💡 Understanding the Process
Treatment for individuals with co-occurring mental health and substance use disorders follows a structured, long-term approach. Progress is non-linear, and clients may move back and forth between stages. Engagement is the foundation for effective intervention.
🟢 Goal: Establish a Therapeutic Alliance & Build Trust
Key Challenges:
- Difficulty acknowledging substance misuse and/or mental health problems.
- Stigma, fear of disclosure, and confidentiality concerns.
- Past negative experiences with services, mistrust of professionals.
- Barriers such as housing instability, financial struggles, or legal issues.
- Cognitive or emotional difficulties that impact engagement.
Best Practices:
- Adopt a non-confrontational, empathetic approach.
- Help meet immediate needs (food, shelter, benefits) before expecting full engagement.
- Offer flexible engagement methods (outreach, home visits, virtual check-ins).
- Work with families/carers where possible to provide additional support.
- Use trauma-informed care principles to avoid re-traumatisation.
- Build motivation by exploring ambivalence and personal goals.
- Use active listening and validation to foster trust and rapport.
- Reduce service barriers by providing accessible locations, transport support, and culturally competent care.
- Allow the client to feel in control by giving choices in treatment planning.
How Do I Achieve This?
- Referral & Triage: Ensure smooth referral into the service, prioritising high-risk individuals.
- Initial Assessment: Conduct a thorough but client-friendly triage assessment.
- Building Early Trust: Use rapport-building techniques, such as open-ended questions and affirmations.
- Address Immediate Needs: Identify urgent concerns (e.g., housing, finances, medical care) and signpost to appropriate support.
- Collaborate with Other Services: Work alongside mental health teams, housing providers, and substance use services.
- Use Strength-Based Approaches: Focus on existing strengths rather than just deficits.
- Monitor Engagement Barriers: Regularly assess why a client may disengage and adapt strategies accordingly.
🚀 Key Takeaway: Engagement is about meeting clients where they are—physically, emotionally, and psychologically. Trust-building takes time, but it is essential for long-term recovery.