Once a goal has been set, then a range of strategies can be identified to assist in the efforts to achieve that goal. This practice aspect involves identifying strategies that young people might find helpful in achieving their goals for controlling, reducing or ceasing their substance use. Some strategies and tips are also included and elaborated on in the Relapse Prevention module.
Practitioners can help each young person identify, develop and rehearse strategies that work for them and articulate these in the young person’s care-plan.
Practical strategies
There are some practical strategies that can be implemented to achieve specific goals. Ideally potential strategies are identified by the young person as the practitioner provides a curious line of inquiry. This includes exploring the young person’s previous experience and identifying their preferences. However, if a young person is finding it difficult to generate their own ideas, the practitioner can provide a menu of options that the young person can adapt to suit themselves. As a starting point these might include:
- Gradually decrease your tolerance. This might involve using at a slower rate, using later in the day or diluting the amount of substance used.
- Try rationing. Planning ahead how much of the substance will be used and when.
- Pace yourself
- Monitor yourself – keep a record that monitors how things are going. This might include a substance use diary.
- How to cope with cravings and urges
- Practice and implement drug refusal skills
- Be aware of high risk situations
- Find ways to deal with stress
The practitioner can break these strategies into small and specific components to ensure they clearly understand the young person’s perception of the practical strategy and the plan. Goal Setting is particularly relevant when assisting the young person in planning and implementing these strategies.
Pam uses cannabis daily. She has decided that she is spending too much time alone in her room using cannabis and not doing her school work. She would like to reduce her use but doesn’t know where to start. When she has tried this before, she says she gets agitated and just “gives in”. After some discussion with her worker she decides it would be a good idea to begin by monitoring her cannabis use to quantify how much she is using and to identify patterns of use.
What is the strategy? Monitor cannabis use – this means keeping a record of some kind that logs her mood and her substance use. Pam could expect to become more aware of how she is feeling before, during and after use as well as how much she is using on each occasion.
How can this strategy be achieved? This can be done by keeping a daily diary on Pam’s smart phone that rates her mood out of 10 (happy/sad or relaxed/anxious) and records how much cannabis she uses, when she uses it and where she is when she is using. Pam may also want to keep a record of the impact it has on her day (for example “I went home instead of going to netball practice because I wanted to smoke”).
How will we know this strategy has been achieved? At the end of the week there will be at least 4 entries in Pam’s smart phone that can be discussed with her counsellor.
Designing, learning and rehearsing drug refusal skills can be an important component in a young person’s list of strategies.
These need to be individually tailored to the young person’s circumstance and practitioners can provide opportunities to rehearse statements and strategies regularly.