How is your work affecting you? The effects of exposure to risky drinking on perceptions of risk. Dr Anna Dimsey, Maureen Eadie, Aneliese Poorter & Stephanie Gough ATDC Conference May 2016
Background to the research Anecdotal reports: perceived risk based on practitioner experiences. risk associated with own drinking behaviour in comparison to clients High prevalence of patients with addictions (50%) within The Hobart Clinic Limited research evidence looking at rates of alcohol use in helping professions Commonly heard client belief everyone drinks staff exposure to this plus higher rates of problematic drinking The Hobart Clinic Association 2
Background to the research Study of college students found biggest predictor of alcohol consumption is the perception of drinking norms (Perkins, Haines & Rice; 2005) Constant exposure to clients with heavy alcohol consumption may skew the norm around levels of consumption Norland (2008). As alcohol consumption has increased public perceptions of what constitutes severe alcohol use have become more permissive. Greater exposure to a population with high levels of use may lead to more permissive attitudes The Hobart Clinic Association 3
Background to the research Lundborg & Lindgren (2002) Examined the effect of health messages in the general population finding increased perceived harm decreases overall alcohol consumption Exposure to risky use should decrease consumption as it increases perceived risk or exposure to heavy use with limited short term harm may actually lower ideas of perceived harm The Hobart Clinic Association 4
Research Questions Does exposure to client s heavy alcohol consumption influence: our own drinking behavior? our perceptions of risk involved in alcohol consumption For ourselves? For new clients? For clients with a history of heavy consumption? Does perceived risk vary according to level of exposure to clients with heavy alcohol use The Hobart Clinic Association 5
Research Questions What is the level of knowledge of current Australian alcohol guidelines? Do perceptions of risk reflect these guidelines? Do health professionals advise clients of low risk drinking guidelines and what influences likelihood of providing this advice? The Hobart Clinic Association 6
Method Brief online and paper based survey 26 questions taking around 10 minutes to complete. Questions designed to collect: Demographic data, levels of alcohol use, perceptions of risk related to both own and client s alcohol use, knowledge of alcohol guidelines, changes in drinking behaviors. Based around questions from the National Household Survey, FARE study (2012), AUDIT. Predominantly data was gathered from staff of The Hobart Clinic, with additional responses collected from professional networks of the researchers. The Hobart Clinic Association 7
Results - Demographics The Hobart Clinic Association 8
Results Professional Background: Medical Practitioner (n=3) Nursing (n=9) Allied Health (n=12) Non-Clinical Support Staff (n=10) The Hobart Clinic Association 9
The Hobart Clinic Association 10
The Hobart Clinic Association 11
Drinking Guidelines Questions used from FARE (2012) Study Perceptions of low-risk drinking levels among Australians during a period of change in the official guidelines Knowledge of guidelines needed to check if perceived risk varies from actual risk The Hobart Clinic Association 12
0 1 or 2 3 or 4 5 or 6 7 to 9 10+ Drinking guidelines Adult male 4+ days 70 60 50 40 30 20 10 0 total clinical non-clinical Number of Standard Drinks The Hobart Clinic Association 13
0 1 or 2 3 or 4 5 or 6 7 to 9 10+ Drinking guidelines Adult male 4+ days 70 60 50 40 30 20 10 0 total clinical non-clinical Number of Standard Drinks The Hobart Clinic Association 14
0 1 or 2 3 or 4 5 or 6 7 to 9 10+ Drinking guidelines Adult female 4+ days 80 70 60 50 40 30 20 10 0 total clinical non-clinical Number of Standard Drinks The Hobart Clinic Association 15
0 1 or 2 3 or 4 5 or 6 7 to 9 10+ Drinking guidelines Adult female 4+ days 80 70 60 50 40 30 20 10 0 total clinical non-clinical Number of Standard Drinks The Hobart Clinic Association 16
0 1 or 2 3 or 4 5 or 6 7 to 9 10+ Drinking guidelines Adult male 6 hour period 70 60 50 40 30 20 10 0 total clinical non-clinical Number of Standard Drinks The Hobart Clinic Association 17
0 1 or 2 3 or 4 5 or 6 7 to 9 10+ Drinking guidelines Adult male 6 hour period 70 60 50 40 30 20 10 0 total clinical non-clinical Number of Standard Drinks The Hobart Clinic Association 18
0 1 or 2 3 or 4 5 or 6 7 to 9 10+ Drinking guidelines Adult female 6 hour period 80 70 60 50 40 30 20 10 0 total clinical non-clinical Number of Standard Drinks The Hobart Clinic Association 19
0 1 or 2 3 or 4 5 or 6 7 to 9 10+ Drinking guidelines Adult female 6 hour period 80 70 60 50 40 30 20 10 0 total clinical non-clinical Number of Standard Drinks The Hobart Clinic Association 20
Drinking guidelines <18 120 100 80 60 40 20 total clinical non-clinical 0 0 1 or 2 3 or 4 5 or 6 Number of Standard Drinks The Hobart Clinic Association 21
