Effective practitioners
Effective practitioners share the characteristics of helpful people and apply these to their interventions.
Effective interventions all depend on making a careful assessment of what a person needs and together choosing the best way forward. Using motivational dialogue…
Understanding where the person is at.
Reaching a decision about what to do.
Getting on with it using iSBNT and problem solving.
① Understanding where the person is at
The starting point for any intervention is to understand a person’s motivation for change. If somebody has yet to think about making changes then the intervention will need to focus on building motivation; if they have already started their recovery journey then supporting change is called for.
Like any good model, stages of change is a simple tool, in this case helping practitioners identify a person's motivational state - ‘where are they at?’
✔︎ The five components of the model are described as: precontemplation (motivated to carry on drinking or drug taking), contemplation (thinking about change), preparation (commitment and planning) action (implementing change), maintenance (strengthening and expanding changes made)
✔︎ Each component has a series of tasks to address in order to progress
✔︎ Active listening is the key to accurate understanding of the stage of change
✔︎ Misjudging can be detrimental - avoid returning to decisions already made or assuming decisions yet to be made
Carlo DiClemente, Professor of Psychology, Maryland University, USA
In this video Carlo talks about accurately assessing where a person is at - their readiness to change
You may also be interested in this video from the early days of the model
② The vehicle for reaching the decision on what to do is motivational dialogue
The humanist approach championed by Carl Rogers has established the core skills:
listening
expressing empathy
expressing positive regard
Core skill - problem solving
Aim
Be creative in finding possible solutions to a problem
Choose a realistic solution likely to be actioned
To do
Clearly define the problem eg rather than “I don’t have enough money” make a specific statement “ I need to find £x a week to pay off my credit card”
Think of as many solutions to the problem as you can
Look at the advantages and disadvantages of each solution
Choose the best all round solution
Plan the steps needed to carry it out
Action and then review the plan. Did it work? Can it be improved? What can be learned?
③ The vehicle for getting on with it is Integrated Social Behaviour and Network Therapy, iSBNT
Practitioners from different backgrounds and training happily adopt iSBNT and problem solving which are…
flexible for all addictions
effective for people with mild to moderate mental health issues
can be face to face, self administered, or a combination
has a strong evidence base
The point of motivational dialogue is to get to the issues that most concern a person - the crucial follow-on is to fix the problem. Problem solving is a widely used technique when something more than just talking is needed.
Core skill - motivational dialogue
Aim
To use motivational dialogue when talking with service users
To elicit concerns and set goals
To do
Use open ended questions
Show accurate empathy
Use selective complex reflections
Outcome
Articulation of service user’s strongest concern
Agreement on goals including for substance use
Avoidance of confrontation and arguments
Effective practitioners maintain a good standing in terms of their supervision, appraisal of practice and lifelong learning…
A good knowledge of the effects of alcohol and drugs on behaviour, psychological and physical health, social functioning and the outcomes of treatment, is a prerequisite for a practitioner to be accepted as an authoritative source of help.
Look at the 'How do drugs work' page
Look at the 'Why are drugs addictive' page
Look at the ‘Harms and Harm Reduction’ page
Make sure that your service users have easy access to guided recovery on the website. Go to the 'Mobiles and posters' page and see some ways of doing this.
more about effective practitioners…
