Managing Interventions

The Importance of Language

The language we use to talk to and about our clients in any community services sector has a significant impact on how our clients see themselves and on how other people see them. People who use alcohol and other drugs (AOD) services are vulnerable to being stigmatised, devalued and discriminated against; and using negative language and terminology contributes to this process.

Defining a person by their diagnosis or condition serves to depersonalise them, so using ‘person first’ language is important. For example, ‘person with a disability’ sends a different message from the phrase ‘disabled person’. Saying a person is a drug addict implies that the addiction is the only important characteristic the person has and reduces them to a diagnostic label.

Labelling theory argues that individuals’ self-image and behaviour is influenced by the language used to describe and classify them. In simple terms, we tend to live up or down to the labels attached to us, and to believe the negative or positive messages that language conveys. This concept has been used in working with people with disability to promote more positive images of them and to reduce stigma and devaluation.

So, in the AOD sector, using language and terminology that reflects positive messages about hopefulness; and the individual’s worth, strengths and capacities will increase the chances of positive behaviour change.

Interpreting Treatment Plans

To interpret treatment plans for your clients, you will also need to understand the terminology used to describe interventions and treatments and the client’s behaviour.

Commonly used terms include:

• Terms used to identify medical conditions (such as ARBI [alcoholic-related brain injury] or delirium tremens)
• Terms used to identify various prescription medications (such as barbiturates or anti- depressants)
• Terms used to describe particular interventions (such as detoxification or detox, or brief intervention)
• Arange of slang terms used to describe illicit drugs (such as speed, snowcone or gear).

Terms such as ‘drunk’, ‘stoner’, ‘meth head’, ‘drunkard’ and ‘junkie’ all send negative messages that reinforce stigma and perpetuate stereotypes.

It is important to know the right words to use so you can ensure the client feels safe, not judged and comfortable at all times. It is also important to listen to the language they use to describe themselves, and if you find they are using more negative terminology, you could suggest using new words.

Workers

Work in the AOD sector includes a range of roles such as counsellor, support worker, peer worker, health worker, nurse, doctor, occupational therapist and psychologist. The focus of work in AOD is supporting people to change their behaviours around alcohol and other drugs and to recover from the negative impacts of these substances. There is also a focus on prevention and harm reduction, so some services provide safe spaces for people to use drugs or provide safe equipment such as needles.

Service settings include residential outreach, day programs, drop-in centres, counselling services, detoxification services, advocacy, and prevention programs.

A worker’s responsibilities include:

• Working within the boundaries of their job role description
• Carrying out the tasks and duties specified in their job role description
• Supporting the values and principles of the organisation
• Working within relevant laws and legal requirements, including duty of care
• Meeting service standards
• Following relevant codes of ethics, codes of practice and codes of conduct
• Following the policies, procedures and work practices of their organisation.

Workers have the right to expect their employer to:

• Provide and maintain safe workplaces and practices
• Meet their obligations under relevant legislation.

Clients and Family Members

Clients have the right to:

• Access services that meet recognised quality standards and are appropriate to their individual needs
• Be treated without discrimination and with dignity and respect, including respect for their culture
• Be provided with information on all aspects of services and their rights and responsibilities so they can give informed consent to treatment.
• Make decisions and choices about their treatment and about who will participate in their treatment and support.
• Have personal information protected and kept confidential unless they consent to the information being disclosed
• Access their own records and information
• Access relevant complaints and appeals procedures.

Client's responsibilities include:

• Treating staff members and other clients with respect
• Keeping information about other clients confidential
• Contributing to a safe, supportive environment
• Participating actively in their own treatment
• Providing information relevant to their treatment
• Following the organisation’s policies and procedures, for example, workplace health and safety procedures.

Family members:

• Family members may be included in a person’s treatment plan if the person gives consent to this.
• Family members of adult clients can be provided with information about the person and their treatment only with the person’s consent.

