Queensland Early Intervention Pilot Project
[ QEIPP]
Providing information about alcohol for young people and adults
A tool kit for Health Service Providers delivering Alcohol Education Awareness Sessions for the Queensland Early Intervention Pilot Project [QEIPP] QPO3558_CouncillorBook_v5.indd 1
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Everyone else is taken
Contents Acronyms...........................................3
Section A Intervention Framework......................9
Section B Complimentary Techniques............. 19
Acknowledgements............................3
Behaviour Change Counselling........10
Family Therapy............................. 20
Preface...............................................4
Rationale........................................10
Psychoeducation......................... 20
QEIPP Project Summary....................6
Model............................................12
Alcohol Assessment tool.............. 21
Counselling Outline ............................8
Strategies
Referral Process........................... 21
Importance...............................13
Bibliography..................................... 22
Confidence...............................14 Techniques.......................................17
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Licence
Disclaimer
Produced by
QEIPP Toolkit for Alcohol Education Awareness Session created by the Queensland Police Service is licensed under a Creative Commons Attribution (BY) 2.5 Australia Licence. Permissions may be available beyond the scope of this licence.
While all care has been taken in preparing this publication, the State of Queensland, acting through the Queensland Police Service, does not warrant that the content is complete, accurate or current. The Queensland Police Service expressly disclaims any liability for any damage resulting from the use of the material contained in this publication and will not be responsible for any loss, however arising, from use of or reliance on this material. The user must make the enquiries relevant to their use in relation to the material available in this publication.
Ms Julia Featherstone Psychologist Senior Research Officer Drug and Alcohol Coordination Unit Queensland Police Service
http://creativecommons.org/ licenses/by/2.5/au/legalcode Written requests for permission should be addressed to the: Intellectual Property Coordinator Information Resource Centre Queensland Police Service GPO Box 1440 Brisbane Qld 4001 Ph 3364 3958 Fx 3364 3942
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The Queensland Police Service web address is www.police.qld.gov.au
Š The State of Queensland (Queensland Police Service) 2010
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Acronyms ACA.............. Australian Counsellors Association ADGP............ Australian Divisions of General Practice AOD.............. Alcohol and Other Drugs BCC.............. Behaviour Change Counselling CBT............... Cognitive Behavioural Therapy DoHA............ Department of Health and Ageing DUMA........... Drug Use Monitoring in Australia EIPP.............. Early Intervention Pilot Program GP ............... General Practitioner HSP.............. Health Service Provider KPI(s)............. Key Performance Indicator(s) MI.................. Motivational Interviewing QCA.............. Queensland Counsellors Association QEIPP........... Queensland Early Intervention Pilot Project QPS.............. Queensland Police Service QHealth......... Queensland Health
Acknowledgements The QPS would like to acknowledge the following organisations and groups that have contributed to the compilation of this resource: QPS Drug and Alcohol Coordination Unit QPS Employee Assistance Service Network QPS Ethical Standards Command QPS Media and Public Affairs Branch Queensland Health Dovetail Effigy Creative We would like to thank you for your guidance, advice and patience during the developmental stages of this tool kit and associated resources.
