Psychology ASMF

COU 640 ASAM Form

 

ASAM DIMENSIONAL SEVERITY PROFILE

ASAM Dimension (0)

No Problem

(1)

Mild

(2)

Moderate

(3)

Substantial

(4)

Severe

Dimension One: Acute intoxication and/or withdrawal potential          
Dimension Two: Biomedical conditions and complications          
Dimension Three: Emotional, behavioral, and cognitive conditions and complications          
Dimension Four: Readiness to change          
Dimension Five: Relapse, continued use, or continued problem potential          
Dimension Six: Recovery/living environment

         

 

 

Notes/Reasons:

 

Dimension One: Acute intoxication and/or withdrawal potential

 

 

 

 

Dimension Two: Biomedical conditions and complications

 

 

 

 

Dimension Three: Emotional, behavioral, and cognitive conditions and complications

 

 

 

 

Dimension Four: Readiness to change

 

 

 

 

Dimension Five: Relapse, continued use, or continued problem potential

 

 

 

Dimension Six: Recovery/living environment

 

 

 

 

Reflection: