Drugs and alcohol workforce: knowledge and skills framework

3. Knowledge and Skills Framework

Delivering Family-Inclusive Care

Informed

Knowledge

1. Understands that family can include anyone identified by a person as being important in their life, and that these people should be involved in their loved one’s treatment and support.

2. Understands that families can be an asset in supporting a person’s recovery and can support change.

3. Understands the exploitative and/or abusive nature of some family relationships and is confident in escalating this to senior members of staff.

4. Understands that fear of losing parenting rights may be a barrier to some people seeking help and openly communicating.

5. Understands that women often face a range of specific barriers that hinder engagement with recovery and treatment services.

Skills

1. Supports families affected by substance use, supporting collaborative working in multi-agency environment.

2. Identifies family needs and challenges, and signposts and refers to appropriate services, with the consent and agreement of the person.

3. Identifies when aspects of family involvement may be harmful to a person’s substance use treatment or support.

4. Supports families to engage with services at an appropriate pace.

Learning resources on ‘Delivering Family-Inclusive Practice’ can be found in the Drug and Alcohol Learning Directory.

Skilled

Knowledge

1. Understands intergenerational trauma in the context of substance use.

2. Understands policies and guidelines related to family involvement in substance use treatment and care.

3. Understands the importance of proactively engaging with families when a substance use risk is identified.

4. Understands the multi-agency approach to family support and has knowledge of local and national services which support families affected by substance use.

5. Understands kinship care in relation to the Children and Young People (Scotland) Act 2014 and the impact kinship care can have on families, and specifically women.

Skills

1. Ensures families have access to relevant information, education and resources on wellbeing, mental health and substance use, and promotes utilisation of these.

2. Ensures that, where appropriate, and when informed consent is provided, that families are involved in discussions around care – adhering to the principles of the Mental Welfare Commission for Scotland ‘Carers, Consent, and Confidentiality’.

3. Facilitates family inclusion in a person’s recovery and care plans and involves families, where appropriate, in changes to plans when informed consent is provided.

4. Engages in multi-agency approaches to family support and creates and maintains relationships with local and national services which support families.

5. Supports families and kinship carers and guardians to engage with organisations which provide kinship information and assistance ensuring children have the best opportunity to grow up where the feel they belong.

Learning resources on ‘Delivering Family-Inclusive Practice’ can be found in the Drug and Alcohol Learning Directory.

Enhanced

Knowledge

1. Understands evidence-based interventions for families, such as family therapy, community reinforcement and family training.

2. Understands when family relationships are exploitative and/or abusive and is confident and competent to appropriately respond by working with relevant services.

4. Understands the rights of children and right to a private and family life, specifically in relation to the UN Convention on The Rights of The Child, and duties of public authorities under the UNCRC (Incorporation) (Scotland) Act 2024.

Skills

1. Creates and maintains relationships participating in multi-agency approaches to supporting families within local authority, health and social care partnership, and children’s partnership contexts to jointly commission services that meet the needs of families.

2. Provides social support and psychosocial therapy to family members or refers them to appropriate services and groups when informed consent is provided.

3. Disseminates resources and information to team members regarding the benefits of including families in recovery and care planning.

Learning resources on ‘Delivering Family-Inclusive Practice’ can be found in the Drug and Alcohol Learning Directory.

Specialist

Knowledge

1. Understands how to implement both local, and national, family-inclusive policies and strategies.

2. Understands local multi-agency approaches to family-inclusive practice and how to implement partnership working in services.

3. Understands that families should be involved in decisions regarding delivery and output of substance use services.

4. Understands the benefits of, and importance of, involving families in recovery and care plans and adaptions to interventions and understands how to facilitate this.

Skills

1. Influences local and national policies and procedures to include family-inclusive practice approaches within substance use service settings.

2. Develops policies and systems which specifically support family-inclusive practice.

3. Supports the inclusion of families within service commissioning.

4. Actively engages in, and facilitates multi-agency approaches to providing family-inclusive support.

5. Develops support services for families affected by substance use seeking support in their own right.

6. Ensures compliance with the UNCRC (Incorporation) (Scotland) Act 2024 in the context of service delivery.

Learning resources on ‘Delivering Family-Inclusive Practice’ can be found in the Drug and Alcohol Learning Directory.

Tackling Stigma

Informed

Knowledge

1. Understands stigma and the different forms which exist, including self-stigma and that this can inhibit access to services.