Many AOD organisations have a charter of client responsibilities and rights. The following quotation is an example of one of these charters:
 

What people can expect of alcohol and other drug services?
People using Victorian alcohol and other drug services have the right to:

• be provided a service in a safe environment
• be provided a service in a fair, honest and non-judgemental manner
• be provided a service that is friendly and respectful
• be given adequate information on all available services and treatment
• participate in all aspects of service provision
• have information about them kept confidential unless disclosure is otherwise authorised
• be provided with a timely and effective service that responds to their needs
• make a complaint and have that complaint addressed efficiently
• be provided culturally sensitive services that take into account their values and beliefs.

To help maintain a high standard of treatment, clients are expected to contribute to maintaining a safe environment and treating others with courtesy and respect. They are asked to participate in the treatment process to the best of their ability and, if necessary, follow the organisation’s complaints process.

^{Department of Health (Vic), ‘Alcohol and Other Drug Client Charter and Resources’}

AOD Service Providers/Organisations

Service providers and organisations in the AOD sector must meet legislative requirements and quality standards, including providing safe workplaces and practices.

The National Framework for Alcohol, Tobacco and Other Drug Treatment 2019–2029 aims to provide high-quality AOD treatment appropriate to people’s needs. It identifies principles for effective treatment, monitoring and evaluation of services and guides the way organisations and individuals work.

The National Drug Strategy 2017–2026

The National Drug Strategy 2017–2026 is a policy framework that aims to build safe, healthy and resilient communities by preventing and minimising social, cultural, economic and health harm caused by alcohol, tobacco and other drugs.

The key focus areas are:

• Reducing demand and preventing people from taking up alcohol and other drugs, reducing use, supporting recovery from addiction
• Reducing the supply and distribution of illicit drugs and limiting the use of alcohol and prescribed opiates
• Reducing or minimising the harm caused by substance use to individuals, families and communities, including social harm such as violence and crime, domestic and family violence, intergenerational trauma and the neglect and abuse of children; harm to health and wellbeing; and economic harm such as increased healthcare costs and decreased productivity.

National Quality Framework for Drug and Alcohol Treatment Services

The National Quality Framework for Drug and Alcohol Treatment Services sets accreditation standards and benchmarks for service providers in the AOD sector.

Download the National Quality Framework and review its explanation of the quality standards: National Quality Framework for Drug and Alcohol Treatment Services by the Department of Health

Employers

The general responsibilities of employers include:

• Providing agreed services to clients
• Providing and maintaining safe workplaces for their workers.
• Employers have the right to expect workers to:
• Comply with relevant legislation and policies
• Meet relevant service standards
• Carry out tasks and duties specified in their job role descriptions.

Self-Help Groups

There is evidence that participating in a self-help group can improve outcomes as long as the group is a good match for the person’s own values, beliefs and perspectives, and the person has the skills and confidence to interact within a group and feels comfortable doing so.

Self-help groups are not run by professionals and consist of a group of people who share a common problem.

There is a range of self-help groups in Australia for people with AOD issues and for people with mental illnesses, so these can be particularly helpful for people with complex or coexisting issues.

Peer support groups and services, where people with lived experience provide support to clients, are also useful.

Participating in a self-help group can give people more control over their lives and reduce feelings of isolation. It also provides opportunities for sharing strategies and knowledge and for providing emotional support and friendship.

Depending on your work role, you may be required to work with clients to plan treatments and interventions or to interpret and follow existing intervention plans.

What Are Treatment or Intervention Plans?

A treatment or intervention plan:

• Identifies the person’s goals and the intended outcomes for an intervention
• Outlines steps and strategies for attaining those goals and outcomes
• Outlines how progress and outcomes will be measured.
• Identifies the resources needed (materials, staff, etc.) and the methods to be used
• Describes the roles and responsibilities of the participants.

A treatment or intervention plan is like a road map. It tells us where we want to go (purpose and goals), why we want to go there (motivation), how we will get there (strategies) and how we will know that we have arrived (evaluation criteria and measures).

A treatment or intervention plan can be used as an agreement between the client and service providers. It provides a ‘map’ for the participants and helps everyone to focus on the person’s goals.

Goals, Objectives and Measures

A goal is a broad statement about what the person wants to achieve, for example, reduce anxiety, reduce alcohol intake, or improve health or well-being.