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Preface This tool kit was developed by the Queensland Police Service (QPS) as part of the Queensland Early Intervention Pilot Project – B.yrslf, everyone else is taken. The tag ‘B.yrslf, everyone else is taken’ originated from the Oscar Wilde quote ‘Be yourself, everyone is taken’, (or ‘already taken’ according to some sources) and connected well with the underlying philosophy of the project. When working with young people, parents, carers and the community; examining the client’s sense of ‘self’ often is a powerful theoretical approach to take. The QEIPP team decided to focus on the theoretical underpinning of the ‘self’ in developing the project and associated resources. Historical Understandings of ‘The Self’ Psychological study of the self principally focuses on either the cognitive and affective representation of one’s identity or the subject of ‘experience’ of the individual. The earliest formulation of the self in modern psychology derived from the distinction between the self as ‘I’, the subjective knower, and the self as ‘Me’, the object that is known. Current views of the self in psychology position the self as playing an integral part in human motivation, cognition, affect, and social identity – factors known to hold considerable influence in models of Health Behaviour Change. Psychoanalyst Heinz Kohut initially proposed a
Kohut articulated the critical role of empathy in explaining human development and change, talking much towards deepening the therapist’s empathic attunement to the client and describing fundamental human needs for healthy development, particularly idealising, mirroring, and twinship needs. Historically, in terms of treatment and intervention of a person experiencing alcohol related harms, this was a contradiction to the confrontational, value driven and more punitive of approaches. By 1984, Kohut’s observation of patients led him to propose two additional forms of transference associated with self deficits: 1) the twinship; and
bipolar ‘self’ compromising two systems of what he
2) the merger transference; two key concepts
termed as narcissistic perfection:
utilised in the development of the information
1) A system of ambitions; and
pack resource that is made available to our clients through the QEIPP process.
2) A system of ideals. Kohut believed that narcissistic injuries were
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The Tool Kit
inevitable and, in any case, necessary to temper
The tool kit aims to provide a ‘how to’ guide for
ambitions and ideals with realism through the
Behaviour Change Counselling of individuals and
experience of more manageable frustrations and
family intervention, psychoeducation and information
disappointments. It was the chronicity and lack
provision that can be applied in community settings
of recovery from these injuries (arising from a
as well as considerations for subregional settings,
number of possible causes) that he regarded as
accessible web design and telephone based
central to the preservation of primitive self systems
resources. The project allows for one session of which
untempered by realism.
the focus is the promotion of personal responsibility
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to foster the development of future attitudes towards a healthier drinking culture and prevent more serious injuries related to alcohol occurring. Essentially, it is a harm reduction driven project. It is hoped the modalities recommended and outlined in the tool kit will assist health service providers to work with young people and their families or caregivers to deal with alcohol-related difficulties. However, this tool kit is not a textbook on counselling and does not attempt to replace face to face workshops and training that aim to develop counselling skills and techniques in those health service providers who act as providers of the QEIPP alcohol education awareness sessions. Counselling young people at risk of alcohol misuse can involve participation from a number of trained people, from specialised professional psychologists, psychiatrists, doctors, social workers, counsellors and youth workers to peer educators who can offer ‘basic counselling’. These professionals are usually experienced in working with cases that are more difficult and can provide an approach that is more ‘in-depth’. Nevertheless, not all young people need such a level of intervention, and nor is that the scope of this project. Therefore, individuals and families can benefit from basic counselling provided by someone with whom they can quickly form trust. This may be sufficient, or it may help them realise that they are in need of more specialised interventions. In the event that the person providing the initial session is unable to provide the specialised intervention, it is essential they link the client in with appropriate ongoing professional intervention or therapy. Young people respond well to peer counsellors and peer educators. Such peers can act as good ‘role models’, providing they have insight into the lives of
young people from similar backgrounds. Some peer counsellors may have previously been substance users themselves. Young people can view them as coming from, or living in, similar situations to themselves, and having ‘recovered’ from substance misuse (for example alcohol) problems similar to those faced by the young people. The value of such pivotal peers, and awareness of pre-established networks within the young person and their family’s community, will contribute to the strengths of the counsellor’s engagement with the client group. Police, teachers, community leaders and residential treatment centre staff can provide support services to young people and may play a pivotal role in early intervention of at-risk groups. At times, nonspecialised counsellors can encourage and support young people experiencing alcohol related difficulties to seek necessary assistance from specialists. This can include specialist attention for serious mental and physical health and family and other abuse issues. It is anticipated that this tool kit will be of use to both those professionally trained and those who need to enhance their skills to provide basic counselling to young people experiencing alcohol misuse related difficulties. Those using the tool kit as a self-directed learning tool will need guidance from counsellors with more experience as providing specialist training is not the intention of this package. Assessment and family interventions are somewhat more specialised, as are some of the more advanced techniques of individual counselling. However, for those professionals working with young people in community or residential settings, whatever your role, it is hoped that you may learn some useful processes and techniques or approaches that can be adapted to assist individual young people and their families.
