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Attitudes, Skills and Knowledge Change in Child and Adolescent Mental Health Workers Following AOD Screening and Brief Intervention Training

  • Grant Christie
  • Stella Black
  • Lucy Dunbar
  • Justin Pulford
  • Amanda Wheeler
Article

Abstract

Adolescent mental health workers are generally poor at identifying and treating co-existing alcohol and other drug (AOD) disorder. This study aimed to evaluate the utility and acceptability of an AOD screening and brief intervention (BI) training package delivered to child and adolescent mental health workers and its impact on relevant attitudes, skills and knowledge. Quantitative data was collected before and after the BI training using a 55-item questionnaire. Focus groups explored issues around AOD screening and BI implementation in practice. The questionnaire and focus group were repeated 10 months later to ascertain change in behaviour. The BI training was well-received and led to improvements in attitudes, skills and knowledge around AOD screening and BI in youth mental health practitioners. Positive change in participants’ attitudes to performing screening and BI were demonstrated. Low response rates at follow-up limited analysis of behaviour change.

Keywords

Substance-related disorders Screening Brief interventions Mental health services Adolescent 

Notes

Acknowledgments

This work was sponsored by the Werry Centre for Child and Adolescent Mental Health through an unrestricted research grant. We also acknowledge the Alcohol Advisory Council of New Zealand, who funded the development of the Substances and Choices Scale screening and outcome measurement instrument and support its availability via the www.sacsinfo.com website.

