last orders brief advice training. by the end of session you will: be confident in using brief...

Last Orders Brief Advice Training

By the end of session you will:

• Be confident in using Brief Advice as a tool to address risky behaviour in young people

• Understand the principles of Brief Advice and how it is a transferable skill

What is a unit?

• Alcoholic content of drinks is measured in ‘units’.

Group Work Exercise 1:

Match the drinks to the number of units it contains.

Match the drinks answers:Drink 1

Large glass of Wine (250ml at 12%)

Drink 2Double Whiskey

(50ml at 40%)

Drink 3Bottle of Lager (330ml at 5%)

Drink 42 Pints of Bitter (568ml x2 at 4%)

Drink 5Can Super Strength Lager

(440ml at 9%)

Drink 62 Bottles of Alco pops

(275ml x2 at 5%)

1.7

2

2.8

3

4

4.6

So what is a unit of Alcohol?

• One unit = 8g or 10ml of pure alcohol

• No of units is calculated byvolume (ml) x % ABV*

1000* ABV – Alcohol by Volume

For example: Bottle of Wine750ml x 12% ABV / 1000 = 9 units

Department of Health recommends for adults:

3-4 units a day

2-3 units a day

FOR YOUNG PEOPLE THERE IS NO

‘SAFE’ LEVELS

So what about ‘Binge Drinking’?

‘Binge drinking’ is considered drinking double the

recommended limits

Binge drinking in the media = young people either underage

or in town centres

Reality of binge drinking = people of all ages do it

Regular ‘binge drinking’ puts you at higher risk levels

So for a male that’s 8 units or more

(e.g. 3 pints of 5% lager)

And for a female it’s 6 units or more

(e.g. 2 large glasses of 12% wine)

Effects of Alcohol

The effects of alcohol misuse can be wide reaching:

Group Work Exercise 2:

We all know that alcohol is linked to health concerns

– both short and long term illnesses - but how

does it effect:

1. The individual young person who is drinking

2. The family and wider society

So what is Brief Advice?

• Opportunistic simple structured advice

• Raises awareness around risky behaviour patterns and the associated effects

• Delivered in 5-10 minutes by non specialist professionals

Alcohol as an example:• Understanding Units• Understanding risk levels• Benefits of cutting down• Tips on cutting down

• MOTIVATING BEHAVIOUR CHANGE

Principles of Brief Advice

• Empathic• Avoid labelling• Understanding there are pre-conceptions: both school staff

and young person receiving the Brief Advice• Supportive• Non threatening / non confrontational• Body language and speech tone• Emphasise the young person’s personal responsibility for

their decisions about their risky behaviour• Confidential and link to school procedure

Stages of Brief Advice

• It could be raised:– As routine with all young people you see– As part of planned tutorial– By the young person – As the response to the reason for seeing the young person

• You should seek permission from the young person to discuss their risky behaviour further (using alcohol as an example)

Raise the issueRaise the issue


Give personalised feedbackGive personalised feedback


• Give factual information on the potential effects of their risky behaviour may have on their health and wellbeing– This may include providing harm reduction messages

• Ask how the young person feels about this• Ask if they would like to discuss it further


Screen and give personalised feedbackScreen and give personalised feedback

Listen for readiness to changeListen for readiness to change


• Listen!!!!• Use open questions, reflect and summarise the discussion• From the young person’s response to the information choose a suitable

approach depending on where they are in the cycle of change

Cycle of Change

Precontemplation

Contemplation

Preparation Action

Maintenance

Relapse

Long term change

(Prochaska and DiClemente, 1983)




Choose a suitable approach: Info and Advice

Enhance Motivation

Build Confidence

Menu of Options

Coping Strategies


Enhance Motivation

Build Confidence

Menu of Options

Coping Strategies


• If the young person is at pre-contemplation stage, start with ‘info and advice’.

• If the young person is already on the cycle of change, choose one or more of the other approaches (using alcohol as an example).

INFORMATION & INFORMATION & ADVICEADVICE

on the effects of alcohol on health

and wellbeing and the benefits of cutting down

ENHANCE MOTIVATIONENHANCE MOTIVATION

build the individual’s motivation to change by

helping them to weigh up the pros and cons of their drinking

MENU OF CHOICESMENU OF CHOICES

for changing drinking behaviour. Ask the individual if they can suggest ways to change

their drinking pattern (e.g. lower strength drinks, having drink free days, taking up

other activities). Be ready to offer ideas if the individual agrees

BUILD CONFIDENCEBUILD CONFIDENCE

using an interviewing style that enhances the

individual’s belief in their ability to change (their self

efficacy). For example, identifying their previous

successes, role models they can learn from and other people who can

support them

COPING STRATEGIESCOPING STRATEGIES

help the individual to identify times when they

might find it more difficult to stick to their plans to

cut down and to come up with strategies for coping

with these situations

Choose a suitable approach

Precontemplation

Contemplation

Preparation

Action

Maintenance




Exit Strategy

Close conversation & give info leaflet

Signpost and onward referral when appropriate

Exit Strategy

Close conversation & give info leaflet

Signpost and onward referral when appropriate


Enhance Motivation

Build Confidence

Menu of Options

Coping Strategies


Enhance Motivation

Build Confidence

Menu of Options

Coping Strategies


Time to have a go!!!!!

In 2’s or 3’s take it in turns to deliver the brief advice

• One of you be the practitioner• One of you be the individual receiving it• One of you observe and provide feedback

• Swap round so everyone has had a go at delivering brief advice

What other risky behaviour could it be used for?

Transferable skills

Referral Process to Support Services (internal & external)

• Specific to each school

Sarah McHardy Alcohol Coordinator

for Oxfordshire

01865 [email protected]

Bill Russell Schools Drug Consultant

Health Oxfordshire Schools Team

01865 [email protected]

last orders brief advice training. by the end of session you will: be confident in using brief...

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