A competency framework has been developed in response to a need identified by nurses working in the addiction treatment sector.
The draft Addiction Specialty Nursing Knowledge and Skills Competency Framework was developed for Matua Raki, the National Addiction Workforce Centre, by Dr Daryle Deering.
The Framework is a professional nursing framework designed to provide, in the addiction specialty context:
Guidance on the clinical career pathway for nurses from Foundation to Advanced Specialist.
A description of the levels of practice of nurses.
Clarification of the Specialist level nursing practice for nurses, other professionals, peer support workers, consumers, consumer advisors, employers, funding and planning personnel.
Guidance for education providers in designing curricula.
Information for effective nursing workforce development.
The potential to develop a process for endorsement.
Dr Deering says the Framework will stand alongside relevant nursing and other professional codes of ethics, legislative and policy frameworks and accepted best practice guidelines. It will also complement the Standards of Practice for Mental Health Nursing (Te Ao Māramatanga). It is expected that a Specialist level nurse would be at the level of Proficient or Expert on a Professional Development and Recognition Programme (PDRP) and an Advanced Specialist level nurse would be at the level of Expert or above.
The Foundation level nurse is likely to enter the addiction specialty via two main pathways:
1. New Zealand new graduate nurses who are completing or who have completed a postgraduate entry to specialty practice programme in mental health and addiction.
2. Registered nurses who have varying levels of experience in other areas of nursing, but who are new to working in the addiction specialty.
Nurses who choose to become Specialist level nurses will develop specialist capabilities through clinically focused addiction related postgraduate programmes of study combined with formal/informal experiential learning.
Nurses who are Advanced Specialist level nurses will have completed clinically focused Masters level programmes (or be on the Pathway) together with formal/informal experiential learning. The advanced level competencies will correspond with Nursing Council of New Zealand advanced competencies and provide guidance for nurses on the Nurse Practitioner pathway.
The Framework has been developed in conjunction with a National Nursing Reference Group and the Drug and Alcohol Nurses of Australasia (DANA) Standards and Competencies Expert Reference Group. DANA is the professional nursing body which will maintain the Framework.
The next step is to develop competency indicators (examples), which is likely to result in further streamlining of the Framework.
Working with people with co-existing addiction and mental health problems (CEP) is one of the biggest challenges facing addiction and mental health treatment services in New Zealand. CEP is common rather than exceptional and people with CEP often fall between the gaps of addiction and mental health services, with the outcome being ineffective treatment, or no treatment at all, and increasing miscommunication between agencies.
The CEP project aims to improve the effectiveness and efficiency of the way addiction and mental health treatment services respond to people with CEP. The Ministry of Health is taking the lead and is supported by Matua Raki.
The Ministry of Health has published two documents: ‘Service Delivery for People with Co-existing Mental Health and Addiction Problems – Integrated Solutions’ (MoH 2010), and ‘Te Ariari o te Oranga: The Assessment and Management of People with Co-existing Mental Health and Substance Use Problems’ (Todd, F.C. 2010). The first is about systems and service development and the second provides detailed clinical guidance to services and health professionals.
The following are planned:
The Ministry of Health and Matua Raki CEP presentation at Building Bridges Conference in Wellington 16 April
The Ministry of Health and Matua Raki CEP workshops in Wellington 4 May, Palmerston North 18 May, and Napier 19 May for Funders, Planners, Mental Health and Addiction Service Clinical Leaders and Managers from the DHB and NGO sectors. Core questions will be:
How has CEP been identified in past and current DAPS?
Business Plans: How are you currently configured to address CEP?
Workforce capacity to address CEP – As routine core business
Specialist business for complex CEP presentations
The Ministry of Health and Matua Raki will provide CEP sessions at the Te Pou Central Region Co-existing Problems Forum Palmerston North 27 April and Central Region Addictions Network Forum at Palmerston North 13 May
Te Pou will provide Tools ‘N’ Techniques training to clinical leaders, service managers and NGO board/trust members
Clinical guidance workshops for practitioners will be provided at a later date.
Workshops will be progressively offered in other Regions over coming months.
The training framework and the two Ministry of Health documents can be found at: www.matuaraki.org.nz.
For more information, contact National Project Managers
Susan Scofield
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027 447 7665
and Helen Warren
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The Matua Raki Consumer Project Leader fills a national role developing the consumer addiction perspective and supports the strengthening of that perspective in areas of peer support, career pathways for the consumer workforce and leadership training, (management and consumer advisor).
Specific actions to take place:
Identify current best practice in the establishment and implementation of dedicated consumer roles.
Establish a Consumer Leadership Advisory Group to meet four times annually to participate in Matua Raki workforce development planning. [Members of the Matua Raki Consumer Leadership Group: Marc Beecroft (ADANZ Christchurch), Joe Hall (PACT Greymouth), Hayley Theyer (Waitemata DHB), Michael Hitchcock (Auckland), Rhonda Robertson (Matua Raki), Vicki Kiddell (Whangarei), Sheridan Pooley (Waitemata DHB), Anaru Perenara (Counties Manukau Alcohol Other Drug Consumer Network)].
Identify, support evaluation of, and champion the development of peer support service models.
Quarterly updates on consumer addiction treatment and workforce development issues, that seek to inform and promote the consumer workforce on local, regional and national activities
Coordinate and facilitate six regional consumer forums:
All specialist addiction treatment workers working with young people should have:
knowledge of co-existing mental health issues for youth and the relationship between adolescent alcohol and drug and mental health issues with abuse, neglect, domestic violence and/or parental alcohol and other drug use;
the ability to work with families and whanau or to access support to do this.
