Stepping Towards Success

Northland DHB is working towards increasing their capacity to provide staff training in an evidence-based programme designed to deliver coping strategies and support to whānau affected by a loved one’s substance use.

The 5-Step Method was developed in the UK after it was discovered that the needs of families experiencing problematic drug and alcohol use were often misunderstood and ignored.

Alcohol and other drugs (AOD) educator, Noeleen Chaney has been raising the profile of the 5-Step Method across Northland to increase the number of practitioners at Northland DHB, and make it more widely available to whānau in the community.

The 5-Step Method can be done individually, as a whānau or in a group situation with multiple family members. Ideally, sessions are held once a week and the timing of each session is fluid and client-driven according to what they feel they need. However, the steps must proceed in order as each has its own aim. If circumstances mean whānau can’t get to all sessions, they can be done via phone or by Zoom.

Each person taking part must fill out a family member questionnaire (FMQ) before they begin. The FMQ provides clarity about the specific stress and strain experienced and helps them to explore the impact of their relative’s addiction. It is anonymised with a code and is a validated tool that contributes to research in New Zealand and internationally.

Step one is an opportunity for the whānau member to ‘tell their story’; which is often the first time they have spoken to a health professional about this.

In step two, they are provided with information and education about addiction and the substance being used to increase their knowledge and address some of the fears and misunderstandings that they may have around it. Whānau members feel empowered by this knowledge and enabled to strengthen their boundaries with their relative who is using AOD.

Step three explores the three common ways affected whānau members cope with the situation and the advantages and disadvantages of each of these, identifying how they currently respond and whether they could respond differently. Noeleen says evidence shows this is the session whānau find most helpful – and it, in turn, can have a positive effect on the person with the AOD problem because family dynamics improve.

Step Four explores the different types of support they currently have, to identify what is and isn’t helpful, and what areas they need to address or improve. The clinician can provide information about what community support is available to them.

Finally, in step five, the practitioner will identify whether they need any further support and establish a plan.

They then fill out another FMQ and again at the 12-week post-intervention where they can review their original answers to the questionnaire and discuss changes. However, the 12 week debrief session is optional and they can send the completed FMQ by post if they prefer. Noeleen says, at this point they usually see the reduction the stress and strain and can see a positive impact.

Noeleen is a qualified and registered social worker who immigrated to New Zealand 13 years ago. She worked for the Department of Corrections as a programme facilitator for eight years, then at the Salvation Army before coming to Northland DHB in May 2019 under the Te Ara Oranga Programme. As an accredited 5-Step Method practitioner and trainer, she has been providing the training and supervision to Northland DHB staff and local non-governmental organisations (NGOs) including the Salvation Army and Ngāti Hine Health Trust to become certified 5-Step Method practitioners.

To become accredited, practitioners undertake a two day 5-Step Method training course and then commence working on this model with clients. Once consent is obtained, the clinician then submits one audio-recorded example of each step of the 5-Step Method, alongside the FMQ’s with each family/whānau member they work with at the pre, post and three months follow-ups. They also complete a self-assessment of these sessions. Once they pass all five steps, they become an accredited 5-Step Method practitioner.

Marking is currently done overseas because there are not enough 5-Step Method assessors in New Zealand. However, Te Pou Limited has provided the resources for Noeleen to become accredited as an assessor of 5-Step Method trainee trainers, and for two people to become accredited trainers of the 5-Step Method in Northland.

Te Pou project lead, Michelle Brewerton said this means Aotearoa New Zealand now has the ability to be self-sustaining in training, assessing and accrediting AOD workers to develop their skills using the 5-Step Method.

“Whānau can receive help that has been proven to be effective in many cultures around the world, and 5-Step Method practitioners are providing research on its effectiveness here.

“Aotearoa New Zealand will remain connected with the international 5-Step Method organisation, Afinet, contributing to international research on this way of effectively supporting whānau,” Michelle said.

Noeleen encourages all those she teaches, to also become trainers and assessors to grow the pool of clinicians in New Zealand.

“My own experience of being assessed outside of New Zealand strengthens my commitment to becoming an assessor partly in recognition that if we grow that in New Zealand, the assessing will reflect our culture. And it will make the 5-step Method more sustainable.”

She recently gave a lecture on the 5-Step Method as part of the AUT Post Graduate studies in Mental Health and Addictions assessment and treatment planning paper. And says accreditation is a great learning experience for trainees because both their counselling skills and adherence to the Method get assessed in detail.

“That feedback is invaluable for developing clinical skills, and those skills are transferable. An accreditated workforce will ensure that we deliver high quality, consistent, and effective interventions across Northland.”

Northland DHB staff should contact Noeleen directly to do the training. For those working outside of Northland DHB, Michelle Brewerton at Te Pou Limited – michelle.brewerton@tepou.co.nz can arrange training.

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