This episode was prerecorded as part of a live continuing education webinar. On-demand CEUs are still available for this presentation through all CEUs. Register at allceus.com slash counselor toolbox. I'd like to welcome everybody to group therapy, which is a product of treatment improvement protocol 41. Today, we're going to be going over chapters one and two. Tip 41, they actually did make into an in-service, which is what I loosely based the next sets of presentations on. And we're going to talk about some of the different ways you can use group and make it beneficial and helpful and hopefully easier than some other ways of approaching treatment. So in the first part of today's presentation, the goal is to provide an overview of group therapy, which is used in substance abuse and mental health treatment. And like I said, I'm loosely basing it on it. But a lot of times the groups that we're doing in substance abuse are the same ones we're doing in mental health. We're going to discuss the uses of group therapy in treatment, define five therapy models, explain the advantages of group therapy and modify group therapy to treat and address substance abuse issues. So group therapy is awesome because it supports members in times of pain and trouble. It's something that we can make available. The community mental health center that I worked at before. And if you've worked in community mental health or even private mental health, maybe a lot of times there are waiting lists to get into IOP, to get into PHP, to get into residential, to get into detox. So one of the things that we started instituting was an intervention level psychoeducational group. So we were able to sort of keep a tab on people who are on our waiting list. They got on the waiting list and they started coming to these groups that provided them tools, provided them skills. We weren't treating any particular issue. We were really focusing more on life skills, distress tolerance, emotion regulation, all that other DPD kind of stuff in order to help them get through. But it was also enabling us to provide them some hope and keep their motivation going. Group therapy can enrich members with insight and guidance. I've found and one of the reasons I love doing group so much is because you can ask a question to a group of 10 people and get eight or 10 different answers to it. And the cool thing about that is that each person has their own blind spots. So what they might not have thought about before might still be germane to them and somebody else puts it out there. So when you start putting asking questions and putting the answers on the board or using the flip chart papers and having stations around the room that people go and contribute to the group process, you start getting a lot more feedback from individuals and they're going to come up with ideas and suggestions and thoughts that not only each other had never had. So they're going to enrich each other's lives, but they teach me something every single time. So I loved doing still do love doing group and it's a natural ally with addiction treatment or treatment in general. Group therapy enables us to provide a basic framework of information to people in a cost effective manner. You know, there are a lot of things like emotion regulation, distress tolerance, self-esteem skills, effective interpersonal communication, relationship skills, self-esteem. I may have already said that that we give to all of our clients, whether it's substance abuse or mental health and everybody who's coming through the program has this curriculum, if you will, to go through. Now it's going to apply a little bit differently to each one and they're going to take the stuff they get from those groups and they're going to be able to take it back to their individual therapist and say, this is what I learned in group. If it is just a group process, then they're going to be able to talk among each other and come up with their own ideas, but IOP, PHP and residential all have an individual counseling component. If you're doing an intervention level group of 0.05 on the ACM, if you will, you may not have that individual therapy component. So you want to make sure that when you provide members with information and you help them start gaining insight that you tie it up in a nice little bow at the end and help them apply it. So what did you get out of today's group that could have been helpful last week and how could you have used it and then go back around the room and say from whatever you got from today's group or what's a morsel you got from today's group that you're going to use next week and how do you expect to do that? So I encourage them to take one or two morsels and figure out how they can use that in their particular, in their particular life, a little bit of a sidetrack here in support groups if somebody is going to celebrate recovery or 12-step group or even a depression or anxiety management group. I encourage them when they walk out of group to be able to answer the question, what was in that group for me? What can I take away from that? Now it may be I know what I don't want to do or it may be that was a great idea that so-and-so had, but I want them to answer that question every time, not just walk out of group and go, well, that was a good group. Why? Why was it a good group? What did you get out of it? Group therapy as opposed to self-help groups and support groups, if you will, has trained leaders. So you do have a lot more ability to facilitate what's going on and kind of point people in directions that you want them to go, whereas support groups may have facilitators, but they don't have the training that clinicians do. And group therapy produces healing and recovery from substance abuse and mental health issues. You see a lot of people gain hope. You see a lot of people gain optimism. You see a lot of people learn tools from one another and nobody can con a con if you will. And I had to figure out a way to say that a little bit nicer than the way I usually do.  Teenagers hear what their parents say and they're like, yeah, okay, whatever. Old buddy, buddy. But when their parents or when their peers say it, it carries a lot more weight. So sometimes the hope and faith and tools and stuff that they hear from their cohort has more impact than what we say if we've created a good supportive, healthy, nurturing environment. So group therapy has a lot of power to it because it's basically like having a bunch of co therapists and the ability to control it a little bit more than in group therapy, you can address factors associated with addiction or these factors by themselves such as depression, anxiety, anger, shame. Temporary cognitive impairment, character pathology, i.e. personality disorders, medication management and pain management. So let's go through these a little bit. Depression groups are wonderful. Now we're going to talk about different types of groups and there's everything from the traditional therapy group where people are sitting in a circle and or however, usually in a circle and sharing what's going on in their particular situation all the way to psycho educational and skills groups where we're providing them the tools to understand what's going on and the tools to deal with what they're experiencing. And you know, with depression, one of the groups I'm going to do in in depression. Well, any of these is to talk about what is it? What causes it? Where did it come from? How is it impacting you and have people start figuring out what that means to them. And then we're going to start talking probably in the next group about what are some ways we can start addressing this and what has worked for you? What what has worked in the past and what things might you want to try? Temporary cognitive impairment can be addressed in group in the sense that we can provide some life skills coaching we can provide in early recovery and substance abuse, for example, a lot of people come to our groups or at least where I used to work, they would get out of detox and they weren't fully detoxed yet. They had two days under them and the drug was out of their system for the most part, you know, except for like marijuana or benzos, but they were still not on their A game. So getting them to just get there on time be prepared pay attention and process what's going on was huge. We didn't expect to make huge therapeutic gains, but what I wanted was somebody to be able to basically dress up and show up, if you will. Character pathology can be addressed in groups. One of the basic one of the reasons that Marshall Linehan created dialectical behavior therapy was to address borderline personality disorder and dbt is very strong on skills groups now has the individual components and coaching components as well, but she uses the skills groups in order to help people with character pathologies, borderline, personality disorder, among other things start learning about what are these symptoms? What do they mean? What does it look like and how can I deal with them and then they personalize it in their individual sessions? Medication management is huge for me. Whether it's somebody who's on antidepressants or somebody who's on methadone. I really don't care, but I think it's really important for people when they start taking medication, especially psychotropic medication, whether it's addiction or mental depression, anxiety to be able to go in to a group and talk with others who've been on similar medications, understand the side effects, understand that gets better, understand what they've done that's helped them deal with the side effects. For example, a lot of my clients used to be on Sarah Quill and Sarah Quill is extremely sedating. So a lot of them found that they needed to take it at night, but I had a small group of people who when they took it at night, you know, they would go to sleep at like 11 get up at 6 30 and they were still groggy as I'll get out from the Sarah Quill and among themselves, they started talking about, okay, so I need to take it at 7 every night in order for it to be out of my system so I can function the next morning. And they worked it out by talking about how long before it starts sedating you and how long do the sedating effects last. But it helped clients stay more compliant with their medication because a lot of times and not to knock psychiatrists or doctors. But the ones that I've had experience with for the most part, I've had a couple of really awesome attendings. They don't have the patients, they don't have the time in their schedule to hear all of the issues and help the client brainstorm. And a lot of times they don't think to share with the patient. These are the most common side effects that people tell me they experience. Yes, they get the hand out from the pharmacist that's like six pages long and eight point font of all the potential side effects. But what really do people feel like when they start taking this Zoloft is another