Supervision is highlighted as one of the key mechanisms in fostering practice change towards more inclusion of families and social networks.
Matua Raki will support Kina Trust to develop a Guide for Supervisors, to equip supervisors in their work to promote and support family inclusive practice. This project will involve compiling contributions from supervisors in the workforce into a guide.Three training workshops based on the Supervisors' Guide will be held to promote and develop Family Inclusive practice.
Matua Raki recognises that many service users and their families accessing alcohol and other drug services experience a range of other challenging social, health and educational issues. These may include significant financial stresses, offending, imprisonment and other Justice Department involvement, family violence and children’s care and protection issues.
Matua Raki supports the development of a series of creative resources to assist practitioners in working with families in ways that address risk but also build on families’ capacities.
Mana Arahi is a virtual learning programme targeting year 13 secondary school students with the aim of encouraging them to pursue a career in the AOD/social services sector. It is being piloted this year from term two and it is envisaged that it will be offered at the start of the academic year in 2011 and in subsequent years.
Matua Raki has initiated a working partnership with WelTec, which will deliver the collaboratively designed programme. The Ministry of Education is supporting the project and allowing Matua Raki to access its virtual learning network for secondary school students. NZQA has also given support and advice to the Project, particularly in the development of unit standards.
The course, which will include work experience with a local treatment provider, will not specifically target Māori students but these students will get preference to other students given the mismatch between Māori and Pakeha in the present addiction workforce. It will provide a skill-based pathway giving students the skills they need to enrol in a bachelors programme in AOD or social service studies. Matua Raki will help students obtain scholarships for their tertiary studies and actively seek a position for each student upon completion of their study. Several NGO addiction treatment providers have indicated their willingness to support the students during the pilot and while they progress through their tertiary studies.
The project has showcased the ability for collaboration between the Ministries of Health and Education, NZQA, tertiary organisations and treatment providers. It is envisaged that this will be the first of many fruitful relationships to come.
The project was given the name Mana Arahi after discussion with kaumatua at Matua Raki/Te Rau Matatini. Mana Arahi represents the students’ self-determined journey onwards and upwards from school through tertiary education and into the workforce.
“The dream has become a reality. Too often plans are made for the betterment of the planners. In this arena, Mana Arahi is designed to give our young, tomorrow’s leaders, a clear ‘pathway’ to determine their own Tino Rangatiratanga and no-one else’s. Kia Kaha Kia Manawanui.” Tunu Walker, Kaumatua.
For more information, contact Project Leader Rawiri McKinney, email
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, or phone 04 499 9340.
Cave T, Robertson P, Pitama S and Huriwai T. Matua Raki. Ōtautahi, Christchurch, NZ. 2008.
He Tētē Kura reviews the growth of the Māori addiction treatment sector and examines the lessons for a new generation of workers and leaders. The title comes from the whakataukī ‘Mate atu he tētē kura, ara mai he tētē kura’. The koru which is often associated with this whakataukī represents birth, regrowth and regeneration and symbolises sustainability and the passing of knowledge and resources from one generation to the next.
The annual Matua Raki-facilitated Māori hui provides an opportunity pre-Cutting Edge for the gathering of a group of like-minded people (those working in addiction) with a common kawa (recovery and addiction related harm) to hear and discuss matters that influence us as opposed to issues pertaining to others. It is a chance to hold our leadership accountable and also to celebrate with them the achievements of the addiction treatment sector. In other words it is a Hui-a-Tau.
Workforce development in the addiction treatment sector has not addressed all the workforce needs of the Māori workforce nor progressed Māori responsiveness. The development of the Takarangi Competency Framework has built on desires expressed at the National Summit held at Manu Ariki in 2000, previous work including Tikanga Totika (MoH) and Te Piringatahi (ALAC), and pilots over the past two years.
The development of the Framework has been a collaborative effort over time, involving Ngā Manga Puriri, ADHB Māori Mental Health and the Northern Region Māori Workforce Development Group. A range of practitioners from AOD, problem gamblng, mental health and primary care have been involved in the pilots which have not only led to fine tuning of the competencies but also the assessment processes and workshop resources.
Engagement with the Takarangi Competency Framework is voluntary and is very useful for services which do not have a quality assurance or workforce development tool for addressing work with Māori. For those who are engaged in other competency requirements of their profession (e.g social workers, nurses etc) or sector (e.g DAPAANZ) they have found the framework a useful complement to evidence their Māori responsiveness requirements.
If you are interested in the framework and or having your team take part in the introductory workshop contact Terry Huriwai (
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) at Matua Raki.
The Takarangi Competency Framework provides a yardstick against which practitioners in the alcohol and other drug, problem gambling and mental health sectors can measure their professional capacity and capability to work with Māori. Last year we had successful introductory workshops in Auckland, the Bay of Plenty, Lakes and Tairawhiti. We continue to field enquiries for our introductory workshop and for information about the framework. In December we had the opportunity to attend a hui of framework participants from Hauora Whanui.
It was awesome to see the progress the 30+ practitioners were making. We are currently evaluating the impact of the framework for services and practitioners and we will be engaging in an independent review to offer suggestions for the future implementation. As part of this evaluation we have been interviewing people who are engaged with the framework. You can now view the video clips of some of these stories online (below) Please check it out, it is an easy way to find out more about this inspirational framework. Special thanks again to everyone who has shared their whakaaro and korero with us.
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