A training DVD accompanies this tool kit
QU
EE
NS
LA ND
TRAINING DVD EAR LY INT E
[ CT OJE T PR RVENTION PILO
IP QE
P]
The purpose of the DVD is to outline the conceptual framework underlying the project and the key principles guiding the intervention that are important to be mindful of when implementing this approach in practice. The DVD also contains a presentation outlining the origin of the project and its main goals. Also included on the DVD are further resources which are considered potentially useful for professionals in the allied health field.
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QEIPP Project Summary Historically the treatment of young people who have developed alcohol dependency and related problems have only had access to programs originally designed for adults; this is problematic as we know that young people have different psychological, social, cognitive and developmental needs to adults. They deserve different and specialised treatment interventions that address their developmental needs; ones that build on their developmental potential. Equally, the role of the family may have largely been overlooked when addressing the misuse of alcohol by young people. There have been several short-term campaigns in the past two decades aimed at reducing the levels of harm associated with alcohol use among the population, and young people in particular. Whilst awareness of these campaigns has been high, and young people have understood and thought about the messages, the level and frequency of risky alcohol consumption has remained high. The results of the 2007 National Drug Strategy Household Survey (2008) showed that young adults, aged 20 to 29 years, were most likely to consume alcohol at risky or high risk levels for short-term harm at least monthly, with 40% of them doing so. The age category next most likely to consume alcohol at risky or high risk levels for short-term harm at least monthly was the 14 to 19 year-old group, with 26% drinking at this level. This seems to indicate that, while previous communication campaigns have been successful in ‘cutting through’ to their target audiences, young people’s tendency to drink at risky levels remains deeply ingrained. This is likely due to the reflection
QEIPP represents commitment to an active search for effective and culturally appropriate treatment and ongoing referrals for young people identified as atrisk of alcohol misuse and the families of these young people. The project has focused on contributing towards meeting the serious need for communitybased intervention and education of this client group.
unacceptability of the harms associated with
The broad aim of QEIPP is to provide police; as part of their core business; with an early intervention in which to address alcohol misuse by young people. It is hoped that through this intervention, successful deviation of at-risk youth will occur away from the youth justice system to the health system. Specifically, the project, through this targeted police intervention, aims to bring a renewed understanding to young people and their parents/guardians, of their need to
excessive alcohol consumption and intoxication.
take personal responsibility for their behaviour.
of the National Alcohol Strategy 2006-2009, that “alcohol retains a deep-rooted cultural significance” in Australia. It is for this reason that early intervention has been identified as an effective strategy in changing attitudes towards excessive alcohol consumption by reducing the perceived acceptability of intoxicated behaviour and reinforcing the responsibility and
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Within this context, in March 2008 the Australian Government, as part of a National Binge Drinking Strategy, announced the funding of a $19.1 million harm minimisation and behavioural change campaign aimed at 15 to 25 year-olds with the message of “costs and consequences of binge drinking”. The overall goal of the campaign is to increase the likelihood of 15 to 25 year-olds who choose to drink alcohol, do so at a low risk level for short-term harm. The national strategy for this framework is known as the Early Intervention Pilot Project (EIPP). In Queensland, legislation influenced the design of the project, which differs from the national program in that it will address alcohol misuse by young people under the age of 17.
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PROJECT OBJECTIVES
KEY PERFORMANCE INDICATORS
The project objectives for EIPP in Queensland include:
The key performance indicators KPI(s) for QEIPP will be identical as the KPI(s) developed for the National EIPP Framework, namely:
• Provision of an alcohol psychoeducation session and booklets to young people increasing awareness of potential harms (physical and social) associated with excessive alcohol consumption, the serious nature of these potential harms and strategies to avoid alcohol-related harm • Provide sufficient training sessions to police regarding QEIPP
• Number of people initially approached through QEIPP • Number of written information packages distributed • Number of young people referred to alcohol education via QEIPP • Compliance rates of those referred to alcohol education
• Establish partnerships between Police, Queensland Health, and other service providers, to facilitate the implementation of the project
• Number of places made available and waiting period.
