Evaluation of Substance-Use Interview for Mental Health Workers

This report provides an evaluation of a substance-use interview utilized by the Victorian Dual Diagnosis Initiative as a training resource for mental health professionals. The analysis examines the interviewer's techniques across several key areas, including initial contact, rapport and respect, the client's readiness to change, and the identification of the effects of substance abuse on lifestyle and health. The report assesses the interviewer's effectiveness in establishing a therapeutic relationship, gathering relevant information, and identifying stressors. The interviewer's skills in active listening, non-judgmental communication, and engagement are also evaluated, with specific attention given to how these skills facilitated the gathering of information related to the client's co-occurring mental condition and substance use. The report highlights both strengths and weaknesses in the interviewer's approach, offering insights into best practices for conducting effective substance-use interviews and supporting individuals with co-occurring disorders. The report concludes that despite some initial areas for improvement, the interviewer demonstrated effective communication skills, ultimately leading to a successful interview.

Running head: ANALYSIS OF SUBSTANCE-USE INTERVIEW
Evaluation of interview on substance use
Name of the Student
Name of the University
Author Note

1ANALYSIS OF SUBSTANCE-USE INTERVIEW
Mental health workers are appointed by residential mental health centres or psychiatric
hospitals and are responsible for providing efficient healthcare services, and support to
respective individuals or families who experience plethora of mental issues. The primary role of
mental health professionals encompasses offering counselling services and pharmacological or
non-pharmacological treatment that facilitates individuals and families to deal with mental health
problems (Patel 2012). Therefore, it is imperative for all mental health workers to develop an
effective therapeutic relationship with all the patients and family members. Conduction of a
psychological assessment assists the workers in understanding about the risk factors that increase
the likelihood of suffering from mental illnesses.
Co-occurring mental disorders are most commonly found in combination with substance-
use disorders among individuals, who are generally subjected to psychiatric services (Becker,
Luebbe and Langberg 2012). These conditions increase severity of the mental symptoms,
complicate treatment and often lead to poor health outcomes of the patients. Also referred to as
dual diagnosis, such conditions refer to presence of both mental illness and substance abuse. A
client is reportedly diagnosed with co-occurring disorders, when at least one type of disorder is
established to be independent of the other (Ruiz et al. 2012). This essay will encompass
evaluation of an interview that was undertaken by the Victorian Dual Diagnosis Initiative as a
training tool for mental health workers and counselors.
Initial contact- Research evidences consider initial contact to be of utmost importance
before an interview is conducted in the healthcare setting (Sommers-Flanagan and Bequette
2013). The aforementioned video shows that the assessor, Jess introduced herself to the patient
Steve and said that she would be identifying and talking about the co-occurring mental disorder
prevailing in the patient. While introducing herself to the patient, the interviewer shook her

2ANALYSIS OF SUBSTANCE-USE INTERVIEW
hands. Initial contact is most often assisted by adoption and portrayal of an empathetic approach
that helps a person to think and visualise situations and instances from another person's
perspective (Nabeel Al-Yateem 2012). The video demonstrates adoption of a formal approach
with the aim of establishing initial contact with the receiver. However, there was lack of
professionalism on the part of the interviewer in establishing initial contact. This could have
been facilitated if she had asked Steve about his day so far, the place he lives, or the food he had
early in the morning. Several evidences also support the existence of a wide range of myth and
stereotypes regarding mental illness among all socioeconomic sections of the society (Clement et
al. 2015). This makes people living in the community discriminate those who are mentally
disadvantaged, which in turn worsens the situation and acts as a barrier in the recovery process
(Corrigan, Druss and Perlick 2014).
Further difficulties are also associated with the fact that people suffering from mental
illness often have low self-confidence and lose hope that they will be able to leave a purposeful
and meaningful life (Corrigan and Rao 2012). Most mental health care services suggest that
professional mental health workers should always adhere to standards of practice that makes
them adopt a non-discriminating and non-judgmental style while communicating with their
clients. Adoption of a non-judgmental approach helps the clients to understand that there is a
willingness on the part of the workers to understand their concern (Thompson, Amatea and
Thompson 2014). The video also shows that there was failure on the part of Steve to maintain
proper eye contact with Jess during the interview. His restlessness is demonstrated by checking
the wall clock. Asking a close-ended question on whether he had attended a mental health care
service before also shows that Jess was judgmental while developing initial contact.