References

  1. Adolescent Health Research Group. (2008). Youth’07 The Health and Wellbeing of Secondary School Students in New Zealand: Technical Report. Auckland: University of Auckland.Google Scholar
  2. Amaral-Sabadini, M. B., Saitz, R., & Souza-Formigoni, M. L. (2010). Do attitudes about unhealthy alcohol and other drug (AOD) use impact primary care professionals' readiness to implement AOD-related preventive care? Drug And Alcohol Review, 29(6), 655–661.PubMedCrossRefGoogle Scholar
  3. American Academy of Pediatrics: Committee on Substance Abuse, & Kokotailo, P. K. (2010). Policy Statement – Alcohol use by youth and adolescents: a pediatric concern. Pediatrics, 125(5), 1078–1087.PubMedCrossRefGoogle Scholar
  4. Anderson, P., & Clement, S. (1987). The AAPPQ revisited: the measurement of general practitioners attitudes towards alcohol problems. British Journal of Addiction, 82, 753–759.PubMedCrossRefGoogle Scholar
  5. Babor, T. F., & Higgins-Biddle, J. C. (2001). Brief intervention for hazardous and harmful drinking: a manual for use in primary care (Vol. Document no. WHO/MSD/MSB/01.6b): World Health Organisation.Google Scholar
  6. Babor, T., McRee, B., Kassebaum, P., Grimaldi, P., Ahmed, K., & Bray, J. (2007). Screening, brief intervention, and referral to treatment (SBIRT): toward a public health approach to the management of substance abuse. Substance Abuse, 28(3), 7–30.PubMedCrossRefGoogle Scholar
  7. Baer, J. S., Garrett, S. B., Beadnell, B., Wells, E. A., & Peterson, P. L. (2007). Brief motivational intervention with homeless adolescents: evaluating effects on substance use and service utilization [Research Support, N.I.H., Extramural]. Psychology of Addictive Behaviors, 21(4), 582–586.PubMedCrossRefGoogle Scholar
  8. Baker, A., Kay-Lambkin, F. J., & Lewin, T. J. (2007). Co-existing mental health and drug and alcohol problems: Steps towards better treatment. Clinical handbook of co-existing mental health and drug and alcohol problems. London: Routledge.Google Scholar
  9. Baker, K., Lubman, D., Cosgrave, E., Killackey, E., Yuen, H., Hides, L., et al. (2007). Impact of co-occuring substance use on 6 month outcomes for young people seeking mental health treatment. The Australian and New Zealand Journal of Psychiatry, 41, 896–902.PubMedCrossRefGoogle Scholar
  10. Barnes, H. M. (2000). Kaupapa maori: explaining the ordinary. Pacific Health Dialogue, 7(1), 13–16.Google Scholar
  11. Bernstein, E., Topp, D., Shaw, E., Girard, C., Pressman, K., Woolcock, E., et al. (2009). A preliminary report of knowledge translation: lessons from taking screening and brief intervention techniques from the research setting into regional systems of care. Academy of Emergency Medicine, 16(11), 1225–1233.CrossRefGoogle Scholar
  12. Bien, T. H., Miller, W. R., & Tonigan, J. S. (1993). Brief Interventions for alcohol problems: a review. Addiction, 88, 315–335.PubMedCrossRefGoogle Scholar
  13. Cartwright, A. K. J. (1980). The attitudes of helping agents towards the alcoholic client: the influence of experience, support, training and self esteem. British Journal of Addiction, 75, 413–431.CrossRefGoogle Scholar
  14. Christie, G. (2010). The Substances and Choices Scale Brief Intervention Manual: Complete Version. Retrieved from http://www.sacsinfo.com/docs/SACSBImanualcom10.pdf
  15. Christie, G., Marsh, R., Sheridan, J., Wheeler, A., Suaalii-Sauni, T., Black, S., et al. (2007). The Substances and Choices Scale (SACS) - the development and testing of a new alcohol and other drug screening and outcome measurement instrument for young people. Addiction, 102(9), 1390.PubMedCrossRefGoogle Scholar
  16. Christie, G., Merry, S., & Robinson, E. (2010). Do young people attending addiction services differ from those attending youth mental health services? Drug and Alcohol Review, 29, 406–412.PubMedCrossRefGoogle Scholar
  17. Clark, D., & Moss, H. (2010). Providing alcohol-related screening and brief interventions to adolescents through health care systems: obstacles and solutions [Research Support, N.I.H., Extramural]. PLoS Medicine/Public Library of Science, 7(3), e1000214.Google Scholar
  18. Durie, M. (2004). Understanding health and illness: research at the interface between science and indigenous knowledge. International Journal of Epidemiology, 33(5), 1138–1143.PubMedCrossRefGoogle Scholar
  19. Fleming, M. (1997). Strategies to increase alcohol screening in health care settings. Alcohol Health and Research World, 21(4), 340–347.PubMedGoogle Scholar
  20. Geirsson, M., Bendtsen, P., & Spak, F. (2005). Attitudes of Swedish general practitioners and nurses to working with lifestyle change, with special reference to alcohol consumption. Alcohol and Alcoholism, 40(5), 388–393.PubMedCrossRefGoogle Scholar
  21. Goti, J., Diaz, R., Serrano, L., Gonzalez, L., Calvo, R., Gual, A., et al. (2010). Brief intervention in substance-use among adolescent psychiatric patients: a randomized controlled trial. European Child & Adolescent Psychiatry, 19(6), 503–511.CrossRefGoogle Scholar
  22. Heather, N. (2002). Effectiveness of brief interventions proved beyond reasonable doubt. Addiction, 97, 293–294.PubMedCrossRefGoogle Scholar
