Training Curriculum on Drug Addition Counseling: … · - substitution treatment models Explain...
Transcript of Training Curriculum on Drug Addition Counseling: … · - substitution treatment models Explain...
Training Curriculum on Drug Addiction Counseling
Appendix
Trainer Manual
VIETNAMESE AND AMERICANSIN PARTNERSHIP TO FIGHT HIV/AIDS
In July 2011, FHI became FHI 360.
FHI 360 is a nonprofit human development organization dedicated to improving lives in lasting ways by advancing integrated, locally driven solutions. Our staff includes experts in health, education, nutrition, environment, economic development, civil society, gender, youth, research and technology – creating a unique mix of capabilities to address today’s interrelated development challenges. FHI 360 serves more than 60 countries, all 50 U.S. states and all U.S. territories.
Visit us at www.fhi360.org.
VIETNAMESE AND AMERICANSIN PARTNERSHIP TO FIGHT HIV/AIDS
APPENDIX
Tr aining CurriCulum on Drug aDDiCTion
Counseling
3Appendix
APPENDIX I - Sample Schedule
Training Agenda Basic Training Course on Drug Addiction Counseling
Goal and Objectives
Goal: To provide prospective counselors with knowledge on drugs, drug addiction and its consequences, drug treatment modalities, drug addiction counseling skills and techniques, and relapse prevention therapy to enhance the effectiveness of their work with drug users and recovering drug users.
Objectives: By the end of this training curriculum, participants will be able to -
� Describe the roles and responsibilities of drug addiction counselors � Explain the principles and practice of drug addiction counseling � Describe common drugs, drug use patterns and consequences of drug use as
they apply in Vietnam � Explain the basis of addiction, recovery and relapse � Explain basic information about different models of drug addiction treatment
including - abstinence-based treatment models and - substitution treatment models � Explain drug treatment services available in Vietnam � Explain factors influencing successful drug addiction treatment � Describe the counseling process � Describe the components and steps involved in conducting a client assessment � Develop an individualized management plan and provide ongoing follow-up and
support � Develop basic drug addiction treatment counseling skills and techniques in the
following areas: - Client assessment - Motivational interviewing - Goal setting - Problem solving - Counseling skills - Relapse prevention with focus on:
- Managing high-risk situations- Refusal skills- Coping with cravings- Dealing with lapse and relapse- Stress management- Time management
4 Training Curriculum on Drug addiction Counseling: Trainer Manual
Day 1
Time What Process/Learning Objective Deliver by:
08.00-08.20 Welcome Representatives of donor(s) and organizers
08.20-08.50 Welcome participants
Self introduction through a game
08.50-09.30 Participants’ expectations, Training objectives, Training agenda
Write learning expectations on pieces of colored paper. Elicit feedback and discussion from participants, and review training agenda. Summarize on flipchart
09.30-09.45 Ground rules, divide participants into groups and assignments
� Participants divided into 4 groups. Groups 1-3 for recap sessions, Group 4 for energizer activities
� Develop ground rules and feedback rules
09.45-10.00 Pre-test
10.00 – 10.15 Tea break
10.15-12.00 Introduction to drug addition counseling:
� Give definition of counseling � Understand the context of counseling � Understand myths about drug use and drug
users � Identify differences between counseling and
health education � Identify attributes of an ideal counselor
12.00 – 13.30 Lunch
13.30-14.00 Basic concepts of drug addition counseling
� Define drug addiction counseling � Explain the role of drug addiction counseling � List four general principles for effective
communication � Explain the differences between empathy
and sympathy
14.00 - 14.30 Key principles in drug addiction treatment counselling
� Identify the principles of drug addiction counseling
� Explain the implication of each principle
APPENDIX I - Sample Schedule
5Appendix
Day 1 (cont.)
Time What Process/Learning Objective Deliver by:
14.30 - 15.00 Counseling techniques
� Identify a range of counseling techniques that will be taught in the course
� Discuss their application and context in drug addiction counselling
15.00 – 15.15 Tea break
15.15-16.45 Counseling skills � Demonstrate basic counselling skills � Understand the difference between
counseling skills and counseling techniques � Practice using counseling skills through role-
playing: One exercise each skill
16.45- 17.00 Evaluation and wrap-up
Fill out Evaluation form for DAY 1
APPENDIX I - Sample Schedule (cont.)
