Practitioner Competencies for Alcohol & Drug Workers in Aotearoa New Zealand Alcohol and Drug Treatment Workforce Development Advisory Group September 2001
Acknowledgements The development of the Practitioner Competencies for Alcohol and Drug Workers in Aotearoa New Zealand was initiated and guided by the Alcohol and Drug Treatment Workforce Development Advisory Group. The Advisory Group was established by ALAC early in 1999 to assist ALAC to develop and implement workforce initiatives aimed at improving responses to people experiencing alcohol problems. The Advisory Group acknowledges the extensive work undertaken by Workwise Consultants in helping to develop the competencies and bring them to fruition. Workwise Consultants assisted with the preparation of an initial draft set of competencies, lead a national consultation on that draft, assisted with the development of a second ( pilot ) draft, evaluated it and helped prepare the final set of competencies presented in this document. The Advisory Group also acknowledges and thanks the many people working in the alcohol and drug treatment field who provided comment on and input into the development of the competencies. Such was the degree of involvement by the field in the development process, that the field can rightfully claim these competencies as their own. Alcohol and Drug Treatment Workforce Development Advisory Group The following people served on the Advisory Group at some stage during the development of the practitioner competencies. The positions indicated are those that they held during the time of their involvement. Greg Ariell Dr Peter Adams Kate Cosgriff Daryle Deering Sue Ellis Tony Gibbs Heather Hapeta Tim Harding Te Pare Kingi Ian MacEwan Eve McMahon Cathie Menzies (Convenor) Manager, Professional Development, ALAC, Wellington Senior Lecturer, University of Auckland, Auckland Project Officer, Mental Health, Health Funding Authority, Hamilton Lecturer, Otago University, Christchurch Senior Advisor, Mental Health Commission, Wellington Programmes Manager, Target Education, Auckland South Island Alcohol and Drug Consumer Advisor, Christchurch Chief Executive, NSAD Care Ltd, Wellington Manager, Te Atea Marino, Māori Regional Alcohol and Drug Service, Auckland Manager, Treatment Development, ALAC, Wellington Consultant, National Mental Health Workforce Development Coordinating Committee, Wellington Manager, Regional Alcohol and Drug Service, Auckland Takarangi Metekingi Service Manager, Te Ngaru o Maniapoto Alcohol and Drug Service, Te Kuiti Tuari Potiki Dr Annie Rainford Debbie Sutton Edward Tanoi Bernard Te Paa Dr Fraser Todd Te Puea Winiata Jenny Wolf Māori Development Co-ordinator, ALAC, Wellington Lecturer, Central Institute of Technology, Wellington Lecturer, Central Institute of Technology, Auckland Manager, Pacific Islands Drug and Alcohol Service, Auckland Project Supervisor, Te Atea Marino, Māori Regional Alcohol and Drug Service, Auckland Senior Lecturer, Otago University, Christchurch Manager, Te Atea Marino, Māori Regional Alcohol and Drug Service, Auckland Manager, Regional Alcohol and Drug Service, Auckland
Practitioner Competencies for Alcohol & Drug Workers in Aotearoa New Zealand Alcohol and Drug Treatment Workforce Development Advisory Group ALAC Occasional Publication: No 13 Alcohol Advisory Council of New Zealand Kaunihera Whakatupato Waipiro o Aotearoa September 2001 ISBN: 0-478-11610-1 ISSN: 1174-2801
Contents 1.0 Introduction 2 1.1 Purpose 2 1.2 Definitions of competence 2 1.3 Values and principles underpinning alcohol and drug treatment in Aotearoa-New Zealand 1.4 Current policy environment 3 1.5 Glossary of terms used 3 2.0 Practitioner Competencies 4 2.1 Overview of competencies 4 2.2 Competency descriptors 4 3.0 Foundation Competencies 6 3.1 Working with Te Tiriti 6 3.2 Working with Pacific Peoples 8 3.3 Working with people from other cultures 10 3.4 Social justice 12 4.0 Generic Competencies 14 4.1 Relating and communicating 14 4.2 Critical thinking 16 4.3 Professional responsibility 17 5.0 Vocational Competencies 19 5.1 Assessment and intervention planning 19 5.2 Intervention management 22 5.3 Working with therapeutic groups, families and significant networks 24 5.4 Working with communities 26 5.5 Public education 27 5.6 Consultation and liaison 28 2
1.0 Introduction 1.1 Purpose The alcohol and drug treatment field has developed the practitioner competencies as a means towards establishing a more credible, professional field and to enhance the quality of service to clients and communities. Defining worker competencies encourages cohesion amongst workers, assists with assessment of workers performance and aids recruitment of new workers into the field. These competencies are intended for use by: " teams and individual practitioners in providing optimal treatment and devising professional development plans " managers in recruiting and appraising staff " educators and trainers in setting the learning outcomes of vocational and in-service training programmes " funders and policy makers in planning service standards and in setting policy directions for workforce development. 