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AOD Sector Clinical Survey

Complex Needs

The Change Agent Network undertook a survey of the Victorian AOD sector clinicians in late 2014 to identify the main areas of clinical concern for AOD counsellors in working with clients who have multiple and complex needs.


Overall, 131 professionals working in the AOD sector responded to the survey. 

Five Clinical Dilemmas

Respondents were asked to identify the most difficult clinical dilemmas they encounter in the course of their work and to rate the difficulty of fourteen clinical dilemmas using a 5 point Likert scale, where 1 represents lowest difficulty and 5 represents highest difficulty. Overall, the five clinical dilemmas respondents rated as most difficult were:


  1. Addressing complexity within a brief intervention framework (M= 3.54),

  2. Working with client experiencing past and/or present trauma (M= 3.48),

  3. Working with clients experiencing family violence (M= 3.38),

  4. Working with clients experiencing suicidal ideations (M= 3.09).

  5. Assessing risk for children within families where there is substance use (M= 2.96).

From the results of the survey, the Change Agent Network identified that working with clients experiencing past and present trauma should be the clinical area of focus of the Practice Translation Model for 2015-2016 


This clinical issue also encompasses the need to address the assessment of risk for children, responding to suicidal ideation and responding to family violence and using modalities of service that meet available timeframes and clinical context (from brief interventions to longer counselling courses).


Also of note, the survey found that training (online and face-to-face) and clinical supervision were identified as the most important resources to enhance knowledge and implement evidence-based practice. Network forums and peer activities also rated highly as important for implementing evidence-based practice.

(M = mean)

Practice Translation Model

The development of the Practice Translation Model has been one of the key objectives of the Change Agent Network. The Practice Translation Model focuses on improving the accessibility and quality of treatment outcomes for clients and communities by:


  • Promoting knowledge of existing evidence-based practice and best practice guidelines,

  • Dissemination of knowledge, resources and  tools already available,

  • Developing consistencies in practice, across the AOD sector in line with service sector reform and configuration.


As part of the Practice Translation Model, the Change Agent Network will, in consultation with the AOD sector:



  • Make the best recommendations for improvement in practice,

  • Identify areas for training and a workforce development strategy,

  • Support the AOD services and practitioners to develop confidence and acquire clinical skills,

  • Collaborate and open lines the of communication within and across the sector,

  • Identify a clear pathway of services to facilitate collaborative care planning between different health service systems.

The research and development of the Practice Translation Model has involved extensive consultation with the Change Agent Network members, the Change Agent Network board and other experts in the AOD sector. In summary the following processes have been completed:


  • An agreement of the definition of what constitutes evidence-based practice and how to make improvements in practice,

  • Identification of the clinical area of concern for AOD counsellors in working with clients who have multiple and complex needs,

  • Documentation of the latest intervention evidence of the identified clinical area of concern and how to best implement the evidence of the intervention into practice,

  • Design of a research pilot to evaluate the process of implementing the latest evidence of an intervention into practice.

If you would like further information regarding these projects please contact the Change Agent Network.


Stage 1

Staff consultation, needs analysis and dissemination of the concept and principles of a trauma informed care framework.


Stage 2

Dissemination, orientation and implementation of practice guidelines, and organisational approach.


Stage 3

Review and refinement of approach based on evaluation and consultation.



The overall aim of the pilot is to implement trauma informed care into the practice of four AOD services, two regional and two metro and to evaluate its progress. More specifically, by participating in the pilot, the AOD pilot services would achieve the following objectives:


  • Improvements in the their knowledge, attitudes and confidence in delivering trauma informed care within their practice,

  • Development of an organisational policy (and relevant procedures) which reflects the principles and philosophies of trauma-informed care which will in turn ensure that trauma-informed care and practice is adhered to at all levels of service delivery,

  • Improvements in delivering trauma informed care into practice by reviewing and making changes to the physical environment of their services, screening and assessment processes as well as interventions with respect to trauma informed care,

  • Improvements in understanding appropriate (when/where/how) referral pathways with respect to trauma informed care.


It is beyond the scope of the project to review changes in client outcomes as a result of the pilot.

The Practice Translation Pilot follows a three stage approach to the dissemination and implementation of a trauma informed care framework within an AOD service as recommended by Associate Professor Petra Staiger and Bonnie Albrecht from the School of Psychology, Deakin University:

The Practice Translation Pilot was implemented in two regions; the Loddon Mallee Region (regional) and the North West Metropolitan Region (metro). The following services were formally invited to participate in the pilot:


Loddon Mallee Region (regional)

  • Bendigo Community Health Services

  • Sunraysia Community Health Service


North & South West Metropolitan Region (metro).

  • Isis Primary Care

  • Co-Health


The pilot is expected to be completed by mid 2016. 


We would like to acknowledge the extensive work by Associate Professor Petra Staiger and Bonnie Albrecht from the School of Psychology, Deakin University in preparing the following documents that informed the Practice Translation Pilot to implement Trauma Informed Care into practice:


  • Background Summary Of Literature On Trauma Informed Care,

  • A Framework For Implementing A Trauma-Informed Care Approach In Alcohol And Other Drug Treatment Contexts.

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