HOW TO DELIVER TREATMENT

❝ practitioners nurture change ❞

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People with addiction problems usually see themselves as having few choices and it is up to practitioners to open up the possibilities for change

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Why have practitioners at all?

People seeking help for an addiction problem may have multiple needs and see a number of practitioners. Professional groups tend to have particular roles, for example doctors and nurses look after the physical and mental health of clients, social workers deal with child protection, while other professionals and voluntary workers help with housing, employment and leisure.

There is a kind of natural history to substance use. Young people and teenagers experiment with available drugs - typically alcohol and cannabis; late teens and twenties tend to be years of heaviest drinking and drug taking and experimentation with peers; in later life substance use tends to reduce or stop altogether. These changes in use are driven by social norms and personal responsibilities and for the majority of people moving in and out of heavy, or even problem use, do not involve help seeking. Those who do seek help are likely to be the more troubled individuals for whom practitioners have an important role. 

Everybody can change (19.56) Professor Fanny Duckert, Department of Psychology, University of Oslo, talks to Gillian Tober about:

  • How everybody can make some changes

  • Different approaches for men and women

  • The importance of the first contact

  • Ground rules

What brings about change?
Key point :: practitioners can often influence those things needed for change
This example illustrates that evidence from the UK Alcohol Treatment Trial points to the importance of both general and treatment specific elements in bringing about change. The greatest importance was given to:
i) involvement with others
ii) awareness of consequences
iii) building a commitment to change.

Treatment delivery (15.01)  Martha Sanchez-Craig, Senior Research Scientist at the world famous Addiction Research Foundation in Toronto, talks to Gillian Tober about:

  • The qualities of good therapists

  • Different approaches for men and women

  • Brief interventions

It is a whole team responsibility to nurture change…

To build a strong therapeutic relationship it is a good thing for help seekers to see as few practitioners as possible and it follows that it is desirable that suitably qualified practitioners multitask. In whatever way roles are managed, some practitioners need to take on the therapist role, and ideally other roles, while the whole team need to help create a positive environment for change.

  • Therapists Addiction is essentially a behavioural problem - albeit with physical consequences - and so what is thought of as ‘treatment’ is psychological in nature and provided by therapists qualified to deliver structured psychosocial interventions.

  • Mutual aiders Mutual aid groups, twelve steps (AA, NA, AlAnon for example) and SMART, are pivotal to the range of help available. Mutual aiders are themselves in recovery and their effectiveness comes from their own experiences and adherence to their particular mutual aid philosophy.

  • Counsellors There are different shades of counselling including for addiction problems. Counsellors come from a variety of backgrounds and typically offer non directive approaches to helping people resolve their problems.

  • Prescribers Prescribers may be doctors, and nurses or pharmacists with a prescribing qualification. Medication is never the sole way to deal with an addiction problem but it can be a very valuable supplement to psychosocial interventions.

  • Care workers This group of practitioners have many different roles and job descriptions which typically are about helping with practical problems especially for people moving into recovery. Practical help is highly valued. Care workers have positivity and problem solving skills.

  • Admin workers Often the first point of contact with an agency, admin workers who have a positive attitude to addiction problems are key team members in the process of helping people and facilitating access to treatment.