6 Training Curriculum on Drug addiction Counseling: Trainer Manual
Day 2
Time What Process/Learning Objective Deliver by:
08.00-08.30 Recap of Day 1 Group 1
08.30-10.00 Drugs, drugs use its and consequences
� Increase their knowledge about drugs, � Understand drug use and its consequences
10.00-10.30 Alcohol � Increase their knowledge about effects of alcohol and consequence of alcohol use,
� Games: effects of alcohol, heroin, ecstasy
10.30-10.45 Tea break
10:45-11.30 Basis of drug addition
� Explain the basis of addiction � Criteria to diagnose drug addiction using ICD
10: Examples and discuss � Explain recovery and relapse
11.30-12.00 Factors influencing successful treatment
� Describe the factors that influence successful treatment
� Link these factors to their application in the Vietnam context
12.00-13.30 Lunch
13:30-15.00 Basic treatment principles
� Identify the principles for successful treatment
15.00-15.15 Tea break
15.15-16.45 Heroin addiction treatment
� Understand drug addiction treatment services available in Vietnam
� Explain basic information on different types of drug addiction treatment approaches including:- Abstinence-based treatment models - Substitution treatment models
16.45 -17.00 Evaluation and wrap-up
APPENDIX I - Sample Schedule (cont.)
7Appendix
Day 3
Time What Process/Learning Objective Deliver by:
08.00-08.30 Recap of Day 2 Group 2
08.30-09.30 The Stage of Change Model and key concepts in motivational interviewing
� Understand the Stages of Change Model � Understand which intervention strategies/
plans are most likely to work with clients who are at different stages of change
9.30-10.15 Principles and procedures for motivational interviewing
� Realize unhelpful assumptions that prohibit behavior change
� Understand the concept of motivational interviewing
� Understand the principles of motivational interviewing
� Understand the interplay between the Stages of Change Model and motivational interviewing
10.15-10.30 Tea break
10.30-12.00 Linking motivational interviewing to stage of change strategies
� Understand the basic principles of motivational interviewing
� Understand the steps in an motivation interviewing intervention
� Demonstrate knowledge and skills in role-playing
� Learn how to apply motivational approaches in counseling
11.30-13.30 Lunch
13.30-15.20 Client assessment
� Understand why client assessment is important
� Understand the assessment procedure and content
� Demonstrate knowledge and skills of client assessment through rol- playing
� Learn how to apply assessment knowledge and skills in counseling
� Role-plays of client assessment
15.20-15.35 Tea break
APPENDIX I - Sample Schedule (cont.)
8 Training Curriculum on Drug addiction Counseling: Trainer Manual
APPENDIX I - Sample Schedule (cont.)
Day 3 (cont.)
Time What Process/Learning Objective Deliver by:
15.35-16.30 Problem solving � Understand the rationale of problem solving � Understand the steps in the problem solving � Role-play to demonstrate knowledge and
skills in problem solving � Learn how to apply problem solving in
counseling
16.30-17.00 Goal setting � Understand the rationale of goal setting � Understand the main characteristics of goal
setting � Understand the use of a structured goal
setting method � Role-play to demonstrate knowledge and
skills in goal setting � Understand the relationship between
problem solving and goal setting � Learn how to apply goal setting skills in
counseling
17.00-17.15 Evaluation and wrap-up
9Appendix
Day 4
Time What Process/Learning Objective Deliver by:
08.00-08.30 Recap of Day 3 Group 3
08.30-10.00 Relapse prevention therapy
� Discuss and identify reasons for relapse � Understand and be able to explain the Model
of Relapse and relapse process � Identifying high risk situations that lead to
relapse � Understand strategies in addressing and
coping with high-risk situations � Understand and be able to explain Global
Relapse Prevention Therapy Interventions � Understand and be able to explain Specific
Relapse Prevention Therapy Interventions
10.00-10.15 Tea break
10.15-11.00 Refusal skills � Discuss rationale for learning refusal skills � Understand how to refuse politely � Discuss non-verbal measures � Discuss verbal measures � Practice heroin refusal skills
11.00-12.00 Coping with cravings
� Understanding craving � Describing craving � Identifying craving triggers � Plan for coping with cravings
11.30-13.30 Lunch
13.30-15.00 Time management
� Understand how important time management is for counseling
� Address time management issues with clients � Understand the connection between time
management and relapse � Practice designing a timetable
15.00-15.15 Tea break
APPENDIX I - Sample Schedule (cont.)
