Comprehensive Training on Tobacco Dependence Screening and Treatment

 
Tobacco Dependence
Screening and Treatment in
Behavioral Health Settings
 
C
o
u
n
s
e
l
i
n
g
 
f
o
r
T
o
b
a
c
c
o
-
 
U
s
e
 
D
i
s
o
r
d
e
r
s
 
OBJECTIVES
 
As a result of this training, participants will be able to:
Develop and understanding of why counseling services related to
tobacco use should be provided to individuals in behavioral health
treatment
Describe how a client’s stage of change with regard to tobacco use
will impact the treatment strategies that a counselor employs in
treating tobacco
Identify the basic skills of motivational interviewing and apply them
to the treatment of tobacco use
Develop the knowledge, skills and abilities necessary to develop a
tobacco quit plan
Identify relapse prevention strategies and apply them to the
treatment of tobacco use
 
2
 
AGENDA
 
Welcome, Introductions, Goal and Objectives
Counselors Role in the Integration of Tobacco Use
Disorder Treatment into Behavioral Health Settings
Trans Theoretical Model (TTM) and Counseling
Strategies
Counseling Skills Practice: Strategies for Engaging
Clients in Pre-contemplation and Contemplation
Creating a Quit Plan and Preventing Relapse: Providing
Services to Clients in Preparation, Action and
Maintenance
Case Studies: Putting It All Together
Closing
 
 
 
 
 
3
 
WELCOME & INTRODUCTIONS
 
Please share your:
Name
Agency
Role
 
4
 
C
OUNSELORS
’ R
OLE
 
IN
 
THE
 I
NTEGRATION
 
OF
T
OBACCO
 
USE
 D
ISORDER
 T
REATMENT
 I
NTO
B
EHAVIORAL
 
HEALTH
 S
ETTINGS
 
 
 
 
 
 
 
 
 
5
 
Chronic Relapsing Illness
 
Treat as a chronic relapsing illness
Few people quit successfully without
treatment
To maximize success, combine
pharmacotherapy and counseling
Treat for as long as it takes
Treat to target-no withdrawal symptoms
 
6
 
BEHAVIORAL HEALTH PROVIDERS
 
Already have the required skill set to help
clients with their tobacco use
Problem-solving
Coping with difficult situations/emotions
Avoiding high risk situations
 
What you fail to say sends a message
 
7
 
O
VERVIEW
 
OF
 T
RANSTHEORETICAL
 M
ODEL
:
A
SSESSING
 T
OBACCO
 D
EPENDENCE
 
AND
C
LIENTS
’ R
EADINESS
 & M
OTIVATION
 
TO
 Q
UIT
 
 
 
 
 
 
 
 
 
8
 
O
VERVIEW
 
OF
 T
RANSTHEORETICAL
M
ODEL
 (TTM):
 
A
SSESSING
 T
OBACCO
 D
EPENDENCE
 & C
LIENTS
R
EADINESS
 
AND
 M
OTIVATION
 
TO
 Q
UIT
 
9
 
STAGES OF CHANGE MODEL
 
Developed by Prochaska and DiClemente
Behavior change does not happen in one step,
but in stages
An individual 
progresses through the stages at
their own pace, depending on their goals and
sources of motivation
 
10
 
THE STAGES OF CHANGE
 
11
 
PRECONTEMPLATION
 
There  is  no  intention  to  change  behavior  in
the  foreseeable  future:
Others  are  aware  of  problem
Unaware  or  under-aware
Change  due  to  outside  pressure
No  plans  to  change (6 months)
Coerced by others to change
 
 
 
 
12
 
13
 
CONTEMPLATION
 
Aware  that  a  problem  exists  and  begins  to  think
about  overcoming  it:
No commitment
Struggles with loss
Decisional-balancing
Can get stuck and remain so
 
 
 
 
 
 
14
 
PREPARATION
 
Making Plans for the intended change:
Intending to take  action within 30 days
Taking steps/making plans
May/may not have taken unsuccessful action in past
year
 
15
 
ACTION
 
Modification of behavior, experiences, or environment
in order to overcome problem behavior
Taking an action is not being in action
Runs from one day to six months
Requires Considerable Commitment
 