one. You know, that's what one is really commonly prescribed and a lot of patients feel kind of like they've got got the flu. They feel real dizzy for the first two, three days and then that wears off if they understand that if they have a place where they can go and talk about the side effects. And talk about how to deal with some of the side effects. It helps. And this is also a place where they can talk about things like weight gain and fatigue and lethargy and how do you deal with this when you're on this particular medication? It doesn't have to be facilitated by a nurse or a doctor. Obviously, that's more helpful. If it's facilitated by a clinician, what we want to do is encourage patients to become aware of what their potential obstacles are to maintain to remaining med compliant. Identify some ways to address it some interventions that might be effective and then go talk to their doctor. So they are armed with knowledge when they go see their psychiatrist and say, I'm having these problems and it also gives them a chance to talk to other people and understand what it actually looks like if the medication is working for them and gives them hope if they have to change two, three, four times to find the right medication. So medication management obviously is a group that I think is really important if you've got clients that are medicated. Pain management is another one. Pain can cause depression and anxiety. Your body perceives pain as a stressor. So anybody who has pain may experience negative affect, especially if it goes on for a while. So helping them figure out ways to deal with the pain, ways to deal with breakthrough pain. If you're dealing with somebody who's in recovery, then you're also dealing with the issue of pain management without narcotics. So pain management groups can be helpful for teaching stress management skills, progressive muscular relaxation and sharing non-pharmacological interventions that they can discuss with their doctor, such as massage physical therapy, acupuncture, yada-yada. It also is a place that people get hope. Again, this is going to keep coming up with group therapy, hope, because they hear other people's stories and yeah, I hear that after John's accident, he was in agony for six months and he was able to get through it so they can share and support one another. Groups provide positive peer support for abstinence from substances or addictive behaviors. Remember, we want to check our clients, assess our clients to make sure they're not engaging in addictive behaviors like internet gaming, pornography, gambling, food issue, food and eating addiction, anything like that. But it also provides positive peer support for positive action in any direction. So if it's growth goals, if it's depression goals, the group is there to cheer you on. They're also there to notice when you're starting to lose your motivation and point it out and help you increase that motivation. Groups reduce isolation. So if you're dealing with someone who's got empty nest syndrome, someone who's got depression, someone who's got an addiction, it helps them understand that they're not the only one dealing with that and they can share and support, enabling the members to witness the recovery or transformation of their fellow group members and see how other people deal with similar problems because we all, I mean, there's what, 12 people in class today. So if I throw out any problem, I'm probably going to get at least eight or nine different suggestions for how to deal with it and that's cool. But that's the awesome part about group too because they can share with each other. What do you do when you can't get to sleep at night? What do you do when the anxiety is so oppressive that you feel like you can't breathe? Groups provide information to clients who are new to the recovery process. So they know what to expect. They're not going to be giddy as I'll get out 24 hours, seven days a week, 365 days a year, probably ever because that's not reality. But it helps them learn what the recovery trajectory looks like, helps them accept the fact that they're going to be bad days and it helps them see how they can be empowered in the process. It provides feedback on group members, values and abilities. They're going to hone in on their own values and I encourage in my groups and obviously from a multicultural perspective, I think it's vital that we encourage members to explore their own values and accept or reject them as they are and it's not for me to say whether your values are right or wrong. But I want you to know what your values are and make sure that they're yours. Not something that came from the media or something that just kind of popped into your head and you don't know where it came from that you don't agree with. And sometimes that'll come up, especially as it pertains to medication use or controlled drinking or anything like that. But it also provides feedback on their abilities and this is where I really focus more than values. What is it that you have done already? What are your strengths? If you went three hours yesterday without being depressed and crying, that is really awesome. What did you do? How did you do it? How are you able to do that? And I want to highlight that ability so we can build on it. We want to highlight the exceptions to the problems and offer sort of a family-like experience where people get a sense of belonging and support when groups are run well, even if they're skills or psychoeducational groups, when a group member leaves, drops out, relapses, whatever happens, they just if they suddenly leave, it affects the entire group. When you've got a well-run group and a group member graduates or completes treatment, there's still a whole process and sort of a grieving process is that person leaves the family, launches out of the nest, whatever you want to say. We, the way I've always run groups and the way I was taught was we always celebrate that at the end of somebody's treatment experience. After the last group that that person attends, we have a little bit, a little pizza party or something in order to celebrate, let people say their goodbyes and have a good sense of closure. A lot of our clients did not have good family experiences. So we want them to have the experience of being supported, being able to have different opinions and disagree with others, but be respected and being able to be cared about. And groups encourage, coach, support and reinforce what they're doing well. We don't have to focus on what they're doing wrong. You know, obviously we can talk about that an individual or you know, it may become germane to group, but what we want to do is reinforce what they're doing right from a management perspective. Groups allow a single treatment professional to help a number of clients at the same time. Like I said, there are a core set of groups, educational modules, if you will, that I think all clients need to be exposed to. So group is a great way to do it. Instead of saying the same thing six times a day to each one of your clients, having a group available with the advent of media and internet, just like we're doing right now, web chat, web groups, you can do some skills-based groups. You know, if they're not treatment, you don't have as many issues with confidentiality, but you can also have videos online that you have them watch, learn from, complete a worksheet and then come and participate in a one-hour group instead of maybe having to sit through the whole lesson, which is an hour or so, and then participate in the group. So there are a lot of different things that you can do using group techniques in order to reach a bunch of people in with one treatment provider in the same hour, basically. Groups add needed structure and discipline because generally the group leader has a certain goal for the group or has a certain style of managing the group so it can help sort of add a rhythm, if you will, to the group process. Now, if we're talking traditional therapy groups, you're going to be sort of like the parent that controls the rhythm of the family. If you're talking skills or psycho-ed groups, you're going to be setting more of a tone of like the teacher and creating a learning experience. But it adds the structure so people feel safe. They know what they can share, what they're what's too much sharing or what's inappropriate sharing and it helps people also learn to bite their tongue, weight their turn, all those other things that can be really helpful in life. They instill hope in a sense that if that person can make it, so can I. So they see people doing a little bit better. Yeah, they also see some people doing a little bit worse sometimes, but that's that's an opportunity for them to be able to reach out and provide support. And that helps the person providing support as much as it helps the person receiving it. I truly believe that most people get a sense of contentment, if you will, by being able and being able to reach out and help someone that they are. Concerned about. It provides support and encouragement to one another outside the group setting. Now this gets a little dicey depending on your groups and your agency philosophy. In reality and substance abuse groups, the people that are in your group are probably going to be going to the same support group meetings. So telling them not to ever contact each other outside of group is unrealistic. They're going to see each other in the community. So it's important to help them understand how to set boundaries and what's okay behavior and what's not okay behavior between group members. Other groups, other facilities are less stringent on that and actually encourage the clients to reach out to one another outside of the group setting. So depending on the group, the issue, your agency, all that kind of stuff. There's going to be more or less sharing. What I want to see, especially is if you have, for example, an IOP, it's three hours. So you're going to have three groups with breaks. I want to see people talking outside of group. I want to see people sharing not just all sitting in there going. When do we get out of here? I want them to develop relationships and learn how to effectively communicate. So group therapy is not individual therapy done with an audience. It is not a mutual support group. It's designed to help people develop and practice knowledge and skills in a microcosm. You're creating a mini family or a mini community. It aids patients in learning how to develop healthy supportive relationships and also how to terminate relationships because sometimes when people graduate, they move on. It doesn't necessarily mean that they're going to continue to interact with the clients in the group. All right. So the second half of this class, we're going to look at the group therapy models used in treatment, explain the stages of change and discuss three specialized group therapy modules that may be used. So stages of change. I've gone over this before for the new people. I'll go over it again real quick. Think about getting into a pool in the summer. It's hot. It's like 90 degrees. You are sweating bullets.  