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Organisational Change Through Action Learning

Appendix 2

Drug Management Clinical Learning Outcomes

Example of clinical learning outcomes as used by

WA Family and Children’s Services (FCS) Clinical Staff

The following table is designed for use by both field staff and supervisors. Supervisors using these 11 domains are advised to ask their supervisees to self-assess themselves against various areas prior to or during a supervision session. Subsequent comparisons with the supervisor's assessment can be very useful.

The eleven domains can also be used by clinical staff as an intervention checklist where drug use issues feature. Staff should review Treatment Steps on which these domains and learning outcomes are based.  For more detailed information, click on the heading of each domain.

While the provision of standards allows for improved quality control, the emphasis in using this instrument is on professional growth and development (growth model of supervision rather than a control model). Higher scores are used as opportunities for praise with lower scores being opportunities for further growth. Staff who are assessed by senior clinical staff as being competent in all eleven areas will be given a certificate of attainment.

A three (3) indicates competent or ‘good enough’ ability with a two (2) indicating that some effort has been made and further professional development is expected.

Indicators are a guide to evidence of achievement of that domain. Other indicators, (eg use of a functional analysis sheet in drug assessments) should also be included where appropriate to encourage further development of clinical skills.

It is anticipated that staff will progress through the standards over a time period (it would be reasonable to expect staff to be achieving scores of twos & threes for most indicators over a twelve-month period).

Contents

1. Routinely raises the issue of drug use with clients
2. Identifies the relationship between drug use and child protection/family issues and provides services within the context of the FCS mandate.
3. Able to conduct and document drug use assessments
4. Demonstrates competent use of motivational interviewing
5. Devises drug treatment plans including case formulation, goals & strategies
6. Provides relapse prevention and management strategies
7. Uses harm reduction procedures appropriately
8. Maximises client's supports
9. Provides appropriate referral where necessary
10. Manages intoxication appropriately
11. Provides appropriate community-based interventions

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Standards & Indicators

Not Achieved

Partially Achieved

Achieved
1. Routinely raises the issue of drug use with clients

Indicators:

Demonstrates a set of standard questions for raising drug issues

1

2

3

Provides safe environment - explains confidentiality & provides a private, non-interrupted environment to enable disclosure

1

2

3

Gives examples of using index of suspicion to raise drug use issues

1

2

3

Gives examples of making links with clients between family functioning and drug use 1 2 3
Other indicator/s (Specify):

1

2

3

Raising the Issue total
(out of a possible 15)

2. Identifies the relationship between drug use and child protection/family issues and provides services within the context of the FCS mandate.

Indicators

Demonstrates or describes child protective strategies in relapse planning

1

2

3

Able to describe the relationship between the ups, downs & in betweens (ie intoxication, hang-over, withdrawal, abstinence) of carer/s drug use and their effects on the parenting child/ren

1

2

3

Identifies the impact of the various patterns of drug use (eg experimental, recreational, chaotic, dependent)  on the care of the child/ren

1

2

3

Can describe any differences of parenting when using drugs or not using drugs and identify specific risks that substance use poses to the child/ren

1

2

3

Demonstrates ability to take appropriate child and family focused action where indication of risk exists

1

2

3

Provides appropriate longer-term strategies to reduce the negative impact of carer drug use on child development 1 2 3
Other indicator/s (Specify):

1

2

3

Child Protection total
(out of a possible 21)
3. Able to conduct and document drug use assessments

Indicators:

Can identify appropriate models and frameworks underpinning assessment

1

2

3

Links drug use to identified issue in a specific manner

1

2

3

Identifies functionality of drug use along with problems

1

2

3

Provides reassessment with client to monitor outcomes and track progress

1

2

3

Reflects assessments back to client

1

2

3

Demonstrates a consistent and clear documentation procedures

1

2

3

Other indicator/s (Specify):

1

2

3

Drug Use Assessment total
(out of a possible 21)

4. Demonstrates competent use of motivational interviewing

Indicators: 

Uses motivational interviewing in a variety of treatment settings

1

2

3

Can demonstrate the steps of motivational interviewing

1

2

3

Has different strategies for dealing with those who want to change, those who don't and those who can't decide.

1

2

3

Other indicator/s (Specify):

1

2

3

Motivational Interviewing total
(out of a possible 12)

5. Devises drug treatment plans including case formulation, goals & strategies

Indicators:

Demonstrates a collaborative approach with client to the development of case formulation, treatment goals and strategy plans.

