Unit Learning Outcomes:
- Apply models of best-practice in the management of alcohol and other drug-use problems across the lifespan.
- Communicate using appropriate listening and responding skills to convey respect and connect professionally with diverse audiences regarding problematic psychoactive drug use and other addictive behaviours.
Task: You are required make a video demonstrating a role play of a brief intervention for alcohol lasting NO MORE THAN 20-MINUTES. You will need to find somebody who is able to play a client/patient. You will be assessed on your ability to effectively demonstrate your counselling skills, including motivational interviewing, and the core components of a brief intervention (i.e., FRAMES).
In doing so, you should use the AUDIT as a screening tool that you then use to provide individualised Feedback to the client regarding any risk associated with their alcohol consumption. Ideally you want a client who will role play having a score that ranges between 8 and 19, as a score of 20 or more requires a referral to specialist services and will not allow you to demonstrate your skills in providing a brief intervention that is within your scope of practice. You then need to use your skills in motivational interviewing to explore the concerns the client might have about their drinking. You then need to work towards getting the client to engage in change talk and collaboratively negotiating a Menu of options for behaviour change.
In addition to learning about the elements needed to implement a brief intervention using motivational interviewing in the online modules, there will be an opportunity to rehearse the skills during online classes. The skills are outlined on the rubric below. As you are providing an opportunistic brief intervention in setting up the role play you need to say at the outset your relationship with your client and the primary reason for your meeting. This means you need to choose a role/position within an agency. Please see below for some ideas and examples:
– You are the social worker seeing your client about child care assistance
– You are the practice nurse seeing your patient for a new dressing on a wound
– You are a nurse in accident/emergency seeing a client with an injury from a fall
– You are a GP in general practice, meeting a patient for the first time NB This should be a brief ‘to camera’ statement of less than 30 seconds. The time does not count as part of the 20 minutes for the video. The role play will be as if it is your first time of meeting your client.
TIPS
Make sure you get the client to role play somebody who is the contemplation stage of change and not in the pre-contemplation stage of change to make your task easier. To make the role play as authentic as possible it is suggested as far as possible the client plays themselves (though perhaps over states the degree to which they have problems associated with their use of alcohol so that they score above 8 on the AUDIT, as a score of below 8 does not require a brief intervention. When you play the client, try and make the task easy for your colleague by being a compliant client and not making the task more difficult than it needs to be. It is fine to take notes, though DO NOT READ FROM A SCRIPT.
High distintion:
OARS: questions are open-ended and develop the momentum of interview. Reflections are used more frequently than questions at a rate of approximately 3:1. Applies complex reflections to build momentum and demonstrate empathy. Appropriately uses genuine affirmations. Effectively uses summaries to collect information and provide forward momentum or to transition to another topic.
Build Rapport: Warmly welcomes client and introduces self. Significant effort is made to put client at ease. Demonstrates excellent attending skills (e.g., SOLER). Use of silence where appropriate. Consistently uses appropriate verbal and non-verbal cues, and clear, relaxed tone of voice. Creates conditions for maximum rapport.
Screening: Clearly introduces AUDIT tool. Provides a well-structured rationale for using the tool, information about the tool and how it will be administered. Consistently accommodates client questions. The tool is completed in a non-judgemental manner that is sensitive and respectful to the client.
Feedback: Accurately provides individualised feedback based on the AUDIT results that includes information on the harms associated with their current behaviour. In doing so, the clinician finds out what the client already knows about the harms associated with their behaviour. Maintains client’s autonomy in advising the person to change their drinking behaviour.
Change talk: Applies numerous motivational strategies to elicit change talk. Sustain talk is not reinforced. Effectively uses questions to support the client to elaborate on change talk. Provides salient reasons for change via concise bouquet summary statements. Avoids transitioning into action too early.
End: Provides appropriate concluding remarks. Logically summarises key elements and suggests relevant next steps using a menu of options.