1

Brief Intervention

Week 1: RollGetting to know youProgram and Assessment criteria

2

What is Brief Intervention? Is something a Mental Health worker does

in their day to day work Can last from 5 minutes to 2 hours Is a 1:1 approach Informal assessment/Information gathering

Can be as simple as exchanging a phone number Can be lengthy, a deep analysis of the clients

situation, thoughts and a strategy for change Involves workers being well resourced, having

access to networks, agencies and information

3

Is based on the principles of harm minimisation.

Discussion on harm minimisation Hand out

4

When to use brief Intervention

To discuss/ assess Personal health of consumer Consumers use/abuse of medications How mental health issues affect the

family Clients use of alcohol Information about mental health

conditions

5

THE MOST IMPORTANT FACTOR IS YOUR RELATIONSHIP WITH THE CONSUMER

Questions for discussion: How might your relationship impact on

the Brief intervention process? What qualities do you need as a

worker?

6

WHEN WOULD YOU NOT USE BRIEF INTERVENTION?

When the person is Resistant, has no desire Intoxicated Is sick or injured Lacking in energy Has severe dependence Highly emotional Where there are highly complex or chronic

psychological or psychiatric issues

7

Question: What would you do in these

situations?

8

You will need to refer on Or

Leave it for another time

9

What are the effects of brief intervention Emerging sense of personal power (and

hope) Growing sense of identity and purpose in life Acceptance of self Acceptance of illness as separate from self Management of social issues such as

Money Housing Employment Education

Social networks

10

always recognise that the decision to change,

or not to, is the person’s choice.

11

Promoting brief intervention

Use pictures or brochures to help explain effects of

Smoking: how they feel about how they find it affects their health and ways to quit

Drinking: at hazardous or harmful levels Cannabis use: impacts on health Diabetes: look at food patterns, nutritional

advise

12

Week 2

13

Communication Strategies Effective Communication: What is it?

Active Listening Skills Reflection Feedback Assessment of Stages of Change

The FLAGS Model will help you to utilise these skills.

14

FLAGS model F — Feedback the results of AUDIT and help client

locate their drinking/smoking level. Do not be judgemental or threatening.

L — Listen to client’s concerns. They may need to ventilate their feelings and may respond defensively.

A — Advise client about consequences of continued alcohol/smoking use.

G — Goals of treatment should be defined. Set goals that both you and client agree are realistic and achievable.

S — Strategies for treatment should be discussed and implemented. Help client develop ways and means of keeping below the upper safe limits.

15

Areas of assessment Type of drug/issue Route administration Quantity Frequency Pattern Duration Withdrawal history

16

Prochaska & DiClemente’s6 Stages of change

1. Pre-contemplation- Not considering change ’Ignorance is bliss’

2. Contemplation- Ambivalent, not considering change in the next month ‘sitting on the fence’

3. Preparation- Trying to change ‘ testing the waters’

4. Action- Practicing new behaviour for 3-6 months

5. Maintenance- Commitment to sustaining new behaviour

6. Relapse- Resume new behaviours ‘fall from grace’

17

Stages of change

18

1. Pre-contemplative stage

Validate lack of readiness Clarify that the decision is theirs Encourage revaluation of current

behaviour Encourage self exploration, not action Explain and personalise the risk

19

2. Contemplative stage

Validate lack of readiness Clarify the decision is theirs Encourage evaluation of pros and

cons of behaviour change Identify and promote new , positive

outcomes

20

3. Preparation stage

Identify and assist in problem solving re obstacles

Help person identify social support Verify that they have the underlying

skills for behaviour change Encourage small steps. ‘baby steps’

21

4. Action Stage

Focus on restructuring social supports Bolster self-efficacy (self worth,

effective skills) for dealing with obstacles

Support them on feelings of loss reiterate long term benefits

22

5. Maintenance stage

Plan for follow up support Reinforce internal rewards Discuss coping with relapse

Many people will stay at this stage for the rest of their lives

However

23

6. Relapse

Evaluate triggers for relapse Reassess motivation and barriers Plan stronger coping strategies

24

Week 3

Motivational interviewing Documentation & monitoring Skills required for motivational

interviewing

25

Video –

Motivational interviewing

26

What is motivational interviewing

‘ A counselling approach based on the principle that all human behaviour is motivated.’

27

Motivational Interviewing Is a directive client centred approach for

behavioural change

Helping clients to explore and resolve ambivalence (inner conflict)

Is focused and goal directed

Resolution of inner conflict is Motivational Interviewing’s central goal

28

Your role: Resolve his or her ambivalence… How?

Keep judging the clients motivation This is a partnership approach not a

hierarchal approach Express empathy Be a friendly consultant Roll with the resistance – explore client’s

views on resistance Explore all costs and benefits of that

change – cost benefit analysis

29

Avoid

A confrontation /persuasive approach This will alienate the client They may see it as argumentative if you push the client It will increase resistance Will diminishes the probability of

change

30

QUIZ –classroom based assessment

What is brief Intervention

31

Brainstorm

What skills/qualities do you need to provide brief intervention