1.2 Definitions of competence Competencies represent what a worker is expected to be capable of doing in their practice. An alcohol and drug worker is defined as someone who provides treatment, educational and other related interventions for alcohol and drug problems. The competencies in this document have been framed in terms of: " competency descriptors a general statement describing the competency " elements a more detailed description of the competency expressed in terms of beliefs, knowledge and skills " performance indicators a description of behaviour that constitutes evidence of competence. The alcohol and drug worker competencies are set at the practitioner level. Practitioner competency is defined as being sufficiently competent to practise independently while part of a team and/or supervision structure. Trainee practitioners may be regarded as those who are working towards these competencies under close supervision. Assessing their performance against the competencies will assist them to plan their training and on-going professional development. Assessment guidelines for the performance indicators have yet to be developed. Once developed, such guidelines will help to more accurately establish the level of competence attained. Advanced or specialist competencies may emerge in time, for example competencies in responding to the special needs of children, and working with clients with complex co-existing disorders, including gambling and eating problems. Specialist knowledge bases within the alcohol and drug treatment field already exist, such as that which informs methadone treatment. Appropriate ways of acknowledging specialist knowledge bases and associated skills are expected to emerge as the competencies evolve and are used in practice. Also, Māori and Pacific practitioners have expressed an interest in developing competencies that describe practice from kaupapa Māori and Pacific Islands perspectives. 1.3 Values and principles underpinning alcohol and drug treatment in Aotearoa- New Zealand The alcohol and drug treatment field in Aotearoa has evolved a set of values which underpin the practice of alcohol and drug workers. Competent alcohol and drug practice: " acknowledges the unique nature of Aotearoa embodied in the articles of Te Tiriti o Waitangi. Competent alcohol and drug treatment practice acknowledges the right of tangata whenua to determine their own pathways to good health. " 2
" is based on the right of all people to enjoy good health and quality of life. Harms associated with alcohol and drug use reduce the quality of life and health. Competent alcohol and drug treatment practice is committed to reducing such harm for individuals and families, and also for communities and society as a whole. Health is understood as overall well-being and thus includes spiritual, emotional, social and physical dimensions. " is based on a commitment to social justice and a recognition of diversity. There is a respect for clients from all social and ethnic communities of Aotearoa and their basic human rights, including the right of informed choice. Competent alcohol and drug practice recognises the connection of clients with their social and cultural systems. These values may overlap with some professional codes of ethics. In time, these values may form the basis for a code of ethics for the alcohol and drug treatment field. 1.4 Current policy environment Alcohol and drug intervention work occurs in an environment of national policy. A competent practitioner is expected to reflect in their work the best practice and principles embodied in current policy. Examples of relevant current policies and practice guidelines include: " National Drug Policy (Ministry of Health) " National Alcohol Strategy (Alcohol Advisory Council of NZ/Ministry of Health) " Strategic Framework for Alcohol and Drug Services (Ministry of Health) " Blueprint for Mental Health Services (Mental Health Commission) " National Mental Health Standards (Ministry of Health) " National Protocol for Methadone Treatment in New Zealand (Ministry of Health) " Assessment and Management of People with Coexisting Substance Use and Mental Health Disorders (National Centre for Treatment Development: Alcohol, Drugs and Addiction) " Guidelines for Clinical Process Self-Evaluation in Alcohol and Drug Treatment Agencies (National Centre for Treatment Development: Alcohol, Drugs and Addiction). 1.5 Glossary of terms used Several terms are used in particular ways in this document: Treatment A generic term to denote the current scope of clinical practice in this country. It is also a common description for the field, as in alcohol and drug treatment field. Intervention A generic term to cover treatment and other interventions such as educational, community and public health interventions. Client A generic term to cover the individual or group presenting for treatment as well as significant other networks such as partners, family, whānau, household members, other social networks and communities. Whānau and As defined by the client family according to relationship, proximity, residence or any other connection. Alcohol and A generic term to cover the drug problems continuum of problems ranging from early stage problematic use to severe dependence on alcohol, drugs and other psychoactive substances. The term also includes health, family, occupational and social problems arising from alcohol and drug use. Culture A term used to describe values and practices based on ethnicity and heritage. " 3
