individual being targeted (e.g., service member, health care professional, Air University student, commander). Program activities related to primary prevention appear to focus exclusively on the individual level, without including prevention at the environmental level (e.g., alcohol control policies).

Tiers II and III focus on secondary/targeted prevention and tertiary care/treatment, respectively. The targeted prevention program, Alcohol Brief Counseling (described below), is correctly directed at individuals who are at high risk because of heavy alcohol use but who do not qualify for a full diagnosis of abuse or dependence. All individuals seen in the ADAPT program also receive an Alcohol Education Module, which reinforces Air Force policies on use of substances and also focuses on clarification of values and anxiety and anger management.

For screening, all ADAPT sites make use of the Substance Use Assessment Tool (SUAT). The SUAT, developed for use in the Air Force in 2007, is a comprehensive mental health and substance use assessment and case management tool that is designed to be self-administered by the service member and is used across all ADAPT sites. It provides a preliminary diagnosis (to then be confirmed or revised by a licensed mental health provider), a level-of-care recommendation, and motivational interviewing feedback.

ADAPT treatment programs are designed to ensure that the individual acquires and applies an understanding of the disease of alcoholism, communication and coping skills, and mechanisms for establishing goals that reinforce an alcohol-free lifestyle. Abstinence from alcohol is required in the initial treatment phase of ADAPT. ADAPT staff evaluate any service members who have problems with abstaining from alcohol to determine appropriate interventions and, if necessary, change the treatment plan to help clients meet their goals and return to full duty status. Treatment is planned according to ASAM placement criteria. In ADAPT Level I treatment, which usually last 8 weeks, service members participate in both individual and group counseling sessions weekly. Counselors offer interventions based on motivational interviewing, as well as cognitive-behavioral treatment. The treatment team includes not only mental health professionals involved in the clinical care being provided but also the service member’s immediate supervisor and the commander and/or first sergeant. The ADAPT staff at each base coordinate with local TRICARE providers to arrange treatment for those service members requiring inpatient residential treatment, a level of care not provided within ADAPT. Upon completion of residential or nonresidential treatment off base, service members normally return to their duty stations and enter the aftercare phase. Failure to complete treatment successfully may lead to administrative separation.

ADAPT staff design individualized aftercare plans providing continued support with at least monthly monitoring. During this phase of treatment, service members demonstrate their ability to meet Air Force standards and

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