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Performing a brief intervention in practice

Watch an example of how to perform a brief intervention with someone addicted to substances.
28.2
So Sam, we’re good to go with the inhaler. OK?
36.7
But I just want to check in with you that everything is OK. I don’t know you very well, but it seems you’re a bit stressed today. Oh, yeah. And I’m not the best, actually. I’m not getting much sleep at the moment and my mind is racing all the time. OK. And is that usual for you, Sam? Well, I guess I’m a little bit tense as well. And I’m just knackered. Sounds horrible. What do you think’s affecting your sleep? Well, nurse, well, it’s like I’ve got a bit of an habit with heroin.
83.2
And I’ve been trying to manage it and it’s been going all right, but it’s getting a bit more lately, and there’s a bloke I owe money to, and I’ve been trying to get the money together. But I’m due in court on Friday on possession, and I’m like this close to losing my job, and I can’t think straight. OK. So that’s things really getting on top of you at the moment. And do you feel that’s affecting your mood as well? Yeah, yeah. Yeah. OK, well we can look at a few things to help you with your stress and also your sleep problems. OK. Can we go through a few questions? Would that be all right? Yeah, yeah. OK, I’ve got this.
136.3
it’s called the CORE-10 assessment. And what it is, it takes a few minutes. I ask you a few questions, and we can get an idea of what your mental health is feeling this week, OK? And hopefully find ways of tweaking it some to make you feel better. All right. OK. Now, I want you to be straight with me as you possibly can. OK. These questions, these statements, I want you to pick the one that you feel best describes how you’re feeling about this week. And I want you to answer as if you’re speaking to a friend now. If it comes to the point where it’s too much for you, we can stop and we can have a break. OK. Yeah.
184.1
Yeah. Over the last week, I have felt panic or terror. Now, would you say that’s not at all, only occasionally, sometimes, often, or most of the time? Yes. It’s embarrassing to say, really, but most of the time.
212.6
Now, that’s completely natural to feel those emotions you’re feeling because of the stress. All right. OK. So over the last week, I made plans to end my life. Yeah. I’ve thought about it in the past. I’ve never made actual plans, but sometimes I just feel it would be easier if I was just gone. So it feels at times you have felt that it would be better that you were dead, but you’ve never really thought about how you would end your life? Yeah, yeah. I’ve never thought about how I would do it. And I just don’t think I could go through with it. It’s because of my family, you know.
276.8
Do you know, it’s very difficult for people to talk about this. And I really hope that because you’re sharing this with me that there’s some relief in that. And that you don’t have to think that the only way is that you should take your life, but there is support out there.
293.7
Have you spoken to anyone about this? No, not really. There’s my mate John. He knows I get low sometimes. But we don’t really talk about this sort of thing very much. But we do sometimes play pool, and that lightens things up a bit. OK. That’s great. And do you think if you told John how you were feeling, you told him that you thinking of ending your life, do you think you could tell him that? I suppose I probably could tell him, actually. And I think he’d take me seriously. And also, we can add to this conversation that we’re having now. And I can put you into contact with the support services as well. All right. OK. So next question.
356.5
Over the last week, I have felt despairing or hopeless. Sometimes. I mean, over this last week I feel like it just, it seems like it’s neverending.
377.3
You know, it sounds that you’ve been– you’re very overwhelmed with what’s going on. You’ve had a very stressful week. But you know, sometimes it’s good to do it step by step instead of trying to do everything altogether. And do it so that it’s manageable.
406.7
OK, Sam. So we’ve got the final score, which is 23. And anything between 20 and 25 suggests that you’ve been distressed, and that’s been moderately severe. Now, obviously, you’ve had a lot of panic and things going on this week, plus also not sleeping. All right. But you do have the support of your friend John. Now, do you think you could ask him to go to court with you? Oh, yeah. I never thought of that. Yeah. I probably could ask him, actually yeah. Yeah. Great. And you said to me that you didn’t feel comfortable about talking about things, and you’ve been chatting away to me about this, haven’t you? Yeah. It’s been really good, actually.
459.7
Do you attend any drug treatment services, by any chance? Yeah. I didn’t mention it to the GP, but I am actually linked in with Main Street Drug Clinic, OK. So it’d be really great to let the court know that you’re getting help, I’ll be a really positive step. And it might be good also to tell the counsellor at Main Street as well. Yeah, all right. I’ll have to think about that. Yeah. So you’ve figured out that you can get support with the drug use at the clinic. You’ve also recognised that you can talk and there’s support out there for you, and you have that support with John.
498.3
And you’ve also recognised that I’m always available to talk with you as well. So before you go I’d like to show you the four to seven eight breathing technique that you can use when you feel a bit overwhelmed. OK. Yeah, yeah. So hopefully these few steps will give you a sense of calm and control going forward. And we can book another appointment and look into strategies going forward. OK. So how does that sound for you? Yeah. Yeah, I’ll give it a try. And listen, thanks so much for this. I didn’t know what I was going to do. And yeah, I feel a bit better just getting some things off my chest. Yeah. Well, you’re really welcome. You’re really welcome, Sam.
540.7
So do we go through the breathing technique? Yeah. Yeah. So what we’re going to do is we’re going to breathe in for four. And then we’re going to hold it for seven.

In this step we observe how to carry out an unplanned brief intervention in practice.

We meet a patient who has arrived for an appointment with their general practitioner. The nurse noticing the patient’s agitation asks how they are and in the process of the conversation arranges an additional appointment for the patient outside of the GP services to address their anxiety.

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Identifying and Responding to Drug and Alcohol Addiction in Nursing, Midwifery and Allied Healthcare Practice

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