Drugs and alcohol workforce: knowledge and skills framework

2. Themes

The Scottish Drug Deaths Taskforce ‘Changing Lives’, report set out that everyone who works in the substance use sector or comes into contact with people who use substances in their work should receive training on five identified themes:

1. Delivering Family-Inclusive Care

2. Tackling Stigma

3. Providing Harm-Reduction Advice

4. Taking A Human Rights-Based Approach

5. Practising Trauma-Informed Care

The order of these themes does not indicate any level of priority.

Delivering Family-Inclusive Care

The workforce should be equipped to recognise the needs and challenges of families, and the impact substance use can have on children. It is important that the workforce understands the specific circumstances of families and how these should be assessed on an individual basis.

Family-inclusive practice is a collaborative approach where professionals actively involve a person’s family and social networks in care, proactively ask about the needs of the whole family, and ensure all family members are supported.

Expected outcome

• The workforce understands ‘family-inclusive practice’ and can confidently embed this within service delivery and should adopt a human rights-based approach when doing so.
• Families are appropriately involved in care and support planning and can access support themselves.

Tackling Stigma

People affected by substance use often experience unfair treatment and attitudes. This stigma can prevent people engaging with services. Education and training can improve joint working between services, reduce stigma, and ultimately ensure more people access services and feel confident and supported to do so.

Expected outcome

• The workforce understands various forms of stigma and the impact it can have on people affected by substance use.
• The workforce can proactively tackle stigma in service delivery and create inclusive environments for people to access support and care.

Providing Harm Reduction Advice

Harm reduction is a term that defines policies, programmes, services and actions that aim to reduce the health, social and economic harms to people, communities, and society associated with substance use. It is expected that practitioners should understand a range of harm reduction options and be able to offer advice in relation to these, where appropriate.

Expected outcome

• The workforce understands harm reduction as an approach and can work with people who use substances to agree on what methods would best suit their needs.
• The workforce feels confident in providing appropriate harm reduction advice.

Taking a Human Rights-Based Approach

A human rights-based approach empowers people to know, and claim, their rights. A human rights-based approach ensures that rights are at the centre of policies and practice. This increases the ability of organisations, public bodies, and businesses to fulfil their human rights obligations and creates accountability.

People affected by substance use have the same rights as everybody else. However, they can too often face cultural, social and economic barriers in realising these rights. It is imperative that the drugs and alcohol workforce delivers services aligned with a human rights-based approach.

Expected outcome

• People accessing services have their rights promoted and upheld by the workforce.
• The workforce feels confident and able to understand people’s rights and can confidently deliver services with those rights upheld.

Practising Trauma-Informed Care

Many people who are affected by substance use have experienced trauma or adversity in their lives. Evidence highlights that when the impact of trauma is understood by staff, barriers to engagement can be reduced. Trauma-informed practice means operating in a way that recognises trauma, understands the effects, and involves adapting processes and practices, based on that understanding.

Expected outcome

• The workforce has the confidence, knowledge and skills to provide consistent, trauma-informed care and support.

Delivering Psychologically Informed Care

In line with other standards and guidance, including the Medication Assisted Treatment Standards, and The Delivery of Psychological Interventions in Substance Misuse Services in Scotland, the drugs and alcohol workforce should have the knowledge and skills to address psychological issues within the workforce and people attending services for treatment.

This includes (but is not limited to) developing knowledge (and application) of the biopsychosocial model to understand presenting strengths and difficulties, and to plan treatment. In addition, it involves drawing on psychological skills such as reflective listening, motivational interviewing, developing healthy relationships, and practising self-care. The level of knowledge and skills required will depend on a person’s role. However, as a minimum, the workforce should meet the requirements to provide psychologically informed care.

While ‘Delivering Psychologically Informed Care’ is not presented as a standalone theme in this Framework, its principles are integrated throughout, where relevant, across the five key themes.

Drug and Alcohol Learning Directory

The Drug and Alcohol Learning Directory complements this Framework by providing access to a range of resources that support development of the knowledge and skills underpinning each of the five key themes. These two resources are designed to be used together to support comprehensive learning and development.