Training for Your Organisation

• Do you know the best ways of approaching the subject of alcohol and drug use with people who are developing problems?
• Do you know the signs and symptoms of alcohol and drug use, and how to do brief interventions in order to assist them?
• Did you know that alcohol costs society the most money in lost productivity, causes most of the accidents and health problems, and is the drug most implicated in violence and criminal offending in New Zealand?
• What is a “standard drink”, and how many standard drinks are in the alcohol beverages you normally purchase and consume?
• Which drugs are most commonly used in New Zealand?
• Are you aware of the health effects of the drug “P”?

These and many more questions about alcohol and other drugs are answered in this programme, which is designed to be interactive and informative, with powerpoint slides and demonstrations and exercises to illustrate the points made. Programmes range from half day introductory to full day programmes, which also offer screening information, brief interventions and interactive exercises.

Our training is tailor-made to meet the needs of groups of individuals, health (including mental health) services, and social services, who wish to inform their employees about this very relevant and potentially problematic issue in the clients who come to them for various services, but may not identify with an alcohol or drug issue. When staff members become aware of ways to identify these issues and learn how to do brief treatments and/or referrals, not only the clients benefit, but also the service outcomes improve and staff feel more effective and positive about their roles.

Alcohol – Brief Interventions and Treatment

This half day training programme introduces participants to the concept of brief and early interventions for those who may be clients of services but who may also have an underlying issue of alcohol use, whether identified, or not. The social and health goals and expected outcomes for clients who have other issues are often compromised by their use of alcohol, when it becomes excessive or problematic. When people try to intervene in unhelpful, critical or judgemental ways, the opportunity can be lost, and clients can become resistant and exit the service, or continue their behaviour, with poor outcomes. In order to engage, identify and work with the problem, it is helpful to have some knowledge and understanding about the cause and effects of alcohol use, and avoiding judgement.

This programme offers information about alcohol, and introduces practitioners and support staff to some helpful ways of raising the issue of alcohol use, identifying potential problems through screening, offers some brief intervention techniques, and information about appropriate referrals. The programme is interactive and offers opportunities to practice screening and interventions with other participants, to integrate learning.

Methamphetamine and Illegal Drugs – Brief Interventions and Treatment

This half day training programme introduces the concept of brief interventions for those who may be clients of health and social services, but who may be compromised by their use of illegal substances. Practitioners and support workers are often fearful and at a loss to know what to do when working with clients who may be experiencing problems with illegal drugs. Their treatment goals and outcomes are also negatively affected and these clients often do not get the help they need. In order to engage, identify and work with the problem, it is helpful to have some knowledge and understanding about the cause and effects of drug use, and avoiding judgement. This enables practitioners to get alongside the client, and work constructively towards appropriate referral and treatment.

This programme introduces practitioners and support staff to some helpful ways of raising the issue of drug use, identifying potential problems through screening, offering some brief intervention techniques, and information about appropriate referrals. The programme is interactive and offers opportunities to practice screening and interventions with other participants, to integrate learning.

In most cases, those affected by mental health conditions will identify with one condition as being the cause of their problems, while there is a high likelihood that they will be affected by two or more mental health conditions. These conditions will usually impact upon each other, and in treatment, the best practice will be to identify them and work with the client using in an integrated approach. In particular, addictions and other mental health conditions commonly coexist, with the result that either the addiction or the mental health condition impact upon each other to deepen the severity of either or both conditions. Coexisting mental health conditions may increase risk for addictions, act as a barrier to their treatment, and increase relapse rates if they not addressed in an integrated manner with the addiction treatment.

The need for identification of coexisting mental health and substance use disorders amongst those presenting in specialist mental health and addiction services is an important process to effectively address the impact of these conditions.