2. Understands when and how to challenge stigma.

3. Understands the importance of social inclusion in supporting people affected by substance use.

4. Understands that women who are affected by substance use often face additional stigma, particularly during the perinatal period.

5. Understands that women often face additional stigma, particularly when they have been subjected to gender-based violence, and will often access services later than men.

6. Understands the importance of involving people in their own care and support planning and decision-making.

Skills

1. Demonstrates respect and empathy towards people affected by substance use, using non-stigmatising communication skills and behaviours.

2. Escalates instances of stigmatising practice to senior members of staff, where appropriate.

3. Supports people affected by substance use to access community support, resources, and networks.

4. Promotes social inclusion and reduces barriers to services for people affected by substance use.

Learning resources on ‘Tackling Stigma’ can be found in the Drug and Alcohol Learning Directory.

Skilled

Knowledge

1. Understands local and national policies and legislation related to substance use and the impact these can have on reducing stigma.

2. Understands how to build working relationships with services, to support people at risk of social isolation.

3. Has knowledge of information, services, and resources available to support people at risk of social isolation.

Skills

1. Challenges stigma and discrimination in the workplace.

2. Actively collaborates with, and includes people affected by substance use, in their own care planning.

3. Has a working relationship with community services which can support people affected by substance use at risk of social isolation.

4. Advocates for policies and practices that challenge stigma within organisations and across systems.

Learning resources on ‘Tackling Stigma’ can be found in the Drug and Alcohol Learning Directory.

Enhanced

Knowledge

1. Understands current evidence-based strategies for reducing stigma and promoting social inclusion.

2. Understands the social determinants of problem substance use and the complex interplay between stigma, discrimination, and substance use.

3. Understands current legislation, procedures, research and best practices in human and legal rights, and anti-stigma interventions and how to implement these in service design and delivery.

Skills

1. Has a working relationship with community services which can support people at risk of social isolation.

2. Provides training and capacity-building support to colleagues and stakeholders on anti-stigma practices.

3. Implements strategies which address stigma, drawing on evidence-based approaches and best practice.

4. Creates opportunities for people affected by substance use to participate in decision-making processes.

5. Creates opportunities for women to access services in preventative ways to minimise risk of crises intervention.

Learning resources on ‘Tackling Stigma’ can be found in the Drug and Alcohol Learning Directory.

Specialist

Knowledge

1. Understands how to implement current strategies, legislation, procedures, research and best practices in human and legal rights, and anti-stigma interventions and how to implement these in service design and delivery.

2. Understands how to co-ordinate local delivery of services and resources to support people to access information required for their recovery.

Skills

1. Promotes anti-stigma and social inclusion practices within organisations and communities.

2. Develops and supports implementation of strategies which address stigma, drawing on knowledge of evidence-based approaches and best practices.

3. Engages with communities and services to address systemic and cultural stigma experienced by those affected by substance use.

4. Actively ensures staff have access to anti-stigma education and training, and promotes uptake of this amongst the workforce.

5. Actively influences collaborative care planning, creating an inclusive environment which allows people to be involved in their own care planning.

Learning resources on ‘Tackling Stigma’ can be found in the Drug and Alcohol Learning Directory.

Providing Harm Reduction Advice

Informed

Knowledge

1. Understands the role of drug checking and monitoring systems.

2. Has awareness of commonly used substances, their effects, and associated risks.

3. Has awareness of local resources and services available for people who use substances.

4. Understands what substance use related harm is, i.e. who is affected, which demographics are more likely to be affected, and how substance harms impact on society.

5. Understands the broad range of harm reduction strategies, such as needle exchange programs, supervised consumption sites, and overdose prevention education.

6. Understands side effects associated with alcohol reduction/detox.

7. Understands Alcohol Brief Interventions.

Skills

1. Has open communication about substance use with people using services to identify the evolving harms providing accurate and accessible information.

2. Encourages people to engage in safer behaviours and access harm reduction services, and provides basic education on harm reduction principles and practices.

3. Understands when it is necessary to administer naloxone.

4. Refers or signposts people to the appropriate services that may be able to provide more enhanced harm reduction service.

5. Reports to drug checking and monitoring systems such as Rapid Action Drug Alerts and Response (RADAR) when necessary.

6. Supports people to assess substance consumption and give appropriate advice on detox or reduction.

7. Supports people to convert alcohol product content into standard UK units.

8. Uses screening tools for, and delivers, Alcohol Brief Interventions.

Learning resources on ‘Providing Harm Reduction Advice’ can be found in the Drug and Alcohol Learning Directory.