2.0 Practitioner Competencies 2.1 Overview of competencies This document outlines thirteen competencies expected of an alcohol and drug worker who is competent to practise independently while part of a team and/or supervision structure. Firstly, four foundation competencies cover Te Tiriti, working with Pacific Peoples, working with people from other cultures, and social justice. These provide a foundation for all alcohol and drug practice, and underpin all the other competencies. Aspects of the foundation competencies may be found in the codes of ethics of other professions. Three generic competencies common to all human service work also flow through the other competencies. These generic competencies include relating and communicating effectively with clients and colleagues, thinking critically and maintaining professional responsibility. Recording of information and other administration tasks are covered under communication. The generic competencies have been tailored to alcohol and drug work. Six vocational competencies cover assessment and intervention planning; intervention management; working with therapeutic groups, families and significant networks; working with communities; public education; and finally, consultation and liaison to assist other professionals to deal with alcohol and drug problems. 2.2 Competency descriptors The thirteen competencies expected of practitioners working in the alcohol and drug treatment field are summarised in the table below. Practice simultaneously involves more than one competency. Foundation competencies - provide the foundation for alcohol and drug practice, and underpin all the other competencies. Working with Te Tiriti A competent alcohol worker understands Te Tiriti o Waitangi and integrates it into their practice. Working with Pacific Peoples A competent alcohol and drug worker understands Pacific perspectives and integrates them into their practice. Working with people from other cultures A competent alcohol and drug worker understands other cultural perspectives based on ethnicity and heritage and integrates them into their practice. Social justice A competent alcohol and drug worker understands political, economic and social justice perspectives and integrates them into their practice. " 4
Generic competencies are common to all human service work and to all the vocational competencies. Relating and communicating A competent alcohol and drug worker relates with empathy and insight to the client or client group, and accesses, interprets, manages and communicates information effectively. Critical thinking A competent alcohol and drug worker analyses and interprets information about people and situations as a basis to make judgements, solve problems and apply models of treatment and prevention. Professional responsibility A competent alcohol and drug worker manages himself or herself and conducts relationships in ways that ensure ethical and professional practice. Vocational competencies are the specific competencies of alcohol and drug workers who practise independently within a team and/or supervision structure. Assessment and intervention planning A competent alcohol and drug worker uses a range of strategies to a) accurately identify and assess alcohol and drug problems, b) negotiate appropriate goals and c) plan relevant interventions with the client or client group. Intervention management A competent alcohol and drug worker intervenes appropriately in alcohol and drug related issues and problems presented by a client or client group. Working with therapeutic groups, families and significant networks A competent alcohol and drug worker works effectively with therapeutic groups, families, whānau and other significant networks in reducing the harms associated with alcohol and drug use. Working with communities A competent alcohol and drug worker works effectively with communities in reducing the harms associated with alcohol and drug use. Public education A competent alcohol and drug worker uses appropriate strategies to inform others about alcohol and drug related issues. Consultation and liaison A competent alcohol and drug worker assists other workers to identify and deal effectively with people experiencing problems related to alcohol and drug use. " 5 "
3.0 Foundation Competencies 3.1 Working with Te Tiriti A competent alcohol and drug worker understands Te Tiriti o Waitangi and integrates it into their practice. A competent practitioner is able to: Beliefs 3.1.1 Demonstrate commitment to Te Tiriti o Waitangi 3.1.1.1 Demonstrates commitment to supporting Māori rights, authority and status as described in Te Tiriti o Waitangi 3.1.1.2 Demonstrates commitment to ensuring cultural safety for Māori 3.1.1.3 Demonstrates commitment to selfdetermination by Māori of their own pathways to healing Knowledge 3.1.2 Demonstrate knowledge of Te Tiriti o Waitangi 3.1.3 Describe social and historical factors affecting Māori 3.1.2.1 Understands the rights of tangata whenua expressed in the articles of Te Tiriti o Waitangi 3.1.3.1 Describes the impact of colonisation on tangata whenua in Aotearoa 3.1.3.2 Describes current social and economic factors affecting Māori " 6
Skills 3.1.4 Demonstrate respect for Māori cultural practices 3.1.4.1 Seeks appropriate Māori guidance for team and client work through connections with iwi 3.1.4.2 Participates in protocol in formal and informal meetings 3.1.4.3 Uses culturally appropriate processes and protocols in providing a service to Māori 3.1.4.4 Makes available information in the language chosen by Māori clients 3.1.4.5 Respects correct pronunciation, spelling and titles and seeks direction on these 3.1.4.6 Recognises the client s cultural needs and refers appropriately 3.1.4.7 Treats each client as unique in the context of their whānau, hapu, iwi and their community 3.1.4.8 Assists the client to explore choices within Māori culture " 7
