Counseling Training for entry level counselors who are working in outreach, low threshold services, and drug treatment
In this intensive 15 session program conducted in increments of 5 days (3 weeks) with month long intervals for application and practice in settings in which participants work, participants will learn strengths based counseling for use in low threshold harm reduction, treatment readiness, and drug treatment programs.
- The first week is devoted to the pharmacology, psychology, and sociality of heroin and opiate use, an understanding of theories and practices that underpin harm reduction, a stages of change approach to engaging the ambivalence of drug users, the techniques and practice of motivational interviewing, reflective listening, accurate empathy, ethics and the concept of the reflexive practitioner ‘wearing two hats (especially for experientially based drug workers)’, basic principles of psychology, and training skills, e.g. to adapt an overdose prevention and management training.
- The second week is devoted to dynamics of groups, principles and characteristics of effective group work, and types of groups including motivational interviewing, psychoeducational, support groups, and peer driven activities. Participants will have opportunities to learn group facilitation in role plays, to developing sessions for short-term groups, and to understand collective empowerment, especially among stigmatized or marginalized populations.
- The third week is devoted to counseling work with families and relatives of people who are drug involved or dependent in ways that can be thought through and adapted to particular cultures. Participants will understand a systems approach to the family, be able to describe the life cycle of the family generation and life span development of individual family members, be able to use a genogram to picture the family, define roles, relationships, and norms through family sculptures and Frierian tableaus, understand the range of effects of drug dependence within families, and techniques for engaging family members in motivational interviewing, narrative therapy, and the DEALs approach to problem solving for families and family members. Participants will be able to practice three techniques for eliciting resiliencies, resources and positive moments and interactions with the family system. They will take a critical look at the theory of codependence, the costs and benefits of its application within their culture, and identify alternative approaches.
A practical and realistic approach to thinking through drug use dependence and treatment (For Professionals Only)
An introduction to theories of drug dependence, approaches to drug treatment and health interventions for drug users. The hands on training will include core components of treatment including, medication assisted treatment, psychoeducational counseling, social rehabilitation, use of peer driven activities and an ‘enabling’ therapeutic milieu, and adjuncts to treatment such as acupuncture, meditation, and yoga, and 12 step activities.
Improving Drug Users’ Access to Health and Medical Services and Health Outcomes (For Physicians and Health Care Providers)
Health care staff often say “the right thing” and then feel frustrated to find their advice falling on seemingly deaf ears. How might you open a conversation about alcohol and other drug use, without getting into a lecture, when you suspect substance use as a factor or “missing link” in problems or patterns of behavior related to a health or medical problem or access to care? For example, in a perinatal clinic, how do you engage a patient who appears either “resistant” to talking about her or her partner’s drug use, or “in denial” about a problem, or is afraid that if she acknowledges a problem, she will be coerced into either an action she may not be ready for or losing custody of her baby?
This consultation offers practical tools to move beyond provision of information to frank and realistic conversation that can lead to more effective provision of health services and referrals.
Objectives:
- Help health care staff identify obstacles to effective communication about the continuum of substance use and abuse in the context of health services.
- Identify specific impacts of substance use and related behaviors on patient’s ability to manage her health and maintain supports outside the health care setting
- Provide an introduction to a framework—and concrete tools—for realistic, frank and more effective discussion of these sensitive subjects within the time constraints of contemporary medical practice.
Motivational Interviewing Counseling Skills (Intro): Training for Counseling and Addiction Professionals (2 Day)
In this training, participants will: (1) gain an understanding of the basic principles and rationale of Motivational Interviewing in Harm Reduction Counseling; (2) learn basic clinical principles and techniques needed to do Motivational Interviewing; (3) learn phases of motivational interviewing, including: clinical principles, interventions to avoid, and counseling strategies to use.
A majority of the material for this curriculum comes directly from or is adapted from Motivational Interviewing: Preparing People to Change Addictive Behavior, Miller & Rollnick, 1991 Guilford Press
Motivational Interviewing with Active Drug Users in Drop-in and Informal Groups (2 Day)
In this 2-day workshop, participants will learn about the benefits of motivational interviewing approach to group work, phases of group formation, and group dynamics. They will have an opportunity to see how client-centered social learning in an informal group setting is actually building on the sociality in which drug users learn drug practices and strategies from each other in ‘natural’ settings, and how they rely on each other to adapt to contingencies inherent to using illegal drugs. Through ‘fishbowl’ exercises, participants will be introduced to facilitation skills and they will have an opportunity to learn how specific motivational interviewing techniques can be adapted in an informal group setting.
