Providing information about alcohol for young people and adults QEIPP [ ]
A tool kit for Health Service Providers delivering Alcohol Education Awareness Sessions for the
Queensland Early Intervention Pilot Project [QEIPP]
Licence
QEIPP Toolkit for Alcohol Education Awareness Session created by the Queensland Police Service is licensed under a Creative Commons Attribution (BY) 2.5 Australia Licence. Permissions may be available beyond the scope of this licence. http://creativecommons.org/ licenses/by/2.5/au/legalcode
Written requests for permission should be addressed to the: Intellectual Property Coordinator Information Resource Centre Queensland Police Service GPO Box 1440 Brisbane Qld 4001 Ph 3364 3958 Fx 3364 3942
Disclaimer
While all care has been taken in preparing this publication, the State of Queensland, acting through the Queensland Police Service, does not warrant that the content is complete, accurate or current. The Queensland Police Service expressly disclaims any liability for any damage resulting from the use of the material contained in this publication and will not be responsible for any loss, however arising, from use of or reliance on this material. The user must make the enquiries relevant to their use in relation to the material available in this publication.
Produced by
Ms Julia Featherstone Psychologist
Senior Research Officer
Drug and Alcohol Coordination Unit
Queensland Police Service
The Queensland Police Service web address is www.police.qld.gov.au
ACA ............. Australian Counsellors Association
ADGP Australian Divisions of General Practice
AOD Alcohol and Other Drugs
BCC Behaviour Change Counselling
CBT Cognitive Behavioural Therapy
DoHA ........... Department of Health and Ageing
DUMA Drug Use Monitoring in Australia
EIPP Early Intervention Pilot Program
GP General Practitioner
HSP Health Service Provider
KPI(s) ............ Key Performance Indicator(s)
MI Motivational Interviewing
QCA Queensland Counsellors Association
QEIPP .......... Queensland Early Intervention Pilot Project
QPS Queensland Police Service
QHealth Queensland Health
Acknowledgements
The QPS would like to acknowledge the following organisations and groups that have contributed to the compilation of this resource:
QPS Drug and Alcohol Coordination Unit
QPS Employee Assistance Service Network
QPS Ethical Standards Command
QPS Media and Public Affairs Branch
Queensland Health
Dovetail
Effigy Creative
We would like to thank you for your guidance, advice and patience during the developmental stages of this tool kit and associated resources.
Preface
This tool kit was developed by the Queensland Police Service (QPS) as part of the Queensland Early Intervention Pilot Project – B.yrslf, everyone else is taken. The tag ‘B.yrslf, everyone else is taken’ originated from the Oscar Wilde quote ‘Be yourself, everyone is taken’, (or ‘already taken’ according to some sources) and connected well with the underlying philosophy of the project. When working with young people, parents, carers and the community; examining the client’s sense of ‘self’ often is a powerful theoretical approach to take. The QEIPP team decided to focus on the theoretical underpinning of the ‘self’ in developing the project and associated resources.
Historical Understandings of ‘The Self’
Psychological study of the self principally focuses on either the cognitive and affective representation of one’s identity or the subject of ‘experience’ of the individual. The earliest formulation of the self in modern psychology derived from the distinction between the self as ‘I’, the subjective knower, and the self as ‘Me’, the object that is known.
Current views of the self in psychology position the self as playing an integral part in human motivation, cognition, affect, and social identity – factors known to hold considerable influence in models of Health Behaviour Change.
Psychoanalyst Heinz Kohut initially proposed a bipolar ‘self’ compromising two systems of what he termed as narcissistic perfection:
1) A system of ambitions; and
2) A system of ideals.
Kohut believed that narcissistic injuries were inevitable and, in any case, necessary to temper ambitions and ideals with realism through the experience of more manageable frustrations and disappointments. It was the chronicity and lack of recovery from these injuries (arising from a number of possible causes) that he regarded as central to the preservation of primitive self systems untempered by realism.
Kohut articulated the critical role of empathy in explaining human development and change, talking much towards deepening the therapist’s empathic attunement to the client and describing fundamental human needs for healthy development, particularly idealising, mirroring, and twinship needs. Historically, in terms of treatment and intervention of a person experiencing alcohol related harms, this was a contradiction to the confrontational, value driven and more punitive of approaches.
By 1984, Kohut’s observation of patients led him to propose two additional forms of transference associated with self deficits:
1) the twinship; and
2) the merger transference; two key concepts utilised in the development of the information pack resource that is made available to our clients through the QEIPP process.
