Wulf Livingston Glyndwr University Grasping the Nettle - Birmingham May 2012.

Wulf LivingstonGlyndwr University

Grasping the Nettle - Birmingham May 2012

OThe one that’s there

OThe one you encouraged to use

OThe one others use

OThe one that makes sense for you setting

OThe one you like

OMore than one in different contexts

The appropriateness of initiatives will vary from one local area to another and inclusion of local initiatives, or actions, on this site does not represent endorsement by the Alcohol Learning Centre or Department of Health

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Identification Communication – like for like Referral Criteria

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Health and social care, criminal justice and community and voluntary sector professionals in both NHS and non-NHS settings who regularly come into contact with people who may be at risk of harm from the amount of alcohol they drink.

Use validated screening tools appropriate to the setting, for example the Alcohol Use Disorders Identification Test (AUDIT). Where time is limited they can use an abbreviated version such as AUDIT-Consumption (AUDIT-C). The Fast Alcohol Screening Test (FAST), the Paddington Alcohol Test (PAT) or Single Alcohol Screening Questionnaire (SASQ) may be more appropriate for an emergency department setting.

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Birmingham DAAT uses AUDITDistinguishes with a score of 19A-Team or Aquarius/Nursing Team

DAATs – have alcohol –leads, strategies Mindful of language – tools, screening,

brief advice, extended brief intervention (what roles are being identified for your agency)

Babies, Bowels, Benefits

Why not booze

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OIf you consistently work with one agency or one client group, then there maybe a specific tool they prefer (common language and understanding)

OA & E and other clinical setting –FAST (or PAT, MASQ)

OProbation –AUDIT full (*)

OG-MAST/G-MAST long for Older Peoples Drinking

Clinical/Health –Partial Social (Time) -Full

Young People

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3. Family and Environment - factors that impact on child’s well-being Family history, functioning and well-being Illness, bereavement, violence, parental substance misuse, criminality, anti-social behaviour; culture, size and composition of household; history of teenage pregnancies; absent parents, relationship breakdow n; domestic abuse; physical disability and mental health; abusive behaviour; discrimination due to disability, sexual orientation, identity or heritage

Wider family Formal and informal support netw orks from extended family and others; w ider caring and employment roles and responsibilities; role models and mentors w ithin w ide family network; conflict/substance misuse impacting from extended family members Housing, employment and financial considerations Water/heating/sanitation facilities, sleeping arrangements; reason for homelessness; w ork and shifts; effects of hardship; employment; income/benefits Social and community elements and resources, including education Day care; places of w orship; transport; shops; leisure facilities; crime, unemployment, anti-social behaviour in area; peer groups, social netw orks and relationships; family regarded positively by neighbours/community Strengths - Assessment Update Needs - Assessment Update

Child 1

Child 1

Concern rating FROM FAMILY PERSPECTIV E *

Concern rating from practitioner perspective *

1 2 3 4 5 6 7 8 9 10

1 2 3 4 5 6 7 8 9 10

Child 2

Child 2

Concern rating FROM FAMILY PERSPECTIV E *

Concern rating from practitioner perspective *

1 2 3 4 5 6 7 8 9 10

1 2 3 4 5 6 7 8 9 10

HIGH LOW

HIGH LOW

Epidermis

Hair Follicle

Sebaceous Gland

Biological fluids

Drug

Self Reporting is (90% +) reliable• live in their own home;• are employed full time;• are over the age of 30;• have not self-reported a drug

dependence in the past 12 months; and

• have not self-reported being engaged in the drug market in the past 30 days

• have been detained for a property offence;

• have had prior contact with the criminal justice system over the past year;

• self-report being on drugs at time of arrest;

• self-report being engaged in the drug market in the past 30 days;

• self-report being drug dependent in the past 12 months; and

• self-report being in drug or alcohol treatment during their lifetime

• MacGregor, K. and Makkai, T (2003) Self reported drug use, how prevalent is under- reporting? Australian Institute of Criminology trends and issues in crime and criminal justice 260 Canberra)

OAUDIT – The gold standard

Ask about UseRelated ProblemsAdvice on Action

Congratulate those drinking at lower-risk levels and encourage them to keep to this level of alcohol consumption

Deliver ‘simple brief advice’ to those drinking above lower-risk levels

Encourage referral to a specialist treatment service for those showing signs of dependence and/or in need of more in-depth treatment.

Do you?

How much and often?

What effects?

Have you thought about?

OFeedback on their alcohol and drug use must be accurate and positive

OResponsibility – be clear that the choice to change and responsibility for it rests with the client

OAdvice giving – give clear information and advice

OMenu – offer a choice of change options

OEmpathy – adopt an empathic counselling style

OSelf-efficacy – promote independence

ask your agency ask your local alcohol and drug team,

voluntary agency, Probation, general practitioner…find out what others are they using

Find – Alcohol Liaison Officer ask is the Drug and Alcohol Action Team

(DAAT) leading on a local universal approach…..find out if the local strategy specifies an approach

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http://www.alcohollearningcentre.org.uk/Topics/Browse/BriefAdvice/

Bliss, D. L. and Pecukonis, E. (2009) Screening and Brief Intervention Practice Model for Social Workers in Non-Substance-Abuse Practice Settings Journal of Social Work Practice in the Addictions, 9:21-4O. (Limitations but explores the issues)

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