Training Overview and Expected Outcomes

1. Training Overview and Expected Outcomes GPRA Tool Administration Training

2. Discuss interviewing techniques Train participants on administration of the GPRA Client Outcomes Demonstrate the techniques and skills required to administer the GPRA Tool Purpose

3. Discuss elements of the client interview and motivational interviewing Review the development of the GPRA Client Outcomes Review each item and instructions on the GPRA tool Practice the questions through a series of role plays Objectives

4. At the end of the day you should… Be able to conduct a GPRA interview by understanding the data collection techniques and individual instructions Understand the intent of the GPRA questions Be ready to share what you learned with colleagues back at work Outcomes

5. Questions

6. The Client Interview GPRA Tool Administration Training CENTER FOR SUBSTANCE ABUSE TREATMENT

7. RAISE YOUR HAND IF…

8. To review issues that arise during the interview process To discuss client interviewing methods to facilitate successful GPRA administration To emphasize the importance of client-interviewer relationship-building Goals

9. Relationship Communication Interview

10. Social & Cultural Issues Ethnicity Acculturation Racial Identity Socioeconomic Status Gender Age

11. Words or phrase choice How you say it tone, volume, speed pauses, laughter Verbal Communication

12. Interview Taboo

13. TABOO

14. Differing perspectives Be sensitive Understand context Client Motivation

15. Client Cooperation • I’ve been waiting… • How many times do I have to answer these questions? • When do I get what I came for?

16. Hard to talk about sex, drugs, and HIV personal negative feelings taboo associated with upsetting events I’m not feeling my best Substance abuse symptoms HIV symptoms Client Cooperation (continued)

17. Boredom and burn out Fear of hostility Too close to home Interviewer biases Self-doubt and conflict Comfort with questions and topics (e.g., sex, drugs) Interviewer Issues

18. F: Provide feedback R: Promote responsibility A: Provide advice M: Provide a menu of options E: Provide empathic counseling S: Affirm self-efficacy FRAMES

19. Persuasive Respectful Constructive Non-confrontational FRAMES Provide Feedback

20. Individuals can choose to change Encourage responsibility for change Increases empowerment and personal investment FRAMES Promote Responsibility

21. Advice can be persuasive Advice can be suggestive Advice can be educational Advice should be individualized FRAMES Provide Advice

22. Lack of choice promotes resistance Having choices increases engagement Choices increase retention rates Choices decrease treatment resistance Choices promote personal responsibility FRAMES Provide Menu of Options

23. Strong predictor of success Warm, respectful, attentive Reflective listening FRAMES Provide Empathic Counseling

24. Reinforce clients beliefs in their own capabilities Identify what has worked previously Affirm small steps Provide positive reinforcement FRAMES AffirmSelf-Efficacy

25. Arguments are counterproductive Defending breeds defensiveness Resistance is a signal to change strategies Avoid Arguments

26. Resistance can indicate different viewpoint Resistance suggests a different approach Rolling with resistance demonstrates respect and empathy Roll With Resistance

27. Current behaviors vs. future goals Identify future goals Identify behaviors which block goals Increase awareness of consequences of behavior Promote Discrepancy

28. Therapeutic context Interviewer-client relationship FRAMES and other therapeutic tools A Reminder

29. http://motivationalinterview.org Treatment Improvement Protocol No. 35 Resources Toll Free: 1-800-729-6686

30. Overview of the Government Performance And Results Act Client Outcome Measures Tool

31. 1993 legislation (Public Law 103-62) Develop strategic plans Set performance targets Report outcomes Conduct evaluations What Is the Government Performance and Results Act (GPRA)?

32. Increase accountability Initiate program performance reform Improve effectiveness Purposes of GPRA Act

33. Improve service delivery Improve congressional decision-making Improve internal management Purposes of GPRA Act (continued)

34. The CSAT GPRA tool is a list of broad items and questions Questions were taken from widely used data collection instruments Addiction Severity Index (ASI) McKinney Homeless Program reporting system AIDS Risk Assessment (ARA) Short Form-36 Health Survey What is the CSAT GPRA Tool?

35. What’s the Big Deal? 1. Providers collect GPRA data 2. Project enters data into the GPRA Web Based Data Entry and Reporting System 3. CSAT Project Officers review data for adherence to goals 4. Branch Chief and Division Director review data.

36. What’s the Big Deal? (continued) 5. CSAT Director submits data to SAMHSA for review 6. SAMHSA analyzes data against CSAT performance measures and submits to DHHS 7. DHHS reviews SAMHSA data and submits to OMB 8. OMB reviews data and submits to Congress

37. What’s the Big Deal? (continued) • Administration for Children and Families • Administration on Aging • Agency for Healthcare Research and Quality • Agency for Toxic Substances and Disease Registry • Centers for Disease Control and Prevention • Centers for Medicare and Medicaid Services • Food and Drug Administration • Health Resources and Services Administration • Indian Health Service • National Institutes of Health • Program Support Center • Substance Abuse and Mental Health • Services Administration 9. Congress reviews data from all agencies under DHHS. Good data help convince Congress to continue funding treatment 10. Limited resources require selective funding by Congress

38. What’s In The Data for Me? You can use GPRA data… To determine client needs To supplement presentations For other grant proposals To market your program To make adjustments to service delivery To assist in budgeting and staffing

39. Questions