• Ensure the collection of minimum data requirements in accordance with the Commonwealth National Key Performance Indicators KPI(s).
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Counselling Outline It is largely recognised that the processes of counselling; such as the healing context, the working alliance and belief in the rationale for treatment and in the treatment itself; are instrumental therapeutic aspects of counselling and psychotherapy, in comparison to the specificity of techniques once heralded by the medical model as the key to an efficacious intervention. This understanding emerged as counselling, like many other therapeutic professions, has been evolving rapidly over the past decades. As such, there are quite a number of therapeutic modalities available for a practitioner to use depending on both counsellor and clients variables. Some examples are brief therapy; career counselling; counselling psychology; behavioural counselling; genetic counselling; grief counselling; mental health counselling; narrative therapy counselling; online counselling; peer counselling; rehabilitation counselling; suicide intervention and telephone counselling.
In terms of the proposed guidelines for QEIPP, the following intervention tools are recommended:
PRIMARY INTERVENTION • Behaviour Change Counselling Framework (BCC) - Please view accompanying training DVD
COMPLIMENTARY TECHNIQUES (when appropriate) • Family Therapy: family of origin dynamics around coping strategies, stress management and drug and alcohol use. • Psychoeducation: increasing awareness of potential harms (physical and social) associated with excessive alcohol consumption, the serious nature of these potential harms, and strategies to avoid alcohol-related harm. • Psychosocial needs assessment (including alcohol assessment tool). • Referral process.
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SECTION A INTERVENTION FRAMEWORK Behaviour Change Counselling
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Behaviour Change Counselling (BCC) Rationale: Behaviour change typically involves changes in lifestyle and medication use for a range of issues – from eating and drinking alcohol less, to exercising and improving medication adherence. Consistently, in the world of health practitioners there exists a paradox between the client’s expressed motives and interests towards changing behaviours that ‘experts’ tell them they need to change and the actual activities the same clients employ that enable immobility. Developed to address these concerns was the Behaviour Change Counselling model (BCC). It is based on the principles of client-centred counselling and motivational interviewing. The following points capture the philosophy of the behavioural change model
VALUE BASE • Respect for autonomy of clients and their choices is paramount • Client needs to decide what behaviour, if any, to focus on
SKILLS • A confrontational interviewing style is not productive • Information exchange is a critical skill • Readiness to change must be continuously monitored • Importance and confidence need to be assessed and responded to
ROLES The practitioner • Provides structure, direction and support • Provides information wanted by the client • Elicits and respects the client’s views and aspirations • Negotiates change sensitively
The client • Is an active decision maker
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The practical guidelines of BCC are initially outlined in
and greater attention is placed on building rapport.
Health Behaviour Change: a Guide for Practitioners
However, this does not necessarily require the
(Rollnick, Mason and Butler, 1999) and were further
intensity of relationship building essential to the good
refined by Rollnick and Miller (2002). It involves using a
practice of motivational interviewing. BCC often has a
wider range of skills than brief advice, but not as wide
‘task oriented flavour’ (Rollnick and Miller, 2002).
as those involved when using motivational interviewing. Essentially, the practitioner encourages the client to make their own decisions about behaviour change. A constructive and trusting atmosphere is used to explore the client’s feelings about the why and how of change.
There is no single text on BCC and whilst the information provided here primarily relates to one text, it is recommended that QEIPP counsellors review Health Behaviour Change: a Guide for Practitioners (Rollnick et al, 1999) as it provides one example of this counselling style. BCC was thought
The roles of the practitioner and client are more
to be a suitable general term for attempts
egalitarian than in a brief advice session. The
to conduct a constructive conversation about
practitioner using behaviour change counselling
change in which the practitioner tries to understand
operates as an advisor to a client who is an active
how the client feels about change, by using
and engaged participant. The encounter is more
mostly open questions and sometimes empathic
collaborative than typically observed with brief advice,
listening statements.
