Elements and Performance Criteria

Work with clients may occur at established premises or at other locations used by outreach, street, remote or off-site services. Other locations may include the client's home, public places, workplaces or mobile service centres.

Clients include:
Families and personal network of the client

Assessment may take place:
Face-to-face
By telephone

Other related information may include:
That provided by other services via referral
Doctor's or other professional's reports
Information provided by family or support network

Current status of the client includes:
Determining readiness to change
Physical, emotional, financial, legal and psychosocial state and immediate needs in these areas
Other drug use in the family
Level of risk of deliberate self harm behaviours and/or harm to others
Levels of risk behaviour associated with alcohol and/or other drug use including behaviours which expose clients to blood borne diseases

Indicators of other issues may include:
A history of mental health issues
Indicators of abuse, neglect or harm including self harm
Indicators of child abuse
Having no accommodation, employment or money

Options for meeting the range of client needs may include:
Referral to other services
Community intervention

Taking a client history refers to collection of relevant information on:
Name, age, gender etc
Drug history
Social and legal history
Current status including housing status
Agency ability to cater for the client needs
Mental health issues
Other relevant related issues affecting clients

Early or short-term programs refers to:
Less intensive, shorter term activities that are an alternative to longer and more intensive programs. These brief interventions carried out by a range of workers, often opportunistically, are usually offered to those individuals who are less severely drug dependent

Current information on related issues includes information on:
Meeting physical, emotional, financial and social needs
Contacts for self-help groups
Resources on dependency
Resources on alcohol and other drugs issues for families or personal network
Advocacy groups
Information regarding mental health and self harm
Crisis and emergency contacts

Goals and action plans may be short and long term and should include:
Harm minimisation (including abstinence, controlled drinking, safer sex, safer drug use, safe injecting)
Strategies to target reducing at risk behaviours

Goals and action plans may include:
Vocational goals (employment and training)
Accommodation
Meeting immediate physical needs
Maintenance of stable social and emotional environment
Reintegration within social context
Ensuring personal safety
Management of crisis
Timelines and priorities

Review refers to:
A short term formative analysis of client progress
Reviewing strategies
Standards against which a review can occur

Relapse prevention strategies may include:
Identification of drug use 'triggers' and working with the client to develop responses to deal with triggers
Referral to self help groups
Stress management advice
Ongoing positive support
Monitoring of the client's progress
Facilitating use of community resources
Encouraging client to develop a support network
Role play
Discussion of strategies for stress management, money management, goal setting, prioritising, problem solving, decision making, disengagement

Client exit (negotiation of with the client) will depend on the organisational policies and procedures and the individual clients needs and may include:
Negotiation of contract with client
Providing information on what the client may expect when they leave
Providing follow-up
Ending the client/worker relationship
Ensuring personal safety of clients at risk of self harm including availability of ongoing supports from appropriate agencies
Access to harm reduction consumables eg. Needles, syringes, and needle exchange programs

Client exit (organisational requirements) may include:
Client questionnaire
Documentation including reason for exit and condition of client at exit
Organisational documentation on treatment/assessment progress

Supporting a client to make contact with other services may include:
Making an appointment for the client
Accompanying client to first appointment
Organising for another appropriate person to accompany the client to an appointment
Organising interpreter services for the client

Other services that are specific to alcohol and/or other drugs use may include:
Detoxification
Inpatient counselling
Outpatient counselling
Self-help groups
Proclaimed place, rehabilitation centres, residential etc
Sobering up units
Services which provide consumables eg. Syringes, thiamine, needle exchange, methadone or other drug substitution/replacement services
Therapeutic communities

Other services include:
Department of Social Security
Accommodation
Emergency services
Mental health services

Follow up will depend on the organisation's policies and procedures and the client needs and may include:
Obtaining feedback and reports on outcomes of referrals from other agency in accordance with organisational policies and procedures including those referring to client confidentiality
Checking protective support for suicide risk is available if required
Making an appointment for follow up
Contact with client at referral agency
Liaison between alcohol and other drugs worker and other services

Outcomes may include:
Measurement of harm minimisation
Changes made during intervention and changes sustained over time
Those negotiated with the client as part of a management plan
Referral and acceptance to another treatment program or half-way house
Both positive and negative outcomes
Linkage with appropriate services
Client being moved from institution or service
Client changes - behaviour, attitudinal