The Tool Kit
The tool kit aims to provide a ‘how to’ guide for Behaviour Change Counselling of individuals and family intervention, psychoeducation and information provision that can be applied in community settings as well as considerations for subregional settings, accessible web design and telephone based resources. The project allows for one session of which the focus is the promotion of personal responsibility
to foster the development of future attitudes towards a healthier drinking culture and prevent more serious injuries related to alcohol occurring. Essentially, it is a harm reduction driven project.
It is hoped the modalities recommended and outlined in the tool kit will assist health service providers to work with young people and their families or caregivers to deal with alcohol-related difficulties. However, this tool kit is not a textbook on counselling and does not attempt to replace face to face workshops and training that aim to develop counselling skills and techniques in those health service providers who act as providers of the QEIPP alcohol education awareness sessions.
Counselling young people at risk of alcohol misuse can involve participation from a number of trained people, from specialised professional psychologists, psychiatrists, doctors, social workers, counsellors and youth workers to peer educators who can offer ‘basic counselling’. These professionals are usually experienced in working with cases that are more difficult and can provide an approach that is more ‘in-depth’. Nevertheless, not all young people need such a level of intervention, and nor is that the scope of this project. Therefore, individuals and families can benefit from basic counselling provided by someone with whom they can quickly form trust. This may be sufficient, or it may help them realise that they are in need of more specialised interventions. In the event that the person providing the initial session is unable to provide the specialised intervention, it is essential they link the client in with appropriate ongoing professional intervention or therapy.
Young people respond well to peer counsellors and peer educators. Such peers can act as good ‘role models’, providing they have insight into the lives of
young people from similar backgrounds. Some peer counsellors may have previously been substance users themselves. Young people can view them as coming from, or living in, similar situations to themselves, and having ‘recovered’ from substance misuse (for example alcohol) problems similar to those faced by the young people. The value of such pivotal peers, and awareness of pre-established networks within the young person and their family’s community, will contribute to the strengths of the counsellor’s engagement with the client group.
Police, teachers, community leaders and residential treatment centre staff can provide support services to young people and may play a pivotal role in early intervention of at-risk groups. At times, nonspecialised counsellors can encourage and support young people experiencing alcohol related difficulties to seek necessary assistance from specialists. This can include specialist attention for serious mental and physical health and family and other abuse issues.
It is anticipated that this tool kit will be of use to both those professionally trained and those who need to enhance their skills to provide basic counselling to young people experiencing alcohol misuse related difficulties. Those using the tool kit as a self-directed learning tool will need guidance from counsellors with more experience as providing specialist training is not the intention of this package.
Assessment and family interventions are somewhat more specialised, as are some of the more advanced techniques of individual counselling. However, for those professionals working with young people in community or residential settings, whatever your role, it is hoped that you may learn some useful processes and techniques or approaches that can be adapted to assist individual young people and their families.
A training DVD accompanies this tool kit
The purpose of the DVD is to outline the conceptual framework underlying the project and the key principles guiding the intervention that are important to be mindful of when implementing this approach in practice. The DVD also contains a presentation outlining the origin of the project and its main goals. Also included on the DVD are further resources which are considered potentially useful for professionals in the allied health field.
QEIPP Project Summary
Historically the treatment of young people who have developed alcohol dependency and related problems have only had access to programs originally designed for adults; this is problematic as we know that young people have different psychological, social, cognitive and developmental needs to adults. They deserve different and specialised treatment interventions that address their developmental needs; ones that build on their developmental potential. Equally, the role of the family may have largely been overlooked when addressing the misuse of alcohol by young people.
There have been several short-term campaigns in the past two decades aimed at reducing the levels of harm associated with alcohol use among the population, and young people in particular. Whilst awareness of these campaigns has been high, and young people have understood and thought about the messages, the level and frequency of risky alcohol consumption has remained high. The results of the 2007 National Drug Strategy Household Survey (2008) showed that young adults, aged 20 to 29 years, were most likely to consume alcohol at risky or high risk levels for short-term harm at least monthly, with 40% of them doing so. The age category next most likely to consume alcohol at risky or high risk levels for short-term harm at least monthly was the 14 to 19 year-old group, with 26% drinking at this level.