 
 
 
16
 
MAINTENANCE
 
Integrated the new behavior into present lifestyle
More than six months
Stabilizing change
Avoiding relapse
Can last a lifetime
 
 
 
 
 
 
 
17
 
THE STAGES OF CHANGE
 
LEARNING DOMAINS FOR CHANGE
 
Cognitive
What a person thinks related to the change
 
Affective
What a person feels related to the change
 
Behavioral
What actions related to the change
 
18
 
19
 
Intervention based on the Stages of Change
 
Pre-contemplation
 
 - Motivational
Interviewing
Contemplation – Motivational Interviewing
Preparation – Motivational Interviewing
Action – Cognitive Behavioral Therapy
Maintenance – Cognitive Behavioral
Therapy
 
20
 
C
OUNSELING
 S
KILLS
 P
RACTICE
O
PEN
-
ENDED
 Q
UESTIONS
AND
 A
FFIRMATIONS
 
 
 
 
 
 
 
 
21
 
MOTIVATIONAL INTERVIEWING
 
Developed by Miller and Rollnick
Person-centered approach
Utilized in multiple settings
Most effective working with individuals in
pre-contemplation and contemplation
 
22
 
O. A. R. S.
 
O
pen-ended Questions
A
ffirmations
R
eflective Listening
S
ummarizing
 
23
 
OPEN-ENDED QUESTION STEMS
 
How…
 
What…
 
Tell me…
 
In what ways…
 
24
 
O
PEN
-E
NDED
 Q
UESTIONS
 A
CTIVITY
 
 
 
 
 
 
 
 
 
25
 
AFFIRMATIONS
 
Statement of understanding and appreciation
for something someone has tried, done, or
achieved
 Genuine and honest
 Positive
 Encouraging
 
26
 
AFFIRMATIONS
 
Make 
someone
 feel good and recognized
Recognize efforts, experiences, and feelings;
this can include intent
Build rapport
 
27
 
A
FFIRMATIONS
 A
CTIVITY
 
 
 
 
 
 
 
 
 
28
 
C
REATING
 Q
UIT
 P
LANS
 
AND
 R
ELAPSE
P
REVENTION
 P
LANS
P
REPARATION
, A
CTION
 
AND
 M
AINTENANCE
 
 
 
 
 
 
 
 
 
29
 
QUIT PLAN
 
Set a quit date
Putting support systems in place
Review reasons for quitting
Discuss previous quit attempts
Plan for managing trigger
 
30
 
Tobacco Use Triggers
 
Internal Triggers
External Triggers
High Risk Situations
 
31
 
DEALING WITH TRIGGERS
 
Coping Strategies
Social Support
 
32
 
 
T
HANK
 Y
OU
!
 
 
 
 
 
 
 
 
33
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Enhance your counseling skills for tobacco use disorders in behavioral health settings through this training program. Learn how to provide effective counseling services, tailor treatment strategies to a client's stage of change, apply motivational interviewing techniques, develop quit plans, and implement relapse prevention strategies. The agenda covers various topics including the role of counselors, Trans-Theoretical Model, counseling strategies, creating quit plans, preventing relapse, and real-world case studies. Behavioral health providers can leverage their existing skills to support clients in overcoming tobacco use challenges effectively.


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  1. Tobacco Dependence Screening and Treatment in Behavioral Health Settings Counseling for Tobacco- Use Disorders

  2. OBJECTIVES As a result of this training, participants will be able to: Develop and understanding of why counseling services related to tobacco use should be provided to individuals in behavioral health treatment Describe how a client s stage of change with regard to tobacco use will impact the treatment strategies that a counselor employs in treating tobacco Identify the basic skills of motivational interviewing and apply them to the treatment of tobacco use Develop the knowledge, skills and abilities necessary to develop a tobacco quit plan Identify relapse prevention strategies and apply them to the treatment of tobacco use 2

  3. AGENDA Welcome, Introductions, Goal and Objectives Counselors Role in the Integration of Tobacco Use Disorder Treatment into Behavioral Health Settings Trans Theoretical Model (TTM) and Counseling Strategies Counseling Skills Practice: Strategies for Engaging Clients in Pre-contemplation and Contemplation Creating a Quit Plan and Preventing Relapse: Providing Services to Clients in Preparation, Action and Maintenance Case Studies: Putting It All Together Closing 3