Drinking guidelines pregnant or breastfeeding 120 100 80 60 40 20 total clinical non-clinical 0 0 1 or 2 3 or 4 5 or 6 Number of Standard Drinks The Hobart Clinic Association 22
Perceptions of Risk Those involved in clinical contact were asked to consider how risky they felt clients drinking behaviour would be at various quantities of alcohol. A distinction was made between clients known to the clinician versus clients new to the service. A comparison was also made between perceived risk of own drinking versus drinking of new clients The Hobart Clinic Association 23
Perceived risk of consumption known client 4+ days a week 100% 80% 60% 40% 20% high risk med risk low risk no risk 0% 1 or 2 3 or 4 5 or 6 7 to 9 10+ The Hobart Clinic Association 24
Perceived risk of consumption new client 4+ days a week 100% 80% 60% 40% 20% high risk med risk low risk no risk 0% 1 or 2 new 3 or 4 new 5 or 6 new 7 to 9 new 10+ new The Hobart Clinic Association 25
Perceived risk of consumption comparison 4+ days a week 100% 80% 60% 40% 20% high risk med risk low risk no risk 0% 1-2 old 1-2 new 3-4 old 3-4 new 5-6 old 5-6 new 7-9 old 7-9 new 10+ old 10+ new The Hobart Clinic Association 26
Perceived risk of consumption known client occasional 100% 80% 60% 40% 20% high risk med risk low risk no risk 0% 1 or 2 3 or 4 5 or 6 7 to 9 10+ The Hobart Clinic Association 27
Perceived risk of consumption new client occasional 100% 80% 60% 40% 20% high risk med risk low risk no risk 0% 1 or 2 3 or 4 5 or 6 7 to 9 10+ The Hobart Clinic Association 28
Perceived risk of occasional consumption - comparison 100% 80% 60% 40% 20% high risk med risk low risk no risk 0% 1-2 old 1-2 new 3-4 old 3-4 new 5-6 old 5-6 new 7-9 old 7-9 new 10+ old 10+ new The Hobart Clinic Association 29
Perceived risk of own consumption 4+ days 100% 80% 60% 40% 20% high risk med risk low risk no risk 0% 1 or 2 3 or 4 5 or 6 7 to 9 10+ The Hobart Clinic Association 30
Perceived risk of consumption own/new client 4+ days a week 100% 80% 60% 40% 20% high risk med risk low risk no risk 0% 1-2 1-2 own new 3-4 3-4 own new 5-6 5-6 own new 7-9 7-9 own new 10+ 10+ own new The Hobart Clinic Association 31
Perceived risk of own consumption occasional 100% 80% 60% 40% 20% high risk med risk low risk no risk 0% 1 or 2 3 or 4 5 or 6 7 to 9 10+ The Hobart Clinic Association 32
Perceived risk of consumption own/new client occasional 100% 80% 60% 40% 20% high risk med risk low risk no risk 0% 1-2 1-2 own new 3-4 3-4 own new 5-6 5-6 own new 7-9 7-9 own new 10+ 10+ own new The Hobart Clinic Association 33
Research Questions Does exposure to client s heavy alcohol consumption influence: our own drinking behaviour? Sample size too small to meaningfully compare drinking levels to household survey data, however 27% reported decreased consumption after working in this area Those with 5+ years of experience were more likely to report a reduction in their alcohol consumption Qualitative data also supports reduction in use which was attributed to increased knowledge of risks involved (in line with Lundborg & Lindgren) The Hobart Clinic Association 34
Research Questions Does exposure to client s heavy alcohol consumption influence: our perceptions of risk involved in alcohol consumption For ourselves? For new clients? Perceptions of risk matched for self & new clients in accordance with guidelines. 59% reported having a greater concern about clients use since working in the area. For clients known to the service? Higher risks attributed to consumption in known clients Qualitative responses suggest higher risk is due to concern of relapse, need for abstinence in cases of heavy consumption The Hobart Clinic Association 35
Research Questions What is the level of knowledge of current Australian alcohol guidelines? Good knowledge across both clinical and non-clinical staff Do perceptions of risk reflect these guidelines? Yes for self & new clients. Estimates for risk for known clients are greater. Do health professionals advise clients of low risk drinking guidelines and what influences likelihood of providing this advice? Most reported advising of low risk guidelines except in instances where they felt abstinence was necessary, where clients were already at low risk levels or where they felt the gap between the current level of drinking and the guidelines was too great The Hobart Clinic Association 36
Where to from here? Why are perceptions of risk so important? What does this mean for you? How does it change the way you view clients alcohol use? How do you view your own use in comparison to client use? How can we ensure we are aware of and challenge unhelpful risk perceptions? What could this mean for clients involved in group treatment programs? The Hobart Clinic Association 37
Thank you Anna Dimsey, Clinical Psychologist Email: adimsey@thehobartclinic.com.au Telephone: 6247 9960 The Hobart Clinic Association 38