Practitioner Competences

Effective practitioners will have the ability to build a working alliance with their FPs and NMs. A working alliance refers to the degree of mutual respect and understanding between the practitioner, the FP and the NMs. It 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 in the resolution of particular problems. The practitioner’s role is team leader in modelling these behaviours.

The Working Alliance Inventory rates how good practitioners are at i) goal setting ii) bonding with their client and iii) keeping task orientated. Complete it yourself in RESULT from the 'Supervision' webpage.

Training and supervision underpin the acquisition and maintenance of practitioner competence. 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.

Go to the 'Effective people' webpage to watch the video of Carl Rogers talking about empathy...

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.

The Brief Process Rating Scale measures the frequency and quality of practitioners' use of core skills. Complete it yourself in RESULT from the 'Supervision' webpage.

The content of treatment is as important as the style of its delivery; the evidence informs us which behaviour change techniques are associated with good outcomes. 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

    It should go 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 the acceptance of the practitioner as an authoritative source of help who will have legitimacy for the task in the eyes of service users, their families and concerned others.

  • Go to the 'How do drugs work' webpage and work through the slide show...

  • Go to the 'Why are drugs addictive' webpage and work through the slide show...

Basic skills #1

motivational dialogue

the essential skill

Aim

  • Always use motivational dialogue when interacting with clients

  • Elicit concerns and set goals

To do

  1. 1.

    Use open ended questions

  2. 2.

    Show accurate empathy

  3. 3.

    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

Motivational dialogue is a purposeful way of talking that allows the practitioner to address the FP’s and NMs’ pace and stage of change, as well as appreciating their perceptions and thoughts and feelings about the work at hand. It is a style of working.


If you have the book, Motivational Dialogue, have a read of Chapter 12

Problem solving is a good way to get the network doing tasks collaboratively. The plan should be carried out as a take-home-task, then reviewed for level of success or need to modify.

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

  1. 1.

    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’)

  2. 2.

    Think of as many solutions to the problem as you can

  3. 3.

    Look at the advantages & disadvantages of each solution

  4. 4.

    Choose the solution that works best

  5. 5.

    Plan and agree the steps to carry it out

  6. 6.

    Put the plan into action

  7. 7.

    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

Go to the 'Supervision' webpage and check out how you rate on the WAI or BPRS...

Go to the 'Mobiles and posters' webpage and see how to give your clients easy access...