  4. WELCOME & INTRODUCTIONS Please share your: Name Agency Role 4

  5. COUNSELORS ROLEINTHE INTEGRATIONOF TOBACCOUSE DISORDER TREATMENT INTO BEHAVIORALHEALTH SETTINGS 5

  6. Chronic Relapsing Illness Treat as a chronic relapsing illness Few people quit successfully without treatment To maximize success, combine pharmacotherapy and counseling Treat for as long as it takes Treat to target-no withdrawal symptoms 6

  7. BEHAVIORAL HEALTH PROVIDERS Already have the required skill set to help clients with their tobacco use Problem-solving Coping with difficult situations/emotions Avoiding high risk situations What you fail to say sends a message 7

  8. OVERVIEWOF TRANSTHEORETICAL MODEL: ASSESSING TOBACCO DEPENDENCEAND CLIENTS READINESS & MOTIVATIONTO QUIT 8

  9. OVERVIEWOF TRANSTHEORETICAL MODEL (TTM): ASSESSING TOBACCO DEPENDENCE & CLIENTS READINESSAND MOTIVATIONTO QUIT 9

  10. STAGES OF CHANGE MODEL Developed by Prochaska and DiClemente Behavior change does not happen in one step, but in stages An individual progresses through the stages at their own pace, depending on their goals and sources of motivation 10

  11. THE STAGES OF CHANGE 11

  12. PRECONTEMPLATION There is no intention to change behavior in the foreseeable future: Others are aware of problem Unaware or under-aware Change due to outside pressure No plans to change (6 months) Coerced by others to change 12

  13. CONTEMPLATION Aware that a problem exists and begins to think about overcoming it: No commitment Struggles with loss Decisional-balancing Can get stuck and remain so 13

  14. PREPARATION Making Plans for the intended change: Intending to take action within 30 days Taking steps/making plans May/may not have taken unsuccessful action in past year 14

  15. ACTION Modification of behavior, experiences, or environment in order to overcome problem behavior Taking an action is not being in action Runs from one day to six months Requires Considerable Commitment 15

  16. MAINTENANCE Integrated the new behavior into present lifestyle More than six months Stabilizing change Avoiding relapse Can last a lifetime 16

  17. THE STAGES OF CHANGE 17

  18. 19

  19. Intervention based on the Stages of Change Pre-contemplation - Motivational Interviewing Contemplation Motivational Interviewing Preparation Motivational Interviewing Action Cognitive Behavioral Therapy Maintenance Cognitive Behavioral Therapy 20

  20. COUNSELING SKILLS PRACTICE OPEN-ENDED QUESTIONS AND AFFIRMATIONS 21

  21. MOTIVATIONAL INTERVIEWING Developed by Miller and Rollnick Person-centered approach Utilized in multiple settings Most effective working with individuals in pre-contemplation and contemplation 22

  22. O. A. R. S. Open-ended Questions Affirmations Reflective Listening Summarizing 23

  23. OPEN-ENDED QUESTION STEMS How What Tell me In what ways 24

  24. OPEN-ENDED QUESTIONS ACTIVITY 25

  25. AFFIRMATIONS Statement of understanding and appreciation for something someone has tried, done, or achieved Genuine and honest Positive Encouraging 26

  26. AFFIRMATIONS Make someone feel good and recognized Recognize efforts, experiences, and feelings; this can include intent Build rapport 27

  27. AFFIRMATIONS ACTIVITY 28

  28. CREATING QUIT PLANSAND RELAPSE PREVENTION PLANS PREPARATION, ACTIONAND MAINTENANCE 29

  29. QUIT PLAN Set a quit date Putting support systems in place Review reasons for quitting Discuss previous quit attempts Plan for managing trigger 30

  30. Tobacco Use Triggers Internal Triggers External Triggers High Risk Situations 31

  31. DEALING WITH TRIGGERS Coping Strategies Social Support 32

  32. THANK YOU! 33

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