Motion: 'the briefer the intervention, the more experienced and skilful practitioners need to be'

For...

You need to establish rapport before you can talk about the substance use and its treatment. If there is no rapport then there is no point to any kind of intervention; service users will not take in anything that is said to them, they will probably dislike their practitioner, and are likely to drop out.

Against...

Establishing rapport is important and needs to be part of dealing with the problem the service user wants help with. It is no good wasting time just trying to strike up some rapport. Service users want to know that they are going to get the help they need and that their practitioner has that as their focus.

For... The majority of people with alcohol and drug problems do not visit specialist addiction services but are in contact with all sorts of other services eg general practice, pharmacy, dentists, ante-natal services. The skilled application of brief interventions is highly effective in these settings. Against... Brief interventions are generally opportunistic, meaning they occur outside specialist services. Practitioners do not need an addiction training as they already have the skills quickly to understand and assess problems and to deliver an effective brief intervention. This WHO report should help you clarify your thoughts on the issues raised by the debate… The point to be made here is that some people will move on from their addiction with only brief contact with professional help; these are most likely people who are already motivated to change and have the social capital that they need. Things do not always work out as expected and, as ever, therapists need to be alert to how well their intervention is going and be flexible in response. It is best not to get bogged down with definitions, rather understand the principles. Browse the WHO alcohol brief intervention training manual for primary care. The content refers to alcohol brief interventions but the same approach can be applied to drugs in most circumstances. This is a really excellent training guide - how much detail you want to read will depend on your role. Everybody can benefit from looking at these sections: pp2-6 What are brief interventions; pp50-52 Practitioner concerns about their role; pp53-56 Beginning a conversation; pp57-66 Screening and feedback using the AUDIT and pp70-73 Eliciting change talk. Read the full text of the report here… WHO alcohol brief intervention training manual for primary care       Decide which side of the debate you support and then Make Your Own Case