INTERIM GROUP: A MODEL FOR RESPONDING TO WAITLIST DEFINITION PHILOSOPHY

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Michael Greer
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1 INTERIM GROUP: A MODEL FOR RESPONDING TO WAITLIST Kelly J. Lundberg, Ph.D. Associate Professor, Department of Psychiatry Director, Assessment & Referral Services Clinical Consultant, Utah Addiction Center University of Utah (801) Kelly.lundberg@hsc.utah.edu DEFINITION Interim Group Services (IGS) provides free groups for adults who are awaiting admission to Salt Lake County funded substance abuse treatment PHILOSOPHY All individuals, regardless of their desire to be there, are welcomed The life of the group is a single session Individuals can be a great support to one another Individuals who are under the influence of alcohol or drugs are typically safer in group than in their usual settings Individuals are capable of being on time 1

2 GOALS Create a safe and supportive atmosphere Honor confidentiality Provide support for individuals awaiting treatment and who may be struggling with their addiction Display unconditional regard, accurate empathy and genuineness GOALS Utilize Motivational Interviewing strategies and philosophies to encourage participation and follow through with treatment Utilize harm reduction strategies so that individuals can remain safe while awaiting treatment Utilize process work to begin to create characterological change GOALS Generate research regarding the effectiveness of Interim Group Serve as a subject pool for studies examining substance abuse Provide training and exposure to a variety of disciplines so that understanding and awareness of those who struggle with addiction can be increased and stigma decreased Save the County money 2

3 FORMAT Groups meet six days per week Times vary to accommodate most work schedules or family responsibilities, and most groups meet in the evenings All groups are free Bus tokens are provided Groups are co-facilitated primarily by students Groups are similar to therapy groups, and are neither didactic nor psychoeducational FORMAT Individuals can access group in less than 48 hours Individuals need only show up at group to begin participation Individuals can attend as often as they d like until admission to treatment REFERRAL SOURCES Salt Lake County substance abuse treatment providers DCFS AP&P Shelters Hospitals Police Judges 211 Word of mouth 3

4 WHO ATTENDS INTERIM GROUP? Indigent individuals 50% indicate no stable residence Average age is 32 Average education is 12 years 68% men 72% Caucasian 25% Mexican Most are unemployed Most are single Most are involved in the criminal justice system WHO ATTENDS INTERIM GROUP? Approximately 60% having been using their primary drug of choice within the last 30 days Among women, primary drug of choice is methamphetamine Among men, primary drug of choice is alcohol All the other major drugs of choice are still largely represented FACILITATORS All facilitators are paid $15 per hour Minimum of $22 per group Most are students Social Work (MSW students) Counseling Psychology (LPC and Ph.D. students) Clinical Psychology (Ph.D. students) Psychiatry (residents) Alcohol & Drug Treatment Training Program (LSAC students) Mix of recovery and non-recovery facilitators 4

5 NECESSARY REQUIREMENTS People who are nice People interested in learning about addiction People whose beliefs regarding the etiology of addiction do not include: It represents a moral failure The individual with an addiction must admit he/she has a problem People who want to learn about a process model of group therapy Prior experience is unnecessary SUPERVISION One hour of supervision is provided for every 4 groups Discuss specific incidents Explore personal beliefs General education regarding addiction and drugs of abuse Motivational Interviewing Process work Application to other work/life experiences FIRST YEAR MEDICAL STUDENTS COMMUNITY PLACEMENT 8-10 first year medical students over one semester Didactic Overview of etiology and philosophy of treatment Overview of drugs of abuse Co-facilitate Interim Groups Observe Felony Drug Court Exit interviews Students seeking honors credit write paper Highest rated community placement site 5

6 OTHER COMMITMENT TO TRAINING/EXPOSURE Any discipline may observe physicians, chaplains, judges, attorneys, anthropologists, pharmacists, probation officers, DCFS employees; and students training to be physician assistants, midwifes and APRNs Must ask permission from group Must be sensitive to any power or authority issues affecting individual group members STUDENT THESIS Examination of the relationship between attendance at IGS and following through with treatment Inclusion Criteria Adults (n=120) Received IGS between January 1, 2003 and January 1, 2004 Self-report methamphetamine as primary drug of choice Attended at least one Interim Group STUDENT THESIS 50% were male 85% were white Average age was 32 (20 to 50) Average education was 12 (8 to 14) Average wait for treatment was 44 days 70% were unmarried 67% were unemployed 50% indicated referral by criminal justice system 6

7 STUDENT THESIS 69% followed through with treatment (p<.001) The only variable which predicted follow-through with treatment was attending Interim Group 100% follow through with treatment for those who attended between 5 and 24 Interim Groups (n=56) (p<.001) ADMITTED TO TREATMENT NOT ADMITTED TO TREATMENT Interim Groups Attended 35+ INT GR INT GR INT GR IN T GR IN T GR IN T GR IN T GR INT GR 0 7 INT GR 0 6 INT GR 0 5 INT GR 0 4 INT GR 3 INT GR 2 INT GR 1 IN T GR M = 36.8 M = 7.58 M = Number of Participants INTERIM GROUP ADMISSIONS Phase 1 December 01 to June 02 lost data July 02 through June 03 lost data July 03 through June July 04 through June Phase 2 July 05 through June July 06 through June Phase 3 July 07 through June

8 JULY 1, 2007 THROUGH JUNE 30, 2008 INTERIM GROUP DATA Total visits: 11,986 (6208 FY07) Average visits per month: 999 (517 FY07) Average number of groups attended per person: 4 (4 FY07) Average cost per person per group: (16.07 FY07) Average cost per person per year: (69.00 FY07) WHY DOES INTERIM GROUP WORK? Participants tell us: They feel welcomed They believe their participation and presence is important and valued They feel like they can get support from other members They feel like they can be honest about their use They feel like they can be honest about their ambivalence 8

Eighth Judicial District Court. Specialty Courts. Elizabeth Gonzalez. Chief Judge. DeNeese Parker. Specialty Court Administrator

Eighth Judicial District Court Specialty Courts Elizabeth Gonzalez Chief Judge DeNeese Parker Specialty Court Administrator Eighth Judicial District Specialty Court Programs Serving 1200 1500 Clark County