Key Concepts BCC can be applied in 5 – 30mins. It targets two main concepts related to successful behavioural change.
Importance Confidence
}
Both aimed to address “readiness to change”
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The Model ESTABLISH RAPPORT
MULTIPLE BEHAVIOURS
SINGLE BEHAVIOURS
REDUCE RESISTANCE
EXCHANGE INFORMATION
SET AGENDA
ASSESS IMPORTANCE AND CONFIDENCE (AND READINESS)
EXPLORE IMPORTANCE
BUILD CONFIDENCE
Source: Rollnick et al, (1999); Health Behaviour Change: a Guide for Practitioners
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Five strategies to explore importance to client of current behaviour Ask the client to rate how important changing their behaviour is; and depending on their response employ the following strategies. Do a little more
What does this mean?
If importance is low (e.g. zero or one) ask client if it is the right time to consider change? Other important issues?
It is important to understand that there may be differences in the value positions of the counsellor as the service provider and the
Scaling questions If importance is greater than three, ask client ‘why so high’, why a six, not a one, what would have to happen to get a four to a nine?
client regarding the importance of changing their behaviours. This can sometimes lead to conflicted situations, particularly when there are time constraints. For example you may
Pros and Cons
believe that it is important for a young person
Best to use when importance = five out of ten
to look after their cognitive development and abstain from consuming alcohol. Many clients
• What are the good things about change
will feel differently for a variety reasons.
• What are the less good things
These differences in values will influence beliefs
Concerns about behaviour
about health and illness and the perceived
When there are significant Cons
costs of adolescent drinking. Managing these differences within the awareness session is an
• What concerns you most regarding
important factor in the process.
behaviour change • Listen and understand
Source: Rollnick et al, (1999); Health Behaviour Change: a Guide for Practitioners
• Ask ‘where does that leave you now?’
Hypothetical look over the fence Also known as ‘miracle question’ • Imagine for a moment that you did change? • What might this be like? Look like? • What/how would you feel? • Listen to and reflect on thoughts and feelings
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Five strategies to build confidence Repeating the strategy from before, ask the clients to rate how confident they are in changing their behaviour; and depending on their response employ the following strategies. Do a little more
Past successes/failures
If confidence is low (e.g. zero or one) ask client if it is the right time to consider change. Is there other more important or pressing issues they would like to discuss?
Identify past successes
Scaling questions If confidence is greater than three, ask client ‘why so high?’, for example: ‘why a six and not a one?’, or ‘what would have to happen to increase a four to a nine?’
Brainstorm solutions
• what made it work? • praise (even if only part change was made) • maintain focus on success/failures under clients control
Reassess confidence • as discussion about confidence continues – confidence may be indecisive • can be useful to reassess and make changes explicit to the client
Emphasis principle • usually more than one course of action • share what has worked with other clients • client is the best judge of what’s worked for them • collaborative approach • encourage client to increase the number of options possible • let client select most suitable option • convey optimism and willingness to re-examine
What does this mean? The terms ‘confidence’ and ‘ability’ in this model are used to understand the clients self-efficacy as this focuses on the clients underlying psychological state, and avoids the mistake of assuming that talking about a behavioural change is merely a process of developing ‘technical coping skills’. Source: Rollnick et al, (1999); Health Behaviour Change: a Guide for Practitioners
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Information Exchange
Encourage client to be an active participant Provide information and facts Leave interpretation to client Ask what their needs are, what would they like to know Ask about client’s interpretation What does this mean? Often within the health behaviour change
the client and can foster resistance to
setting there is the temptation to fall into ‘simple
advice given.
advice giving’. The strategies provided in the
A secondary concern with ‘simple advice
BCC model aim to address this by consistently
giving’ is that it usually takes the form of a
encouraging the counsellor to invite the client
single ‘simple’ piece of advice. Arguably,
into the discussion regarding their behaviour,
if change was this simple the client would
what is important to them to work on and
have already adjusted their behaviour and
explore their ideas for potential change. It has
moved forward along the continuum of
been shown that the problem with simple
positive behaviour change. It is essential that
advice giving is that it can restrict a client’s
practitioners avoid minimising and dismissive
sense of autonomy within the therapist–client
approaches when working with clients faced
relationship, which in turn can act as a threat to
with change.
