Prevention Interventions for Substance Abuse Professionals

1. Prevention Interventions for Substance Abuse Professionals

2. 1993 MMWR Recommendations • HIV counseling should be Client Centered • Tailor to the behaviors circumstances and special needs of the person being served • HIV counseling should include a personalized client risk assessment • HIV counseling should result in a personalized plan for the client to reduce the risk of HIV infection / Transmission

3. Important Points • Must be client focused • Must focus on a personalized risk assessment and personalized action plan • Intervention is not just education

4. Six Major Steps to Prevention Counseling • Introduce and orient the client to a session • Identify the clients personal risk behaviors and circumstances • Identify safer goal behaviors • Develop a client action plan • Make appropriate referrals and provide support • Summarize and close the session

5. Question • What did you observe? • How did it feel to defend an opinion that was not your own? • How can a counselor achieve “non- judgmental behavior?”

6. Points • It is impossible to be completely non-judgmental. • You need to be aware of your own values, judgments, prejudices so you can recognize them before discussing these issues with clients. • Don’t dump your issues into your clients lap • Examine what makes you feel uncomfortable • What triggers that response • Deal with the issue or refer the client.

7. Use Basic Counseling Techniques • Open ended questions • Attend well • Offer options, not directives • Buffet • Give information simply • No jargon

8. Risk and Safer Goal Behaviors • Need to identify what the client does that puts them at risk for acquiring a BBP. • Need to identify behaviors that prevent or reduce the risk. • Pure harm reduction here • Identify what action steps the client can make to achieve the safer goal behavior.

9. Example • Current risk behavior • Unprotected anal sex • Background • has used condoms occasionally in the past • Safer goal behavior • Use condoms more often

10. Doesn’t have condoms when needed Afraid of partner reaction Not sure how to bring it up Condoms ruin the mood Friends think they are important to use. Client feels safer when they are used. Care about their future. Reduces risk for HIV Barriers and Benefits

11. Action StepsWhat can they do?

12. Referrals • Are important • Help client define priorities • Discuss options • Offer the referral • Only refer to known and trusted sources • Assess client response to referral • Facilitate an active referral • DEVELOP A FOLLOW UP PLAN

13. Referral Groups • Medical Practices • Appropriate counseling services • Public Health • Others

14. Closure • Provide a review of what you have discussed. • Make sure client is ready to closure the session

15. Advantages • Can do in 15 minutes • Can be combined with other aspects of substance abuse treatment

16. Issues • Know the local public health professionals • Who provides services? • Have knowledge of referral services • Some aspects are pure case-management • May not have resources