An objective is an action or something observable that will bring the person closer to achieving their goal, for example, attending AA meetings, walking around the park each morning or visiting the GP for regular check-ups.

A measure identifies how the objectives, goals, and outcomes will be assessed or measured. For example, an AA meeting can be attended every week, a walk around the park each day for a week, or a visit to the GP each month. Measures usually refer to something observable and include numbers.

Objectives are the ‘nitty gritty’ of the plan. They describe what the participants will do.

SMART Objectives

Smart objectives are:

• Specific
  What will the client do exactly?
• Measurable
  How many times must the client do it?
• Achievable
  Is it realistic? Can the client do it?
• Relevant
• How does it relate to the goals and desired outcomes?
• Time Limited
  What is the time frame? Is this reasonable?

We discussed the principles and theory underpinning motivational counselling in section ‘Motivational Interviewing Principles and Theory’. In this section we will examine the communication and counselling techniques used in motivational interviewing

Watch

Watch these videos to learn about motivational interviewing.

Interpersonal communication is a key element of all human interactions. A core component of community services work involves human interactions, so it is essential for community services workers to develop and use effective interpersonal communication skills.

What is Communication?

Communication is the process of exchanging messages with other people.

Humans communicate in order to get their needs met; communication is an essential survival tool. Everyone communicates in some way – it is almost impossible for a human not to communicate. Even people who are unable to speak, or who have little or no control over their movements, may communicate through facial expressions, noises, or tiny movements such as eye blinks.

Interpersonal communication is a dynamic process that includes the following steps.

1. Message
2. Encoding and sending the message
3. Receiving and decoding the message
4. Feedback

The message

One person (the sender) has a thought, idea, feeling, or piece of information that they want to share with someone else.

Encoding and sending the message

Because humans are not telepathic, we cannot simply‘think’ the message we want to share into another person’s head.

This means that we must turn our idea, thought, feeling, or piece of information, into a form that can be transmitted (sent) to another person. This part of the process is called encoding.

We can choose from a number of different codes. (In some texts, the code is called the channel.)

• Verbal (speech and language)
• Nonverbal (anything that is not speech)
• Pictures
• Signs and symbols

Receiving and decoding the message

To receive the message, the receiver must have the right equipment – in interpersonal communication, this means functional sensory organs (eyes and ear).

The receiver must also understand the code that is being used; for example, the receiver must understand the language that is used in order to decode speech, or the system of signs and symbols, or the body language (a common form of nonverbal communication).

Feedback

Feedback means the receiver sends messages back to the sender to indicate whether or not the message is understood and how they feel about the message. (Most interpersonal exchanges include a feeling component aswell as an informational component or facts.)

Feedback is an important part of the process as it includes information the sender can use to make anyamendments or additions to the message in order to make its meaning clearer.

The communication process is irreversible and unrepeatable. This means that once you have sent a message you cannot take it back, and that the same message cannot be replicated or repeated exactly, because something will have changed with the passing of even a short period of time.

Key Points

Communication is an exchange of messages between people. It is a process (it involves actions).

We communicate to address the full range of human needs:

• Physical/survival
• Identity and ego
• Social and relationship
• Practical
• Spiritual

Communication

• Can be intentional or unintentional.
• It is almost impossible not to communicate.
• All messages have fact and feeling dimensions.
• Is irreversible.
• Is unrepeatable.
• Is open to misinterpretation.
• Is a set of skills.

Effective communication happens when the message you intended to send is the message understood by the other person.

Other Important Aspects of Interpersonal Communication

Context and Environment

All interpersonal communication happens within a context and an environment.

The context includes:

• The purpose of the communication.
• The roles, status, and relationships of the participants. For example, is there a difference in power or status? How do they feel about each other?
• The social situation and setting. For example, is it formal or informal? Work or recreation? Public or intimate?
• The cultural framework or background. For example, what cultural and social norms apply?
• The characteristics of the participants, including:
  • Age, gender, physical characteristics such as size, appearance.
  • Skills, abilities, knowledge (especially of communication techniques)
  • Internal factors such as emotions, physical comfort/discomfort, pain, fatigue, illness
  • Interests and goals
  • Personal history, such as past interactions.