Source: Rollnick et al, (1999); Health Behaviour Change: a Guide for Practitioners
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Resistance Identify
What does this mean?
Reluctance
There are often three main traps that health service providers fall into when met with resistance. They are:
Rebellion Resignation Rationalisation
Roll with it Avoid arguing Do not directly oppose client’s expressed interpretation Signal to client any potential for difference Articulate that there is no expectation the client will change in the session
1. Take control away – when a client is compliant and likes to be told what to do 2. Misjudge importance, confidence or readiness 3. Meet with force. With any of these traps it is important to continue to emphasise to the client that they have personal choice and control within your interactions. Continually reassess the counsellors understanding of the client’s readiness, importance and confidence regarding change and when appropriate the counsellor needs to know when to ‘back off’ and come alongside the client. Source: Rollnick et al, (1999); Health Behaviour Change: a Guide for Practitioners
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Techniques The behaviour change counselling framework is not a one step method, or one model approach to working with clients towards more positive health and self-care, rather it is a ‘toolbox of strategies’ that allows for personalisation of both the counsellor, in terms of preference and skill of practice, and the client of what is appropriate to their individual situation. In terms of health behaviour change counselling there are key techniques that have been proposed to be used with clients who present with alcohol use as the identified behaviour that needs to be addressed. They are:
It is important to allow the client to tell the story. As the counsellor you may ask for some extra information here or there, but it is the client providing most of the detail. The interviewing style is more curious than investigative.
A typical day
Pros and cons
‘Can you take me through a typical day in your life, so that I can understand in more detail what happens?’
‘Would you like to spend a few minutes talking about what it is you like and don’t like about it?’
This strategy simply involves asking the client to take you through a typical day in their life. It can take as little as three to five minutes to use, although the ideal is six to eight minutes (NB – a good variation of this approach if you have a resistant client is to turn it into a hypothetical question – ‘tell me about a typical heavy drinker/ tell me about typical alcohol consumption of young people these days’).
Another term often used interchangeably within this strategy is looking at the costs and benefits of staying the same or changing. This strategy can take as little as five to seven minutes to use. If you have more time, use it, and allow the client to explore it in further detail. The most important first step is to ask the client whether he or she would like to look at the pros and cons. There are two ways of examining the pros and cons, either to look at the current behaviour, or change. A useful tool to implement here is a ‘balance sheet’.
NO CHANGE
CHANGE
COSTS
COSTS
BENEFITS
BENEFITS
Source: Rollnick et al, (1999); Health Behaviour Change: a Guide for Practitioners
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Techniques - continued Exploring concerns
Brain storming solutions
‘What concerns do you have about your drinking?’
This strategy is designed to maximise client interaction while allowing the counsellor to use their knowledge and skill to enhance this process. There are four key considerations within this strategy:
Two principles guide this strategy, firstly the client not the counsellor expresses concerns; and secondly once the client has finished describing their concerns, the counsellor asks some key questions about the possibility of change. As the counsellor, your role is to provide structure, listen carefully and then summarise at the end. The client’s role is to explain to you how he or she feels. It is important to ask the client about the next step, in a gentle and non-confrontational manner, for example ‘where does this leave you now?’
