CHCCS422b respond holistically to client issues and refer appropriately Today’s lesson will cover Providing a brief intervention Features of a brief intervention Identify reasons for using brief interventions Behaviour change model Steps for doing brief intervention

Anyone who works with people to help them change their behaviour probably uses brief interventions A brief intervention is a short structured series of questions designed to quickly: Assess a person’s level of substance use( or screening) Assist the person to identify any problems they are experiencing associated with their use ( a motivational intervention) Assist a person to identify strategies to reduce their use, use the substance more safely or to cease use altogether(an action planning/harm minimisation /relapse prevention intervention)

The key differences between brief interventions and other more intensive drug and alcohol treatments are: Brief intervention take between 5-60mins to administer. Brief interventions do not need to be delivered by specialist drug and alcohol clinicians. They can be delivered by health/welfare workers. They can be delivered in community settings as a targeted health promotion activity Brief interventions are structured They are effective for people who are dependent on substances but may be using alcohol and drugs in harmful ways.

3 Types of brief interventions Specialist brief intervention- provided by drug and alcohol treatment services- eg- quit smoking program Opportunistic or primary care interventions- delivered to people who are experiencing health or other problems associated with use Community based brief interventions- personalised screening and intervention activities offered in the wider community to people who are not seeking information or assistance for any problem (a breathalyser unit manned by drug and alcohol workers at a licensed venue)

Health care can be divided into three sectors- Primary care- health promotion and illness prevention Secondary care- diagnosis and treatment Tertiary care- rehabilitation or long term care

Stages of the behaviour change model Think of a time you have tried to make a lifestyle change. It could be quitting smoking, losing weight Why did you decide to change? What did you do? How easy or hard was it? How many attempts did it take you?

An important concept that provides the foundation for all drug and alcohol work is the Stages of Behaviour change Model Prochaska and Diclemente (1982) found there were four stages that people moved through when quitting smoking Precontemplation Contemplation Action Maintenance stage and the model has been expanded to include a decision making/determination stage and a relapse stage

Stages of Change Model ( Prochaska & Di Clemente,1986)

Basic counselling skills form the foundation for providing brief interventions: Geldard (1993) describes some important counselling skills: Having an attitude of non judgemental acceptance of the person Being empathetic No barriers to communications in the environment Using active listening

Brief intervention differ from traditional counselling sessions in important ways: They have a structure with a beginning, middle and end The worker directs the session They are time framed The worker gives the person health advise

Miller and Sanchez 1993 outlined six elements for successful brief intervention Feedback- the person is given personalised feedback about the level of risks associated with their habit. Responsibility- ownership is given to the person Advice- Some health information and benefits of changing behaviour is outlined Menu- a range of options to support change are given Empathy- a non judgemental approach Self efficacy- a person is given positive messages about their capacity for change.

Another useful model to use when developing or implementing brief interventions is the five A’s. The five A’s are: Ask- establish whether or not the person is using a substance Assess- use open, non confrontational questions to identify the person’s stage of change and level of dependency Advise –give a clear but supportive health message about their use Assist- use motivational interviewing to identify ways the person can change their behaviour Arrange-ensure that the person has the support they need by discussing future options and arranging referrals where appropriate

Questions 1.List four questions that you need to ask to assess whether or not a person’s use of a substance is regular, intoxicating or dependent? 2.Describe a strategy that you could offer a smoker in the following stages of change: Precontemplative Contemplative Action Maintenance How did you feel about the questions that were asked? How would you feel if someone asked you these questions in a public place?

Activity Think about a health behaviour you would like to change. (smoking, losing weight etc)Write down on one side of a piece of paper the reasons why you don’t want to change it and on the other side, the reasons you should. Give each reason a score out of 10. Add up the scores on each side separately. Which side has the highest score? What does this tell you about your readiness to change?

Question Think of a time when you have made positive lifestyle changes. How did you get there? Who did you find the most supportive and what did they say or do that helped?

References Geldard,D, 1993, Basic Personal Counselling- a training manual for counsellors, Prentice Hall, Melbourne DiClemenet, C.C., & Prochaska, J.O. (1982). Self change and therapy change of smoking behavior: A comparison of processes of change in cessation and maintenance. Addictive Behavior. &: Provide Brief Intervention, TAFE Western Institute