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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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