10 Training Curriculum on Drug addiction Counseling: Trainer Manual
APPENDIX I - Sample Schedule (cont.)
Time What Process/Learning Objective Deliver by:
15.15-16.45 Stress management � Understand stress � Understand the symptoms of stress � Understand the causes of stress � Understand how stress affects clients � Understand ways to mitigate Stress
(Relaxing exercise as an example)
16.45-17.00 Summaries Summary of key content, questions and answers
Day 4 (cont.)
11Appendix
APPENDIX I - Sample Schedule (cont.)
Time What Process/Learning Objective Deliver by:
08.00-08.30 Recap of Day4 Group 4
08.30-9.30 Additional Role play
Problem solving and goal setting. Putting it together
9.30-10.15 Discussion Relapse prevention: � Relapse cues identification � Coping with cravings � Refusal skills � Time management � Stress management
10.15-10.30 Tea break
10.30-11.30 Additional Role play
Assessment/stage of change/motivational interviewing. Putting it together
11.30-13.30 Lunch
13.30-15.00 Questions and answers
15.00-15.10 Tea break
15.10-15.40 Post course assessment
15.40-16.20 Feedback and final questions
16.20-17.00 Close
Day 5
12 Training Curriculum on Drug addiction Counseling: Trainer Manual
Day 1
Time What Process/Learning Objective
08.00-08.20 Welcome Representatives of donor(s) and organizer(s)
Training objectives Presentation and discussion, record on flipchart as needed. Participants will be able to describe the purpose of the training
08.20-9.30 Refresh the topics andskill building sessions ondrug addiction treatmentcounseling from theprevious training
Feedback and discussion from the participants based on their experiences in drug addiction counseling
9:30 - 10:30 Counseling procedures � List the counseling procedures � Explain the interactions between the steps of the
procedures � Practice providing counseling sessions according to
the counseling procedures through role-plays � Apply goal-setting and problem-solving techniques
in role-plays
10.30-10.50 Tea break
10.50-12.00 Review the counselingtechniques and skillslearned in the 1st course
� Counseling skills: Attending, opening questions, summary, probing, silent, listening, and rolling with resistance
� Counseling techniques
12.00-13.30 Lunch
13.30-14.30 Review client assessment Group discussion: Asking participants why we need to assess clients, when to do it and what areas of information are needed for the assessment.Participants will understand the importance of client assessment
14.30-15.30 Two pairs of participantsrole-play. Feedback onthe role-plays
Practice taking a client’s drug use history (role-play): trainer in the role of a client and a participant in the role of a counselor
15.30-15.50 Tea break
Training AgendaAdvanced Training Course on Drug Addiction Counseling
APPENDIX I - Sample Schedule
13Appendix
Day 1 (cont.)
Time What Process/Learning Objective
15.50-17.00 Review of motivationalinterviewing
� motivational interviewing is a useful strategy for � those who have ambivalence about changing
behavior (including drug use) � Appropriate timing of this strategy within overall
case management
17.00-17.15 Evaluation and wrap-up
APPENDIX I - Sample Schedule (cont.)