Information exchange As a strategy, information exchange occurs throughout various stages in the session. The following principles are important: • Does the client want or need to know information? About which topic? How much does he or she already know? It can be considered time wasting and negatively affect the client-therapist relationship if you provide inappropriate information or that which the client does not want to receive. The best time to provide information is when the client asks for it. • Make a distinction, if possible, between factual information and the personal interpretation of it. You present the information and encourage the client to interpret its meaning.
1. Emphasise the principles • There is usually not one, but many possible courses of action • I can tell you what has worked for other people • You will be the best judge of what’s right for you • Let’s go through some options together. 2. Go through the options It is important to note here, your attitude about the possibilities should be neutral; it is up to the client to decide. 3. Let the client select the most suitable option ‘which one suits you best?’ Your task here is to elicit and to understand how the client is really feeling about what to do. 4. Convey optimism and willingness to re-examine If the client selects an option be sure to let them know that if things don’t work out there will be other options that might work. It’s a matter of working out what best suits the individual. Source: Rollnick et al, (1999); Health Behaviour Change: a Guide for Practitioners
• When presenting information, use a neutral tone of voice and avoid too much use of the word ‘you’ and the question ‘why’?
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SECTION B COMPLIMENTARY TECHNIQUES Family Therapy Psychoeducation Alcohol Assessments Referral Process
*
It is important to note: these techniques are solely mentioned as potential alternatives to be used within the context of the session; and when appropriate, depending on the presentation of the client(s). They are not listed as recommended primary intervention techniques.
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Family Therapy
Psychoeducation
It is the recommendation of QEIPP, when identified as appropriate, that Systemic Family Therapy techniques are applied, with a particular focus on Family of Origin history of the client groups, specifically in terms of:
As stated earlier in this document, it is the expectation that during the course of the session counsellor’s engage in psychoeducation addressing:
• learned behaviours • coping skills • stress management • belief systems.
• increasing awareness of potential harms (physical and social) associated with excessive alcohol consumption, the serious nature of these potential harms, and strategies to avoid alcoholrelated harm • principally, it is the aim of the session to identify and challenge presenting attitudes towards excessive alcohol consumption by reducing the perceived acceptability of intoxicated behaviour and reinforcing the concepts of responsibility and unacceptability of the harms associated with alcohol consumption and intoxication • finally, it is recommended the counsellor allow time for generating and reinforcing intentions to avoid drinking to intoxication and to adopt strategies to avoid alcohol-related harm, and generating intentions among those who experience alcoholrelated problems to seek help.
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Alcohol Assessment tool
Referral Process
According to the national framework for QEIPP, the optional use of an alcohol assessment tool during the education session is designed ‘to better manage and target alcohol information and additional referral pathways for young Australians’.
The scope of QEIPP is to provide a session to youth identified as ‘at-risk’ and their families about the responsibilities and potential harms associated with risky alcohol use.
Evidence suggestive of the efficacy of the use of alcohol assessment tools in the treatment of a young person’s substance use issues is increasing. Perhaps the most important developmental factor in the assessment of alcohol and other drug (AOD) involvement among adolescents is the need to distinguish normative and developmental roles played by AOD use in this age group. The normal trajectory for adolescents is to experiment with the use of alcohol and to some extent other drugs. In the event the service provider chooses to use an assessment tool during the initial information session, it is the recommendation of QEIPP that the World Health Organisation’s (WHO) AUDIT be used. This resource was provided to clients in the booklet sent to them with the offer of the alcohol education awareness session. It may be a useful resource to discuss with your clients.
A project with such a time constrained capacity lends itself to ongoing treatment referral, when identified, as appropriate. Counsellors cannot always provide all the services our clients need. For instance, a social worker might be able to help a client with housing or other services outside the scope of this initiative. In order to meet the needs of the identified client groups, counsellors will need to know and demonstrate an established network with other services in their communities.
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Please note: It is not a requirement of the project that an ongoing referral is recommended. There will be times where such action would be inappropriate. It is at the discretion of the health service provider to determine when ongoing treatment is required.
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The Queensland Early Intervention Pilot Project is an initiative under the Australian Government’s National Binge Drinking Strategy
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