No, I'm not anywhere near hot enough to go near that pool. Contemplation, you're starting to get get hot and sweaty and you're looking at the pool going, you know, that might actually be a nice change. In preparation, you move to the side of the pool and you're dangling your feet in the water, trying to figure out if you're ready to take the plunge because it's cold. I mean, compared to the 90 90 to 5 degrees that is outside and you know, you're 98.6 body temperature and water's cold. So you're preparing.  I'm too hot. Jump in the pool.   That's sort of basically like treatment and you're getting the swing of things. Then you just want to maintain. So you don't get cold again. And recurrence obviously is when you get out, you get hot again and go through this process again. So pre contemplation. I ain't got a problem. Contemplation. Yeah, I'm a little uncomfortable but I'm not ready to do anything yet. Preparation. I'm starting to get ready to make a change because this is uncomfortable but I'm not there yet. Action. I'm on it and maintenance is keeping your gains and maintaining a steady state. So variable factors for groups, the group leader group or leader focus. So if you're focusing on the part of it is your training. You know, if you are more rogerian client centered in your training versus cognitive behavioral versus DBT versus ACT, whatever your theoretical underpinnings are and what you choose to focus on in that particular group. There's a lot of stuff we can focus on whether it's cognitive, physical, emotional. We want to another thing that affects it is the specificity of the group agenda. If you're going to have a group and it's on self esteem. Well, that's not real specific. So we could go 16 different ways till Sunday. If you're looking at self esteem and disarming the internal critic. Now that's much more specific for that group. So that's going to really affect what that group looks like for that session or that set of sessions. How similar or different your group members are. If they have a lot of different experiences, you're going to have a different experience as a group leader. Then if you have a lot of people who have the same experiences open-ended or determinant duration of treatment. If you've got a group that somebody can join and if they want to stay for a hundred and four weeks, they can stay for a hundred and four weeks. That's up to them versus a group that is 16 weeks long. That's also going to affect how your group goes, what you cover, how connected group members become. I use a hundred and four weeks just to sort of overemphasize. I hope nobody stays in group for a hundred and four weeks, but the level of leader activity. I have seen groups where leaders will throw out a discussion and they're like, okay, topic for today is what do you think about it and let the group facility sort of self facilitate with a little bit of nudging here and there versus other groups where the leader is very involved and goes around and goes, okay, Sam, what do you think about this? Sally, what do you think about it? That affects how people react and what they expect. It doesn't necessarily affect what they get out of it, but these are variables which could affect how someone meshes with the group. Not everybody is going to like a real open-ended loosey-goosey group. I don't, you know, I'm real structured. So I prefer to be in groups where I know what the agenda is, what we're going to do. My groups, we start out with a review from the last group. That's the first five minutes and check in with everybody next five minutes. We do a 15 to 20 minute psycho-ed piece.  What do you think you could, how do you think you could use this next week, et cetera, and really applying it to what they know. So that's how my groups go. So they're really very structured. Obviously, you've got to be able to drop back and punt if a client is in crisis or something really strikes a nerve with them.  The duration of treatment and length of each session, you're going to cover a lot more in a three hour IOP session that and treatment is five days a week for 12 weeks. Then you're going to cover in a treatment program that's one hour a week for eight weeks. Just knowing what you're going to try to cover will affect the depth or the breadth of what you go through. The arrangement of the room also affects how the people interact. If you have them set up in theater style or classroom style, people interact differently than if they're all sitting around in a circle. And if you ever want to experiment with that, it is interesting to notice how much differently people interact and how much more they seem to participate when they're sitting sort of in a circle versus when they're in theater style and they feel like they can hide. And the characteristics of the individuals, sometimes you're going to have people who are really enthusiastic and chatty. Sometimes you're going to have people who are not and it could be for a whole host of reasons. It could be a bad fit. It could be they're involuntary. It could be they just got out of detox. It could be that they're all just at that level of clinical depression that they're having a hard time staying with the group. And it's up to us to adjust in order to try to meet the needs of as many people in group as possible. Now, while I'm saying this, they didn't really say the size of group here. The recommended size of group is 8 to 12 people. If you're dealing with adolescents or people with severe and persistent mental illness, it's more along the lines of 8. 12 for your average group, 15 for psycho educational and skills groups any more than 15. You're really doing a class and not a group. Psycho ed groups assist individuals in every stage of change, pre contemplation, contemplation, yada, yada. It helps clients learn about their disorders, their treatment or intervention options and other resources that might be available to them such as assistance with prescriptions or physical therapy or whatever other wraparound services we often call it might be available. They can also be used to provide family members with an understanding of the person in recovery. So family ed groups can be really awesome because then you get to understand and hear what the family thinks is going on and expects is going to happen in treatment and what they're seeing and hearing. And you can normalize for them. What's actually going on with the client. So somebody recovering from clinical depression or somebody with bipolar disorder, you know, this is what recovery looks like. This is what living with the disorder looks like. This is what being on this medication looks like. I've had a lot of patients because I deal with mainly co-occurring. I've had a lot of patients who have bipolar disorder and, you know, some sort of substance abuse issue. They start taking Seroquel because that seemed to be the drug of choice for our prescribing at that particular time and they would start acting all groggy and the family would freak out going you're using again. And so family education groups were a great time for us to educate not only about the disorder, but also about treatment medication side effects and how to interact with the loved one to be as most as supportive as possible. Psycho ed groups educate about a disorder or teach a skill or tool and work to engage the clients in the discussion. I don't want to stand up there and lecture. I want them to be able to throw out ideas. So if I say, you know, what is it that you do when you're struggling with somebody because they just great on your every less nerve? What are some things you do to solve that problem or to deal with it? I don't want to just tell them everything. I want to do something more Socratic and encourage them to tell me how they work with it. And if they come up with something that's not quite on point as far as being the most effective or healthiest approach, then we'll talk about it and we'll say, well, I'm sure that's worked for you. I'm wondering, you know, if there's a kinder, gentler way to do it or, you know, kind of massage it a little bit to more fit into something that is useful. We want to prompt clients to relate what they learn to their own issues, including their disorders. You know, how do you?  Psycho ed groups are highly structured and follow a manual or curriculum and it doesn't have to be a manualized curriculum that you buy from somewhere. You can create your own curriculum, but you teach the same thing and it's sequential and it follows a teach apply practice method. So you teach a skill, you have them talk about how they would apply it, how that might apply to them and then you have them practice it in role plays or imagining how they might use it next week. Basic teaching skills are required for psycho ed groups though, which requires that you understand the basic components of learning and I call these the three C's capture, which is how you get the knowledge.  I am a visual kinesthetic learner. I learned virtually nothing from sitting in lecture classes. I'm off in La La Land in about 30 seconds. I know this about myself. So I need to have material that I can see, which is why I do PowerPoints here. Some of you all may not might not even be looking at the screen. You may be off doing something else and listening to me more power to you. However you get the information in your brain is great. Global and sequential. Some people are are global. They need the big picture when they're doing a puzzle. They want to see the box first in order to do the frame and then fit all the pieces in sequential people don't want the box. That's cheating. They look for pieces and put them together and then try to figure out how all the pieces go together to make a hole and then they're wallah. There's a hole in order to appeal to both of those at the beginning of group given overview of what you're going to cover in group. And if you can sort of a written agenda, it's not always practical. I always tried to put it up on the whiteboard. We always had issues with how many copies we were allowed to make and stuff. So in the interest of saving trees try to give them some sort of an agenda so they know what the progress is or what they can expect from group. Talk about it so people can hear it apply it through role plays having them apply it to themselves make them manipulate that information in their mind and provide visual representations like bullet points of what you're going over. If you can't if copies again or an issue have them bring a notebook and write on a whiteboard so they can see it so you're presenting information as many ways as possible conceptualization is relating the information to building blocks. So if you're teaching a unit on cognitive distortions then you're going to talk about maybe using extreme words all or nothing talk.  