Environment

Physical features of the environment in which the communication occurs influence the process.

• Noise levels
• Light levels
• Temperature
• Space, distance, proximity
• Furniture (degree of comfort, how it is arranged)
• Number of people present.

Communication Barriers

Communication barriers include any element that can alter or interfere with the communication process and limit or prevent messages being sent, received, or understood.

Barriers may stem from:

• Environmental features such as high levels of noise, high or low light levels that make it difficult to see or focus, high or low temperatures causing discomfort, participants being too close or too far away from each other, can all present barriers to effective communication.
• Roles, status, and relationships. These may create differences in expectations of behaviour or contribute to differences in power which can also alter communication. For example, a worker may feel unable to communicate openly with the boss; people who dislike each other may be unwilling to see each other’s point of view; strangers may be reluctant to engage in discussions about personal maers.
• Different social occasions carry different expectations; for example, it may not be appropriate to discuss your divorce proceedings at a dinner party, or to tell your colleagues about your drunken weekend. Ignoring social norms can present barriers to effective communication.
• Cultural differences around communication can also present barriers. For example, in some cultures it is not considered polite to disagree with someone who is in a superior position or role to you; there are some topics that are ‘taboo’; and the way nonverbal communication is used varies across cultures. Language differences present an obvious barrier.
• Our cultural framework influences how we see the world, our values, and our beliefs. All these factors can contribute to miscommunication.
• Personal characteristics may also present communication barriers; for example, there are age differences in the way language is used; illness and fatigue often make it difficult to concentrate; strong emotions, such as fear and anxiety, can all colour how we communicate.

There are so many potential barriers to communication, we might think it is a miracle that we ever succeed in getting our messages across.

Nonverbal Communication

In interpersonal communication, nonverbal communication accounts for nearly 90% of how a message is conveyed and interpreted, so how we say something is more important than our words.

Nonverbal communication is made up of:

• Visual components
• Vocal components

The visual components are made up of the following:

• Physical appearance, including body size and shape,manner of dress.
• Eye contact and eye movements.
• Facial expressions.
• Body movements.
• Posture and muscle tension.
• Hand movements and gestures.
• Proximity and distance between speakers: personal space.

‘Personal space’ varies according to the social situation and how close the relationship is. We usually divide personal space into zones or circles:

• Intimate zone – for people we are emotionally close to, such as family members and partners. This zone includes intimate touch.
• Personal zone – for people we know fairly well but are not intimate with, such as friends and colleagues. This zoneincludes less intimate touch.
• Social zone – in social situations for strangers and people we do not know well but are interacting with, perhaps on a professional basis, for example, tradespeople. This zone only includes formal touch, such as shaking hands.
• Public zone – for people we encounter in public situations. This zone does not include touch.
• Touch

All these components are often called ‘body language’.

Cultural Variations in the use of Body Language

There are many cultural variations in how we use aspects of body language, especially in eye contact, gestures, and distance/proximity.

Nonverbal communication is a key component in effective communication. Being aware of the nonverbal messages that you send others and developing your skills in ‘reading’ other people’s nonverbal messages will help you to communicate effectively with your clients and establish trusting, professional relationships with them.

Listening

Listening is more than simply hearing what the other person says. Listening includes interpreting and responding to what they say. Good listening skills are essential for all community service workers.

Listening is a complex process that includes:

• Hearing – receiving sounds through our ears.
• Interpreting – making sense of the sounds we receive through our ears.
• Recalling or remembering.
• Responding.

Active listening

The process of listening aentively while the other person speaks and making sure the other person feels heard.

Informational listening

Learning about the topic that the speaker is talking about.

Empathetic listening

Encouraging the speaker to continue with what they are saying.

Critical listening

Analysing information through a filter of unbiased, rational and open-minded scrutiny.

Reflective listening

Involves paying aention to what the person is saying as well as what they are feeling.