Abacus offers half day introductory or more intensive one-day programmes for:

1. Mental health workers effectively addressing coexisting mental health and substance use disorders
2. Alcohol and other drug workers effectively addressing coexisting substance use disorders and mental health conditions

The programmes will cover:

• Evidence for addressing coexisting conditions and effectiveness of integrated interventions
• Screening for mental health and/or substance use disorders
• Assessment
• Treatment planning
• Collaborative and single site approaches: when to refer
• Working with clients/patients with coexisting conditions
• Developing skills and coping behaviours
• Service needs and appropriate client/patient environment
• Exercises, role plays

Delivery of the training will be provided by experienced registered mental health professionals, with client examples providing illustration of key points. An NZQA registered certificate of attendance will be provided upon completion.

Co-existing problem (CEP) service checklist

The CEP service checklist is a brief tool for mental health and addiction (AOD/problem gambling) services to use for self-assessment, reflection and planning to develop service level CEP responsiveness and capability. A number of areas across service delivery and workforce development have been identified for services to consider how these are reflected in their organisation. This can be used to identify current areas of practice and areas for improvement that can be used to develop an action plan.

Please contact ABACUS if you need further information or wish to discuss how to use it in your organisation.

Motivational interviewing is a conversation style that is useful for clients that present with ambivalence around behaviour change. Sometimes clients tell us their goal is to do or be something different, yet their behaviour stays the same (e.g., alcohol misuse, drug misuse, diet, exercise, procrastination). A motivational interviewing approach avoids argument, resistance or defensiveness and can be integrated into your current style of having conversations with clients.

• Have you ever tried to assist someone towards helpful or constructive change, only to come away thinking that they “aren’t ready”, don’t think there is a problem, or just end up arguing with you and carry on with the same destructive or unhelpful behaviour?
• Motivational Interviewing is more than just a type of therapy or something that only counselling professionals use. It is a style and approach that once integrated, is extremely useful and effective when working with people who may not yet be fully aware of their problematic behaviour or who may still be ambivalent towards change.
• Did you know that when someone is arguing with you against change, it may not be because they don’t want to change, but what they need is for you to change your approach?
• Motivational Interviewing can be used in a wide range of everyday situations to produce positive outcomes.

Abacus has developed a range of brief programmes, for those who have no prior knowledge and want a brief introduction, right through to those who have knowledge and experience, and want more in-depth, advanced training. Each training programme is targeted to the level of the participants, working in an interactive way with powerpoint information, and including opportunities to practice and integrate skills. More advanced programmes include trainers’ modelling and role-plays, and provide feedback and coaching to participants, to guide more advanced skills development.

These programmes will assist staff members to ascertain levels of motivation and readiness for change, and equip them with the skills to work effectively with people to achieve desired outcomes for progress toward their goals. They will also find that these skills have wide application for any purpose that involves improving motivation and encouraging positive change.

Two-day Training Programme Highlights

INTRODUCTION content – this interactive one-day course will cover:

• Motivation, ambivalence and change
• What is MI and how does it work?
• The spirit of MI
• How MI works with (and complements) other concepts and therapies
• Communication and Interaction skills used throughout MI (OARS)
• Opportunities to practice skills and work with other participants

INTRODUCTION expected outcomes – at the conclusion of this one-day MI introductory course you will have:

• An understanding of the underlying theory of MI
• An understanding of how MI is strength-based, strategic, and honours client autonomy (improves retention and outcomes)
• Knowledge of basic MI processes and communication tools
• An awareness of how to use MI in your client work (and other settings)
• Practiced interventions with other participants using MI
• A grounding in MI that prepares for more intensive MI learning and approaches

INTERMEDIATE content – this interactive one-day course will cover:

• MI quick review of principles and techniques (all on the ‘same page’)
• Video demonstration of MI in practice (critique and discussion)
• The four processes of MI
• Creating focus
• Responding to ‘sustain talk’ and discord
• Other useful strategies used in MI
• ‘Change talk’/responding to change talk
• Opportunities to practice skills and work with other participants

INTERMEDIATE expected outcomes – at the conclusion of this one-day MI Intermediate course you will have:

• An opportunity to observe the practice of MI in a video demonstration
• More understanding of, and confidence in using MI with clients
• Knowledge of, and opportunity to use a range of additional MI tools and techniques
• Understanding of how to listen for, and respond to, ‘change talk’
• Some tools to use when working with ‘sustain talk’ and discord
• Practiced interventions in scenarios with other participants using MI

In all walks of life, there are situations which can arise where individuals are at risk, or feel threatened by, anger leading to abuse, intimidation or physical violence. This can happen anywhere: on the street, during driving road rage incidents, and in shops, factories and offices. In specialist health and some social services, issues can arise with people who may be affected by mental health conditions. Usual ways of responding may be compromised by the effects or manifestations of psychiatric conditions, and this requires some knowledge and understanding of underlying issues and use of appropriate approaches, to keep themselves and others, safe.