And then we're going to talk about how to change that and how you know thinking about things that way might be contributing to some of their distress and then caring. This is the biggest one which is again why I have clients when they leave a group ask themselves what could I get out of that. Why was that important to me. If they're not motivated to remember it. They're not going to think back to high school biology or college humanities archaeology 101 for me. I learned what I needed to learn for as long as I need to learn it to pass the test. And then I forgot it all because I didn't care about it so we want them to care or they're not going to remember so get it in their heads help them relate it to something they know and make them care about it make them figure out why it's important to them foster an environment that supports participation encouraged participants to take responsibility for their own learning. Use a variety of learning methods that require sensory experiences which means talking about it you know talking about it listening to it and maybe drawing art therapy try to incorporate as many senses as possible. I always find that role plays are a big hit. You can also break up concepts and have break up your group into smaller groups and have each of the smaller groups reteach a concept to make sure that they understand it. And be mindful of cognitive impairments. So if you've got someone who is impaired in some way make sure that you have some sort of method to ensure that that person is keeping up with the rest of the group if it's a diverse group. Skills development cultivate the necessary skills to prevent a relapse depression anxiety addiction and achieve an acceptable quality of life. Part of skills groups assume that the clients lack needed skills such as coping skills interpersonal skills communication skills. Hence the term skills group. So we want to allow clients to practice skills and group psycho Ed groups provide the knowledge and if you remember in basic treatment planning knowledge skills then abilities. So you know it you learn how to use the skill and then an ability is the ability to put those skills into practice. So we want them to be able to practice these skills in a safe microcosm. You want to focus on skills directly related to recovery and those to thrive in general. Think about Maslow's hierarchy. They need to get those biological needs met. They need food shelter medication pain management health safety and safety from themselves and love and belonging. So we want to help them make sure they're getting those not just focusing specifically on depression or anxiety. Skills development groups have a limited number of sessions and a limited number of participants so everybody can practice. We don't want a big auditorium. We want that 8 to 15 number ideally and they're used to strengthen behavioral and cognitive resources. Skills groups focused on developing an information base on which decisions can be made and actions can be taken. So when they're thinking when they practice the pause and they're trying to decide OK what is the best reaction to this current situation. That's when skills kick in and they've got a menu of skills to choose from cognitive behavioral groups conceptualized dependence on substances as a learned behavior that's subject to modifications through various interventions which is a bunch of garbagely garbled a gook for CBT groups really look at using as a triggered behavior in response to pain you want pain to go away and your drug of choice does that the same is true for self-injury or a variety of other symptoms that we see in our patients. So we want to look at what's triggering those and how can we what are they trying to meet what need are they trying to meet with that behavior and how can we help them meet that otherwise. Sorry my nose is really itchy today work to change learned behavior by changing thinking patterns beliefs and perceptions and includes psychological elements like thoughts beliefs decisions opinions and assumptions CBT groups develop social networks that support abstinence. So the person with dependence becomes aware of behaviors that may lead to relapse and develop strategies to continue in recovery. Now that's for addictions groups for anxiety and depression the same is true. We want them to have social networks of other people who experience the same diagnosis if you will so they can become aware of relapse warning signs when they're starting to become impatient they're not sleeping as much there whatever their relapse warning signs are for their condition disorder whatever you want to call it. So they can develop strategies to stay happy and healthy educational devices used in CBT groups include worksheets roleplays and videos and encompass a variety of approach approaches that focus on changing the way we think and the behavior that flows from it like I cannot stand feeling this way can be changed to I really don't like feeling this way but I know it will change in the next moment CBT techniques keep teach group members about self-destructive behavior and thinking that lead to maladaptive behavior we really look at those unhelpful cognitions and the effects of them how does that impact you in your relationships the way you perceive the world and your general sense of empowerment and happiness. They focus on problem solving and short and long term goal setting which a lot of people don't know how to do imagine how much better people and more empowered people feel when they figure out hey I know how to do that I know how to see a problem develop a plan and solve the problem and they help clients monitor feelings and behavior particularly those associated with their diagnosis support groups are useful for apprehensive clients who are looking for a safe environment and they bolster members efforts to develop and strengthen their ability to manage thinking and emotions and interpersonal skills support groups don't have a trained facilitator necessarily so they're not necessarily how do I want to say this there only as effective as the effectiveness of the group leader and the health of the group leader support groups address pragmatic concerns and generally improve members self-esteem and self-confidence they're often open-ended with changing members encourage discussion about members current situations and recent problems so we're less focused on education and skill building and more focused on what's going on with you today and they provide peer feedback and require members are accountable to one another support groups vary with group goals and member needs and include facilitate facilitating discussion among members maintaining appropriate group boundaries which can be a little difficult especially with untrained if there's no trained facilitators there these groups can help the group the whole group work through obstacles and conflicts so if you've got people that are arguing within the group remember this is a microcosm this is a little family whether it's a support group or any other kind of group these people meet every week and there are going to be conflicts so we want to help people work through these and develop acceptance and regard for one another support groups ensure that interpersonal struggles among group members do not hinder group development so if you've got a relationship budding between two people not unheard of or if you've got a huge conflict getting ready to happen between two people you want to make sure that doesn't interfere with the group process so you may need to handle that outside of group or you know figure out how to address it interpersonal process groups recognize that conflicting forces in the mind some of which may be outside of one's awareness determine a person's behavior whether it's helpful or unhelpful so interpersonal process groups really help people identify the developmental influences and other things that have gotten them to where they are that influence how they act and react the way they do currently and bring a lot of stuff into awareness like oh that makes sense that I react that way because that's how my mom used to react or when I did that when I was a kid I got in trouble for it or whatever the case may be interpersonal process groups delve into major developmental issues searching for patterns that contribute to the problem or interfere with recovery abandonment issues is one that comes up a lot looking at the family of origin their coping skills we want to learn what did you learn when you were growing up that are you are using now and how effective is that for you these groups use psychodynamics or the way people function psychologically to promote change and healing and rely on the here and now interactions of members so we're really focusing on all this stuff that made you who you are and gave you the tools that you have right now how's that working for you so there are multiple types of groups that are available to assist clients in achieving their goals we view current coping skills as creative adaptations to what they've learned and ways to get their needs met they may not be the healthiest coping skills but they are serving a purpose so we want to look at the way clients are coping acting interacting just look at their behaviors and ask ourselves what's the benefit to that what's motivating that because we always choose the behavior that seems and I emphasize the word seems to have the most reward to it based on reward and effort groups help strengthen the healthy skills but they also help point out some of the unhealthy ones and again a lot of times it has more to it if it comes from a peer as opposed to if it comes from a therapist skills required to facilitate groups overlap significantly a lot of my psycho way groups are also kind of skills groups I kind of do a psycho had skills blend what I do groups and that's my style though and it's important for the group facilitator to figure out his or her own style because you're going to set the tone for your group not everybody is going to thrive in your group just like not everybody is going to mesh with you as an individual therapist but knowing your style and being confident is one of the first steps to having a really strong group experience types of groups include psycho educational which provides your knowledge and classroom type format skills development provides takes that information that knowledge and helps people translated into skills okay now I know what an unhelpful thought or a cognitive distortion is what do I do about it skills group is the what do I do about it and let's practice it so when I have this thought what can I do cognitive behavioral groups really kind of integrate those but focus strongly on what's going on with the individual and the thoughts the if you think of the ABC's the automatic beliefs that may be perpetuating or maintaining the unpleasant consequences and