Counselling guidelines: Alcohol and other drug issues

1 Counselling guidelines : Alcohol and other drug issues Fourth Edition 2019. Judi Stone, Ali Marsh, Ali Dale, Laura Willis, Stefanie O'Toole, Sue Helfgott, Anna Bennetts, Leigh Cleary, Sharon Ditchburn, Heather Jacobson, Rachael Rea, Dionne Aitken, Mark Lowery, Grace Oh, Robynne Stark and Clare Stevens Suggested citation: Stone, J., Marsh, A., Dale, A., Willis, L., O'Toole, S., Helfgott, S., Bennetts, A., Cleary, L., Ditchburn, S., Jacobson, H., Rea, R., Aitken, D., Lowery, M., Oh, G., Stark, R., & Stevens, C. (2019). Counselling guidelines : Alcohol and other drug issues (4th ed.).Perth, Western Australia: Mental Health Commission ISBN 978-0-9944434-8-9. Western Australian Mental Health Commission, 2019. Publication number: MHC012019. This publication was produced by Workforce Development, Mental Health Commission.

2 It may be reproduced in whole or in part for study or training purposes subject to an inclusion of an acknowledgement of the source and no commercial usage or sale. Reproduction for purposes other than those above requires the written permission of: The Manager Workforce Development Mental Health Commission Box X2299 Perth Business Centre WA 6847. E: W: 2 Counselling guidelines : Alcohol and other drug issues | 4th Edition Acknowledgements The authors extend their thanks to the following people for their expert review of the fourth edition of the Counselling guidelines : Alcohol and other drug issues : Allan Colthart, Clinical Coordinator, Drug and Alcohol Youth Service Bram Dickens, Manager Metropolitan Community Services, Palmerston Association Dr Celia Wilkinson, Consultant Charlotte McConnell, Parent and Family Services, Alcohol and Drug Support Services, Mental Health Commission Cliff Collard, Manager, Strong Spirit Strong Minds Aboriginal Programs, Mental Health Commission Colette Wrynn, Manager Clinical Governance, Wungening Aboriginal Corporation Jason Newman, Senior Counsellor, Sexual Assault Resource Centre Jennifer Keen, Senior Project Officer, Quitline Aboriginal Liaison Team, Mental Health Commission Jenny Holmes, Senior Social Worker/ Team Leader, Sexual Assault Resource Centre Joanne Marinko, Clinical Psychologist, Next Step Drug and Alcohol Services.

3 Mental Health Commission Justin Dorigo, Clinical Coordinator North Metro Community Alcohol and Drug Service, Next Step Drug and Alcohol Services, Mental Health Commission Karin Dewar, Acting Training and Education Coordinator, Sexual Assault Resource Centre Karina Clarkson, Workforce Development Officer, Strong Spirit Strong Minds Aboriginal Programs, Mental Health Commission Kim Ziapur, Project Officer, Western Australian Network of Alcohol and other Drug Agencies Liana Marrone, Coordinator, Alcohol and Drug Support Services, Mental Health Commission Marcelle George, Acting Sector Development Manager, Western Australian Network of Alcohol and other Drug Agencies Margaret Slattery, Manager Diversion Program, Mental Health Commission Melinda Beckwith, PhD Candidate, Eastern Health Clinical School, Monash University Michelle Macleod, Aboriginal Case Manager/ Mentor, Drug and Alcohol Youth Service Nicola Iannantuoni, Services Development Manager, Cyrenian House Patrick Langford, Chief Information Officer, Corporate Services, Mental Health Commission Dr Richard O'Regan, Clinical Director, Next Step Drug and Alcohol Services, Mental Health Commission Ruth Wernham, Health Promotion Officer, Peer Based Harm Reduction WA.

4 Dr Sally Appleton, Clinical Psychologist, Next Step Drug and Alcohol Services, Mental Health Commission Sharene Kocsis, Workforce Development Officer, Strong Spirit Strong Minds Aboriginal Programs, Mental Health Commission Sharon Hillman, Gatekeeper Suicide Prevention Coordinator Statewide, Department of Education Stacey Child, Manager, Alcohol and Drug Support Services, Mental Health Commission Sumi Paull, Senior Policy and Workforce Development Officer, Strong Spirit Strong Minds Aboriginal Programs, Mental Health Commission Tania Lamond, Senior Policy and Project Officer, Diversion Program, Mental Health Commission Tom Hopkins, Programs Manager, Cyrenian House Non Residential Services Wendy Shannon, Project Manager, Residential Services, Palmerston Association Additional thanks to Jen Dalby, Assistant Project Officer, Mental Health Commission for supporting production and development of the fourth edition of the Counselling guidelines .

5 Counselling guidelines : Alcohol and other drug issues | 4th Edition 3. Table of contents Acknowledgements 3. Abbreviations and acronyms 6. Section One: Setting the scene 8. 1 Introduction 9. 2 Principles of effective treatment 11. 3 Ingredients of effective treatment 13. 4 Best practice outcome performance indicators 17. Section Two: Professional practice 19. 5 Confidentiality 20. 6 Case notes 22. 7 Waitlist management and follow-up 27. 8 Working with significant others 29. 9 Clinical supervision 34. 10 Stress and burnout 40. 11 Secondary traumatic stress, compassion fatigue, and vicarious trauma 44. 12 De-escalating aggressive behaviours 48. 13 Critical incidents 51. 14 Case management 55. Section Three: AOD knowledge and skills 58. 15 Managing intoxicated clients 59. 16 Withdrawal management 63.