This seems to indicate that, while previous communication campaigns have been successful in ‘cutting through’ to their target audiences, young people’s tendency to drink at risky levels remains deeply ingrained. This is likely due to the reflection of the National Alcohol Strategy 2006-2009, that “alcohol retains a deep-rooted cultural significance” in Australia. It is for this reason that early intervention has been identified as an effective strategy in changing attitudes towards excessive alcohol consumption by reducing the perceived acceptability of intoxicated behaviour and reinforcing the responsibility and unacceptability of the harms associated with excessive alcohol consumption and intoxication.
Within this context, in March 2008 the Australian Government, as part of a National Binge Drinking Strategy, announced the funding of a $19.1 million harm minimisation and behavioural change campaign aimed at 15 to 25 year-olds with the message of “costs and consequences of binge drinking”. The overall goal of the campaign is to increase the likelihood of 15 to 25 year-olds who choose to drink alcohol, do so at a low risk level for short-term harm. The national strategy for this framework is known as the Early Intervention Pilot Project (EIPP). In Queensland, legislation influenced the design of the project, which differs from the national program in that it will address alcohol misuse by young people under the age of 17.
QEIPP represents commitment to an active search for effective and culturally appropriate treatment and ongoing referrals for young people identified as atrisk of alcohol misuse and the families of these young people. The project has focused on contributing towards meeting the serious need for communitybased intervention and education of this client group.
The broad aim of QEIPP is to provide police; as part of their core business; with an early intervention in which to address alcohol misuse by young people. It is hoped that through this intervention, successful deviation of at-risk youth will occur away from the youth justice system to the health system. Specifically, the project, through this targeted police intervention, aims to bring a renewed understanding to young people and their parents/guardians, of their need to take personal responsibility for their behaviour.
PROJECT OBJECTIVES
The project objectives for EIPP in Queensland include:
• Provision of an alcohol psychoeducation session and booklets to young people increasing awareness of potential harms (physical and social) associated with excessive alcohol consumption, the serious nature of these potential harms and strategies to avoid alcohol-related harm
• Provide sufficient training sessions to police regarding QEIPP
• Establish partnerships between Police, Queensland Health, and other service providers, to facilitate the implementation of the project
• Ensure the collection of minimum data requirements in accordance with the Commonwealth National Key Performance Indicators KPI(s).
KEY PERFORMANCE INDICATORS
The key performance indicators KPI(s) for QEIPP will be identical as the KPI(s) developed for the National EIPP Framework, namely:
• Number of people initially approached through QEIPP
• Number of written information packages distributed
• Number of young people referred to alcohol education via QEIPP
• Compliance rates of those referred to alcohol education
• Number of places made available and waiting period.
Counselling Outline
It is largely recognised that the processes of counselling; such as the healing context, the working alliance and belief in the rationale for treatment and in the treatment itself; are instrumental therapeutic aspects of counselling and psychotherapy, in comparison to the specificity of techniques once heralded by the medical model as the key to an efficacious intervention.
This understanding emerged as counselling, like many other therapeutic professions, has been evolving rapidly over the past decades. As such, there are quite a number of therapeutic modalities available for a practitioner to use depending on both counsellor and clients variables. Some examples are brief therapy; career counselling; counselling psychology; behavioural counselling; genetic counselling; grief counselling; mental health counselling; narrative therapy counselling; online counselling; peer counselling; rehabilitation counselling; suicide intervention and telephone counselling.
In terms of the proposed guidelines for QEIPP, the following intervention tools are recommended:
PRIMARY INTERVENTION
• Behaviour Change Counselling Framework (BCC) - Please view accompanying training DVD
COMPLIMENTARY TECHNIQUES
(when appropriate)
• Family Therapy: family of origin dynamics around coping strategies, stress management and drug and alcohol use.
• Psychoeducation: increasing awareness of potential harms (physical and social) associated with excessive alcohol consumption, the serious nature of these potential harms, and strategies to avoid alcohol-related harm.
Rationale: Behaviour change typically involves changes in lifestyle and medication use for a range of issues – from eating and drinking alcohol less, to exercising and improving medication adherence. Consistently, in the world of health practitioners there exists a paradox between the client’s expressed motives and interests towards changing behaviours that ‘experts’ tell them they need to change and the actual activities the same clients employ that enable immobility. Developed to address these concerns was the Behaviour Change Counselling model (BCC). It is based on the principles of client-centred counselling and motivational interviewing.
