Substance Use and Mental Health — Clinician dialogue

Invite and obtain permission

Offer: "Would it be useful to explore substance use and mental health using an ordinary or fictional example? We can adapt it, observe, or stop." Ask what the person wants from the conversation.

Elicit before teaching

Ask: "How does this show up, if at all, in your own words?" Offer this idea tentatively: IMR-informed planning can address substance use and mental health together. Ask what fits and what does not.

Guide the task

Map how a substance-use pattern and mental health concerns may interact, labeling uncertainty and questions for the team. Ask for permission before giving an example. Use this fictional illustration if useful: Casey notices difficulty remembering routines after some evenings and wants a nonjudgmental discussion.

Reflect and check accuracy

Reflect only what was offered: "I heard you describe ___. What did I miss?" Ask: What should be explored without jumping to a causal conclusion? Avoid assigning motives or interpreting silence as agreement.

Respond to a mismatch

If the person rejects the frame, say: "Thank you for correcting it. What would be more useful?" Return to their language or choose a different approach.

Close with agency

Ask which observation, question, or support request the person wants to keep. Confirm a manageable ending and appropriate follow-up; do not turn a tentative possibility into a homework obligation.

Prompts for this resource

1. Readiness, permission, cultural context, and access needs to check:
2. What should be explored without jumping to a causal conclusion?
3. What would tell me to adapt, stop, or seek supervision?