6 17 Pharmacotherapies for AOD dependence 73. 18 Recovery 81. 19 Stages of change 87. Section Four: assessment and treatment planning 91. 20 Treatment planning 92. 21 assessment 94. 22 Suicide assessment and management 107. 23 Case formulation 114. 24 Referral 119. Section Five: Counselling interventions 122. 25 Motivational interviewing 123. 26 Problem-solving 129. 27 Goal-setting 131. 28 Relapse prevention and management 134. 29 Harm Reduction 138. 30 Brief intervention 144. 31 Group work 147. 32 Relaxation strategies 150. 33 Grounding 153. 34 Mindfulness 155. 35 Challenging unhelpful thinking 160. 36 Anger management 165. 37 Assertiveness training 170. 4 Counselling guidelines : Alcohol and other drug issues | 4th Edition Section Six: Working with specific issues 174. 38 Grief and loss 175. 39 Counselling using technology 181.

7 40 Coerced clients 188. 41 cognitive impairment 191. 42 Working with clients referred by the justice system 196. 43 Young people 203. 44 Child protection and parenting interventions 208. 45 Gender and sexual diversity 215. 46 Culturally and linguistically diverse people 220. 47 Aboriginal clients, their families and communities 224. 48 AOD use during pregnancy 228. 49 Older people 233. 50 Pain management for dependent clients 239. 51 Residential settings 247. 52 Co-occurring AOD and anxiety 251. 53 Co-occurring AOD and depressive disorders 258. 54 Co-occurring severe mental health disorders 262. 55 Co-occurring trauma issues 265. Appendices 275. Appendix 1: AOD and prevention resources 276. Appendix 2: The termination checklist 279. Appendix 3: Clinical Institute Withdrawal assessment Scale Alcohol , revised (CIWA-Ar) 280.

8 Appendix 4: Benzodiazepine Withdrawal assessment Scale (CIWA-B) 282. Appendix 5a: The Short Opiate Withdrawal Scale (SOWS-Gossop) 284. Appendix 5b: Clinical Opiate Withdrawal Scale (COWS) 285. Appendix 6: Naloxone Brief Education Tool 287. Appendix 7: Amphetamine Cessation Symptom assessment Scale (ASCA) 294. Appendix 8: Cannabis Withdrawal Scale 295. Appendix 9: Session Rating Scale (SRS) and Outcome Rating Scale (ORS) 296. Appendix 10: Mental State examination (MSE) 300. Appendix 11: Depression, Anxiety and Stress Scale (DASS) 302. Appendix 12: Psychosis Screener 305. Appendix 13: Suicide Risk Screener 306. Appendix 14: Problem-solving practice sheet 308. Appendix 15: Goal-setting worksheet 309. Appendix 16: Relapse prevention worksheet 310. Appendix 17: Controlled breathing 312. Appendix 18: Progressive muscle relaxation 313.

9 Appendix 19: Creating an imaginary safe place 314. Appendix 20: Grounding 315. Appendix 21: Mindfulness of breath 316. Appendix 22: Mindfulness of emotions 317. Appendix 23: Mindfulness of thoughts: cognitive defusion 318. Appendix 24: Common unhelpful thinking styles 319. Appendix 25: cognitive restructuring using the ABCDE model worksheet 320. Appendix 26: Bill of Assertive Rights 321. Counselling guidelines : Alcohol and other drug issues | 4th Edition 5. Abbreviations and acronyms 5As Ask, Assess, Advise, Assist and Arrange [model]. ABS Australian Bureau of Statistics ACE Adverse childhood experience ACE-R Addenbrooke's cognitive examination -Revised ACSA Amphetamine Cessation Symptom assessment Scale ACT Acceptance and commitment therapy / Australian Capital Territory ADF Alcohol and Drug Foundation ADHD Attention deficit hyperactivity disorder AIDS Acquired immunodeficiency syndrome AIHW Australian Institute of Health and Welfare AIVL Australian Injecting and Illicit Drug Users League AOD Alcohol and other drug ASSIST Alcohol , Smoking.

10 And Substance Involvement Screening Test ATS Amphetamine-type stimulants AUDIT Alcohol Use Disorders Identification Test BAC Blood Alcohol concentration BBV Blood-borne virus BI Brief intervention BMI Brief motivational interview CALD Culturally and linguistically diverse CBT cognitive behaviour therapy CF Compassion fatigue CI cognitive impairment CIWA-Ar Clinical Institute Withdrawal assessment Scale Alcohol , revised CIWA-B Clinical Institute Withdrawal assessment Scale Benzodiazepines CNCP Chronic non-cancer pain CNS Central nervous system COWS Clinical Opiate Withdrawal Scale CPR Cardiopulmonary resuscitation CPFS Child Protection and Family Support [WA]. CPOP Community Program for Opioid Pharmacotherapy [WA]. CRT cognitive rehabilitation therapies CSAT Center for Substance Abuse Treatment [USA].