14 Training Curriculum on Drug addiction Counseling: Trainer Manual
Day 2
Time What Process/Learning Objective
08.00-09.00 Recap of Day 1
09.00-10.15 Alcohol and relatedproblems
� Define nature of alcohol related problems � Understand the continuum of risk for alcohol
consumption � Define low-risk drinking levels � Understand the pharmacokinetics of alcohol
10.15 -10.30 Tea break
10.30 -12.00 Treatment of heroin addiction
� Describe different therapies of drug addiction treatment available in international setting
� Describe strengths and limitations of each of the therapies
� Suggest therapy combinations to enhance effectiveness
� Participants will also have a basic understanding of the effects of methadone and naltrexone as treatments for heroin addiction
12.00 -13.30 Lunch
13.30 -14.30 Review problem solvingand goal setting with role-play
� Understand the context of problem solving techniques
� Describe the steps involved in problem solving � Describe common difficulties encountered in
problem solving � Implement problem-solving techniques � Describe why short-term goal setting is important � Describe the steps involved in goal setting � Describe the relationship between goal setting and
problem solving
14.30-15.50 Counseling techniques:Conflict Resolution
� Define conflict � Identify conflict resolution styles � Identify conflict resolution steps � Demonstrate understanding of principles in practical
exercise and resolution of possible everyday life conflicts
15.50-16.00 Tea break
APPENDIX I - Sample Schedule (cont.)
15Appendix
Day 2 (cont.)
Time What Process/Learning Objective
16.00-17.00 Approaches to address Risk Reduction and HIV prevention during counseling
� Understand the definition of risk reduction � Understand the principles of risk reduction � Understand the practice of safe injection and safe
disposal of used needles and syringes � Vein care � Prevention of overdose
17.00-17.15 Evaluation and wrap-up
APPENDIX I - Sample Schedule (cont.)
16 Training Curriculum on Drug addiction Counseling: Trainer Manual
Day 3
Time What Process/Learning Objective
08.00-09.00 Recap of Day 2
09.00-10.30 Relapse preventionrevision and skillsenhancement in:
� Managing high-risk situations
� Refusal skills � Coping with cravings � Dealing with lapse and
relapse
� Revision of lessons from previous training by asking probing questions to the participants
� This session will be interactive and draw on participants’ previous learning. All facilitators will need to encourage participants to reflect on their understanding around these issues and use that as the basis of filling in any missing components. It needs to be very interactive
10.30-10.50 Tea break
10.50-12.00 Practice with real clients � Practice working with real clients � Apply counseling procedures and appropriate
counseling skills and techniques � Feedbacks by observers and clients
12.00-13.30 Lunch
13.30-15.00 Working with families toenhance their support torecovering drug users
� Understand the role of the family in recovery � Understand the effect that substance use has on the
family � Understand how the family can provide enhanced
support to drug users � Understand key content of a supportive family
meeting
15.00-15.15 Tea break
15.15-16.00 Counseling technique:Time management
� Understand how important time management is for counseling
� Address time management issues with clients � Understand the connection between time
management and relapse
16:00-17:00 Counseling technique:Stress management
� Understand stress � Understand the symptoms of stress � Understand the causes of stress � Understand how stress affects clients � Understand ways to mitigate Stress
17.00-17.15 Evaluation and wrap-up
APPENDIX I - Sample Schedule (cont.)
17Appendix
Day 4
Time What Process/Learning Objective
08.00 - 09.00 Recap of Day 3
09.00-10.00 Anger management � Develop an understanding of differences between anger and aggression
� Develop an understanding of what triggers anger or aggression
� Develop an understanding of strategies to deal with anger and aggression
10.15-10.30 Tea break
10.15-12.00 Managing clients withaggressive behaviors
� Identify aggressive and potentially violent behavior � Identify ways to defuse and avoid potentially violent
confrontations � Develop crisis communication strategies � Examine why people become aggressive or violent � Develop strategies for managing intimidation � Know when and how to exit a scene � Recognize behavior which may lead to violence � Look at strategies for managing our emotions,
controlling fear and anger � Identify the necessary personal safety steps needed
to avoid or reduce physical injury � Assess and manage a range of risky or dangerous
situations � Develop a proactive approach to reducing aggressive
and violent behavior
12.00-13.30 Lunch
13.30-14.30 Management ofintoxicated clients
� Define intoxication and know its effects � Recognize evidences of intoxication at different
levels � Know the principles of management of intoxicated
clients � Practice management of an intoxicated client
through role-play
APPENDIX I - Sample Schedule (cont.)