  23. Jernigan, D. H. (2001). Global Status report: Alcohol and Young People. Geneva: World Health Organisation.Google Scholar
  24. Johnson, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2009). Monitoring the Future: National results on adolescent drug use: Overview of key findings, 2008 NIH Publication NO. 09-7401. Bethseda: National Institute on Drug Abuse.Google Scholar
  25. Kaner, E., Heather, N., McAvoy, B., Lock, C., & Gilvarry, E. (1999). Intervention for excessive alcohol consumption in primary healthcare: attitudes and practices of english general practitioners. Alcohol and Alcoholism, 34(4), 559–566.PubMedCrossRefGoogle Scholar
  26. King, R. D., Gaines, L. S., Lambert, W. E., Summerfelt, T. W., & Bickman, L. (2000). The co-occurrence of psychiatric and substance use diagnoses in adolescent in different services systems: Frequency, recognition, cost, and outcomes. The Journal of Behavioral Health Services & Research, 27(4), 417–430.CrossRefGoogle Scholar
  27. Kramer, T. L., Robbins, J. M., Phillips, S. D., Miller, T. L., & Burns, B. J. (2003). Detection and outcomes of substance use disorders in adolescents seeking mental health treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 42(11), 1318–1326.PubMedCrossRefGoogle Scholar
  28. Krupski, A., Sears, J. M., Joesch, J. M., Estee, S., He, L., Dunn, C., et al. (2010). Impact of brief interventions and brief treatment on admissions to chemical dependency treatment [Research Support, N.I.H., Extramural]. Drug and Alcohol Dependence, 110(1-2), 126–136.PubMedCrossRefGoogle Scholar
  29. Liddle, H. A., & Rowe, C. L. (2006). Adolescent substance abuse. New York: Cambridge University Press.CrossRefGoogle Scholar
  30. McCambridge, J., & Strang, J. (2004). The efficacy of single-session motivational interviewing in reducing drug consumption and perceptions of drug related risk and harm among young people: results from a multi-site cluster randomised trial. Addiction, 99, 39–52.PubMedCrossRefGoogle Scholar
  31. Miller, W. R., & Rollnick, S. (2002). Motivational Interviewing: Preparing People for Change (2nd ed.). London: Guildford Press.Google Scholar
  32. Moyer, A., Finney, J. W., Swearingen, C. E., & Vergun, P. (2002). Brief interventions for alcohol problems: a meta-analytic review of controlled investigations in treatment seeking and non-treatment seeking populations. Addiction, 97, 279–292.PubMedCrossRefGoogle Scholar
  33. National Ethics Advisory Committee. (2006). Ethical Guidelines for Observational Studies: Observational research, audits and related activities. Retrieved July 22, 2008, from http://www.neac.health.govt.nz/moh.nsf/pagescm/520/$File/ethicalguidelines.pdf
  34. National Treatment Agency For Substance Misuse. (2009). Getting to grips with substance misuse among young people - The data for 2007/2008. London: National Treatment Agency for Substance Misuse.Google Scholar
  35. O’Leary-Tevyaw, T., & Monti, P. M. (2004). Motivational enhancement and other brief interventions for adolescent substance abuse: foundations, applications and evaluations. Addiction, 99(Suppl. 2), 63–75.CrossRefGoogle Scholar
  36. Pulford, J., McCormick, R., Wheeler, A., Firkin, P., Scott, I., & Robinson, G. (2007). Alcohol assessment: the practice, knowledge, and attitudes of staff working in the general medical wards of a large metropolitan hospital. The New Zealand Medical Journal, 120(1257).Google Scholar
  37. Roche, A., & Freeman, T. (2004). Brief interventions: good in theory but weak in practice. Drug and Alcohol Review, 23, 11–18.PubMedCrossRefGoogle Scholar
  38. Royal, C. (2006). Methodology. Retrieved 16 July 2011from http://www.rangahau.co.nz/methodology/59/
  39. Sheridan, J., Wheeler, A., Ju-Hsing Chen, L., Chen-Yun Huang, A., Nga-Yee Leung, I., & Yow-Chyi Tien, K. (2008). Screening and brief interventions for alcohol: attitudes, knowledge and experience of community pharmacists in Auckland, New Zealand. Drug and Alcohol Review, 27, 380–387.PubMedCrossRefGoogle Scholar
  40. Skinner, N., Roche, A., Freeman, T., & McKinnon, A. (2009). Health professionals’ attitudes to AOD-related work: moving the traditional focus from education and training to organizational culture. Drugs: Education, Prevention and Policy, 16(3), 232–249.CrossRefGoogle Scholar
  41. Tait, R. J., & Hulse, G. K. (2003). A systematic review of the effectiveness of brief interventions with substance using adolescents by type of drug. Drug and Alcohol Review, 22(3), 337–346.PubMedCrossRefGoogle Scholar
  42. Thomas, D. (2006). A general inductive approach for analyzing qualitative evaluation data. American Journal of Evaluation, 27, 237–246.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Grant Christie
    • 1
  • Stella Black
    • 2
  • Lucy Dunbar
    • 2
  • Justin Pulford
    • 3
  • Amanda Wheeler
    • 4
  1. 1.Community Alcohol and Drug Service Altered High Youth ServiceWaitemata District Health BoardAucklandNew Zealand
  2. 2.Clinical Research & Resource Centre (CRRC)Waitemata District Health BoardAucklandNew Zealand
  3. 3.Papua New Guinea Institute of Medical Research and the School of Population HealthUniversity of QueenslandQueenslandAustralia
  4. 4.Griffith Health Institute, Griffith UniversityBrisbaneAustralia

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