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Training and professional development

Ongoing training and education are a key component of any service's professional development and continuing quality improvement. It is particularly important in regard to clients with complex needs. This section covers workforce development and managing organisational change.

Benefits of training

Training can be used to build up individual and whole-of-staff skill sets. By including complex needs in your mandatory orientation and recurrent refresher training, you'll ensure both consistency and stability of service provision for all clients.

Training on particular complex needs issues will:

  • Increase staff understanding, awareness and empathy when working with clients with complex needs
  • Reduce the stigma and labelling associated with people with complex needs issues
  • Improve staff communication techniques when working with people with complex needs
  • Increase staff confidence in managing people with complex needs
  • Increase staff skills for working with people with complex needs.
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Implementing training

With a small amount of planning, you can implement an organisational staff training needs analysis that will assist to accurately gauge the training needs of individual staff and the organisation in cognitive impairment and/or criminal justice.

Before and after training, measure the impact of training by implementing pre- and post-training staff surveys. The pre-training survey will identify specific areas to focus on in training, including identifying workers' self-reported level of knowledge, skills and confidence. The post-training survey will assess change in workers' knowledge, skills and confidence and help identify any further areas of training need on the topic. You can reduce costs associated with training by:

  • Sourcing and accessing free training, training grants and scholarships
  • Using free online education and training tools
  • Having systems in place for staff who attend training to feedback key learning (e.g. by developing policy and procedures related to the topic area, giving a presentation and providing resources in a staff meeting)
  • Sourcing in-house training
  • Developing training packages tailored to your service
  • Partnering with other local organisations.
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The Lyndon Community - Cognitive Impairment and Organisational Change

The Lyndon Community implemented a staff training needs survey across all their program sites. At the same time, they screened all current service users for cognitive impairment using the ACE-R screening tool (this project was undertaken as part of the NADA Practice Enhancement Program (PEP) Seeding Grant Program 2011-2012).

The results from both surveys strongly supported the need for Lyndon to address the management of clients with cognitive impairment across the organisation (Allan et al 2012).

The training needs analysis survey found that:

  • The majority of staff believed few people in treatment at Lyndon had a cognitive impairment
  • Staff had minimal or no training in recognising or screening for cognitive impairment
  • Staff had no strategies to work with people with a cognitive impairment.

The cognitive screening tool implementation found that:

  • 40% of all current clients screened identified as having a possible mild cognitive impairment
  • 12% of people screened identified possible moderate to severe cognitive impairment.

These results were used to develop an in-house training package, Working with Clients With Complex Needs - Cognitive Impairment - On-Site Training Workbook for the use of all staff across every site and program. Contact the Lyndon community for more information.

Managing Change

It's important to remember that, although training and education are crucial to increasing the capacity of drug and alcohol services in responding to the emerging needs of the community, they are not sufficient on their own to bring about sustained improvement in service delivery and system responses (Roche & Skinner 2005). To bring about sustained improvement through organisational change management, an effective process is essential.

There are three main components of change management outlined by Guarino et al (2009):

  1. Setting the scene - creating an atmosphere of change
  2. Assessing and evaluating current practice
  3. Developing a plan for change and change implementation.

All staff should be involved in assessing and evaluating the current strengths and challenges of the organisation before the change implementation process commences, ensuring all staff have input and take ownership of the change process.

A change management plan should incorporate space for staff to discuss challenges, frustrations and success stories, as implementing change can have a significant impact on organisational culture. Clients should be included in the organisational assessment process. This may involve speaking to current and past clients as well as their family and carers.

Staff at Karralika Programs Inc. talk about organisational change

Karralika Programs Inc, a therapeutic community in the ACT, has focused on becoming a more complex needs capable service. This has meant there has been an increasing expectation on staff to work with people with a range of complex issues beyond drug and alcohol and mental health. Here, staff talk about their experience of the implementation of Karralika's change management approach.

What changes have you seen among staff and clients in the last year in relation to working with people with more complex needs? Would you have felt confident to work with people with a cognitive impairment a year ago?
  • Definitely not confident a year ago - much more confident now, and so is the therapeutic community, in working with complex needs.
  • We've slowed down, changed the way we do things - come from a one-size-fits-all attitude to working more individually with residents, engaging more with them about their needs (e.g. rest and time out).
  • We use the same principles now for all people with complex needs, not just those identified in regards to the grants project.
  • Modelling from staff helped the rest of the therapeutic community understand complex needs and those who need additional attention and flexibility, with peers and senior peers being very supportive.
  • There's been real growth and understanding in the therapeutic community of complex needs.
What advice would you give to other drug and alcohol services that are becoming complex needs capable?
  • Expect the unexpected!
  • Be prepared to not stick to your routine and structure - flexibility is really important, and the need to slow down.
  • Have calm and understanding staff. Staff skill mix is important. The health worker role is important and support/backup by external experts (e.g. GPs and mental health). Formal diagnosis of conditions may be important at some stage, especially to the resident.
  • Recognise that complex needs are what we have been working with every day anyway.
  • In the therapeutic community there are really only minor modifications required - communicate with all staff and residents about what you're doing.
  • Draw on the strengths of the person and their previous experience.
  • Make sure that your environment supports what you want to do, including special areas for time out.
Has the training in complex needs areas assisted you in your work?
  • The training has been really important.
  • Training really verified a lot of what we do anyway in the therapeutic community.
  • It was great to be able learn more strategies.
  • There's more depth of understanding as a result of the training - we are working better with clients.
What are the main learnings you've gained through the complex needs project?
  • We have more tools and strategies to use than before and lots of information we can draw on.
  • That we can make small changes which help a lot.
  • Small meetings before and after group as a check-in for people with complex needs - how is everyone going?
  • Changing language, reframing questions and working with what is presented.
  • As we gradually get an understanding of the person, we're able to take a much more personalised approach.
  • We can create a much more inclusive environment.
What has impacted on your confidence in relation to working with people with a cognitive impairment?
  • That I have improved confidence is probably the main thing.
  • Working with the cognitively impaired residents - knowing that I can do it.
  • Knowing that in working with people with complex needs I am supported by my team and organisation.
  • Improved awareness of other agencies who know what we do.
Have you noticed a change in the level of people with complex needs accessing the service?
  • There seems to be increased access - or maybe we're identifying them as such now. We are not excluding now as we might have before.
  • We're becoming more tuned in to needs of people with complex needs and more flexible in our approach.
  • We have more resources now - increased knowledge and understanding, a supportive environment, more training and information.
  • We've made changes in the organisation to cater to current demand.

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List of training organisations

See a list of organisations that provide training.

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Find out more

The following resources can help your service take a whole-of-organisation training approach to complex needs:

For guidance on developing a training needs assessment and staff professional development in the sector, see the NCETA Workforce Development 'TIPS (Theory Into Practice Strategies): A Resource Kit for the Alcohol and Other Drugs Field (Chapter 9: Professional Development).

For information on how NADA members The Lyndon Community, Karralika Programs Inc and We Help Ourselves implemented change management processes to become complex needs capable, see Case Studies: Becoming Complex Needs Capable

For guidance on developing a change management workforce development approach see NCETA Workforce Development 'TIPS (Theory Into Practice Strategies): A resource Kit for the Alcohol and Other Drugs Field (Chapter 7: Organisational Change) and the Trauma-Informed Organizational Toolkit for Homeless Services, developed by the National Centre on Family Homelessness (US).

See also Change Management Template (NADA, 2013a).

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