Effective iSBNT practitioners

This guidance is for practitioners and supplements the guided recovery pages that service users follow. Familiarise yourself with the…

‘guided recovery’- the four core iSBNT tasks….

iSBNT is an effective intervention for people with an addiction problem including mild to moderate mental health issues. You can deliver the core sessions in person or use them as take-home tasks. Network members are referred to as NMs and the person with an addiction problem as the focal person FP. Make sure that you are familiar with the guidance to the four core sessions that service users will follow.It is the psychological element of effective treatments…

The basic skills on which the interventions are built derive from the well-established core skills:

  • listening

  • expressing empathy

  • expressing positive regard

described by Carl Rogers and demonstrated to be effective in repeated studies of practitioner behaviours.

Combined with the directiveness expressed in motivational interviewing and cognitive behavioural counselling, the practitioner delivers purposeful, agenda driven, non-confrontational practice.

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?

The content of treatment is as important as the style of its delivery. The competent practitioner will...

  1. set goals

  2. elicit commitment to goals

  3. plan specific behaviours that result in alternative rewards to drinking or taking drugs

  4. monitor behaviour change

  5. review goals

  6. set and monitor Take-Home-Tasks to achieve goals

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

The stages of change model

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

✔︎ Treatments that promote the achievement of these tasks tend to be effective

✔︎ Be specific about the goal

✔︎ Mismatching can be detrimental - move forwards, not back to decisions already 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

Watch now

You may also be interested in this video from the early days of the model

Watch now

practitioner guides to iSBNT…

Be sure that you maintain…

A good standing as a practitioner in terms of your supervision and appraisal of your practice…

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.

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.