3.2 Working with Pacific Peoples A competent alcohol and drug worker understands Pacific perspectives and integrates them into their practice. A competent practitioner is able to: Beliefs 3.2.1 Demonstrate commitment to the Pacific Peoples Health Charter 3.2.1.1 Demonstrates commitment to the Consumer participation requirements of the Pacific Peoples Health Charter 3.2.1.2 Demonstrates commitment to the Culturally appropriate health service provision requirements of the Pacific Peoples Health Charter Knowledge 3.2.2 Describe social and historical factors affecting Pacific Peoples 3.2.3 Demonstrate an understanding of Pacific Peoples cultural practices 3.2.2.1 Describes the impact of colonisation and migration on Pacific Peoples 3.2.2.2 Describes the current social and economic factors affecting Pacific Peoples 3.2.3.1 Is aware of the diversity that exists within and between Pacific cultures 3.2.3.2 Displays an understanding of the values that underpin Pacific Peoples concepts of health 3.2.3.3 Demonstrates an understanding of Pacific concepts of family and community and their role in the treatment and support of Pacific Peoples 3.2.3.4 Is able to identify appropriate individuals and organisations from whom to seek information and advice relevant to working with Pacific Peoples " 8
Skills 3.2.4 Facilitate culturally safe and appropriate treatment for Pacific clients 3.2.4.1 Uses Pacific networks that are representative of Pacific Peoples 3.2.4.2 Uses culturally appropriate processes and protocols in providing a service to Pacific Peoples 3.2.4.3 Is responsive to the role of the family and community leaders in treatment and support, and works effectively with them in conjunction with the client " 9
3.3 Working with people from other cultures A competent alcohol and drug worker understands other cultural perspectives based on ethnicity and heritage and integrates them into their practice. A competent practitioner is able to: Beliefs 3.3.1 Demonstrate commitment to cultural safety and self determination for all people 3.3.1.1 Demonstrates commitment to upskilling and continued learning in new cultural perspectives 3.3.1.2 Demonstrates commitment to ensuring cultural and spiritual safety for all people 3.3.1.3 Demonstrates respect for culturally based systems of authority and decision-making Knowledge 3.3.2 Describe historical and social factors affecting cultural communities in Aotearoa 3.3.3 Demonstrate an awareness of the diversity that exists within and between cultural communities and the need to be responsive to that diversity 3.3.2.1 Recognises the impact of migration on individuals and communities and understands the importance of cultural heritage 3.3.3.1 Identifies the needs of cultural communities without stereotyping 3.3.3.2 Recognises the spiritual nature of the healing process within many cultural communities 3.3.3.3 Describes their own cultural values and assumptions, and recognises the effect of these on others " 10
Skills 3.3.4 Demonstrate respect for cultural practices of clients 3.3.5 Facilitate culturally safe and appropriate treatment for clients 3.3.4.1 Recognises cultural norms and seeks guidance in responding to these 3.3.4.2 Respects correct pronunciation, spelling and titles and seeks direction on these 3.3.5.1 Seeks relevant cultural or community expertise and oversight to guide practice, and works closely with available services 3.3.5.2 Provides available information in the language chosen by clients 3.3.5.3 Recognises the need for different communication and counselling skills to meet the cultural needs of clients and refers appropriately 3.3.5.4 Treats each client as unique in the context of their family and community and provides for their safety 3.3.5.5 Assists the client to explore choices within their culture and community " 11
3.4 Social justice A competent alcohol and drug worker understands political, economic and social justice perspectives and integrates them into their practice. Respect for how people define themselves socially as well as social justice for all social communities within Aotearoa are key elements in alcohol and drug practice. Social communities are defined as those linked by values and practices based on socio-economic status, life experiences and life choices. A competent practitioner assists clients who are often discriminated against in wider society, for example lesbian and gay clients, clients living with disability or mental illness, clients using opioids or marijuana. A competent practitioner also recognises the social, political and economic factors that may impact on the context of their practice. A competent practitioner is able to: Beliefs 3.4.1 Convey support for social justice and self-determination for all people 3.4.1.1 Demonstrates ongoing commitment to equal rights and self-determination for all people 3.4.1.2 Demonstrates ongoing commitment to examine and recognise social forces which have contributed to the client s issues 3.4.1.3 Demonstrates ongoing belief in the importance of client choice and empowerment Knowledge 3.4.2 Describe social, political and economic factors affecting people s lives 3.4.2.1 Recognises the impact of social, political and economic factors on individuals lives, including the impact of institutional power 3.4.2.2 Recognises examples of discrimination and oppression relevant to client groups in Aotearoa 3.4.2.3 Identifies the needs of a particular group without stereotyping 3.4.2.4 Describes their own social values and assumptions, and recognises the effect of these on others 3.4.2.5 Recognises the impact of social, political and economic factors on the context of their practice " 12