1

2

3

Explores options of abstinence and controlled use with clients

1

2

3

Includes direct drug-related interventions and other life domains in treatment goals and plan

1

2

3

Demonstrates the use of both short-term (S.M.A.RT.) and longer-term goal setting.

1

2

3

Other indicator/s (Specify):

1

2

3

Treatment Goals, Plans and Strategies total (out of a possible 15)

6. Provides relapse prevention and management strategies

Indicators:

Identifies high risk situations with clients and explores management and avoidance strategies

1

2

3

Provides coaching and practise in refusal skills where appropriate, uses skill rehearsal techniques

1

2

3

Develops appropriate strategies to manage cravings, urges and impulse control

1

2

3

Helps client maintain vigilance around resolution to change, obstacles to change and strategies to maintain change

1

2

3

Demonstrates a focus on the development of other competing behaviours

1

2

3

Discusses strategies to help client deal with 'slips'

1

2

3

Demonstrates the use of a 'lapse' or relapse as a learning opportunity with clients

1

2

3

Other indicator/s (Specify):

1

2

3

Relapse Prevention and Management total (out of a possible 24)

7. Uses harm reduction procedures appropriately

Indicators:

Works with client to define outcomes in terms of reduced drug-related harm and risk of harm, rather than just consumption

1

2

3

Can identify problem solving steps and demonstrate these steps in reducing drug-related harm

1

2

3

Able to identify key areas of severe drug-related harm (and interventions) via the use of Thorley's & Roizen's frameworks (eg blood borne virus problems, relationship between drug use and child protection, overdose, suicide, accidents, and violence)

1

2

3

Other indicator/s (Specify):

1

2

3

Harm Reduction total (out of a possible 12)

8. Maximises client's supports

Indicators:

Demonstrates use of family, friends and 'buddy' supports for client

1

2

3

Provides options of professional supports (eg ADIS, PDIS drug agencies) where appropriate

1

2

3

Provides self-help booklets and written material where appropriate

1

2

3

Other indicator/s (Specify):

1

2

3

Client Supports total (out of a possible 12)

9. Provides appropriate referral where necessary

Indicators:

Can differentiate between drug-related work carried out within agency, issues to be referred and shared case management

1

2

3

Uses a range of strategies to maximise the possibility of successful referrals

1

2

3

Provides the referral agent with adequate documentation including any former drug assessment and clear indication for the referral (including the type of drug intervention if known)

1

2

3

Can discuss the Department's shared-case management procedures

1

2

3

Other indicator/s (Specify):

1

2

3

Referral total (out of a possible 15)

10. Manages intoxication appropriately

Indicators:

Able to identify signs of intoxication and withdrawal while acknowledging that many may be from non-drug causes

1

2

3

Demonstrates knowledge and use of safety procedures (including management of drug overdose)

1

2

3

Demonstrates the use of clear, simple and directive messages to client when intoxicated

1

2

3

Can explain the boundaries of working or not working with someone who is intoxicated

1

2

3

Can describe or demonstrate duty of care issues in dealing with intoxicated clients

1

2

3

Other indicator/s (Specify):

1

2

3

Managing intoxication total
(out of a possible 18)

11. Provides appropriate community-based interventions

Indicators:

Able to use a system's approach to identify possible community interventions:
a. arising out of individual cases or
b. through direct community action
(eg need for agency interventions, policy changes, community led liquor licensing, availability of solvents, etc)

1

2

3

Channels community issues appropriately (eg through supervisors, Local Drug Action Groups, Community Drug Service Teams)

1

2

3

Other indicator/s (Specify):

1

2

3

Community-based interventions total
(out of a possible 9)

TOTAL OF STANDARDS
add sub-totals - (out of a possible 174)

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Other Chapters of Organisational Change Through Action Learning

Action Learning
Project Management
Drug Management
Example of a PDP
Workshop Key Components
Supports
Appendix 1
Appendix 2
Appendix 3
Appendix 4
Appendix 5
Appendix 6
Appendix 7

Chapters:
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Other DrugNet Pages in this Subject Heading

Introduction ] Action Learning ] Project Management ] Drug Management ] Example of a PDP ] Workshop Key Components ] Supports ] Appendix 1 ] [ Appendix 2 ] Appendix 3 ] Appendix 4 ] Appendix 5 ] Appendix 6 ] Appendix 7 ]

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