The following points capture the philosophy of the behavioural change model
VALUE BASE
• Respect for autonomy of clients and their choices is paramount
• Client needs to decide what behaviour, if any, to focus on
SKILLS
• A confrontational interviewing style is not productive
• Information exchange is a critical skill
• Readiness to change must be continuously monitored
• Importance and confidence need to be assessed and responded to
ROLES
The practitioner
• Provides structure, direction and support
• Provides information wanted by the client
• Elicits and respects the client’s views and aspirations
• Negotiates change sensitively
The client
• Is an active decision maker
The practical guidelines of BCC are initially outlined in Health Behaviour Change: a Guide for Practitioners (Rollnick, Mason and Butler, 1999) and were further refined by Rollnick and Miller (2002). It involves using a wider range of skills than brief advice, but not as wide as those involved when using motivational interviewing. Essentially, the practitioner encourages the client to make their own decisions about behaviour change. A constructive and trusting atmosphere is used to explore the client’s feelings about the why and how of change.
The roles of the practitioner and client are more egalitarian than in a brief advice session. The practitioner using behaviour change counselling operates as an advisor to a client who is an active and engaged participant. The encounter is more collaborative than typically observed with brief advice,
Key Concepts
BCC can be applied in 5 – 30mins. It targets two main concepts related to successful behavioural change.
and greater attention is placed on building rapport. However, this does not necessarily require the intensity of relationship building essential to the good practice of motivational interviewing. BCC often has a ‘task oriented flavour’ (Rollnick and Miller, 2002).
There is no single text on BCC and whilst the information provided here primarily relates to one text, it is recommended that QEIPP counsellors review Health Behaviour Change: a Guide for Practitioners (Rollnick et al, 1999) as it provides one example of this counselling style. BCC was thought to be a suitable general term for attempts to conduct a constructive conversation about change in which the practitioner tries to understand how the client feels about change, by using mostly open questions and sometimes empathic listening statements.
Source: Rollnick et al, (1999); Health Behaviour Change: a Guide for Practitioners
Five strategies to explore importance to client of current behaviour
Ask the client to rate how important changing their behaviour is; and depending on their response employ the following strategies.
Do a little more
If importance is low (e.g. zero or one) ask client if it is the right time to consider change?
Other important issues?
Scaling questions
If importance is greater than three, ask client ‘why so high’, why a six, not a one, what would have to happen to get a four to a nine?
Pros and Cons
Best to use when importance = five out of ten
• What are the good things about change
• What are the less good things
Concerns about behaviour
When there are significant Cons
• What concerns you most regarding behaviour change
• Listen and understand
• Ask ‘where does that leave you now?’
Hypothetical look over the fence
Also known as ‘miracle question’
• Imagine for a moment that you did change?
• What might this be like? Look like?
• What/how would you feel?
• Listen to and reflect on thoughts and feelings
What does this mean?
It is important to understand that there may be differences in the value positions of the counsellor as the service provider and the client regarding the importance of changing their behaviours. This can sometimes lead to conflicted situations, particularly when there are time constraints. For example you may believe that it is important for a young person to look after their cognitive development and abstain from consuming alcohol. Many clients will feel differently for a variety reasons. These differences in values will influence beliefs about health and illness and the perceived costs of adolescent drinking. Managing these differences within the awareness session is an important factor in the process.
Source: Rollnick et al, (1999); Health Behaviour Change: a Guide for Practitioners
Five strategies to build confidence
Repeating the strategy from before, ask the clients to rate how confident they are in changing their behaviour; and depending on their response employ the following strategies.
Do a little more
If confidence is low (e.g. zero or one) ask client if it is the right time to consider change. Is there other more important or pressing issues they would like to discuss?
Scaling questions
If confidence is greater than three, ask client ‘why so high?’, for example: ‘why a six and not a one?’, or ‘what would have to happen to increase a four to a nine?’
Brainstorm solutions
Emphasis principle
• usually more than one course of action
• share what has worked with other clients
• client is the best judge of what’s worked for them
• collaborative approach
• encourage client to increase the number of options possible
• let client select most suitable option
• convey optimism and willingness to re-examine
Past successes/failures
Identify past successes
• what made it work?
• praise (even if only part change was made)
• maintain focus on success/failures under clients control
Reassess confidence
• as discussion about confidence continues –confidence may be indecisive
• can be useful to reassess and make changes explicit to the client
What does this mean?
The terms ‘confidence’ and ‘ability’ in this model are used to understand the clients self-efficacy as this focuses on the clients underlying psychological state, and avoids the mistake of assuming that talking about a behavioural change is merely a process of developing ‘technical coping skills’.