18 Training Curriculum on Drug addiction Counseling: Trainer Manual
Time What Process/Learning Objective
14.30-15.30 Working with women � Understand some of the characteristics of women who need treatment, their history and experiences
� Understand why some of these issues are challenges to accessing services for treatment
� Understand some of the clinical strategies that have been employed to assist women stop using drugs as well as preventing relapse
15.30-15.45 Tea break
15.45-17.00 Working with youngpeople
� Understand adolescence as a developmental life stage
� Identify possible significant others and how they make impact on a young persons drug use
� Explore clinical strategies that assist working with young people
� Understand young people are at a different stage in respect to brain development
� Discuss risk reduction approaches when working with youth
� Develop skills in raising the issue of drug use with young people
17.00-17.15 Evaluation and wrap-up
Day 4 (cont.)
APPENDIX I - Sample Schedule (cont.)
19Appendix
Time What Process/Learning Objective
08.00-09.00 Recap of Day4
09.00-10.00 Questions and Answers; any of the left over contents from the previous 4 days
10.00-10:15 Tea break
10:15-12:00 EXAM
12.00-14.00 Lunch
14.00-15.15 Release of exam results, questions/answers any of the left over contents from theprevious 4 days
15.15-15.35 Tea break
15.35-16.00 Certificate Awards Ceremony, Closing Remarks
16.30-16.45 Evaluation and close of training
Day 5
APPENDIX I - Sample Schedule (cont.)
21Appendix
APPENDIX II - Sample Evaluation
Sample Daily Evaluation Form(for Day 1, Advanced Training on Drug Addiction Counseling)
1. The training content today satisfied my needs.
Strongly disagree Strongly agree
1 2 3 4 5 2. I am more confident in my understanding of general counseling skillsand techniques.
Strongly disagree Strongly agree
1 2 3 4 5
3. I am more confident in utilizing counseling skills and techniques in drugcounseling.
Strongly disagree Strongly agree
1 2 3 4 5
4. I am more confident in my understanding of drugs, drug useand its consequences.
Strongly disagree Strongly agree
1 2 3 4 5
5. I am more confident in my understanding of the basis ofaddiction.
Strongly disagree Strongly agree
1 2 3 4 5
6. I am more confident in my understanding of heroin addiction treatment.
Strongly disagree Strongly agree
1 2 3 4 5
22 Training Curriculum on Drug addiction Counseling: Trainer Manual
7. I am more confident in my understanding of motivational interviewing techniques.
Strongly disagree Strongly agree
1 2 3 4 5
8. I am more confident in the application of motivational interviewing techniques in drug addiction counseling.
Strongly disagree Strongly agree
1 2 3 4 5
9. What did you like the most today?
10. Which training session could have been done better?
How it could be done better?
APPENDIX II - Sample Evaluation (cont.)
23Appendix
APPENDIX II - Sample Evaluation (cont.)
Sample Whole Training Course Evaluation Form
1. Overall, I feel the five-day training course satisfied my expectations.
Strongly disagree Strongly agree
1 2 3 4 5
2. What did you like the most in this five-day training course?
3. In the five-day training course, which training session could have been done better?
How could it have done better?
a. Logistics
b. Class organization
c. Training materials
d. Trainers
e. Practice sessions
25Appendix
APPENDIX III - Sample written exam with answers
Question 1. List three principles of effective treatment
Model answer: � No single treatment is always appropriate � Deals with the multiple needs of individuals, not just their drug use � Needs to be readily available � Remaining in treatment for an adequate period of time is critical � Medication is important but not the only component � Counseling and other behavior components are critical � Treatment progress and continuance of drug use treatment should be monitored � Treatment plans need to be assessed and modified continually � Detox is only the first step � Treatment should provide assessment of all needs � Treatment of comorbid conditions should be integrated
Question 2. Name two dimensions of treatment outcomes
Model answer: � Reduction in drug and alcohol use � Increased personal and social functioning � Improved public health and safety
Question 3. Answer true or false to the following:
� Alcohol is a depressant. True � Opiates are a stimulant. False � Amphetamines are depressants. False � Cannabis is a stimulant. False
Question 4. List three components of heroin addiction syndrome
Model answer: � Tolerance � Withdrawal � Substance taken in larger amounts or over a longer period than intended � Unsuccessful effort or a persistent desire to cut down or control substance use � A great deal of time spent on obtaining the substance
26 Training Curriculum on Drug addiction Counseling: Trainer Manual
� Important social, occupational or recreational activities given up or reduced because of substance use
� Continued substance use despite knowledge of having had a persistent or recurrent physical or psychological problem
Question 5. List three counseling skills that are used when counseling clients
Model answer: � Open-ended questions � Reflective listening � Rolling with resistance � Reframing � Affirmation � Summarizing
Question 6. List three things to avoid when counseling clients
Model answer: � Moralizing � Ordering � Threatening � Arguing � Disagreeing � Over-interpreting � Sympathizing � Judging
APPENDIX III - Sample written exam with answers (cont.)
