuse professional.
Specialists from partner agencies rely heavily on psycho-social assessment interviews to explore unobserved barriers. Although many psycho-social interviews are guided by a form that outlines the topics to be covered, this was considered merely a guide by those conducting interviews. Across the study sites, specialists noted that the psychosocial form is used as a springboard for a conversation and that strong interpersonal or “soft” skills were as important as clinical training when conducting this interview. However, psycho-social interviews differ from other in-depth interviews in that they require advanced training to administer and interpret the results.
Psycho-social interviews are conducted by clinically trained Targeted Assessment Project (TAP) assessors in Owensboro, KY, therapists at River Valley Behavioral Health in Owensboro, KY, therapists at Four County Mental Health in Montgomery County, KS, as well as the on-site therapist at the IRIS Program in Minneapolis, MN. Generally this assessment is conducted as an in-depth interview covering topics such as: medical history, family history of physical/psychiatric illness, chemical (alcohol/drug) history, gambling history, sexual history, domestic violence history, education/learning, social history, measures of functioning (e.g., activities of daily living) employment history, legal involvement, interactions with family/household members, history of previous treatment, recent stressful life situations, mental status, client’s strengths, and clinical impression.
21 The state of Kansas requires that two tools be used to diagnose an addiction.