Skills 3.4.3 Integrate political, economic and social justice perspectives to inform and guide practice 3.4.3.1 Advocates for and assists individuals, families and communities to receive relevant and appropriate services 3.4.3.2 Seeks relevant community expertise and guidance, and refers when required 3.4.3.3 Treats each client appropriately in the context of their family, network and community, and provides for their safety 3.4.3.4 Assists the client to explore choices within their community " 13
4.0 Generic Competencies 4.1 Relating and communicating A competent alcohol and drug worker relates with empathy and insight to the client or client group, and accesses, interprets, manages and communicates information effectively. The profession of alcohol and drug work is conducted primarily through communication between people. Communication may be verbal (speaking and writing), non-verbal (through look, tone, gesture, attitude and environment) and socio-cultural (appropriate to people and context). A competent practitioner is able to: Beliefs 4.1.1 Convey empathy and insight towards others in their life context 4.1.1.1 Displays non-judgemental views towards alcohol and drug users 4.1.1.2 Conveys a courteous and respectful attitude to clients and colleagues and acknowledges cultural interpretation of communication 4.1.1.3 Displays an openness to the communication style and manner of clients and colleagues 4.1.1.4 Does not impose personal beliefs on the client Knowledge 4.1.2 Describe factors which aid or hinder effective communication 4.1.2.1 Identifies central aspects of verbal and nonverbal communication and describes the major blocks to communication 4.1.2.2 Acknowledges power imbalance within relationships and recognises the contribution of power differences to communication 4.1.2.3 Knows how to maintain role boundaries within interactions " 14
Skills 4.1.3 Communicate effectively with clients and colleagues to achieve client goals 4.1.3.1 Incorporates the values of the alcohol and drug field into everyday practice 4.1.3.2 Uses behaviour appropriate to the professional context, and uses power appropriately 4.1.3.3 Works effectively with cultural interpretations of communication, and seeks help when needed 4.1.3.4 Uses a range of verbal and non-verbal behaviours which convey interest and attention 4.1.3.5 Uses a range of reflective listening skills to clarify communication 4.1.3.6 Records relevant information in a way that is clear, understandable and appropriate to clients, significant others and colleagues 4.1.3.7 Reports clearly, objectively and constructively to colleagues, supervisors, referrers and others " 15
4.2 Critical thinking A competent alcohol and drug worker analyses and interprets information about people and situations as a basis to make judgements, solve problems and apply models of treatment and prevention. Competent performance requires an alcohol and drug worker to be a discriminating and creative thinker in interpreting observations, information and theory. A competent practitioner is able to: Knowledge 4.2.1 Describe patterns of behaviour typically associated with alcohol and drug related problems and relevant explanatory models 4.2.1.1 Recognises patterns of behaviour typically associated with alcohol and drug related problems 4.2.1.2 Understands a range of explanatory models in current use on alcohol and drug related problems 4.2.1.3 Uses available sources to keep up to date on current research and current thinking about alcohol and drug related problems 4.2.1.4 Recognises limits of theories and models Skills 4.2.2 Analyse and interpret information about people and situations as a basis for decision-making 4.2.2.1 Observes and interprets behaviour and other relevant sources of information 4.2.2.2 Links judgements to observations, assumptions and theories 4.2.2.3 Evaluates the basis of theories and frameworks, including those derived from research evidence 4.2.2.4 Uses creative, problem solving approaches to formulate intervention plans 4.2.2.5 Evaluates and reviews interventions, and responds to relevant feedback " 16
4.3 Professional Responsibility A competent alcohol and drug worker manages himself or herself and conducts relationships in ways that ensure ethical and professional practice. A competent practitioner is able to: Beliefs 4.3.1 Demonstrate commitment to practising in an ethical and professional manner 4.3.1.1 Demonstrates responsibility for maintaining client and personal safety 4.3.1.2 Demonstrates accountability to clients, peers, employers and the community Knowledge 4.3.2 Describe relevant ethical and professional practice 4.3.2.1 Demonstrates knowledge of relevant professional codes of ethics 4.3.2.2 Demonstrates an understanding of how to practise in a professional manner 4.3.2.3 Understands the purpose and practices of performance monitoring, evaluation and appraisal 4.3.2.4 Describes relevant legislation, policy and contractual obligations " 17