support groups are those groups that are not facilitated by a trained facilitator or by a clinical facilitator some groups like smart recovery the facilitators are trained but they're not necessarily clinicians and group members are accountable to one another more so than accountable to a group leader start group by telling people what they're going to learn and do and why it's useful to them make them care give them that global perspective of what's going to happen and then go through the information step by step or sequentially so all of your learners are getting as much as possible provide an overview of what you're talking about have written material like I said if copies are a big issue where you come from it's not unheard of or if you just don't like making lots of Xerox copies write it on a whiteboard and encourage clients to bring a notebook and write it down clients will actually remember things better if they have to write it down because they're going to paraphrase it which is a form of kinesthetic learning before they write it down most likely because they want to write down as little as possible discuss the material and apply it ask for their input how do you deal with this what do you think about this option how could you use this how could you have used this last week and what do you think you might how do you think you might use it next week and give me an example of what that would look like you can also have them role play maybe they're having a particular somebody in the group is having a particular issue with a supervisor or roommate you may choose to role play that in group and have them apply a skill that you're talking about have each group member closed by identifying one thing they got out of group and how they're going to use it in their recovery plan again this brings it back to caring has them kind of tie it up into a neat bow and be able to walk out with one tool you give them to too many tools in one group and they're going to walk out and none of them are going to get used you give them one tool and they walk out they may try to use it throughout the week and then next week in group you can ask them had it go you enjoy this podcast please like and subscribe either in your podcast player or on YouTube you can attend and participate in our live webinars with Dr. Snipes by subscribing at all see us dot com slash counselor toolbox this episode has been brought to you in part by all see us dot com providing twenty four seven multimedia continuing education and pre-certification training to counselors therapists and nurses since two thousand and six use coupon code counselor toolbox to get a twenty percent discount off your order this month


Mert hynny wrth meddwl i ddarparu cyfnodig dod o adeiladau cyfnodig yn cymdeithasyn a cyr dysg yst restart. 1. David Stewart I thank you, Presiding Officer, to ask the Scottish Government when it last met European Commission officials and what was discussed. 1. Jonathan Watt Discussions between the European Commission and the Scottish Government take place regularly at both ministerial and official level. Routine discussions have continued since the EU referendum to ensure the effect of continuation of EU-related business and to underline the Scottish Government's commitment to working with the European Commission. Only yesterday, the Cabinet Secretary for Environment, Climate Change and Land Reform attended the EU Environment Council in Brussels, attended by the EU Commission. Presiding Officer, the Cabinet Secretary will be well aware that the EU emissions trading scheme is the world's largest scheme for trading emissions and alignment systems and is a key weapon in fighting climate change. At the next meeting with the European Commission and indeed UK officials, will the minister raise ETS, which raises billions of euros to help the industry innovate and invest in clean technologies and is an essential, it remains a key part of the Scottish climate change plan? Clearly, clean technologies and the opportunities and investments that can be afforded by our partnership with colleagues across the European Union is one of the vital factors as to why we have to make sure that we can have some kind of continuing positive relationship with the EU and in relation to standards. That's clearly important in terms of climate justice and tackling climate change. In terms of my meetings with the European Commission, I would attend the Education and Culture Council in particular and also in relation to the EU referendum. It would be my colleagues in other portfolios, whether it's the energy portfolio or indeed the climate change portfolio that would take forward these matters, but I will relay them to the relevant ministers. When the minister or whichever minister meets with the European Commission, is there any confusion from the commission? Do they ask why, indeed, we have so many European ministers in the Scottish Government? Every minister in the Scottish Government not only has responsibility for our international profile but also for the economy. Every single one of our ministers, when they engage with the European Commission, are advancing the economic cause and interests of Scotland. In relation to my activities, I particularly focus on the bilateral discussions with the EU capitals and with the institutions. It's very important that we don't descend into parochial and inward-looking approaches, which I think that some people in the chamber would like us to see. I hope that Neil Findlay isn't one of them. 2. George Adam To ask the Scottish Government how the historic environment can promote culture in towns and cities. The historic environment promotes culture in our towns and cities in many ways. It's intrinsic to our sense of place and strong cultural identity. It tells the story of our shared past and offers creative inspiration. As the physical embodiment of our cultural traditions, a well-managed historic environment helps to present a positive image of Scotland around the globe, attracting UK and international visitors and investors. As the backdrop to our daily lives, it supports all forms of cultural activity, providing venues for a wide range of cultural events and meeting places, which are such a feature of Scotland's community life, from folk music to amateur dramatic literary societies. In every way, the historic environment is at the heart of our flourishing and dynamic cultural life. George Adam I thank the cabinet secretary for answering. The cabinet secretary will know that Paisley has a very high number of listed buildings. Does he agree that that is an asset that is important to promotion of culture and, although challenging, is one of the many strengths that Paisley has in being named as UK city of culture in 2021? George Adam continues in his campaign for the city of Paisley. I recognise that Paisley has one of the highest number of listed buildings in the country. Paisley Abbey is certainly one of our finest examples of medieval churches, but it is also about the rich heritage of Victorian buildings and the very important textile and economic history of our country, which is well illustrated by the cultural connections and the building heritage and the built environment heritage that has passed on from courts and clerks, for example. Building that into the bid is a very wise thing for the city of Paisley to do. John Scott Thank you, Presiding Officer. I declare an interest as the convener of the cross-party group on towns and town centres. Given her own roots, the cabinet secretary will be well aware of a significant and important cultural history of air going back to the 11th and 12th centuries and before, and she will know the need to promote and raise awareness of the tourism potential that exists in air based on its cultural heritage. What contact has her office had with South Ayrshire Council in recent years on that and is there help that she might be able to provide in future to support tourism growth and cultural development in all the air town centres? I attended a very important visit to South Ayrshire where they were developing their cultural place partnership with Creative Scotland. A lot of that was about the contemporary culture, but it then delved into the wider, deeper history of air. I am very interested, in particular in our most recent contact with air, in relation to the archaeology that is currently being undertaken with the demolition of some of the buildings that are around the town centre of air. I think that the story that it will tell of the medieval past of air will be fascinating and will help to enhance what is already a very strong history story about air that can attract visitors from near and far. I welcome the preservation and enhancement of our historic urban environment, but the true measure of success for such projects in promoting cultural enrichment must surely take account of both the public's ability to access, share and participate in cultural capital and, also, and critically, for a resulting and sustained long-tail dividend. What steps is the Scottish Government taking to ensure that this is the case? I am very proud as part of the budget that was just passed last week, which was opposed by the Conservatives. We managed to maintain free access to our museums and galleries, which is very important. In the fantastic results that we have seen this week in terms of visitor attendances and our key attractions. Of the top six, I think that five of them had free access, which was very important. The other being Edinburgh Castle. That is a very important part of what we do is making sure that people have access to their story, their buildings and their places. Lewis MacDonald, the cabinet secretary will be aware that both Historic Environment Scotland and Aberdein City Council have recently pledged over £1 million towards the revitalisation of landmark buildings in Union Street. Does she agree that that offers the potential for transformation of Aberdein city centre over the next five years, and is it a model that other cities could also follow? I am very keen that, in some of the agreements that are being made, particularly in relation to city deals, heritage, tourism and culture are at the heart of that. The transformation of city centres and town centres is very important. Indeed, the cars, projects and funding from Historic Environment has been very important in that. Dalkeith, Kilmarnock have all benefited from that, but in terms of the investment, I know in the music hall for example, in Aberdein that has been something that I have had a keen interest in and has had support from government agencies and, indeed, from Creative Scotland to Historic Environment Scotland, they have been very critical in some of that funding. Therefore, we work very hard to deliver that, and I think that it is really important, and I am delighted that the support is there from Aberdein City Council as well. To ask the Scottish Government how successful