Source: Rollnick et al, (1999); Health Behaviour Change: a Guide for Practitioners
Information Exchange
Encourage client to be an active participant
Provide information and facts
Leave interpretation to client
Ask what their needs are, what would they like to know
Ask about client’s interpretation
What does this mean?
Often within the health behaviour change setting there is the temptation to fall into ‘simple advice giving’. The strategies provided in the BCC model aim to address this by consistently encouraging the counsellor to invite the client into the discussion regarding their behaviour, what is important to them to work on and explore their ideas for potential change. It has been shown that the problem with simple advice giving is that it can restrict a client’s sense of autonomy within the therapist–client relationship, which in turn can act as a threat to
the client and can foster resistance to advice given.
A secondary concern with ‘simple advice giving’ is that it usually takes the form of a single ‘simple’ piece of advice. Arguably, if change was this simple the client would have already adjusted their behaviour and moved forward along the continuum of positive behaviour change. It is essential that practitioners avoid minimising and dismissive approaches when working with clients faced with change.
Source: Rollnick et al, (1999); Health Behaviour Change: a Guide for Practitioners
Resistance
Identify
Reluctance
Rebellion
Resignation
Rationalisation
Roll with it
Avoid arguing
Do not directly oppose client’s expressed interpretation
Signal to client any potential for difference
Articulate that there is no expectation the client will change in the session
What does this mean?
There are often three main traps that health service providers fall into when met with resistance. They are:
1. Take control away – when a client is compliant and likes to be told what to do
2. Misjudge importance, confidence or readiness
3. Meet with force.
With any of these traps it is important to continue to emphasise to the client that they have personal choice and control within your interactions. Continually reassess the counsellors understanding of the client’s readiness, importance and confidence regarding change and when appropriate the counsellor needs to know when to ‘back off’ and come alongside the client.
Source: Rollnick et al, (1999); Health Behaviour Change: a Guide for Practitioners
Techniques
The behaviour change counselling framework is not a one step method, or one model approach to working with clients towards more positive health and self-care, rather it is a ‘toolbox of strategies’ that allows for personalisation of both the counsellor, in terms of preference and skill of practice, and the client of what is appropriate to their individual situation.
In terms of health behaviour change counselling there are key techniques that have been proposed to be used with clients who present with alcohol use as the identified behaviour that needs to be addressed. They are:
A typical day
‘Can you take me through a typical day in your life, so that I can understand in more detail what happens?’
This strategy simply involves asking the client to take you through a typical day in their life. It can take as little as three to five minutes to use, although the ideal is six to eight minutes (NB – a good variation of this approach if you have a resistant client is to turn it into a hypothetical question – ‘tell me about a typical heavy drinker/ tell me about typical alcohol consumption of young people these days’).
NO CHANGE
COSTS
BENEFITS
It is important to allow the client to tell the story. As the counsellor you may ask for some extra information here or there, but it is the client providing most of the detail. The interviewing style is more curious than investigative.
Pros and cons
‘Would you like to spend a few minutes talking about what it is you like and don’t like about it?’
Another term often used interchangeably within this strategy is looking at the costs and benefits of staying the same or changing. This strategy can take as little as five to seven minutes to use. If you have more time, use it, and allow the client to explore it in further detail. The most important first step is to ask the client whether he or she would like to look at the pros and cons. There are two ways of examining the pros and cons, either to look at the current behaviour, or change. A useful tool to implement here is a ‘balance sheet’.
CHANGE
COSTS
BENEFITS
Source: Rollnick et al, (1999); Health Behaviour Change: a Guide for Practitioners
Techniques - continued
Exploring concerns
‘What concerns do you have about your drinking?’
Two principles guide this strategy, firstly the client not the counsellor expresses concerns; and secondly once the client has finished describing their concerns, the counsellor asks some key questions about the possibility of change. As the counsellor, your role is to provide structure, listen carefully and then summarise at the end. The client’s role is to explain to you how he or she feels.
It is important to ask the client about the next step, in a gentle and non-confrontational manner, for example ‘where does this leave you now?’
Information exchange
As a strategy, information exchange occurs throughout various stages in the session. The following principles are important:
• Does the client want or need to know information? About which topic? How much does he or she already know? It can be considered time wasting and negatively affect the client-therapist relationship if you provide inappropriate information or that which the client does not want to receive. The best time to provide information is when the client asks for it.