3ANALYSIS OF SUBSTANCE-USE INTERVIEW
Rapport and respect- In order to deliver efficient mental health care services it is a
professional duty of all health workers to establish an effective therapeutic relationship and
rapport with their clients and family members. Rapport establishment increases likelihood of
success of an intervention and enhances patient outcome (Thompson, Amatea and Thompson
2014). This is generally facilitated by effective interpersonal communication skills, which if
utilised properly, help the workers to understand previous history, needs and demands of a client,
and change the healthcare plan accordingly (Thompson and McCabe 2012). Jess was found to
talk about the benefits that the client would receive from the service, following which she
received an acknowledgement. She gave adequate time to Steve to answer her questions, without
interrupting him, which suggests that she was successful in maintaining dignity and respect of
the client. This gradually made him comfortable.
Exhibiting adequate respect towards the autonomy and confidentiality of all patients, is
another the role of mental health professionals that helps patients to identify their uniqueness
(Wilson and Deane 2012). Active listening is also considered a major priority and involves
providing regular feedback and listening to the speaker (Gunasekara et al. 2014). These skills
were displayed by the interviewer during the entire conversation as she provided the client
adequate time to respond to her questions and did not force him to answer more specifically,
unless needed.
Readiness to change- According to evidences relapse or recurrence of particular health
disorders often bring about changes in opinion and personal habits of the concerned individual.
These changes are commonly referred to as behavioural change, adoption of which helps in
enhancing the health outcome and well being of all patients (Patrick and Williams 2012). Jess
asked Steve whether the latter had adopted any coping strategies to deal with the co-occurring

4ANALYSIS OF SUBSTANCE-USE INTERVIEW
mental health concern. She also questioned him on his drinking habits, frequency of drinking,
and its potential impact on his social and family life. Answering these questions made him
overwhelmed and he failed to hide his disappointment. This resulted in an emotional outburst
and Steve began to cry. His responses help the interviewer to understand that he was not taking
proper measures for coping with the problem. However, she was successful in making him
understand that all possible efforts would be taken by the mental healthcare service to help him
cope with the prevailing condition. This brought about a change in his behaviour, as depicted
towards the end of the video.
Identification of effects of substance abuse on lifestyle and health- Several researches
have been conducted that successfully established association between drug abuse, alcoholism,
and their potential negative implications on family life that includes children, parents, or
partners. Moreover, substance abuse also results in increasing the severity of mental disturbance
and often leads to depression, hallucination or anxiety (Lander, Howsare and Byrne 2013).
Hence, it is essential to understand the attitude, feelings and knowledge of a patient regarding its
impact. This helps in formulating a successful recovery plan. The interviewer was able to
identify the frequency of alcohol drinking and the patient's understanding of its impact on his
life. His responses suggested that he had lost his driving license and was unemployed. This can
be related to the fact that substance abuse often results and discrimination towards the people and
creates apprehension, which leads to loss of job and unemployment, thereby contributing to
financial stress (Mizock and Mueser 2014).
The questions asked also helped the interviewer to understand that Steve suffered from
social isolation, after being separated from his children, spouse and the community. Although
Jess was initially judgmental in her approach while talking to her client, it is quite evident that

5ANALYSIS OF SUBSTANCE-USE INTERVIEW
during the later part of the interview, she was able to engage in an effective conversation. Asking
mixed variety of questions (both open and close-ended) helped her to retrieve maximum
information about Steve.
Identification of stressors- A person suffering from chronic stress experiences negative
impacts on the mental and physical health. Such people find it difficult to effectively cope with
stress or recover from such stressful events. Negative changes such as unemployment, or
separation from family members harms mental peace (Keller et al. 2012). The interviewer tried
to understand whether Steve faced any stressful events, and what were their probable impacts.
She questioned him several times to understand if his financial loss or separation from kids made
him adopt a suicidal ideation by taking sleeping pills. On repeated questioning, she was able to
understand that there was no manifestation of suicidal tendency in the patient, and he took the
pills for only curing his sleeping problem.
Effective interpersonal communication skills are also considered imperative in mental
health nursing, and facilitate establishment of a therapeutic relationship with the clients (Cooper
et al. 2012). The interviewer that helped her in gaining his trust, which made the latter, reveal
relevant information regarding his physical and mental condition, and previous family history as
well, accurately demonstrated this. Maintaining calmness, direct eye contact, and reassuring the
patient that he will be provided with the adequate services for coping with the persisting
condition was successful.
Engagement- Jess demonstrated a moderate to good level of engagement with her client.
Although initially she should have adopted a more friendly approach to facilitate easy initial
contact and establishment of rapport, she was later on able to gain trust of her client and make

6ANALYSIS OF SUBSTANCE-USE INTERVIEW
him discuss about the difficulties he was facing. The total time allotted for the interview was
quite less, and can be considered as a major hindrance to effective engagement. The interviewer
should have spent more time for understanding the actual needs and demands of the client in
order to formulate the care plan or his appointment with the mental health worker in future.
Thus, it can be concluded that good communication skills were demonstrated by the
interviewer Jess, which in turn facilitated her professional duty of gathering relevant information
from the client regarding the factors that might have contributed to the co-occurring mental
condition. Therefore, she was able to conduct the interview with the substance-abuse patient
successfully.

7ANALYSIS OF SUBSTANCE-USE INTERVIEW
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