it considers Celtic Connections 2017 has been for Glasgow and Scotland. Celtic Connections has grown since 1994. It is the largest winter music festival that is kind in the UK. In 2017, it hosted 2,375 artists, 1,800 hours of music on 26 stages throughout Glasgow, 110,000 tickets, and 80 per cent of shows were sold out, breaking all previous records. An independent impact study conducted on behalf of Celtic Connections found that it generated over £7 million from visitors in Scotland, providing a benefit of more than £4 million across Scotland. Success and cultural highlights for 2017 included Labanda, Europa, inspiring women, the Canada 150th anniversary and a very successful Brazilian music showcase. John Mason. I thank her for that answer and very much agree with the points that she makes. Some people feel that the definition of Celtic has become wider and wider. Does she think that that is a good thing to be very inclusive, or does the definition of Celtic music need to be narrower? I am the culture secretary. In terms of decisions about what is the curatorial excellence of any cultural activity, I think that is for the festivals and indeed the galleries and museums themselves. What I would say is that internationalist outlook in the fusion, particularly of whether it is Indian traditional musicians and our own or indeed Brazilian, as I have just mentioned, is very important. Next year, in the 25th anniversary of Celtic Connections, I am sure that John Mason and others will be delighted to know that the partner country for next year will be Ireland, and I think that that is about as Celtic as you can get. Annie Wells. Thank you, Presiding Officer. It has been well documented in the media that a teen who parks this festival will be taking place in Glasgow this summer. Can I ask what discussion the Scottish Government has had with organisers and Police Scotland about managing the potential impact of antisocial behaviour on local residents? Cabinet Secretary. That is not a matter of the responsibility from myself as Cabinet Secretary, but I think that in terms of any major festival, the authority concern that will be taking forward those discussions with Transport Scotland but also with Police Scotland. It is very much part and parcel of our event management across Scotland that these agencies work together in order to deliver a great experience for people, and I am sure that the festival will be of great economic benefit to the city. Graham Dey. Thank you, Presiding Officer. To ask the Scottish Government what progress is being made in negotiations with the UK Government regarding the freedom of movement of agricultural and horticultural workers post Brexit. Presiding Officer, we are aware that the UK's forthcoming exit of the EU has created significant uncertainty within the agricultural sector. We need to ensure the continued protection of the rights of all workers employed in Scotland's rural economy, limiting free movement of people and has the potential to seriously harm Scotland's long-term economic future. There have been discussions and exchanges with the UK Government on freedom of movement, including those in the joint ministerial committee on European negotiations, which I attend alongside representatives of the Welsh Government and the Northern Ireland Executive. Within those discussions, I have consistently raised the importance of freedom of movement to Scotland in terms of contributing to sustainable economic growth, mitigating the effects of demographic change and enriching our culture and communities. The First Minister has also repeatedly called on the Prime Minister to guarantee EU nationals' right to remain in the UK. Unfortunately, despite our consistent representations of the UK Government on this issue, the Prime Minister still refuses to deliver that guarantee, despite having the power to do so. The Scottish Government appreciates the importance of obtaining a guaranteed right to remain for EU nationals and will continue to strongly support that. Graham Dey. I thank the minister for that answer. Can I ask him further what it is about this Tory Government that it seems so incapable of grasping the impact of this uncertainty on the businesses, the economy, just as important as the individual's concern, or is it that it just does not care? Minister. I would hesitate to speculate about the motivations of the present Tory Government. They are a mystery to most people, but the Tory obsession with immigration and the Scottish Tory's determination to become born again Brexiteers are working against the interests of the rural sector, against the interests of our economy and against the interests of fair treatment of citizens of Europe who are living here. Surely it is time for them to reflect upon it and having reflected to act. I refer members to my register of interests. The minister will be aware that farmers north and south of the tweed will be looking carefully at the issue of agricultural workers. Does he agree with me that the UK's Brexit approach should be based on economic issues across sectors and not geography? I think that Mr Chapman is right to say that the economic focus is of great importance. The economic importance of freedom of movement and the economic importance of migration is very great indeed in Scotland, where he, to travel westwards to my constituency, he would see a constituency that is losing population from the rural areas in which there is a shortage of labour that needs to be replaced by European migration. 90 per cent of the growth in population in Scotland in the next 20 years is anticipated to come from European migration. I would hope that Mr Chapman would stand up for the people who elected him, the people of Scotland and stand up for Scotland, but I keep hoping that from Scottish Tories, Presiding Officer, and I never hear it. To ask the Scottish Government what plans it has to acknowledge and commemorate the role of the founding director of the Edinburgh International Festival, Rudolph Bing, in its 70th anniversary year. In recognition of the 70th anniversary of the founding of Edinburgh's festivals, the Scottish Government is providing an additional £300,000 of funding through the Edinburgh Festival's Expo Fund. Each festival will develop its own celebrations of the anniversary and its specific expo funded projects, with the Edinburgh International Festival announcing its programme on 15 March, and it intends to mark Rudolph Bing as the founding director in 1947. Thank you, cabinet secretary, for that response. Rudolph Bing, of course, was a Jew and tonight in Edinburgh city chambers there will be a reception to commemorate and celebrate the 200th anniversary of the Jewish community here in Edinburgh. She will be aware of the International Shalom Festival, which brings together Israelis of all religions for an evening of culture and performance at the Edinburgh Festival. Because of the minority but vocal protests that were faced last year, many venues are reluctant to host the Shalom Festival this year. In the light of that, what support can the Scottish Government give to ensure that the Shalom Festival is able to continue in this 70th anniversary year of the Edinburgh Festival, founded by a Scottish Jew? Every festival is responsible for how they support those who come. Some are curated, some are not. In terms of the festival that he is talking about, I will be interested to see the details of which festival is being celebrated as part of it. However, it is very important that we send out a message to all communities that we are an inclusive and open society and in celebrating those who contribute today and in the past. We should also be mindful of how we conduct ourselves will be understood across the world. The director of the Edinburgh International Festival has previously stated that the poisonous rhetoric of Brexit talks could seriously damage the festival. Unfortunately, it is something that Jackson Carlaw's UK Government colleagues bear responsibility for. Does the cabinet secretary agree that the interests of our culture and creative industries are best served by protecting Scotland's strong relationship with the EU? Our festivals are testament to the importance of that international reach. In terms of our culture and creative industries that are in Scotland, freedom of movement is absolutely vital. It is an economic interest of this country, but in terms of the culture and creativity of those connections, that is irreplaceable. If the destruction to that or even the threat of destruction to that causes harm to our culture and creative life, the manifest of that will not be just experienced by those in the current day, it will be experienced for generations to come. That is how serious freedom of movement is to this country. To ask the Scottish Government what progress it is making in securing additional funding for BBC Alba. The Scottish Government has made strong, clear and consistent representations to the BBC in order to secure additional funding for BBC Alba. The BBC announced on 22 February that it would cover the £1.2 million cost of Gaelic programmes that BBC Alba to date has funded, releasing welcome funds for BBC Alba. Separately, it will support weekend news coverage. We look forward to receiving further details from the BBC in order to understand more fully what the implications and benefits of the recent announcement will be. We will continue to press the BBC to deliver more for Gaelic broadcasting so that we can move towards parity with the resources afforded to S4C. I thank the cabinet secretary for her reply and I certainly join her in welcoming the extra £1.2 million for BBC Alba. That said, the cabinet secretary may be aware of concerns in the Gaelic community following last week's new channel announcement that the creation of the channel could result in a detrimental impact on funding for BBC Alba. With the commitment given last week of up to 7.2 hours fresh in-house programming for BBC Alba per week, the BBC investment announced last week falls well short of what BBC Alba needs to ensure that it can sustain its historic success and continue to be an effective contributor to the revitalisation of Gaelic. The cabinet secretary has given a commitment to impress upon the BBC the need for a 10-hours-per-week in-house contribution, and I urge her to continue to do that. I think that the case for BBC Alba is well made. Indeed, I think that it has been fairly instructional on how a BBC programme-making can help to develop and support the creative industries. We will have a debate on that later on on this very matter, but it is essential that 10-hours-per-week of in-house contributions to BBC Alba is secured. That is not what has been secured to date, and it is something that we will continue to support and continue to make the case for. To ask the Scottish Government what progress it has made in developing links with Qatar. The Scottish Government remains open