Amphetamine Type Stimulant Treatment Protocol. Developed by Lynne Magor-Blatch & James Pitts, Odyssey House McGrath Foundation

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1 Amphetamine Type Stimulant Treatment Protocol Developed by Lynne Magor-Blatch & James Pitts, Odyssey House McGrath Foundation

2 David Kelly Manager, WHOS Hunter Valley

3 Background to the Project Dramatic rise in Amphetamine Type Stimulant use in Australia % of population to 9.1% in 2004 to 6.3% in 2007, 1.1million regular users

4 Background to the Project National Minimum Data Set ( ) 23% of treatment episodes reported ATS as a drug of concern 20% with ATS as a drug of concern were treated in a TC Consultation phase of ATS project found that in TCs, ATS was most prevalent drug of concern.

5 Background to the Project Cogger, McKetin, Ross & Najman (2008) in an NDARC study found: ATS users 44% Major Depression, further 45% Substance Induced Major Depression 83% had experienced psychosis 47% had experienced clinically significant suspiciousness, unusual thought content or hallucinations

6 Background to the Project Cogger, McKetin, Ross & Najman (2008) in the same study (unpublished results) found: ATS users who sought treatment in a TC were more likely to be using ATS more often More likely to have clinically significant psychosis More likely to have panic disorder More likely to have general impairment than ATS users who had sought other treatment

7 Background to the Project Gunn and Rickwood (2009) study of 104 residents in Odyssey House (NSW), Karralika, Mirikai and Goldbridge TCs ATS users higher levels of impairment in global executive function Difficulties with behavioural regulation, attention management and problem solving Difficulties with impulse control, holding attention to one task, monitoring social behaviour

8 Background to the Project Gunn and Rickwood (2009) cont. These areas of executive functioning shown to be most affected are related to reflective functioning Self monitoring, self evaluation Inhibited reflection on behaviour Inhibited impulse control, objectivity, and ability to learn from mistakes

9 Background to the Project Funding through Australian Government s Amphetamine Type Stimulants Treatment Grants Program Following Literature Review Therapeutic Community and other consultations Trials at Mirikai and Cyrenian House Launch at the ATCA conference in Canberra (2009) Research continues with 6 and 12 month data being collected ATS Sites (WHOS Hunter, WHOS Najara, Goldbridge, Cyrenian House and Karralika) TAU Sites (WHOS Rozelle sites, Canberra Recovery Services, Central Coast Recovery Services (Selah), Odyssey NSW, Odyssey Victoria, Palmerston and Logan House)

10 ATS Treatment Protocol Most Treatment Protocols and including ATS Treatment Protocols written with individual treatment in mind. Require extensive re-working to be applicable to a group setting, particularly a Therapeutic Community setting The ATS Treatment Protocol particularly designed for Therapeutic Community setting

11 ATS Treatment Protocol Combines Mindfulness Based Cognitive Therapy and CBT Acceptance and Commitment Therapy (ACT) Motivational Interviewing

12 ATS Treatment Protocol Pre Admission or Assessment Phase Treatment Phase Module 1: Building Motivation Module 3: How Thoughts influence Behaviour Module 2: Coping with Cravings Module 4: Understanding Feelings Module 5: Learning how to deal with anxiety Module 6: Core Beliefs and Values Flexible Module 7: Relapse Prevention

13 ATS Treatment Protocol Each Module contains Facilitators Instructions Worksheets Tip Sheets

14 WHOS Hunter Valley 29 Bed Facility 2 6 bed support houses Mixed gender Regional area, very high prevalence ATS use (60%), very high prevalence ATS combined with Cannabis use Entrenched ATS use culture

15 ATS protocol at WHOS Firstly had to change the name! (Treatment Protocol for use by staff and clinicians working with ATS clients of Therapeutic Communities doesn t exactly roll off the tongue) Foundations of Recovery Group (interim) Implemented at the two sites with highest ATS use, two sites that were already implementing Psycheck At WHOS Hunter initially tried to divide groups up and make modules 3-6 a closed group but proved unworkable Presented to all clients

16 ATS protocol at WHOS So what do the residents and staff think? Love the worksheets Enjoyed the way they put metaphors to our drug use ACT fits very well with TC ethos, focus on values and principles, goals and positives Very helpful for ATS clients in particular, focusing on recognising feelings through bodily sensations then putting a label to them and developing strategies for dealing with them All clients benefited from the discussions around cravings, especially in view of our moves toward smoking cessation

17 ATS protocol at WHOS Plans for the future? 6 month trial is over Adapt a little for WHOS milieu Present to other WHOS services, hope to become part of the WHOS general program

18 Thank you!