Skilled

Knowledge

1. Understands, and adheres to, the eight principles of harm reduction, set out by the National Harm Reduction Coalition.

2. Understands that harm reduction consists of policies, programmes, services, and actions that reduce the social, physical and economic harm of a person’s substance use and the broader structural factors which may harm an individual.

3. Understands what wound care is in the context of substance use.

4. Understands the need to be open and transparent about the available offerings in service and the timeframes of service.

5. Understands psychological interventions to support recovery and reduce substance use harms.

6. Understands importance of monitoring of malnutrition vitamin deficiency with regards to alcohol use.

Skills

1. Assesses harm and risk and is able to refer and signpost to appropriate services able to provide more enhanced harm reduction services.

2. Engages in collaborative and client-centred approaches to harm reduction service delivery.

3. Maximises a range of intervention options: identifying, measuring, and assessing the benefits of utilising different methods appropriate to the person.

4. Distributes harm reduction supplies such as clean needles, condoms, and naloxone kits, and demonstrates their proper use.

5. Can administer naloxone when necessary.

6. Addresses barriers to harm reduction service access, including stigma and discrimination.

7. Identifies signs of injection, wounds and associated risks.

8. Supports people to access recovery organisations and services delivering psychological interventions.

9. Supports people to develop coping skills to deal with alcohol-related environments.

Learning resources on ‘Providing Harm Reduction Advice’ can be found in the Drug and Alcohol Learning Directory.

Enhanced

Knowledge

1. Understands the legal and ethical considerations related to harm reduction service delivery in Scotland.

2. Understands the biopsychological model of health and its relationship to substance use.

3. Understands when and how to support safer injecting practice.

4. Has awareness of emerging trends and understands the evolution of substance use harms, including changing regional behaviours.

5. Understands when and how to incorporate appropriate psychological interventions within harm reduction planning according to a person’s needs.

Skills

1. Teaches, disseminates and upholds the practice of the principles of harm reduction set out by the National Harm Reduction Coalition.

2. Conducts comprehensive harm reduction assessments and develops tailored harm reduction plans, maximising a range of intervention options and methods.

3. Provides overdose prevention education and naloxone training.

4. Distributes naloxone and trains others in education of naloxone administration.

5. Works with services and experts to assess psychological interventions appropriate to needs and works to incorporate these into recovery and care plans.

Learning resources on ‘Providing Harm Reduction Advice’ can be found in the Drug and Alcohol Learning Directory.

Specialist

Knowledge

1. Understands the policies and practices which demonstrate the principles of harm reduction.

2. Understands how to design, implement and evaluate complex harm reduction interventions and programs.

3. Understands harm reduction within the broader context of public health and social justice.

4. Understands Alcohol Brief Interventions and how to embed this within day-to-day service delivery, where appropriate.

Skills

1. Influences policy, strategy and raises the profile of new and emerging trends, behaviours, and strategies.

2. Plans, implements and evaluates complex harm reduction interventions and programmes.

3. Serves as a leader and advocates for harm reduction principles and practices within organisations and communities.

4. Provides consultation and training to colleagues and stakeholders on advanced harm reduction strategies.

5. Engages in policy development and systems change efforts to promote harm reduction at the local, national, and international levels.

6. Implements Alcohol Brief Interventions within service delivery and assesses ongoing delivery, as per national guidance.

Learning resources on ‘Providing Harm Reduction Advice’ can be found in the Drug and Alcohol Learning Directory.

Taking a Human Rights-Based Approach

Informed

Knowledge

1. Understands that a human rights-based approach to service delivery empowers people to know and claim their human rights and increases accountability of institutions responsible for respecting, protecting, and fulfilling human rights.

2. Understands that people affected by substance use are particularly vulnerable to having their human rights infringed and often face cultural, social, and economic barriers to having their human rights fulfilled.

3. Is aware of the key human rights that are likely to be engaged in relation to people who use substances as outlined within the ‘Charter of Rights for People Affected by Substance Use’.

4. Understands that people affected by substance use should be able to participate in, and meaningfully contribute to the decisions that affect them.

5. Understands that advocacy services can support and empower people to have their views meaningfully recognised.

Skills

1. Interacts with people affected by substance use in a way that recognises, respects, and upholds their human rights, wishes, priorities and needs.

