Introducing the 5-step model to Ireland

1. Introducing the 5-step model to Ireland Richard Velleman and Alex Copello

2. 5-Step in Ireland In 2011 we were approached by the Family Support Network in Ireland (FSN http://www.fsn.ie/), an NGO which supports the development of Family Support Groups and Networks across all of Ireland. They had read about our work and wanted to use it across Ireland FSN are autonomous and non-judgemental, their aim is to improve the situation of families coping with substance misuse by: developing, supporting and reinforcing the work of family support groups and regional family support networks, working for positive change in policy and practice and raising public awareness about the problem of drugs for families and communities, They have a strong community development ethos, and are committed to promoting the empowerment, inclusion and participation of Family Members. We felt that this fitted well with our ideas within the ADF Group and how we think about 5-Step. We were impressed with the emphasis on working over a sustained period of time and commitment to robust evaluation of the work.

3. 5-Step in Ireland Two of them (Sadie Grace, CEO, and Megan O’Leary, Development Officer) came over to meet us, we held discussions over a period of time, and Megan attended our ADF International meeting in York in November 2011. Over the course of this time, we developed ‘A Plan’: - it sounds clear, but in reality, it is something that we gradually worked out, incrementally Train a group of practitioners in Ireland to do 5-Step Get them to implement it, and record their sessions We develop a way of assessing their competence and assess them Once they reach competence, we train them to train others Trained practitioners then train these others, who then get assessed, and once competent, they deliver 5-Step across Ireland. They develop peer-supervision, and we run refresher courses and tweak their competencies. We co-train others as trainers, who continue the model. Soon, Ireland only needs us to do a once/year refresher and tweaking session.

4. The model • So our emphasis was from the start on training as a way of helping FSN to develop their own capacity to continue to deliver and develop implementation of the 5-step across Ireland with minimal support from us in the long term • Contrast to other pyramid models where reliance on the experts is encouraged and maintained

5. 5-Step in Ireland Where we have got to We have trained a group of 12 practitioners in Ireland to do 5-Step. They implemented 5-Step, with (an) individual and in (a) group, and they audio-recorded their sessions. We developed a way of assessing their competence and of assessing them. Some have reached competence, others have not. But we have run a further training course, training them to train others. [We are here]

6. 5-Step in Ireland Issues arising Length of time to assess (5 x 1 hour) x 12 potential trainers = 60 hours x 2 or 3 raters = 120-180 hours [x 10 trainees each = 1200-1800 hours!] Quality of Audio recordings; quality of written submissions (Work Report (see next page) and Log of Contacts (details of the person(s), nature and length of contacts etc) Assessment of Competence. Follow the lead of others. Who? Motivational Interviewing? (no central accreditation programmes in MI, although some people do offer them – not Bill Miller or Steve Rollnick. Pip Mason offers an Advanced MI Practitioner course, and will assess a tape if people submit one – half do) So – do it ourselves! Developing and using an Assessment of Competence measure. Decide on: ?4? ?5? Key dimensions for each step (example, next page) rating scale – 3 point? 5 point? [1 = Very Poor. 2 = Poor. 3 = Acceptable. 4 = Good. 5 = Excellent. Can use .5 scores as necessary e.g. 3.5] Pass level? [Each section should mainly have 4’s/5s and not more than one score of 3.] Then have a 2nd table, for Counselling Skills – same scoring.

7. 5-Step in Ireland Work Report: For each session, complete: Preparation work completed. Information learnt. Level of engagement of family member (or members if this is for a group). Aspects of the session that went well, including practitioner skills Aspects of the session that could be improved, including practitioner skills Information to research before next session

8. 5-Step in Ireland

9. 5-Step in Ireland Score: 1 = Very Poor. 2 = Poor. 3 = Acceptable. 4 = Good. 5 = Excellent. Can use .5 scores as necessary e.g. 3.5 Table 1: 5 Step Skills Pass Rate = Each section should mainly have 4’s/5s and not more than one score of 3. The total score should be a minimum of 14 for each section (As a percentage this is 70%). There may be unusual circumstances where someone fails on a section but where you still feel that they should pass overall - if so, add explanatory comments. Table 2: Counselling and Other Skills Pass Rate = 4 for each item. Again, if an item is not relevant (e.g. use of handbook for someone e.g. with literacy problems), it can be discounted. In summary at end, state Pass / Pass with reservations (state how needs to improve) / In Progress (this will mean that following feedback and training, there needs to be a resubmission of a tape for the relevant section/s).

10. 5-Step in Ireland Issues arising (continued) Individual and Group 5-Step = deceptively simple Trainer-Assessment. Self-Assessment. Peer-Assessment Cost of ratings Appeals process Generic skills versus specific skills Context of the delivery of 5-Step and the importance of non-specific factors

11. 5-Step in Ireland • Key points for accreditation • Individual report (person details and contacts)  • Work report log (reflect on work carried out and what needed for next session) • Record session. (volume) • Self assess against criteria - see handout • Experienced colleague to assess against criteria • Submit to assessor only when self/colleague pass  • Upload onto Drop box • Assessor reviews against criteria • Assessment sheet returned to counsellor • Can resubmit steps that do not pass and be reassessed

12. 5-Step in Ireland • Conclusions • Exciting development • Challenging to work out Assessment of competence, Fidelity to 5-Steps, plus Accreditation, all in one go and one process • FSN are great to work with, and hence challenges become solvable (very different experience to other National organisations we have worked with!) • Reaffirms how helpful the 5-Step method is to so many family members