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Integrated Care for drug users: Principles and practice
CHRISTO INVENTORY FOR SUBSTANCE MISUSE SERVICES (C.I.S.S.)
Background
The CISS is a simple, validated, 10-item questionnaire producing a single score of 0 to 20 which is a general index of client problems. It has been used with both drug and alcohol services. CISS was developed to find out workers' impressions of their clients in a quick, standardised and reliable way and outcome areas are scored on a three point scale of problem severity (0 = none, 1 = moderate, 2 = severe). It can be used to monitor client problems at intake and at structured follow-up points. As with the MAP, CISS can be used to establish changes over time. For example, the CISS collects information on HIV risk behaviour that can be compared between first assessment and follow-up assessments, both for individuals and for the population of service users as a whole. |
Where did you find out about this tool | Journal / Research 42%
Conference / Seminar 25%
Commissioners of Service 25%
Word of Mouth 17%
Internal 8% |
How long have you used this tool | Mean 7.82 Months
Standard Deviation 5.04 |
Origin | Original Format 75%
Modified for agency's use 8.3%
Developed for agency's use 8.3%
Developed as joint tool with other agencies 8.3% |
Comparative Information | Published Research Literature | Survey Results (n=12) |
Application | | |
Primary Use | The tool has been validated for outcome monitoring in a practice setting. Outcome measures include physical health, psychological health, drug use, HIV risk and criminal behaviour. | Assessment 83%
Evaluation 16.6%
Screening 16.6%
Audit 8.3%
Research 8.3% |
Secondary Use | It also measures three areas of client-support interaction: the use of structured support (e.g. AA / NA counselling), compliance (e.g. with treatment requirements), and working relationships (e.g. ease of interviewing). | Evaluation 58.3%
Research 33.3%
Audit 33.3%
Assessment 16.6%
Audit 16.6% |
Client Groups | All | Adult 100%
Adolescent 83%
Women 83%
Ethnic Groups 83%
Prisoners 50% |
How often is this tool completed with each client | No information | 3 Monthly 50%
6 Monthly 16.6%
12 Monthly 16.6%
Monthly 8.3%
Once & Review 8.3%
As Required 8.3% |
Administrative Issues | | |
Guidelines/Manual required | Guidelines are on form | No 66.6%
Yes 33.3% |
Approximate time to complete | The author notes that a worker familiar with the tool can complete it in three to five minutes. | Mean 13.6 minutes
Standard Deviation 12.59 |
Time to score | No information | Mean 4.8 minutes
Standard Deviation 3.6 |
Scoring by | No information | No information |
Validation: A validation study conducted by Christo and his colleagues was positive (Christo et al 2000). The CISS demonstrates good face validity because its items were acceptable to workers and clients. The CISS also scored well against other existing multi-dimensional instruments suggesting that content validity is also good. Further it appears to have good discriminant validity - the spread of scores was good and there were no ceilings on the scores. |
Training requirements | None | Mean 0.7 day |
Users Opinion & Comment | |
Positive features | Relative Score 60.4% Quick to complete
Good evaluation data
Tick boxes make information easy to record
Can be used for all clients
Supports fuller assessment of clients needs
Records information in a consistent manner which can be
shared with other agencies |
Concerns | Relative Score 16.7% Too simplified
Does not record the clients views / opinions |
Christo G, Spurrell S, Alcorn R. Christo Inventory for Substance- Misuse Services.Drug and Alcohol Dependence 2000; 59: 189-197.
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