2. Provides information to people about their human rights, and how to claim these, in a way that is easily understandable.

3. Signposts to and co-operates with legal and advocacy services to ensure that appropriate support is available for people to realise their human rights.

Learning resources on ‘Taking a Human Rights-Based Approach’ can be found in the Drug and Alcohol Learning Directory.

Skilled

Knowledge

1. Understands the difference between absolute and qualified human rights and how this affects how rights may be limited or interfered with.

2. Understands the role of the ‘Charter of Rights’ in outlining the key human rights and supporting service providers in taking a human rights-based approach.

3. Understands the term and concept of duty bearers and rights holders.

4. Understands the FAIR model and the PANEL principles and how these contribute to the development of human rights-based policies and practices.

Skills

1. Facilitates the meaningful participation of people affected by substance use within decisions that affect them.

2. Supports people to exercise their human rights; for example, facilitating people initiating internal complaints processes.

3. Ensures that people affected by substance use can access information relating to their care and support in a form and language which is easily understood.

Learning resources on ‘Taking a Human Rights-Based Approach’ can be found in the Drug and Alcohol Learning Directory.

Enhanced

Knowledge

1. Understands the International Guidelines on Human Rights and Drug Policy.

2. Understands the legislative framework for human rights, including the Human Rights Act 1998, the European Convention on Human Rights 1953 and the UN International Covenant on Economic, Social and Cultural Rights 1966.

3. Understands the role of proportionality in instances where it may be necessary to restrict a qualified right and understands the importance of establishing a legal basis and legitimate justification for any restriction.

Skills

1. Develops effective monitoring and evaluation methods for human rights standards within the organisation.

2. Implements policies and practices which utilise the PANEL principles in order to facilitate a human rights-based approach, as outlined in the ‘Charter of Rights’.

3. Uses the FAIR model to assist in taking a human rights-based approach towards balancing rights in decision making.

Learning resources on ‘Taking a Human Rights-Based Approach’ can be found in the Drug and Alcohol Learning Directory.

Specialist

Knowledge

1. Understands the Universal Declaration of Human Rights and how this should safeguard and promote people’s human rights in service design and delivery.

2. Understands how to involve people affected by substance use in decision making and the planning of services which affect them.

3. Understands that procurement assessments should consider any potential impact on human rights.

Skills

1. Develops and fosters organisational systems to address the social and economic determinants that support or hinder positive health outcomes including stigma and discrimination of various kinds against people who use substances.

2. Takes deliberate, concrete, and targeted steps to ensure that substance use services are available in sufficient quantity and are geographically and financially accessible.

3. Carefully considers human rights in commissioning and service provision decision making.

4. Develops effective monitoring and evaluation methods for human rights standards within the organisation.

5. Engages with people affected by substance use meaningfully in the design, implementation and assessment of laws, policies and practices affecting them.

Learning resources on ‘Taking a Human Rights-Based Approach’ can be found in the Drug and Alcohol Learning Directory.

Practising Trauma-Informed Care

To embed a trauma-informed approach, staff and services should refer to the established Transforming Psychological Trauma: A Knowledge and Skills Framework for the Scottish Workforce.

The Transforming Psychological Trauma Framework is intended to be used alongside appropriate generic and/or professional guidance to aid understanding of the knowledge and skills workers should have to successfully deliver trauma-informed services.

It sets out what the expectations are with regards to embedding trauma-informed care within substance use services.

In addition, the National Trauma Transformation Programme provides access to evidence-based training, tools, and guidance to support trauma-informed workforces. Whilst these resources are not exclusive to the drugs and alcohol sector; they will support the workforce in understanding how to embed trauma-informed practice.

The ‘Specialist’ level of the Drugs and Alcohol Workforce Knowledge and Skills Framework applies to those in roles where the postholder is leading, guiding, supporting, or educating colleagues; and to those who are influencing strategic direction. It is therefore not expected that those working at ‘Specialist’ level would possess all the practical knowledge and skills outlined in the ‘Specialist’ level of the Transforming Psychological Trauma framework.

It is suggested that employers apply the knowledge and skills appropriately to their own workforce. Training, workforce development, and continuous professional development related to trauma-informed care should, therefore, be appropriate to the employer’s expectations.

Learning resources on ‘Practising Trauma Informed Care’ can be found in the Drug and Alcohol Learning Directory.