Starting a Treatment Readiness Program (1 Day)
Drug treatment is often positioned as separate from or even in opposition to harm reduction. Low-threshold “treatment readiness" programs see drug use and dependence as complex, changing and varied across individuals and contexts, rather than monolithic. Based on the harm reduction philosophy of reducing barriers (such as demand for abstinence, labeling, hierarchical positioning of professionals and need for services to take place in the clinic), treatment readiness builds on and expands effective outreach team to include drug counselors and social workers. Treatment readiness is a strengths based approach to growth and change where drug users can set their own incremental goals and move at their own pace.
In this workshop, participants will discuss how a stepped approach to change can be organized building on existing harm reduction models: from an unstructured, informal, supportive and affirmative service environment to semi structured activities where individuals consciously form therapeutic alliances and attachments to staff, peers, and activities, and have opportunity to have new experience of themselves in a more intensive and regular engagement with counseling and peer work, including volunteering, to a structured collaborative, individualized treatment plan that they can begin to implement. This approach calls into question what treatment is, where and when it can begin, where it can happen and what forms it can take, as well as who can provide it.
Wearing Two Hats: Practicing Harm Reduction for Counselors and Case Managers
Who Are Themselves in Recovery (1 Day)
This workshop addresses the concerns of people in recovery who work in harm reduction programs or who work with active and relapsing substance users in social service and medical care settings. This workshop will explore the potential conflicts between your personal experience of recovery from addiction and helping a client who: 1) continues to use; 2) stops one drug but continues to use another; 3) is ambivalent about or resistant to change; or 3) is not interested in recovery. In a safe and non-judgmental environment, through open dialog and interactive discussion, participants will be able to clarify and affirm their own value systems, while learning to develop effective strategies that expand their capacity to deal with difficult, uncomfortable, or challenging situations at work.
You Don't Have To Preach: A Realistic and Frank Approach to Engaging Youth at Risk About Their Drug Use and Sex Practices (1 Day)
Well-meaning folks often say the "right thing" only to find that their advice or clearly articulated message is falling on seemingly deaf ears. How do you learn from youth their real story – what they feel they are really up against on the street and with their friends? What does their thinking look like? This harm reduction workshop offers tools and approaches to move beyond slogans to real two-way conversations that can help engage at risk youth, help them feel listened to, able to learn from each other, and make more effective decisions for themselves.
Clinical and Supervisory Training in Harm Reduction Programs
This training is meant to introduce and then help clinicians effectively integrate the harm reduction and stages of change approaches into health and human service settings. Participants will (1) learn a framework in which to understand HR and relay to their experience working with active or relapsing substance users; (2) gain an understanding of theories and concepts that underpin harm reduction; (3) learn counseling strategies and tools and have an opportunity to practice applying them; (4) explore a model of clinical supervision within which to reflect on the use of the strategies and tools and their own effectiveness.
Putting the ‘Om’ in Harm Reduction
This workshop introduced participants to the use of meditation and stress reduction for clients who are using substances, relapsing or are in early stages of recovery from addiction. Participants will have an opportunity to get hands-on experience and reflect on the use of techniques which can help develop: awareness; a nurturing of the non-judgmental observing ego, learning to “sit with” oneself and uncomfortable feelings, finding and experiencing a quiet place within, the capacity to manage transitions and participate in group activities. Training participants will discuss how particular techniques can benefit and be integrated into current program services or match with specific populations or settings. Wear comfortable clothes!
Providing Effective HIV Prevention and Treatment Services for Men who have sex with Men (MSM)
Health providers and AIDS centers often encounter difficulty outreaching to, engaging, and retaining stigmatized or illegal populations such as non-gay identified homosexually active men. The objective of this three day training is to:
- Reach out and engage homosexually active men (whether or not they identify as such) within natural settings where they interact
- Provide anonymous, safe, non-judgmental and empathic space, facilitated by experientially based workers for homosexually active men (whether or not they identify as such) to share with each other and staff their perspectives of sexual experiences, practices, relationships, and desire, questions and their family and social relationships, their concerns about sexual health and HIV, without fear of stigmatization or adverse consequences.
- Provide anonymous professional and paraprofessional health and social services for homosexually active men (whether or not they identify as such) who may be a risk for or living with HIV/AIDS.
- Build the capacity of professional and paraprofessional workers and experientially based volunteers to deliver such services effectively.
