–Past or present treatment: The social worker should assess if the client has been treated for substance use in the past or is currently in treatment. The type of treatment should be determined (e.g., inpatient, outpatient, AA) as well as its outcome (i.e., whether sobriety or a reduction in consumption was achieved and for how long)
› Family history • Family history can have physical, psychological, social, and spiritual impacts on the client and should be included in all
biopsychosocial-spiritual assessments. Some medical and psychiatric disorders can run in families. Substance use is often “passed down” from one generation to another as a result of a complex combination of biological, psychological, and social factors. Family dynamics often repeat themselves throughout multiple generations. Assessing at least three generations of family history can allow for the emergence of patterns of experiences or behaviors. In addition, the social worker should be alert to nonverbal information from the client and family members regarding their feelings about their family and
whether they sense the family as a whole as being a source of strength or stress for them. Completing a genogram can be particularly helpful for assessing family history. The following areas should be assessed –Medical: family history of diseases including cancers, heart disease, genetic disorders, disabilities, and dementia or other
cognitive disorders –Psychiatric: history of mental illness, suicide (both completed and attempted) –Substance use: family members’ use of alcohol and other substances, including known or suspected addictions, or family
members who do not use substances at all. If there is a history of addiction in the family, the social worker should note any attempted or successful treatments as well as length of sustained sobriety