There are others who may make unreasonable demands often through a “sense of entitlement”, because of hardship or other expectations (real or assumed), or because of misinterpretation or misunderstanding.

Naturally, people would wish to avoid physical conflict for safety reasons, and equally, would not wish to be vulnerable to a charge of assault for being caught up in physical altercations with others. For this reason, having some understanding about underlying causes and predispositions for anger/violence, as well as knowing how to use communication and de-escalation skills to effectively defuse these situations, is essential.

Abacus has developed a programme incorporating a number of pairs or small group exercises, which assist to integrate learning by skills practice, and also provide an interactive learning experience. The training also incorporates information and practice around telephone contact, as this is the other “front door” to your organisation. This training emphasises the role of communication, and informs staff with knowledge from an individual, social, cultural, and environmental perspective, equipping staff with the skills to give them the confidence to deal with potentially risky and stressful situations with clients (and others) in their workplace.

Suicide and attempted suicide has lasting impacts on a wide range of individuals, family and whanau, especially when the person who was at risk was young. Many of those with suicidal ideation may provide indications to others of their intentions, risk, and need for support, or may be within a group known to be at high risk. Knowledge of the signs and symptoms of suicide, assessment of level of risk, appropriate responses and interventions, and of available community resources, can assist to reduce this risk.

Abacus can provide either a one-day course that will focus upon this knowledge, and training in appropriate intervention skills, or provide a two-day in depth course that involves higher skills training with training involving realistic scenarios. Programmes will be adjusted and designed to complement the trainee organisation’s field of work, with resources, including referral options, provided in a pack.

Training content will include:

• Current information, research, models and theories of suicide
• Levels of risk for suicide of different cultures, ages, gender, and those with co-occurring health issues
• Signs and symptoms of suicide
• Assessment of risk
• Relationship of depression, and alcohol and other drug use to suicide
• Appropriate interventions
• Referral agencies
• Interactive exercises

Delivery of the training will be provided by experienced registered mental health professionals, with client examples providing illustration of key points. An NZQA registered certificate of attendance will be provided upon completion.

Abacus comprises a team of highly qualified and experienced practising health professionals that have many years experience in health training. It has the ability to develop systems, supervise, and provide training across a wide range of mental health topics. Training provided is allied to competencies and to requirements of employers, and to this end the programme can be designed to address specific issues of interest while acknowledging time constraints.

Examples of topics that a programme may include are:

• Identifying/screening for mental health and impacting lifestyle issues
• Brief interventions for substance use disorders in an integrative approach
• Brief interventions for problem gambling in an integrative approach
• When to refer, and establishing case management processes
• Identifying and addressing anxiety conditions
• Identifying and addressing depression conditions
• Suicide risk assessment and interventions
• Supervision – getting the most out of this support
• DSM-IV assessments: what is the paradigm used; assessments using an Axis approach; draft DSM-V proposals and how these will affect assessments
• Motivational Interviewing approaches for establishing rapport with patients and enhancing treatment compliance

Delivery of the training will be provided by experienced registered mental health professionals, with client examples providing illustration of key points. An NZQA registered certificate of attendance will be provided upon completion.

Depression

Depression is a very common mental health condition, and risk is increased substantially after subsequent episodes. Although there are a range of conditions with depression (e.g. dysthymic disorder, bipolar disorder, or substance-induced mood disorder) the most common is major depressive disorder. Although risk may increase if close relatives have the condition, in many cases it will develop from behaviour or from environmental causes. Major depression can result in negative thoughts, suicidal ideation, weight change, concentration deficits and loss of energy. These can impact upon clients’ wellbeing, their ability to perform normal work and obligations, and their ability to change other harmful behaviours, such as addictions.