to opportunities to engage with Qatar through diplomatic, economic, educational and cultural ties. In addition, the Scottish Development and International Middle East Office, based at the British Embassy in Dubai, works closely with companies from countries in the Gulf region, including Qatar, who are looking to invest, relocate, partner or expand in Scotland. Scotland has a strong and enduring commitment to securing democracy, the rule of law and human rights across the world. As a good global citizen, the Scottish Government takes this seriously when exploring links with any country. We expect all states to comply with international human rights law and we use our international engagement as an opportunity to promote respect for and understanding of human rights. The Scottish Government previously dispatched the former First Minister and the current Transport Secretary to Qatar to build cultural links and to flog public service infrastructure to the Qatari sovereign wealth fund. Can the minister now tell me what investments have been made in our public infrastructure and in our cultural sector by the Qataris at the same time as building workers lose their lives on world-cut projects in Qatar? Let me address directly the points that were made about human rights, since that is legitimately what the question is about. I think that it is important to say and he mentions him that my distinguished predecessor, Humza Yousaf, has raised specifically the issue of migrant worker rights with the ambassador of Qatari, who did so on 10 March 2015. Humza Yousaf also met with Amnesty International regarding Qatari human rights and was briefed by them. He has raised similar issues at the festival of literature that took place in the Emirates in 2015. Specifically on the issue of construction, I know that Humza Yousaf spoke with the Qatari authorities regarding specifically human rights and the world cup. Indeed, that is something that the Scottish Government has continued to keep an eye on. That concludes our questions on culture. We move on to justice and the law officers. I start with question 1 from Lewis MacDonald. To ask the Scottish Government what its response is to the recent update report by Her Majesty's Inspectorate of Constabulary in Scotland on call handling in Police Scotland. Cabinet Secretary Michael Matheson. The Scottish Government welcomes the publication of the HMICS update report on call handling and notes the considerable progress made by Police Scotland since November 2015's HMICS independent assurance review on the same subject. We expect the Scottish Police Authority and Police Scotland to give careful consideration to the findings of the update report and to continue working closely with HMICS as it seeks to further strengthen its approach to police call handling. Lewis MacDonald. Thank you very much. Given that the report says that limited progress has been made in improving the functionality and accuracy of the gazetteer used by control room staff and that nearly a quarter of all notable incidents were because the wrong location was chosen by the service advisor, what further action will the cabinet secretary now take to address those issues? Will he, for example, reconsider at this stage his plans to close the control rooms in Aberdein and Inverness, which can only lead to an increase in such incidents? As the member will recognise, the report overall does show very good progress that has been made by Police Scotland in the way in which they are taking forward reforms around call handling in only last week. The chief inspector of HMICS gave evidence to the sub-committee of the Justice Committee on Policing, in which he praised the work that has been taken for by police call handling staff and the service in taking forward this area of reform work. He has identified an area where there is an issue around stability of the gazetteer system. There is a practical issue here and a practical issue is that we have three emergency services that have historically all used separate gazetteer systems for the very same purpose. Our ambulance services had one, our fire services had one and our police services had one. One of the areas of work that is being considered is the use of a single gazetteer system that would be used for all of our emergency services, which would ensure that it was most up-to-date as possible. That is an area of work that we would expect to continue to see progress being made on. However, overall, from the assurance review, we are now in a situation where, of the 30 recommendations, 16 have been discharged, 12 have been partially discharged and only two remain open. The issue around the intended changes in Aberdeen and Inverness are areas of work where there is still progress being made. The assurance review group met only yesterday to consider the on-going changes at Aberdeen, and there will be further work taken followed over the coming weeks, but it demonstrated that very good progress is being made in the change and transfer in Aberdeen. The SPA will consider that further at its next board meeting on 22 March. I do not have good news for the member in his call for the call centre changes in Aberdeen and Inverness to remain open. Obviously, Inverness is changing for another purpose under Police Scotland in a way in which it is going to be operating, but what I can give them an assurance is that good progress has been made and the assurance review work that I directed and expect HMICS to continue to make progress on will continue to be reviewed and monitored as we move forward with this. Peter Chapman Thank you. To ask the Scottish Government what steps it is taking to improve the completion rate of community payback orders. The delivering community payback orders and ensuring completion of those orders is the responsibility of the relevant local authority. The national outcomes and standards for social work services in the criminal justice system contains guidance on the procedures involved and the actions that social work case managers can take in cases where the individual is failing to complete their order. That can include returning the case to court. The Government is committed to supporting local authorities in delivering robust community sentences and funding for criminal justice social work remains at record levels. We also invested an additional £4 million in community services in 2016-17, and that additional funding continues in the Scottish budget for this coming year. From 1 April, our new model for community justice will come into effect. Statutory community justice partners will jointly plan and deliver services to prevent further offending and support those who have offended to reintegrate into communities. A new public body, Community Justice Scotland, will provide national leadership in this area and report to ministers on performance across Scotland that will promote improvement in the delivery and impact of community justice services, including prevention, early intervention and community sentences. Peter Chapman I thank the cabinet secretary for that answer. However, the fact is that nearly a third of orders were not completed in 2015-16, and completion rates have fallen for two years in a row.  Will the Government commit to an urgent review of the system of community payback orders to ensure that criminals do not start treating them with contempt? The member clearly is not aware that there was a full review of community payback orders back in 2015, which was published in looking at the way in which CPOs were operating. In the view of that review, it identified that there was a broad degree of confidence about how community payback orders were being taken forward. In fact, I will quote from the review where it says that sheriffs appeared to have broad confidence in CPOs in terms of monitoring of progress and appropriate use of breaches. There has already been a review of community payback orders. In relation to matters regarding completion rates, the member is obviously not aware that completion rates for community sentencing has increased over recent years from around 62 per cent back in 2006-07 up to just over 68 per cent in the last year or so. We are continuing to look at what further measures can be done in order to make sure that the benefits of CPOs are taken forward, and we will always look at other measures that can add value to them, including ensuring greater levels of completion rates. I welcome much of what the cabinet secretary said. He will be aware that the latest statistics show that, in terms of re-offending, community payback orders have the lowest levels of re-offending. By contrast, those serving sentences below three months have the highest rates of re-offending. On that basis, will the cabinet secretary update Parliament on when we will be moving to raise the minimum sentence to 12 months to reduce the levels of re-offending? The member makes an important point. The evidence base demonstrates that community payback orders and community sentencing are much more effective than short-term prison sentences. The evidence shows that someone who receives a community disposal is much less likely to go on to re-offending compared to someone who receives a short-term sentence of six months or less. Actually, someone who receives a sentence of six months or less is almost twice as likely to go on and re-offending someone who completed a CPO. As the member will be aware, I am very clear that we need to make sure that we use the evidence that demonstrates the benefits of CPOs, not just in the issue of reducing re-offending, but also the benefits that are then provided to local communities through CPOs. We know that, in the last annual report of CPO provision, there were some 1.8 million hours of unpaid work provided in local communities across Scotland through the scheme. On his point about the presumption against short sentences, I know that that is a matter that the member has considerable interest in, as I have, but I will intend to update Parliament in due course on that particular matter following some further work that is currently being carried out. To ask the Scottish Government what its response is to reports that 30 per cent of sheriff courts are failing to reach the 26-week target from caution or charge to verdict. Thank you, Presiding Officer. I would just remind members of my entry in the register of entries wherein they will note that I am a member of the Law Society of Scotland. Hold a current practicing certificate, but I am not currently practicing in response to Mr Tomkins' question the 26-week indicator from caution to charge to verdict covers activity not just on the part of the Scottish Courts and Tribunals Service, but obviously also of Police Scotland and the Crown and Procurator Fiscal Service. When, in fact, we compared the period December 2014 to November 2015 with December 2015 to November 2016, national performance has increased from 64.2 per cent to 66.1 