27Appendix
APPENDIX III - Sample written exam with answers (cont.)
Question 7. List three key differences between methadone and naltrexone
Model answer:
Methadone Naltrexone
Acts like heroin Block heroin
Liquid Tablet
Last 24 hours Lasts 2 -3 days
Can initiate while still using Need to be detoxified before starting
Can work for all Best for people with much to lose
Pregnant women can use it Pregnant women cannot use it
Start slow, gradual increase Can start on same dose
No effect on alcohol addiction Can stop alcohol addiction
Question 8. Identify three categories of intrapersonal risk for relapse
Model answer: � Negative emotions, negative physical psychological states, positive emotions, testing
control
Question 9. List three interpersonal/social reasons for relapse
Model answer: � Conflict, social pressure, enhancement of positive emotional states
Question 10. Name three characteristics of short-term goals
Model answer: � Specific � Measurable � Achievable � Realistic � Timely
28 Training Curriculum on Drug addiction Counseling: Trainer Manual
Question 11. List three behaviors that a good counselor will exhibit when managing intoxicated people
Model answer: � Calm � Relaxed � Attentive � Not physically intimidating � Aware of how appears � Sees them in a quiet environment � Avoids giving stimulants � Only gets basic details � Does not patronize
Question 12. List the steps of problem solving
Model answer: � Orientation � Define the problem � Generate solutions � Make decisions based upon pros and cons. � Implement.
Question 13. List three strategies to cope with cravings
Model answer:
Behavioral � Delay � Distract � Decide
Cognitive � Positive self-talk � Relaxation � Imagery
APPENDIX III - Sample written exam with answers (cont.)
29Appendix
APPENDIX III - Sample written exam with answers (cont.)
Question 14. List three verbal refusal skills that clients can use to resist drug users
Model answer: � Use a clear, firm, confident tone in the voice � No should be the first word out of your mouth � Suggest an alternative � Request behavior change so the other person stops asking � Change the subject to something else � Avoid using excuses and avoid vague answers
Question 15. What skills do counselors need to deal with angry/violent clients?
Model answer:
Step 1 – Defusing aggression � Clear, calm, communication � Empathetic listening, acknowledgement and clarification
Step 2 – Controlling aggression � Negotiate assertively and clearly � Take safety steps, space and scan
Step 3 – Terminate the interaction � Remove yourself or ask client to leave � Evade injury and call for assistance � Defend yourself
Question 16. Identify the three components of a formal warning you would give to control aggression
Model answer: � Negotiate assertively and clearly � Take safety steps, keep space and scan around you � Defend yourself
30 Training Curriculum on Drug addiction Counseling: Trainer Manual
Question 17. List three steps a counselor can use to overcome fear and regain control
Model answer: � Self-talk � Think rationally � One step at a time � Problem-solving actions
Question 18. List three skills that clients need to acquire to manage anger
� Identify a range of feelings including anger � Identify aggressive acts by self and others � Identify potential consequences to self and other from these aggressive acts � Identify self-destructive behavior � Identify thoughts prior to aggressive acts � Identify internal cues to feelings of anger � Develop coping mechanisms for dealing with anger � Express anger without loss of control
APPENDIX III - Sample written exam with answers (cont.)