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FACILITATOR GUIDE C H O I C E S A Program for Women About Choosing Healthy Beha

FACILITATOR GUIDE C H O I C E S A Program for Women About Choosing Healthy Behaviors National Center on Birth Defects and Developmental Disabilities Division of Birth Defects and Developmental Disabilities CHOICES A Program for Women About Choosing Healthy Behaviors to Avoid Alcohol-Exposed Pregnancies FACILITATOR GUIDE U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Birth Defects and Developmental Disorders Division of Birth Defects and Developmental Disabilities Atlanta, GA August 2011 ACKNOWLEDGEMENTS The Project CHOICES Intervention Development Team developed and wrote the CHOICES intervention that included the Client Workbook and Counselor Manual from which the Facilitator Guide for this curriculum was developed. The Team included Mary M. Velasquez, PhD, Karen Ingersoll, PhD, Mark B. Sobell, PhD, ABPP, R. Louise Floyd, DSN, RN, Patricia D. Mullen, DrPH, Mary Nettleman, MD, MS, Linda Carter Sobell, PhD, ABPP, Deborah Gould, PhD, Sherry Ceperich, PhD, and Kirk Von Sternberg PhD. The following participated in the development of the curriculum materials: Mary M. Velasquez, PhD, Karen Ingersoll, PhD, Mark B. Sobell, PhD, ABPP, R. Louise Floyd, DSN, RN, Linda Carter Sobell, PhD, ABPP, and Sherry Ceperich, PhD. Centers for Disease Control and Prevention (CDC) provided oversight of the curriculum development project and participated in all aspects of the process. CDC participants were R. Louise Floyd, DSN, RN and Catherine A. Hutsell, MPH. TKC Integration Services (TKC) worked with key members of the CHOICES Intervention Development Team and CDC in the development of a training curriculum based on the original protocols used in the successful Project CHOICES Efficacy Study. TKC staff included Caroline Bailey, MA, MPH, Julie Emery, MS, MPH, Jim Sacco, MSW, Sheryl Scott, MPH, and Jodi Verbeek. Social Solutions International, Inc. (SSI) worked with TKC to provide support services in formatting and editing the printed curriculum components. SSI staff included Susanna Nemes, PhD, Jenny Namur Karp, MPH, Ami Lynch, PhD, Sakiya Thomas, and Elaine Bonneau. The Academic Edge, Inc. provided video production services in filming selected components of the intervention using actual interventionists and actors hired by the Academic Edge. These individuals included Sherry Ceperich, PhD, Nanette Stephens PhD (interventionists), TyMyra Henderson, Angie Raygada, Amy Morgan , and Rae Damon (actors). Richard Goldsworthy, Peter Honebein, and Steve Rapa filmed and produced the videos. The findings and conclusions in this report are those of the authors and do not necessarily represent this official position of the Centers for Disease Control and Prevention. This document is in the public domain and may be reproduced without permission. Photographic images are not public property and may not be used exclusive of this document. Logos of the Federal Government, Departments, Bureaus, and Independent Agencies are not in the public domain and cannot be used without specific authorization of the agency involved. CONTENTS Overall Learning Objectives. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Facilitator’s Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Introduction to Course (Slides 1-5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Pre-tests Learning Objectives Overview of training Module 1: Overview of CHOICES and the Effects of Alcohol on Pregnancy (Slides 6-39) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Objectives of Module 1 Why drinking during pregnancy is a problem What can be done to prevent alcohol exposed pregnancies What is CHOICES Summary of Module 1 Module 2: Motivational Interviewing (Slides 40-50) . . . . . . . . . . . . . 29 Objectives of Module 2 Introduction to Motivational Interviewing Exercise: Motivational Interviewing and Non-Motivational Interviewing Comparison Exercise: Motivation Interviewing Ruler Why we use Motivational Interviewing Summary of Module 2 Module 3: Motivational Interviewing Skills (Slides 51-81) . . . . . 37 Objectives of Module 3 Characteristics of Motivational Interviewing Counseling techniques: OARS Exercise: Role Play-- Open-ended Word Video: Demonstrating O.A.R.S. Exercise: Skill Practice Change Talk Exercise: Drumming for Change Consolidating Skills Real Play: Consolidating Skills-Practice Summary of Module 3 4 Module 4: Increasing Readiness for Change (Slides 82-97) . . . . 55 Objectives of Module 4 Role of ambivalence in the change process Ambivalence and the righting reflex Increasing readiness to change Exercise: Staging Video: Decisional Balance Activity: Alcohol Summary of Module 4 Review of Day 1 Module 5: CHOICES Session 1, Introduction to CHOICES (Slides 98-118) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Objectives of Module 5 Overview and components of CHOICES Session 1 Objectives of CHOICES Session 1 Time and Materials needed for CHOICES Session 1 Activities of CHOICES Session 1 Exercise: Role Play-Temptation and Confidence Video: Introducing the Daily Journal Summary of CHOICES Session 1 Module 6: CHOICES Session 2, Reviewing Feedback and Setting Goals (Slides 119-159) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Objectives of Module 6 Overview and components of CHOICES Session 2 Objectives of CHOICES Session 2 Time and Materials Needed for CHOICES Session 2 Activities of CHOICES Session 2 Video: Reviewing the Daily Journal Video: Providing Feedback Activity—Birth Control Exercise: Providing Personalized Feedback Exercise: Trainer Demonstration of Readiness Summary of CHOICES Session 2 5 Module 7: CHOICES Session 3, Reviewing Goals and Revisiting CHOICES (Slides 160-169) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 Objectives of Module 7 Overview and components of CHOICES Session 3 Objectives of CHOICES Session 3 Time and Materials needed for CHOICES Session 3 Activities of CHOICES Session 3 Exercise: Role Play 1—CHOICES Session 3 Exercise: Role Play 2—CHOICES Session 3 Summary of CHOICES Session 3 Module 8: CHOICES Session 4, Future Goals and Planning (Slides 170-182) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 Objectives of Module 8 Overview and components of CHOICES Session 4 Objectives of CHOICES Session 4 Materials and Time needed for CHOICES Session 4 Activities of CHOICES Session 4 Exercise: Trainer Demonstrations of CHOICES Session 4 Exercise: Role Play 2—Readiness Ruler Summary of CHOICES Session 4 Conclusion (Slides 183-186). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 Review of Learning Objectives Questions about CHOICES Post-tests Training evaluation Appendix: Exercises and Handouts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 6 Overall Learning Objectives By the end of the training, participants will be able to: • Discuss the risks of an alcohol-exposed pregnancy (AEP) • Discuss ways to prevent an AEP • Describe components of the Motivational Interviewing (MI) spirit that are fundamental to the CHOICES program • Demonstrate MI strategies used in CHOICES • Discuss the key components in each of the four CHOICES intervention sessions Facilitator’s Checklist Equipment and Materials Needed: • Laptop/PC, LCD projector, and screen • Training videos • Copies of handouts and training exercises • Flip chart or whiteboard, easel, uploads/Management/ facilitator-guide.pdf