• Make a distinction, if possible, between factual information and the personal interpretation of it. You present the information and encourage the client to interpret its meaning.
• When presenting information, use a neutral tone of voice and avoid too much use of the word ‘you’ and the question ‘why’?
Brain storming solutions
This strategy is designed to maximise client interaction while allowing the counsellor to use their knowledge and skill to enhance this process. There are four key considerations within this strategy:
1. Emphasise the principles
• There is usually not one, but many possible courses of action
• I can tell you what has worked for other people
• You will be the best judge of what’s right for you
• Let’s go through some options together.
2. Go through the options
It is important to note here, your attitude about the possibilities should be neutral; it is up to the client to decide.
3. Let the client select the most suitable option ‘which one suits you best?’
Your task here is to elicit and to understand how the client is really feeling about what to do.
4. Convey optimism and willingness to re-examine
If the client selects an option be sure to let them know that if things don’t work out there will be other options that might work. It’s a matter of working out what best suits the individual.
Source: Rollnick et al, (1999); Health Behaviour Change: a Guide for Practitioners
SECTION B
COMPLIMENTARY TECHNIQUES
Family Therapy
Psychoeducation
Alcohol Assessments
Referral Process
It is important to note: these techniques are solely mentioned as potential alternatives to be used within the context of the session; and when appropriate, depending on the presentation of the client(s). They are not listed as recommended primary intervention techniques.
Family Therapy
It is the recommendation of QEIPP, when identified as appropriate, that Systemic Family Therapy techniques are applied, with a particular focus on Family of Origin history of the client groups, specifically in terms of:
• learned behaviours
• coping skills
• stress management
• belief systems.
Psychoeducation
As stated earlier in this document, it is the expectation that during the course of the session counsellor’s engage in psychoeducation addressing:
• increasing awareness of potential harms (physical and social) associated with excessive alcohol consumption, the serious nature of these potential harms, and strategies to avoid alcoholrelated harm
• principally, it is the aim of the session to identify and challenge presenting attitudes towards excessive alcohol consumption by reducing the perceived acceptability of intoxicated behaviour and reinforcing the concepts of responsibility and unacceptability of the harms associated with alcohol consumption and intoxication
• finally, it is recommended the counsellor allow time for generating and reinforcing intentions to avoid drinking to intoxication and to adopt strategies to avoid alcohol-related harm, and generating intentions among those who experience alcoholrelated problems to seek help.
Alcohol Assessment tool
According to the national framework for QEIPP, the optional use of an alcohol assessment tool during the education session is designed ‘to better manage and target alcohol information and additional referral pathways for young Australians’.
Evidence suggestive of the efficacy of the use of alcohol assessment tools in the treatment of a young person’s substance use issues is increasing.
Perhaps the most important developmental factor in the assessment of alcohol and other drug (AOD) involvement among adolescents is the need to distinguish normative and developmental roles played by AOD use in this age group. The normal trajectory for adolescents is to experiment with the use of alcohol and to some extent other drugs.
In the event the service provider chooses to use an assessment tool during the initial information session, it is the recommendation of QEIPP that the World Health Organisation’s (WHO) AUDIT be used. This resource was provided to clients in the booklet sent to them with the offer of the alcohol education awareness session. It may be a useful resource to discuss with your clients.
Referral Process
The scope of QEIPP is to provide a session to youth identified as ‘at-risk’ and their families about the responsibilities and potential harms associated with risky alcohol use.
A project with such a time constrained capacity lends itself to ongoing treatment referral, when identified, as appropriate.
Counsellors cannot always provide all the services our clients need. For instance, a social worker might be able to help a client with housing or other services outside the scope of this initiative.
In order to meet the needs of the identified client groups, counsellors will need to know and demonstrate an established network with other services in their communities.
*Please note: It is not a requirement of the project that an ongoing referral is recommended.
There will be times where such action would be inappropriate. It is at the discretion of the health service provider to determine when ongoing treatment is required.
Bibliography
Australian Institute of Health and Welfare: 2005. 2004 National Drug Strategy Household Survey: Detailed Findings. AIHW cat. no. PHE 66. Canberra: AIHW (Drug Statistics Series No.16).
Australian Institute of Health and Welfare: 2008. 2007 National Drug Strategy Household Survey: first results. AIHW cat. no. PHE 98. Canberra: AIHW (Drug Statistics Series number 20).