per cent. I would also say that, in recent years, the reporting and detection of crimes, particularly domestic abuse and sexual offences, has increased, reflecting proactive policing and prosecution and greater victim confidence to report crimes. Those cases have not only increased in volume, but are more complex cases, often requiring more court time. This has placed additional pressure on the Crown, the courts and the wider justice system, and we have and continue to respond to those pressures and additional resources have been made available. Adam Tomkins I thank the minister for that answer, but almost half of Scotland's 40 sheriff courts are performing worse now than they were a year ago, including Glasgow and Strathkelven, with only 53.3 per cent of cases concluded within the target 26-week period. Solicitors working at the sharp end of our criminal justice system cite court closures for a backlog of cases and an increase in the number of adjournments. Could the minister tell my constituents seeking access to justice what action the Scottish Government is taking to remedy the situation? The First Minister What I would say to the member is that the methodology that he has applied or his press office has applied to interpreting and analysing the actual stats collected by the independent Scottish Court of Tribunal Service seems a wee bit less than robust, if I may say so. What we need to do is compare not just a one-month static figure with another month in a different year, but to look at the figures on a year-by-year basis. If we do that, we will indeed see that there has been an overall improvement of 1.9 per cent between 14.15 and 15.16 per cent on the issue of adjournments and the possible effect of court closures. I would say that I do not agree with the member. He should bear in mind the independent data that is collected by the SCTS, which shows that there has been an increase in the overall number of cases, but at the same time the number of cases that have been reduced as a result have been adjourned in the year 1516 was 5.6 per cent and, in the previous year, it was 6.3 per cent, so that, in fact, represents a reduction. The minister touched on the increased reporting and detection of crimes, particularly domestic abuse and sexual offences. I recall and welcomed the funding announcement by the First Minister through the Violence Against Women funding stream that assists in the development of measures to tackle all forms of violence against women. Is that funding helping to improve domestic abuse court performance? The member is right to highlight the additional funding that the Scottish Government has made available to deal specifically with the increased caseload that we have seen in terms of domestic abuse. We have made available the sum of £2.4 million in each year of 1516-1617, and that will be the case also for 1718. Indeed, we can see that this is having a very significant impact on the time within which trials have been proceeding. There is a current, agreed 10 to 12-week period, and from April 2017 the aim is to offer domestic abuse trials within 8 to 10 weeks. We are very optimistic that that will be achieved on the basis that already 95 per cent of courts are meeting this accelerated timescale. In light of the inquiry carried out by the Justice Committee into the Crown Office and Procurator Fiscal Service, and the many issues that we have heard regarding performance and the serious concerns that have been raised, does the minister believe that a £4 million cut to the COPFS budget this year will improve quick and access to justice? I know that the Justice Committee has been looking into the operation of the Crown Procurator Fiscal Service in some great death, and we await in due course the report of the Justice Committee. A number of figures have been bandied about at the committee, but what I would say to the member, as the member well knows, is that the operation of the Scottish Courts and Tribunals Service is a matter for ultimately the Lord President, and they monitor very carefully the performance of the courts. I believe, in fact, on a monthly basis by the justice system planning group, a subgroup of the national justice board. What we are seeing in fact is an improvement, as I have already indicated, in terms of domestic abuse and in terms of the general position of the performance of summary criminal trials. We are seeing an improvement. I think that that is down to the great work that is being conducted by the Scottish Courts and Tribunals Service. To ask the Scottish Government what its position is on the time taken to conclude cases in the courts. As I stated in my earlier response to his colleague, the Scottish Government recognises that the reporting and prosecution of certain categories of crime have increased. Criminal investigations have also become more complex, and that is reflected in the number of court cases that are proceeding to evidence-led trials. Over the last five years, there has been a 38 per cent increase in evidence-led trials. However, even allowing for that, the evidence shows an improving picture, as in January 2017, 95 per cent of sheriff courts are offering trials within the optimum 16 weeks compared to only 50 per cent in April 2014. With the help of additional funding from the Scottish Government, the percentage of cases fully disposed within 20 weeks has increased from 58 per cent in 2014-15 to 67 per cent in 2016-17. It is quite clear that improvement has been made, but there is always more that can be done. I thank the cabinet secretary for that answer. Pressure on Scotland's courts is not a new issue. In 2015, Audit Scotland published a report highlighting the difficulties to the face, and the situation seems to be getting worse. This is after the Scottish Government ignored warnings from opposition parties and slashed the number of courts across the country, including Cacubrie Sheriff Court in my constituency. Can the cabinet secretary indicate whether the Scottish Court and Tribunal service has successfully implemented Audit Scotland's recommendations to improve Scotland's court system? I would say to the member that, if he looks back at the record of those proceedings at question time today, he will see the various statistics that I have referred to that come from the Scottish Court and Tribunal service in terms of data that they have collected and reviewed on a monthly basis, and he will see that the improvements that have been made. The member mentioned Cacubrie Sheriff Court. That was closed, I think, some three years ago, and it is important to remember that, at that time, it was dealing with, on average, two summary criminal trials per month. Obviously, Dumfries is now receiving court, and there has been no impact on Dumfries Sheriff Court following the transfer of this business. Clare Haughey. Thank you, Presiding Officer, and I would like to refer members to my register of interests. I am a registered mental health nurse. While I am, of course, very interested in the time taken to conclude cases in court, I have a particular interest in drug courts. Can the minister please advise what the position is here? What I would say to the member is that what we have seen in Glasgow is a very successful dedicated drugs court, and what we are doing across Scotland is setting up problem-solving courts in Aberdeen, Edinburgh, and recently in Forfer to look at the bigger picture. Therefore, I would say that what we are looking at is looking at the particular position of that individual, and the individual will vary, obviously, from case to case. Therefore, in those circumstances, it is the outcome for the individual that is the key important determinant, and perhaps not the actual time of the proceedings that court themselves. Question 5, Daniel Johnson. To ask the Scottish Government what progress it is making with the implementation of section 179 of the Criminal Justice and Licensing Scotland Act 2010 regarding disabled access. Section 179 of the Criminal Justice and Licensing Scotland Act 2010 requires individuals applying for a liquor premises licence to provide a disability access and facilities statement along with their application. The statement is to contain information about disabled access to the premises and the facilities and any other provisions that are available to aid the use of the premises by disabled people. Failure to provide a statement is not a ground for refusing an application, but means that the premises application would be incomplete and could not be considered by the licensing board. The provision does not interfere with the existing duty under equality law to make reasonable adjustment to make sure that a disabled person can use a service as close as it is reasonably possible to get the standard that is usually offered to non-disabled people. Section 179 cannot be commenced in isolation. It is also necessary to update secondary legislation to provide the necessary statutory forms alongside providing guidance to applicants. We intend to complete this work within the remainder of this year. I thank the minister for that answer. In 2010, an amendment was passed with cross-party support following BARD, a campaign run by Mark Cooper in association with Capability Scotland, provided that licensed premises must provide the information that he outlined. Unfortunately, the Government has yet to enact the law. The Government has stated that it would do so by the end of this Parliament, but that would obviously be a delay over the decade, so I welcome the commitment that he makes today. Will he, therefore, act without delay, ensure that it is enacted within this year, and would he agree with me that, for many disabled people, a beer delayed is a beer denied? On that point, it is important to recognise that, although there was cross-party support for this amendment, it does not require a licence holder to commit to any amendments or alterations to their premises. It is about a factual basis of information that has to be provided at the time when an application for a liquor licence is being made. As the member will recognise, there has been a significant amount of new regulations that have been taken forward around licence premises in Scotland, including the introduction of licensing for scrap metal companies and air weapons as well. We try to take those forward on a phased basis in order to ensure that we manage that process for those who are required to have a licence or to apply for a licence. I can say to the member that there are some secondary legislation issues that have to accompany that particular provision, and we will seek to try to make progress on that in over the course of this year. I will try to make sure that that work is taken forward as early as possible, but at this stage I cannot give him a final date as to when that process will be completed. I will now move on to the next item of business. I will give members a few seconds to change seats.