Skills 4.3.3 Act to ensure ethical and professional practice 4.3.3.1 Abides by relevant professional codes of ethics 4.3.3.2 Maintains clear personal and professional boundaries and acts appropriately to ensure personal safety and the safety of clients and colleagues 4.3.3.3 Exercises professional judgement supported by evidence 4.3.3.4 Attends and actively contributes to appropriate regular supervision towards ongoing professional development 4.3.3.5 Attends appropriate training towards ongoing professional development 4.3.3.6 Recognises and addresses indicators of personal stress 4.3.3.7 Evaluates their own competencies and practice, attends to feedback from others and takes appropriate remedial action 4.3.3.8 Keeps informed and up-to-date with recent developments in research and intervention approaches 4.3.3.9 Maintains collegial relationships and other relevant professional relationships 4.3.3.10 Complies with legislation and current policy governing the alcohol and drug field 4.3.3.11 Complies with national legislation, current policy and relevant contractual obligations governing the employing organisation 4.3.4 Work constructively in a team structure 4.3.4.1 Gives and receives support and feedback to team members 4.3.4.2 Fulfils designated roles and actively contributes to others fulfilling their roles 4.3.4.3 Manages conflict constructively 4.3.4.4 Contributes actively to the ongoing professional development of the team " 18
5.0 Vocational Competencies 5.1 Assessment and intervention planning A competent alcohol and drug worker uses a range of strategies to a) accurately identify and assess alcohol and drug problems, b) negotiate appropriate goals and c) plan relevant interventions with the client or client group. A competent practitioner is able to: Beliefs 5.1.1 Promote client participation and maintain flexibility about intervention approaches 5.1.1.1 Collaborates with the client and significant others to formulate the problem 5.1.1.2 Considers and promotes a variety of intervention options supported by evidence and available resources Knowledge 5.1.2 Recognise alcohol and drug related problems likely to be experienced by clients presenting for treatment 5.1.2.1 Names and describes the effects of common drugs, and their interactions 5.1.2.2 Recognises alcohol and drug induced conditions such as intoxication, tolerance and dependence 5.1.2.3 Recognises the physical, psychological and social consequences typical of different levels of alcohol and drug use 5.1.2.3 Recognises other common co-occurring addictive behaviours and mental illnesses " 19
Knowledge continued 5.1.3 Describe basic and 5.1.3.1 Knows how and when to use screening, comprehensive brief and comprehensive assessments and assessment strategies describes the appropriate use of each for alcohol and strategy drug problems 5.1.3.2 Knows how and when to use diagnostic 1 tools used within the field or agency to assess alcohol and drug and co-existing problems 5.1.3.3 Describes the potential risks and safety concerns around alcohol and drug use, and knows how to minimise or prevent harm 5.1.3.4 Recognises stages and processes of change in alcohol and drug use in the lifespan and development of individuals 5.1.3.5 Identifies appropriate goals for different clients and client groups such as abstinence, controlled drinking or opioid substitution 1 Diagnostic systems currently recognised in the field include, for example, kaupapa Maori systems, DSM IV and ICD 10. Skills 5.1.4 Assess with client their alcohol and drug use in their life context 5.1.4.1 Establishes a safe, conducive and culturally appropriate environment for conducting screening or assessment 5.1.4.2 Selects screening, brief assessment and comprehensive assessment strategies appropriately 5.1.4.3 Gathers and records relevant information from the client, significant others and other health workers 5.1.4.4 Assesses the client s potential for self-harm or harm to others, identifies risks, prioritises safety issues, and acts appropriately 5.1.4.5 Accurately identifies alcohol and drug problems, and formulates with the client an understanding of the client s needs " 20
Skills continued 5.1.4 Assess with client their alcohol and drug use in their life context (continued) 5.1.5 Negotiate with the client appropriate goals and intervention plans 5.1.4.6 Uses an appropriate diagnostic system to assess alcohol and drug and co-existing problems and works with the client to identify links between co-existing problems 5.1.4.7 Recognises the specialist nature of opioid dependence and works with the client to identify appropriate treatment including substitution programmes, and advocates for access to such programmes 5.1.5.1 Provides client with a range of detoxification and intervention options, and describes accurately to the client the implications of each option, including cost 5.1.5.2 Works collaboratively and motivationally with the client to negotiate appropriate goals to reduce alcohol and drug related problems and associated harm 5.1.5.3 Assists client to recognise their own resources and encourages the client s own responsibility for change 5.1.5.4 Designs with the client an intervention plan which meets the goals of national protocols where applicable and which contains measurable outcomes and a time frame for reviewing progress 5.1.5.5 Writes comprehensive intervention plans appropriate to the recipient " 21