Babor, T., Caetano, R., Casswell, S., Edwards, G., Glesbrecht, F., Grube, J., et al. (2003). Alcohol: no ordinary commodity. Oxford: Oxford University Press.
Begg, S., Vos, T., Barker, B., Stevenson, C., Stanley, L., & Lopez, A. D. (2007) The burden of disease and injury in Australia 2003. PHE 82 Canberra: AIHW
Chikritzhs, T., & Brady, M. (2006). Fact or fiction? A critique of the National Aboriginal and Torres Strait Islander Social Survey 2002. Drug and Alcohol Review, 25.
Chikritzhs, T., Calalano, P., Stockwell, T., Donath, S., Young, D., et al (2003). Australian alcohol indicators 1990-2001, Patterns of alcohol use and related harms for Australian states and territories. Perth: National Drug Research Institute.
Copeland, J., Stevenson, R.J., Gates, P. & Dillon, P. (2007) Young Australians and alcohol: the acceptability of ready-to-drink (RTD) alcoholic beverages among 12–30-year-olds. Addiction, 102: 17401746.
Copello, A. G., Templeton, L., & Velleman, R. (2006). Addictive disorders Family interventions for drug and alcohol misuse: is there a best practice? Current opinion in Psychiatry, 19(3), 271-276.
Hogue, A., & Liddle, H. A. (2009). Family-based treatment for adolescent substance abuse: Controlled trials and new horizons in services research. Journal of Family Therapy, 31(2), 126-154.
Kohut, H. (1991). The search for the self: selected writings of Heinz Kohut 1978-1981. (Vol. 4). New York: International Universities Press.
Livingstone, M., Laslett, A.M., & Dietze, P. (2008). Individual and community correlates of young people’s high-risk drinking in Victoria, Australia. Drug and Alcohol Dependence, 98(3), 241-248.
Liddle, H. A., Rowe, C. L., Dakof, G. A., Henderson, C., & Greenbaum, P. (2009). Multidimensional Family Therapy for early adolescent substance abusers: Twelve month outcomes of a randomized controlled trial. Journal of Consulting and Clinical Psychology, 77(1), 12-25.
Liddle, H. A., Rowe, C., Diamond, G. M., Sessa, F. M., Schmidt, S., & Ettinger, D. (2000). Towards a developmental family therapy: The clinical utility of research on adolescence. Journal of Marital and Family Therapy, 26(4), 485-499.
Maggs, J. L., & Schulenberg, J. E. (2005). Initiation and course of alcohol consumption among adolescents and young adults. Recent Developments in Alcoholism, 17, 29-47. Retrieved from, http://www.aph. gov.au/senate/committee/clac_ctte/alcohol_beverages/submissions/ sub32.pdf
Ministerial Council on Drug Strategy. (2001). Alcohol in Australia: Issues and Strategies. Canberra: Department of Health and Aged Care.
Ministerial Council on Drug Strategy. (2006). National Alcohol Strategy 2006-2009. Canberra.
Prochaska, J. O., Di Clemente, C. C., & Norcross, J. (1992). In search of how people change. American Psychologist, 47(9), 1102-1114.
Miller, W. R., & Rollnick, S. (1991). Motivational interviewing: preparing people to change addictive behaviour. New York: Guilford Press.
National Health and Medical Research Council. (2007). Australian Guidelines for low-risk drinking: draft for public consultation. Retrieved from, www.nhmrc.gov.au
Roche, A. M., Bywood, P., Borlagdan, J., Lunnay, B., Freeman, T., Lawton, L., et al. (2007). Young people and alcohol: The role of cultural influences. Adelaide: DrinkWise Australia Ltd.
Rollnick, S., Mason, P., & Butler, C. (1999). Health Behavior Change: A Guide for Practitioners. London: Churchill, Livingstone (Harcourt, Brace and Company Ltd).
Rollnick, S., & Miller, W.R., (2002). Motivational Interviewing: Preparing people to change. New York: Guilford Press
White, V., & Hayman, J. (2006). Australian secondary school students’ use of alcohol in 2005: Australian Government Department of Health & Ageing.
Yamaguchi, K., & Kandel, D. (1993). Marital Homophily on Illicit Drug Use among Young Adults: Assortative Mating or Marital Influence? Social Forces, 72(2), 505-528.
The Queensland Early Intervention Pilot Project is an initiative under the Australian Government’s National Binge Drinking Strategy
