GUIDANCE FOR CONSULTATIONS
Is patient aware of how our chemsex services work? -Brief, 20 min sessions, focused on our primary responsibilities; chems use, goal achievement, change, harm reduction; not to be distracted by exploration of underlying issues, which is better left to qualified therapists. Make BEST use of brief time with us.
Begin session with a (very) recent history (1st visit). OR (follow-up visit) with a summary of goal accomplishment (or otherwise) in last week(s).
- Affirm accomplishments & successes. They did something right; what was that?
- Explore non-accomplishments; what wasn’t done right? What can be improved upon? Lessons learned.
- Prepare for coming week. Does patient understand their personal triggers? Is patient’s mastery of craving management improving?
If ambivalent; decisional balance/pros & cons.
“What brought you here?” “Why have you come?”
“How can we help you?” “What do you want to achieve here?”
“How can we best make use of these sessions”?
If someone isn’t motivated… that’s ok; don’t force change or goals upon them. Reflective questions can be helpful in these cases. Invite them to reflect and return when they are more certain of what they want to achieve.
All patients deserve to have some goal identified before they leave. Some kind of Change. It might be they are leaving with some information to be safer. Another goal might be to reflect on their use and return with a clearer idea of how they’d like us to help them. It might be a small reduction, or a big one. It might be an invitation to try a weekend without chems. There are many options for different kinds of change, different goals.
Always remember, it is the patient’s goals we are working with; not our own. Be vigilant and kind in separating your own concerns and wishes for the patient, and remain true to the principle of supporting every patient to identify and work toward their own goals.
Is patient aware of their plan before leaving? Clear on their goal? Some advice on how to be successful with it? Can they clearly explain their plan to the next worker they see, next visit? Are they aware of ALL the available walk in services we offer?
Guidance for Handovers, client notes
- Reason for presentation:
- History/contexts of recent use
- Goal identified?
- Motivation to achieve goals?
- Plan (for coming weeks. Returning?)
- Any urgent risks?
Follow up email? referral made? Info sent?