Effective iSBNT practitioners
❝ Therapy hasn’t really made me feel any better, it just made me understand why I feel bad ❞ Corey Pandolph
Effective practitioners will have the ability to build a working alliance with service users and supporting family and friends. A working alliance refers to the degree of mutual respect and understanding, which comes from the practitioner’s ability to communicate empathy, a non-judgmental approach and a task orientation. It will be built upon the perception of the practitioner as a source of help. The practitioner’s role is team leader and to model these behaviours.
The basic skills on which the interventions are built derive from the well-established core skills of listening, expressing empathy, positive regard and respect, as described by Carl Rogers and demonstrated to be effective in repeated studies of practitioner behaviours. These are combined with the directiveness expressed in motivational interviewing and cognitive behavioural counselling to produce a purposeful, agenda driven, non-confrontational practice style.
Basic skills #2
problem solving
Aim
Be creative in finding possible solutions to a problem
Choose a realistic solution likely to be implemented
To do
Clearly define the problem (rather than ‘I don’t have enough money’, make it specific such as ‘I need to find £X a week to pay off my credit card bill’)
Think of as many solutions to the problem as you can
Look at the advantages & disadvantages of each solution
Choose the solution that works best
Plan and agree the steps to carry it out
Put the plan into action
Review the outcome (Was it successful? Did we achieve the goal? What did we learn?)
Outcome
Have a selection of possible solutions to the problem
Agree a plan to implement the best solution
Basic skills #1
motivational dialogue
Aim
Always use motivational dialogue when interacting with clients
Elicit concerns and set goals
To do
Use open ended questions
Show accurate empathy
Use selective complex reflections
Outcome
Discover your client's biggest concern
Have agreed goals always including the substance use goal
Avoidance of confrontations or arguments
The content of treatment is as important as the style of its delivery. The competent practitioner will...
set goals
elicit commitment to goals
plan specific behaviours that result in alternative rewards to drinking or taking drugs
monitor behaviour change
review goals
set and monitor Take-Home-Tasks to achieve goals
Regular supervision has been shown to be essential: competences are lost without constant vigilance and supervision of recorded practice, and even the most experienced practitioners lose focus and drift away from good practice habits. The manual is no substitute either for training or supervision but forms the reference point on which to build both.
You need to be familiar with all of these…
The Working Alliance Inventory rates how good practitioners are at i) goal setting ii) bonding with their client and iii) keeping task orientated. Read more about the scale.
Empathy has been shown to be one of the most important elements of effective interventions. Have you seen the video by Carl Rogers? Go to the 'Effective people' page to watch it now.
The Brief Process Rating Scale measures the frequency and quality of practitioners' use of core skills. Complete it yourself from the ‘Lifelong Learning’ page.
It goes without saying that 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.
Watch the 'How do drugs work' slide show now.
Watch the 'Why are drugs addictive' slide show now.
Watch the ‘Harms and Harm Reduction’ slide show now.
Motivational dialogue is a purposeful way of talking that allows the practitioner to steer the intervention in a desirable direction. It is a style of working. If you have the book, Motivational Dialogue, have a read of Chapter 12. Find out more about identifying where a person is at and how to use motivational dialogue on the What works: motivation page.
Make sure that your service users have easy access to iSBNT and the website more generally. Go to the 'Mobiles and posters' page and see some ways of doing this.