Review against care plan may be:
Within the organisation
In consultation with other agencies

The Evidence Guide identifies the critical aspects of assessment, and the essential knowledge and skills to be demonstrated to confirm competency in this unit. The Evidence Guide is an integral part of the assessment of competency and it should be read carefully in conjunction with the Range Statement, Elements and Performance Criteria.
Critical aspects of performance:

To be assessed as competent in this unit workers will need demonstrate the capacity to work with clients:

With a range of issues
In a range of settings
From different cultural backgrounds
In a non-judgemental way
In emergency situations

General Essential knowledge:
A basic First Aid certificate or equivalent is a requirement of this unit. This includes cardio pulmonary resuscitation (CPR), bandaging, managing toxic substances, managing bleeding, managing broken bones, managing consciousness, managing choking and knowledge of coma positions. Units

Legal and organisational knowledge:
Legal and organisational requirements for client registration, allocation and referral
Organisational policies on reporting and confidentiality
Organisational policies and procedures for documenting work with clients
Understanding agency role, agency target group and the impacts on the local community
Range of alcohol and other drugs specific treatment intervention options including detoxification, inpatient treatment programs, outpatient treatment services, and brief interventions

Effects of alcohol and other drugs use:
Signs and symptoms of medical risk associated with alcohol and other drugs use
Stages and symptoms of alcohol and other drugs withdrawal
Basic health issues relating to alcohol and/or other drugs use - eg. malnutrition, blood borne diseases, skin infestations, effects of drug use on health, cognitive, social, emotional development and impact on others
Basic pharmacology - types of drugs; dose levels; effects of specific drugs; tolerance; treatment approaches broadly
The effects of alcohol related brain injury
Consequences and effects of drug substitution/replacement
Effects of prescribed drugs on the use of other drugs
Patterns of drug use in Australia and the local community
Range of use and use scenarios eg. Lifestyle context of illegal drug use

Legal issues:
Legal status of drugs
Legal issues surrounding alcohol and other drugs use

Policy:
Public health model - interaction of impact of drugs, individual and the environment
Harm minimisation including a range of approaches: prevention, early intervention, abstinence, specialist treatment, supply control and safer drug use

Working with clients:
Common relapse precipitants
A range of strategies for working with clients
Strategies to promote participation in programs
Range of cultural contexts - lifestyle, set of beliefs, customs
Client empowerment/disempowerment
Rights of workers and clients
Different lifestyles
Self-esteem, abuse issues, self-awareness, own biases, ethical obligations re: helping relationships
Types of counselling eg. motivational interviewing, brief and intensive intervention, relapse prevention
Protocols around use of interpreters
Client centredness
Case management principles

Working with clients - clients at risk of self harm:
Suicidal or self harming behaviour, ideation or intention
No-suicide contracts and other protective strategies
Links between predisposing factors for self harm, drug use and mental health problems
Legal and ethical obligations regarding clients at risk of self harm or with mental illnesses

Interdependent assessment of units:

Essential skills:
Establishing rapport
Active listening including questioning
Interpretation of verbal and non-verbal communication
Ability to work with a range of clients
Contracting with clients
Conflict resolution
Negotiation
Crisis intervention
Protective intervention
Advocacy
Networking and liaison with other agencies
Identification of support structures

Resource implications:
Assessment of this competency will require human resources consistent with those outlined in the Assessment Guidelines

Consistency in performance:
Competence in this unit must be assessed over a period of time in order to ensure consistency of performance over the Range Statement and contexts applicable to the work environment
Consistency in performance should consider the work environment, worker's role and responsibilities in the workplace

Context for assessment:
Competency must be demonstrated in a real work environment
In cases where the learner does not have the opportunity to cover all categories of the Range Statement in the work environment, the remainder should be assessed through realistic simulations, projects, previous relevant experience or oral questioning on "What if?" scenarios
Assessment of this unit of competence will usually include observation of processes and procedures, oral and/or written questioning on Essential knowledge and skills and consideration of required attitudes
Where performance is not directly observed and/or is required to be demonstrated over a "period of time" and/or in a "number of locations", any evidence should be authenticated by colleagues, supervisors, clients or other appropriate persons