- Provide training and technical assistance to other formal and informal institutions in which homosexually active men (whether or not they identify as such) interact, including health workers, AIDS center workers, law enforcement, government agencies, families and local organizations.
- Encourage the development of collective empowerment among homosexually active men (whether or not they identify as such), and improve the policy environment so that HIV prevention work and treatment services can be provided and accessed.
I'll Hold Your Story
An oral history workshop, where men will have an experience talking about their experiences with sex within the context of the lives they are living. Behavioral studies give us pictures of sex lives in numbers, making for a flat one-dimensional view. What about the rich details of our sex lives--our experiences, relationships, how our desire and practices change and are shaped by partners we meet and networks we move in looking for sex? This experiential workshop is about learning to create an oral history project to put the sex we have and our desire in the context of the real lives we are living: our early memories of sexuality and desire; the diverse cultures and communities we live in, and our feelings about lovers, friends, and ourselves. (1.5 hrs if possible)
The Use and Application of Ethnographic Methods in Drug Research, Social Epidemiology, and Needs Assessments for Drug Users (4 Days)
The objectives of the intensive four and a half day training for experienced research teams are: (1) to learn the efficacy and use of ethnographic methods in research and assessment studies of “hard-to-reach” or “hidden populations” such as heroin/opiate users, or select groups of migrants, sex workers, vulnerable women, or street involved youth; (2) to acquire familiarity with the specific tools of ethnography which can be applied to the program development; (3) to develop within their organizations the capacity to train field work staff and NGOs in conducting ethnographic research as program monitoring and evaluation; and (4) to examine how ethnographic data can be used in conjunction with other qualitative and quantitative data to assess drug demand reduction service delivery and impact.
Researchers participating in the training should have the capacity to integrate ethnographic methodology and qualitative analysis in program monitoring and evaluation and short term focused assessment studies of select populations targeted for public health programs. Specifically, the research organization needs to have the organizational capacity to absorb an intensive training that they will then disseminate to their staff, intern field workers whom they supervise, or to NGO partners with whom they work.
Each module corresponds to a particular substantive aspect of ethnography or an exercise used to learn ethnographic methods. A brief description of each module:
Module 1 – Training Overview. Provides an outline of the four days of ethnographic training.
Module 2 – Monitoring Hidden Populations. Introduces the concept of hidden populations, and describes ethnographic strategies for monitoring hidden populations, including community assessment, participant observation, and structured interviews.
Module 3 – Participant Observation. Describes the principal components of participant observation, including researcher roles, entering field settings, and specific ethnographic skills
Module 4 – Writing Field Notes. Describes key methods of recording data while undertaking participant observation, such as head notes and scratch notes, and details the content of well-written field notes, such as actors, activities, and objects .
Module 5 – Conduct Field Observations in Almaty. Describes an exercise for participants to practice participant observation skills in surrounding environment.
Module 6 – Field Note Exercise. Describes an exercise for participants to practice field note writing skills following the participant observation exercise in surrounding environment.
Module 7 – Coding Field Notes. Details specific skills for coding and analyzing field notes, such as open and focused coding techniques, and writing analytical memos.
Module 8 – Social Maps and Sampling Techniques. Describes particular methods for monitoring hidden populations, such as targeted sampling, social mapping, and ethnographic mapping, and contrasts targeted sampling with other sampling methods, such as snowball and respondent driven sampling.
Module 9 – Rapid Assessment. Overviews methods for conducing a rapid assessment and a case study. .
Module 10 - Applying Participant Observation to Monitoring, Evaluation, and Assessment Studies. .
Module 11 – Qualitative Interviewing. Describes specific kinds of qualitative interviewing, including informal, semi-structured, and structured interviews .
Module 12 – Interviewing Exercise. Describes an exercise for participants to practice interviewing skills.
Module 13 – Integrating Data Sources. Details methods for integrating various types of data. .
Module 14 – Ethical/Safety Issues/Hiring Field Staff. Describes methods for integrating indigenous workers into projects focusing on drug research.
Other trainings include:
- A hands-on training and certification for the use of auricular acupuncture in the context of harm reduction, low threshold treatment, or treatment and rehabilitation.
- Counseling Theories and Skills for Professionals and Paraprofessionals Working with Drug Users
- The Pharmacology, Protocol, and Additive Effects of Oral Substitution Treatment for Medical Professionals and Paraprofessionals
- Starting an effective needle exchange program
- Overdose Prevention and Management
- Starting an effective low threshold treatment readiness program
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