5.2 Intervention management A competent alcohol and drug worker intervenes appropriately in alcohol and drug related issues and problems presented by a client or client group. Competent intervention management is based on a recognition that alcohol and drug use may involve a relapsing condition for many clients. The treatment relationship is grounded in supporting the ongoing efforts of clients and communities towards achieving good health. A competent practitioner is able to: Beliefs 5.2.1 Convey a belief in the client s ability to achieve their treatment goals 5.2.1.1 Conveys a belief that people can change and maintain their own change 5.2.1.2 Advocates for the ability of clients to make changes Knowledge 5.2.2 Describe a range of 5.2.2.1 Describes models for establishing, intervention maintaining and terminating relationships, strategies and and understands counselling theory resources for treatment 5.2.2.2 Demonstrates a comprehensive knowledge 2 of a range of interventions, including individual, family, group, self-help and community approaches 5.2.2.3 Recognises the relapsing nature of alcohol and drug dependence 5.2.2.4 Demonstrates an extensive, relevant and upto-date knowledge of available community resources, and how to access them 2 The range covers current intervention approaches supported by evidence and safe practice, including brief, pharmacological (eg. opioid substitution), Twelve Step, cognitive behavioural, motivational, family, social network and community based approaches. " 22
Skills 5.2.3 Intervene appropriately in alcohol and drug related issues and problems 5.2.3.1 Establishes a sense of common purpose in relationships with clients and colleagues and works positively with client ambivalence 5.2.3.2 Manages the safe detoxification of clients, or refers appropriately 5.2.3.3 Manages pharmacological interventions, or refers appropriately 5.2.3.4 Uses appropriate motivational and psychosocial strategies to assist clients to achieve agreed goals 5.2.3.5 Maintains a relationship with the client throughout relapse and crisis 5.2.3.6 Deals with and diffuses aggressive and abusive behaviour while maintaining personal safety 5.2.3.7 Takes steps to prevent violence, abuse and neglect in the client s relationships 5.2.3.8 Provides accurate feedback to the client about their progress, reviews progress with the client and adjusts the intervention accordingly 5.2.3.9 Completes appropriate administration and record keeping 5.2.4 Access appropriate resources on behalf of the client 5.2.4.1 Advocates effectively within the agency and with other services and community agencies for the best treatment outcomes for the client 5.2.4.2 Makes appropriate referrals internally and to other services and agencies 5.2.4.3 Works collaboratively with mental health and dual diagnosis services for the best treatment outcomes for the client " 23
5.3 Working with therapeutic groups, families and significant networks A competent alcohol and drug worker works effectively with therapeutic groups, families, whānau and other significant networks in reducing the harms associated with alcohol and drug use. A competent practitioner is able to: Beliefs 5.3.1 Convey an inclusive and respectful attitude to family, whānau and social networks 5.3.1.1 Demonstrates respect for the diverse and changing forms of groups, families and networks 5.3.1.2 Promotes the involvement of family, whānau and other significant networks in all aspects of assessment and intervention 5.3.1.3 Conveys respect for the ability of groups and significant networks to find solutions to alcohol and drug related problems Knowledge 5.3.2 Describe models and interventions of alcohol and drug related problems for families, whānau and groups 5.3.2.1 Demonstrates a basic understanding of family system and social system functioning with a particular focus on alcohol and drug related problems 5.3.2.2 Demonstrates an understanding of group dynamics and power issues within families and groups 5.3.2.3 Demonstrates an understanding of ways of assisting families and groups with alcohol and drug related problems " 24
Skills 5.3.3 Work effectively with groups 5.3.3.1 Uses facilitation and group process skills when working with a group 5.3.3.2 Effectively educates groups on alcohol and drug use and dependence in an inclusive and accessible way 5.3.3.3 Uses therapeutic models effectively in the context of group work and structured programmes, e.g in a residential setting 5.3.3.3 Ensures safety for all group members 5.3.4 Provide appropriate support to families, groups and other significant networks dealing with alcohol and drug problems 5.3.4.1 Involves family and social networks who can assist in achieving client goals with client consent 5.3.4.2 Conducts sound screening and risk assessment interviews with families, whānau, and other significant networks and provides a setting that facilitates their involvement 5.3.4.3 Recognises the need for safety and protection of children and others where the client is a caregiver, and refers to appropriate services 5.3.4.4 Provides alcohol and drug information and advice which is accessible to all family, group and network members 5.3.4.5 Provides ongoing support for families coping with alcohol and drug-related problems and refers to family services as appropriate " 25
