ITEP: Helping Substance Misuse Clients Become Their Own Change Makers

scott-henery_200x200ITEP and Node-Link Mapping and Abstinence and Integrated Recovery trainer Scott Henery explains how ITEP works, and how it is changing lives:

The International Treatment Effectiveness Project – or ITEP for short – has one simple aim for clients on a substance misuse pathway: to improve treatment effectiveness by making the delivery of psychosocial interventions easier and clearer, and by promoting improvements to organisations.

One of the best predictors of negative therapy outcome is lack of focus and structure.

Mohl, 1995

So, a structured, systemised approach is needed if we are to make the most of ‘talking therapies’ and engage service users more effectively in care plan delivery.
ITEP gives us a toolkit to do this.

Node-link mapping is a visually-represented counselling strategy recommended by ITEP. It is used for improving communication and decision-making that can enhance any therapeutic or psycho-educational exercise, either in group or individual settings. Evidence shows mapping significantly improves treatment engagement and client progress indicators, as well as helping to compensate for a variety of cognitive and social deficits common among drug users in treatment.

As clients entering drug treatment usually have some degree of ambivalence about their use, a worker will ideally try to expose this uncertainty by exploring both the positives and negatives around substance use. The key task is to help the client develop a discrepancy between what they are doing now and how they would like to be in an ideal world. The difference between these two positions creates discomfort, which can be used to help the client move towards making changes.

As you’re aware, telling the client what to do – or offering expert opinion – does not usually achieve positive treatment outcomes. The worker will ideally aim to elicit self-motivational statements from the client and then amplify and feed them back as part of the process of building towards change. A key aim of these sessions is to install in the client the belief that they can become their own change-maker. In many cases this will lead to positive action without any directive work from the worker.

Public Health England recognises that mapping serves several major functions in the key working process:
  • It provides a communication tool for clarifying information and sharing meaning between keyworker and client. It can be used effectively with whatever therapeutic orientation or style a keyworker or counsellor follows.
  • Regular use of mapping-based strategies helps with the continuity of care. Mapping worksheets or notes can be placed in the client’s file, so that discussions of Care Planning or treatment issues – for example, around goals – can be picked up where they were left off at the end of the previous session. Clients may also be offered copies of maps they have worked on in a session to help with focus and task completion between visits.
  • When mapping is part of the key working or counselling process with clients, this material can be discussed jointly in supervision. Maps placed in the client’s file document efficiently outline the work being done in session. This provides a foundation and focus for supervisors to offer specific feedback and guidance.

The ITEP and Node-Link Mapping combines motivational interviewing and ITEP, together with mapping as a tool to prioritise key issues that are important for the client to address.

Of course, from the client’s perspective, it is the conversation itself that is most important. And if workers get this right, ITEP and mapping could be used as some of the stepping stones that lead to positive and lasting change.

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