However, there are recognised brief interventions that can lift depressive symptoms and reduce dysphoria, risk of harm, and facilitate better outcomes for those affected by mild, moderate or severe depression.

Abacus offers a half-day or more intensive full day, evidence based training programme on depressions that will cover:

• Risk criteria
• Signs and symptoms
• Screening and assessment
• Brief interventions
• Building the client’s own resources to address depression
• Referral resources and handout resources
• Interactive exercises

Delivery of the training will be provided by experienced registered mental health professionals, with client examples providing illustration of key points. An NZQA registered certificate of attendance will be provided upon completion.

Anxiety

Anxiety disorders are common, and comprise a wide range of conditions where the stress and worry have increased to where they are interfering with the person’s wellbeing and life. They include generalised anxiety disorder, panic attacks, agoraphobia, phobias, and post-traumatic stress disorder, and often co-occur with other mental health conditions, such as depression or another anxiety issue (e.g. phobia and generalised anxiety). Anxiety may not be addressed by the person because they assume it’s normal for them, may think its depression, or may focus on the physical discomfort the anxiety causes. It may endure, and lead to other problems, such as addictions. The identification of anxiety disorders may improve the wellbeing of clients, reduce risk for self harm, reduce risk for development of other problems, and improve outcomes for treatment of other conditions.

Abacus offers a half-day or more intensive full day, evidence based training programme on anxiety conditions that will cover:

• Risk criteria
• Signs and symptoms
• Screening and assessment
• Brief interventions
• Building the client’s own resources to address anxiety
• Referral resources and handout resources
• Interactive exercises

Delivery of the training will be provided by experienced registered mental health professionals, with client examples providing illustration of key points. An NZQA registered certificate of attendance will be provided upon completion.

Abacus is contracted by the Ministry of Health to develop the Problem Gambling Treatment (PG) workforce and has been involved in developing the minimum competencies for PG practitioners and alignment of these with Alcohol and other drug (AOD), and Smoking Cessation (SC) competencies. Abacus provides ongoing training to most of the PG workforce contracted by the Ministry of Health.

Problem gambling issues may arise in any health or social setting, and Abacus can provide short programmes, delivered if required on-site, tailored to all skill levels, and trainee time constraints. These programmes may include:

• Problem gambling continuum: who is at risk, co-occurring issues, profiles of those affected
• Signs and symptoms of problem gambling and those affected by another’s gambling
• Screening and effective enquiring about problem gambling issues (gambler and affected family/whanau members)
• Brief interventions with those affected by gambling
• Referral options

Delivery of the training will be provided at an appropriate level by experienced registered mental health professionals, with client examples providing illustration of key points. An NZQA registered certificate of attendance will be provided upon completion.

Abacus comprises a team of highly qualified and experienced practising health professionals that have many years experience in AOD training. It has the ability to develop systems, supervise, and provide training across a wide range of AOD topics. Training provided is allied to competencies and to requirements of employers, and to this end the programme can be designed to address specific issues of interest while acknowledging time constraints.

Examples of topics that a programme may include are:

• Screening for AOD issues and providing feedback effectively and appropriately
• Identifying/screening for co-occurring mental health and AOD impacting lifestyle issues
• Brief interventions for substance use disorders
• Brief interventions for co-occurring conditions in an integrative approach
• Identifying and addressing moderate to severe anxiety conditions
• Identifying and addressing moderate to severe depression conditions
• When to refer, and establishing case management processes
• Suicide risk assessment and interventions
• Supervision – getting the most out of this support
• DSM-IV assessments: what is the paradigm used; assessments using Axis approach; draft DSM-V proposals and how these will affect assessments
• Motivational Interviewing approaches for establishing rapport with clients and enhancing treatment compliance
• CBT approaches to address distorted perceptions and to develop client coping skills

Delivery of the training will be provided by experienced registered mental health/AOD professionals, with client examples providing illustration of key points. An NZQA registered certificate of attendance will be provided upon completion.