5.4 Working with communities A competent alcohol and drug worker works effectively with communities in reducing the harms associated with alcohol and drug use. A competent practitioner is able to: Beliefs 5.4.1 Convey a positive attitude to the roles and abilities of communities 5.4.1.1 Projects a positive view of the importance of community networks in reducing harms associated with alcohol and drug use 5.4.1.2 Conveys a belief in the ability of communities to generate solutions to alcohol and drug related problems 5.4.1.3 Recognises the cultural norms of communities Knowledge 5.4.2 Describe public health and health promotion models of alcohol and drug use interventions 5.4.2.1 Describes the role social systems play in alcohol and drug related problems 5.4.2.2 Describes public health, community development, and health promotion principles 5.4.2.3 Describes the impact of current alcohol and drug policy issues at the community level 5.4.2.4 Knows how to access information about key funding, service and community organisations Skills 5.4.3 Work effectively with communities 5.4.3.1 Adapts communication style to be congruent with the culture and setting 5.4.3.2 Assists in identifying community needs 5.4.3.3 Accesses local networks effectively, including key funding, service and community organisations 5.4.3.4 Supports realistic community responses to alcohol and drug related problems " 26 "
5.5 Public education A competent alcohol and drug worker uses appropriate strategies to inform others about alcohol and drug related issues. This competency assumes a knowledge base similar to that required for Critical thinking (4.2), Assessment and intervention planning (5.1) and Working with communities (5.4). A competent practitioner is able to: Beliefs 5.5.1 Convey the importance of providing accurate, balanced and appropriately targeted information 5.5.1.1 Displays an awareness of the complexity of alcohol and drug issues and the sensitivities that surround them 5.5.1.2 Provides balanced comment on alcohol and drug issues that is appropriate to the context Knowledge 5.5.2 Recognise appropriate drug education 5.5.2.1 Describes the impact of educational interventions on the audience 5.5.2.2 Describes the limits and risks of drug education 5.5.2.3 Distinguishes between appropriate and inappropriate drug education Skills 5.5.3 Educate effectively and appropriately on alcohol and drug use and related problems 5.5.3.1 Accurately assesses the needs, levels of knowledge and levels of exposure to alcohol and drugs of the target audience 5.5.3.2 Selects appropriate educational strategies and accesses resources appropriate to the audience and task 5.5.3.3 Presents accurate and practical information appropriate to the audience 5.5.3.4 Adapts presentation style to the audience 5.5.3.5 Manages the education process to completion safely, including making referrals where appropriate 5.5.3.6 Evaluates the educational event " 27 "
5.6 Consultation and liaison A competent alcohol and drug worker assists other workers to identify and deal effectively with people experiencing problems related to alcohol and drug use. The competency of consultation and liaison describes the ability to advise and liaise with other workers outside the alcohol and drug field. Alcohol and drug work often involves assisting other health, social, justice, education and community workers in their dealings with clients who may have alcohol and drug related problems. This competency assumes a comprehensive understanding of alcohol and drug use and intervention, as described in previous competencies. However, it does not imply formal training of other professionals. A competent practitioner is able to: Beliefs 5.6.1 Convey a positive attitude towards people with alcohol and drug problems and their rights 5.6.1.1 Projects a non-judgemental view of people having problems with alcohol and drug use 5.6.1.2 Advocates on behalf of people with alcohol and drug problems for quality service from other agencies Knowledge 5.6.2 Describe different roles in consultation and liaison 5.6.2.1 Identifies different roles and responsibilities in referral, consultation, liaison and supervision Skills 5.6.3 Assist others to identify and to deal effectively with people experiencing problems with alcohol and drug use 5.6.4 Liaise effectively with other health, social service and alcohol and drug workers 5.6.3.1 Elicits sufficient relevant information to enable the giving of informed advice 5.6.3.2 Gives advice to assist other workers to achieve the best treatment outcomes for the client 5.6.3.3 Advises on appropriate use of and referral to alcohol and drug treatment services 5.6.4.1 Maintains effective relationships with relevant health, social service and alcohol and drug treatment workers and teams 5.6.4.2 Works collaboratively with others in dealing with issues and problems related to alcohol and drug use 5.6.4.3 Advocates for the needs of clients and client groups " 28
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Additional copies of Practitioner Competencies for Alcohol and Drug Workers in Aotearoa New Zealand may be obtained from ALAC or downloaded from the ALAC website www.alcohol.org.nz National Office: ALAC National Office (also Wellington Regional Office) P O Box 5023 WELLINGTON Ph 04 472 0997 Fax 04 473 0890 central@alac.org.nz FREEPHONE 0508 258 258 Regional Offices: ALAC Northern Office P O Box 8391 AUCKLAND Ph 09 916 0330 Fax 09 916 0339 northern@alac.org.nz ALAC Southern Office P O Box 2688 CHRISTCHURCH Ph 03 365 8540 Fax 03 365 8542 southern@alac.org.nz " 31