Motivational Interviewing

All counselling techniques rely on effective communication skills:

• Physical attending and use of body language
  This means using non-verbal communication to show that you are interested, engaged and paying attention. Facing the other person, with an open body posture; leaning slightly towards the other person; giving eye contact; and avoiding fidgeting sends strong messages of interest and attention.
• Paraphrasing and summarising
  Paraphrasing what the other person says is a good way to check that you have understood them and can help to acknowledge their feelings. Summarising the key points also shows interest and attention and helps to clarify and check for understanding.
• Reflecting feelings
  Identifying and acknowledging the other person’s feelings shows empathy, which helps to build a good professional relationship. It also reassures the other person that you are aware of how their situation affects them.
• Reframing and normalising
  Reframing is a technique for helping the other person see things from another point of view, which can help them to change their behaviour.
  Using normalising statements reduces the person’s sense of isolation and helps them see that other people share their experiences, for example, ‘Yes, I have heard that other people also experience that.’
• Using open and closed questions to elicit information
  Open questions do not limit the person’s choice of responses. Instead, they encourage the person to tell their story and provide more information.
  Closed questions limit the possible responses and are used to check that information is accurate.
  ‘Did you watch the football match last night?’ is a closed question (yes/no). ‘What did you do last night?’ is an open question with many possible respond.
• Exploring options
  Exploring options means providing the person with a range of choices, for example, what services to accept.
  This helps to empower the person and allows them to be in control of their services, which increases the likelihood of successful outcomes.

OARS

OARS is a useful acronym for remembering four key skills and techniques used in motivational interviewing.

Open questions

Open questions establish a safe, trusting, respectful relationship. They are used to help you understand your client’s perspective and learn about their history, feelings, thoughts and beliefs.
Open questions allow your client to take control of the conversation and to do most of the talking.

Affirmations

Affirmations are positive statements about the client’s strengths, skills and capacity.
Affirmations reassure the client that they have overcome problems in the past and they are able to do so again.

Reflective listening

Reflective listening is a powerful tool for building rapport and prompting the client to work towards behavioural change. Reflective listening involves observing and listening for the client’s feelings and repeating back what you understand and observe.

Summarising

Summarising the key points helps you and your client move towards the end of a session by reiterating what has been covered and summarising any actions or agreements for future actions so you are both clear about what has been achieved and what the next steps are.

Watch

Watch the video below to better understand OARS.

Therapeutic Alliances

‘Therapeutic alliance’ is a term used to describe the worker–client relationship in which the client and worker collaborateand work in partnership to define and achieve the client’s goals. This relationship is central to the success of treatments and interventions and is a key factor no matter which approach or model is used.

The therapeutic relationship has two components: a relational or personal component, and a task-oriented component.

This means the therapist must nurture both components if the intervention is to succeed.

Relational Aspects

Relational aspects include establishing rapport and demonstrating empathy with your client so that a trusting, mutually respectful relationship develops.

It is important to adapt your communication to match your client’s communication needs. You must also provide information in a form that the client is able to understand and relate to so they can give informed consent. Clarifying misunderstandings and maintaining open communication is also important, as is providing and seeking feedback.

A degree of attachment and emotional bonding must occur for the relationship to be successful, and at the same time, clear boundaries must be established to create a ‘safe’ space for you and for your client.

Task Aspects

Task aspects of the relationship include activitiessuch as:

• Clarifying roles and responsibilities
• Sharing skills and knowledge
• Setting and clarifying goals
• Identifying and obtaining resources to meet those goals
• Addressing practical needs.

Planning Interventions

Providing an intervention for a client with AOD issues follows a cycle that moves through various steps:

1. Prepare
   • Interpret the client’s treatment plan.
   • Identify, locate and obtain the resources needed to carry out the intervention.
   • Collaborate with the client to plan the intervention in line with the client’s needs.
2. Confirm with the client
   • Describe and discuss with the client how the intervention will be carried out.
   • Check that your client understands what will happen and why, and if necessary, seek advice from your supervisor.
   • Obtain informed consent from your client.
3. Carry out the intervention
   • Encourage and support the client to participate.
   • Provide feedback to the client about progress and achievements
   • Identify any issues or concerns and make changes in line with the client’s responses and changing needs.
   • Seek assistance from others to address issues that fall outside the boundaries of your role and/or competence.
4. Monitor and document progress
   • Report progress to your supervisor.
   • Follow advice from your supervisor to make changes to the intervention.
   • Keep clear records of activities and progress.
   • Give your client feedback about progress.
   • Identify unmet needs and refer to other services in consultation with your supervisor.

