ANSA: Becoming a Recovery Focused Tool

Abstract

The Adult Needs and Strength Assessment (ANSA, Lyons, 2009) has been used across public mental health and addiction services in Indiana to help develop intervention plans and to monitor client progress. ANSA consists of six core domains (Life Functioning, Behavioral Health Needs, Risk Behaviors, Strengths, Acculturation, and Caregiver). Domain items are rated on a four-point scale to describe the degree to which a need interferes with functioning or a useful strength is present. Despite statewide implementation, literature related to the ANSA is scarce. The study evaluates the psychometric properties of ANSA and its role as an outcome performance measure. Adults for whom the ANSA had been rated at four points between 2008 and 2010 were included (N=6320). Internal consistency reliability was measured for each ANSA domain and outcome measure. Reliable change indices (RCI) for each domain were used to calculate significant change. At each point of assessment and across time, the Cronbach’s alphas for all domains, except Risk Behaviors, are in the acceptable to high ranges (0.71 to 0.92), indicating good internal consistency and stability. For outcome performance measures, a more realistic timeframe for assessments (12 months) was required to document reliable improvement in at least one ANSA domain for individuals with serious mental health needs. The Residential Stability outcome measure has the low internal consistency and stability. From the recovery perspective, a new Community Integration measure was proposed as an alternative outcome measure and proved to be reliable (α = .90). Study findings helped enhance the ANSA tool, create a new outcome measure, and inform state policy. Specifically, bridging research to practice, findings resulted in restructuring the ANSA Risk Domain and modifying how outcomes are measured for adults in recovery focused behavioral health services.