The Videotaped Addiction Challenge Tool: A new instrument for qualitative substance abuse assessment, treatment planning and research in therapeutic communities

This article describes the different phases of the development and implementation of the Videotaped Addiction Challenge Tool (VACT, initially termed the Video Addiction Challenge Test). This instrument employs a video depicting the 'average life-story' of a resident of a Therapeutic Community for substance abusers. The video film is used as a clinical method for assessment and individual treatment planning, and as a research instrument that gives care-givers a deeper insight into the residents' personal characteristics and treatment requirements at any given moment in the Therapeutic Community. The article reports the results of administering the VACT to 38 residents (31 male and 7 female) at the De Kiem Therapeutic Community in Belgium. Detailed description of the procedure and its principles assures reliability and makes accurate reproduction possible. The validity of the instrument was tested by comparing, characteristic by characteristic, the results of the VACT, life-story and social anamnesis. The correspondence between the VACT and the life-story was 94% and between the VACT and the social anamnesis, 98%. The VACT has also contributed new information not measured by other instruments. Content analysis of this information shows that TC residents are characterised by negative communication between parents, negative communication with father, an unhappy childhood, child maltreatment or abuse, and relational problems due to drug abuse. Residents reported feelings of inferiority and suicidal thoughts and/or suicide attempts. Many new residents also reported sexually related problems such as abortion, sexual abuse, prostitution and shyness. There were no specific female problems; men reported sexual abuse as often as women. The implementation of this new instrument leads to a more methodical approach. It is, however, also more time-consuming and can be a problem for staff who tend to give priority to immediate action and direct problem-solving.