It is good practice to take a holistic approach and include supports to address all the issues a client is experiencing, and to help your client prioritise the various issues in order of urgency and/or importance. When you create an individual plan for a client, you need to incorporate all the supports and services that the client will need.

This might include addressing needs such as housing, employment, child care, and mental health support. You may need to refer your client to other organisations and services for these needs.

Detoxification is a specialised service that may require inpatient treatment.

You need your client’s consent to refer them to another service provider and to share their information with others. It is good practice to send copies of client forms to the other organisation, marked as confidential; and to keep the originals.

Other Resources and ‘Natural’ Support Networks

Informal, community-based and ‘natural’ support networks can be included in a treatment plan (with the consent of the client and others involved).

Family members and friends may be able to provide practical, day-to-day support. For example, a family member or friend might agree to check on the person daily or weekly; or to be a confidante providing emotional support and listening to the person’s concerns; and to recognise and help celebrate achievements and milestones.

Boundaries are important when including family and friends. They are not qualified therapists but are often in the best position to notice and provide information about changes in the client’s behaviour. Family and friends can provide valuable support and reassurance to the client.

Client Choice and Capacity

Prioritise the goals and strategies that are of highest importance to the client. Ensuring that the client has choices and feels ‘in control’ will increase the likelihood of success.

• Detox andwithdrawal
• Support with anxiety and sleep from GP and nutritionist
• Counselling (individual andfamily)
• Weekly check-ins with a close friend(someone outside immediate family)

Think about the client’s ability/capacity to make the most of any suggested or chosen supports. For example:

• Does the person need detox or withdrawal support before starting a weekly therapy program?
• Would support from a GP alongside a counselling or therapy program be helpful with issues such as insomnia, panic attacks and nausea?
• Do the supports and services fit around the client’s other commitments, such as work and family responsibilities?
• Is there a history of trauma that should be addressed to help the person develop trust and to build a good relationship with a therapist or counsellor?
• Are there any cultural issues that must be addressed?

Recording the Treatment Plan

Treatment plans must be recorded accurately and updated regularly. Make sure that you present information clearly and unambiguously so that other workers can understand it easily.

Tips for recording plans and progress clearly:

• Stick to facts, not opinions.
• Use bullet points and headings to highlight important information.
• Describe events and challenges objectively, giving examples wherever possible, for example, ‘[The client] has chosen to avoid contact with parents because of a history of abuse’ or ‘[The client] feels very guilty about how their behaviour has affected their children’.
• Include difficulties with accessing services and supports. Check the person’s history with service providers and avoid referring them to an agency where they had a bad experience in the past.
• Follow your own organisation’s policy and procedures for recording and storing treatment and intervention plans.
• There may be a template or form that is used, and guidelines for what information to include or how often the plan should be updated.
• Follow your organisation’s policy and procedures for keeping the client informed and for clients to access their records.
• Make sure your client understands how the treatment plan will work; and what their responsibilities are, for example, what to do if they need to reschedule an appointment, or what they need to do to follow up on contact with other organisations and services.
• Always provide clear information about your role, your responsibilities and the boundaries of your role.

People who experience issues with alcohol andother drugs may also have difficult or challenging behaviours and relationships. This means you will need to have good skills in managing difficult situations and behaviours.

Sometimes confusion and misunderstandings about plans and interventions can lead to conflict. For example, a client who misunderstands the focus for a brief intervention may become upset, so you may need to use your communication skills to defuse the situation. Remember that assertive communication techniques, such as reiterating statements and instructions in a calm tone of voice or agreeing with any valid points the person is making, can help to calm the situation.

It is also important to report misunderstandings to your supervisor, especially if conflict has arisen. It may also be necessary to amend progress notes and/or intervention plans to clarify any points that have led to misunderstanding or confusion. Additionally, it may be necessary for you to reflect on how you shared the information so as to identify any need for improving your skills. This is something to discuss with your supervisor.

