Ken Wassum & Etta Short

1. Ken Wassum & Etta Short Service Delivery Models and Protocols (Part 3): Counselor Training

2. Core Competencies for Tobacco Treatment Specialists

3. Tobacco Treatment Specialist • Quitline counselors are commonly referred to as Tobacco Treatment Specialists (TTS). • A TTS should possesses the skills, knowledge and training to provide effective, evidence-based interventions for tobacco dependence. • Ask; Advise; Refer model increases the need for proficient TTS

4. Core Competencies for Tobacco Treatment Specialists Tobacco Dependence Knowledge and Education Provide clear and accurate information about tobacco use, strategies for quitting, the scope of the health impact on the population, the causes and consequences of tobacco use. • Demonstrate understanding of the prevalence and patterns of tobacco use. • Utilize the findings of national reports, research studies and guidelines on • tobacco treatment. • Explain the health consequences of tobacco use and benefits of quitting. • Describe how tobacco dependence develops and be able to explain the biological, • psychological, and social causes of tobacco dependence. • Provide information that is gender, age, and culturally sensitive and appropriate • to learning style and abilities.

5. Core Competencies for Tobacco Treatment Specialists Counseling Skills Demonstrate effective application of counseling theories and strategies to establish a collaborative relationship, and to facilitate client involvement in treatment and commitment to change. • Demonstrate effective counseling skills. • Demonstrate establishing a warm, confidential and nonjudgmental counseling • environment. • Describe the use of models of behavior change. • Demonstrate the effective use of clinically sound strategiesto enhance motivation • and encourage commitment to change. • Demonstrate competence in telephone counseling.

6. Core Competencies for Tobacco Treatment Specialists Assessment Interview Conduct an assessment interview to obtain comprehensive and accurate data needed for treatment planning. • Demonstrate the ability to conduct an intake assessment interview including in a • conversational and collaborative manner. • Demonstrate the ability to gather basic medical history information. • Describe when to consult with primary medical care providers and make appropriate • referrals.

7. Core Competencies for Tobacco Treatment Specialists Treatment Planning Demonstrate the ability to develop an individualized treatment plan using evidence-based treatment strategies. • In collaboration with the caller, identify specific and measurable treatment objectives. • Plan individualized treatments based on assessment data. • Collaboratively develop a treatment plan that uses evidence-based strategies. • Describe a plan for follow up. • Demonstrate the process to make referrals to other health care providers.

8. Core Competencies for Tobacco Treatment Specialists Pharmacotherapy Provide clear and accurate information about pharmacotherapy options available and their therapeutic use. • Describe the benefits of combining pharmacotherapy and counseling. • Provide information on correct use, adverse events, known side effects and • precautions for available tobacco dependence medications approved by national • regulatory agencies. • Communicate the symptoms of nicotine withdrawal. • Describe the use of combinations of medications and higher dose medications to • enhance the probability of abstinence.

9. Core Competencies for Tobacco Treatment Specialists Relapse Prevention Offer methods to reduce relapse and provide ongoing support for tobacco-dependent persons. • Identify personal risk factors for relapse and incorporate into the treatment plan. • Describe strategies and coping skills that can reduce relapse risk. • Describe a plan for continued aftercare following initial treatment. • Describe how to make referrals to additional resources to reduce risk of relapse. • Implement treatment strategies for someone who has lapsed or relapsed.

10. Core Competencies for Tobacco Treatment Specialists Diversity and Specific Health Issues Demonstrate competence in working with population subgroups and those who have specific health issues. • Provide culturally competent counseling • Describe specific treatment indications for special population groups. • Demonstrate an ability to respond to high-risk client situations. • Make effective treatment recommendations for non-cigarette tobacco users. • Describe recommendations for those exposed to second-hand smoke.

11. Core Competencies for Tobacco Treatment Specialists Documentation and Evaluation Describe and use methods for tracking individual progress, record keeping, program documentation, outcome measurement and reporting. • Maintain accurate records. • Develop and implement a protocol for tracking client follow-up and progress. • Describe standardized methods of measuring recognized outcomes of • tobacco dependence treatment for individuals and programs.

12. Core Competencies for Tobacco Treatment Specialists Professional Resources Utilize resources available for client support and for professional education or consultation. • Describe resources (web based, community, quitlines) available for continued support. • Identify community resources for referral for medical and psychiatric problems. • Demonstrate some ability to use peer-reviewed journals, professional societies, • websites, and newsletters, related to tobacco dependence treatment and/or research. • Describe how patients can explore reimbursement for treatments.

13. Core Competencies for Tobacco Treatment Specialists Law and Ethics Consistently use a code of ethics and adhere to government regulations specific to the health care or work site setting. • Describe and use a code of ethics. • Describe and utilize the regulations that apply to the tobacco treatment setting • (confidentiality & work site specific regulations).

14. Core Competencies for Tobacco Treatment Specialists Professional Development Assume responsibility for continued professional development and contributing to the development of others. • Maintain professional standards as required by professional license or certification. • Utilize the literature and other formal sources of inquiry to remain current in tobacco • dependence treatment. • Describe the implications of current research to the practice of tobacco dependence • treatment. • 4. Disseminate knowledge and findings about tobacco treatment with others.

16. Etta Short Session 15: Counselor Training

17. Building a Training Program Build training programs that are skill based, derived from competencies. consistent with best-practiced for adult education and worksite skills training.

18. Components of a Training Program

19. New Counselors Training: How Many Hours of Training? It Depends QL protocols and goals QL features Course objectives Counselor entry skills Business Needs Cost

20. Curriculum Development Roadmap

21. Building a Training Program

22. Building a Training Program Assessment Skills Counseling Strategies Evidenced Based Bx • Environment • Cognitive • Behaviors • Biology • Self Efficacy • Motivation Confidence Skill Building Education CBT/MI Reinforcement Modeling Set a QD Use Medicines Manage Urges Control Environment Support

23. Relationship and Trust

24. Culturally Competent Care • Family • Community • Kinship Patterns • Decision Making • Communication Styles • Time Orientation • Spirituality

25. When Content Matters Tobacco Use Prevalence Types of Tobacco Used Population Specific Tobacco Customs Population Specific Illness

26. Flexing Style

27. Flexing Style

28. Build your training based on competencies, learning objectives, adult education theory, customized to your quitlines goals and needs.

29. Thank You