Conflict and Conflict Management

There are different styles of conflict management. Although we are all capable of using different approaches and techniques, we tend to gravitate towards one style.

Five common ways of dealing with conflict:

• Ignoring
  This means avoiding conflict, sweeping it under the carpet or pretending that it does not exist. Sometimes it is appropriate to ignore a conflict temporarily while we gather more information, but generally, if we ignore a conflict, it can get worse. Ignoring conflict is very common because expressing conflict openly can make us feel uncomfortable.
• Giving in
  Giving in to the other person can be an appropriate way of dealing with conflict in some situations, but people who give in to others all the time tend to have low self- esteem and poor assertiveness and communication skills. If you typically give in, other people will come to expect this, and you may begin to feel resentful.
• Win–lose
  A person who uses a win–lose approach to dealing with conflict is out to win and to beat the other person. This can mean using power, threats, bluffs and similar strategies. A win–lose approach can be appropriate in some situations, but if you are working in a team, the losers may feel resentful, resulting in a lack of commitment to making the team work well.
• Splitting the difference
  ‘Splitting the difference’ involves compromise, or ‘meeting halfway’. It can be a very quick and easy way of resolving conflict, but often neither party is satisfied with the solution.
• Cooperation
  Cooperation is the most constructive way of dealing with conflict. It involves working together to solve problems. It is about collaboration and consensus and creating a win–win solution, where both parties have theirneeds met.
  There are three techniques in achieving cooperation:
• Share the problem.
• Uncover needs.
• Identify creative solutions.

Mediation and Negotiation

Mediation and negotiation are strategies used to manage conflicts.

Mediation is used when two (or more) parties cannot reach an agreement. A third party is brought in to act as a neutral facilitator to help the participants reach a resolution.

Negotiation is a form of bargaining, a strategy often used to resolve a conflict with another person. The aim is for both parties to get at least some of what they want, so using a win–win approach is effective.

You may find yourself negotiating with clients to agree on goals, treatment strategies, and other issues. Or, you may find yourself supporting a client who wishes to make a formal complaint through a mediation process.

Reviewing and reporting progress and outcomes is an important aspect of supporting people with AOD issues to change their behaviour.

Your responsibilities may include writing progress notes that include a description of any queries or concerns the client expresses, reporting progress to your supervisor and identifying any needed changes to the intervention. Your supervisor can advise and guide you if you are unsure about how to adjust interventions and plans to meet the client’s changing needs.

Documenting information about the intervention’s progress and outcomes clearly is essential so that others involved in delivering services and supporting the client are all ‘on the same page’ and are providing services and supports consistently.

Reports should be:

• Accurate
  This means checking the facts and making sure the information is up to date and accurate.
• Objective
  This means that the language you use and the information you include should be objective and verifiable. Objective information describes facts and events and is based on observation rather than opinion, interpretation and assumptions.
• Relevant
  This means you should include only information that is relevant to the client’s needs and progress, and you should not include information that is irrelevant. Your role also includes providing feedback to your client about their progress and achievements so that they can see how far they have come and to motivate them to continue. This can be done informally on a routine basis, or more formally at progress reviews and case conferences, especially if there are several service providers involved.

You will often come across situations where your own organisation cannot meet all the needs a client has, so you will need to know how to refer clients to other organisations and services.

Always explain to your client why you are making the referral and ask for their consent. Provide enough information for the client to make an informed choice. The following information should be included in a referral:

• Name, address and contact details of the client
• Your name, role and contact details
• A brief history of your client and an overview of relevant conditions, issues and problems
• The reason for the referral and an outline of what you are asking the other organisation to do

You will need to check the organisation’s eligibility criteria and address those, making sure the client is eligible.

Follow-Up

It is good practice to follow up on a referral and offer any further information and support that may be required.

Client Support

You may need to provide practical support, for example, transport to the new organisation; and/or emotional and psychological support, such as offering to accompany the client on a first-contact interview or visit, if that is appropriate.

Keep in touch with your client until you are sure they are settled into the new service.