ATCA Symposium A Reflection of the Janus Program Improved Services Initiative Odyssey Residential and After Care 2010

Size: px

Start display at page:

Download "ATCA Symposium A Reflection of the Janus Program Improved Services Initiative Odyssey Residential and After Care 2010"

Tracy Hunt
5 years ago
Views:

1 ATCA Symposium A Reflection of the Janus Program Improved Services Initiative Odyssey Residential and After Care 2010

2 Improved Services Initiative An Initiative of the Council of Australian Governments (COAG) National Action Plan on Mental Health ( ). Funded by the Department of Health and Ageing and commenced in D&A NGOs received grants in Australia 26 D & A NGOs received grants in NSW National project aims To build the capacity of non-government drug and alcohol organisations to effectively identify and treat co-morbid substance use and mental illness To build Cross Sectoral Support and Strategic Partnership (CSSSP) project

3 Dual Diagnosis Capability in Addition Treatment (DDCAT) An Instrument for measuring Alcohol and Other Drug treatment program services capability to deal with cooccurring disorders 35 program elements are subdivided into seven dimensions as below. Program Structure -Program Milieu Assessment -Continuity of Care Staffing -Training -Treatment Scored on a 5 pt Likert Scale 1 = Alcohol Only Service 3 = Dual Diagnosis Capable Service 5 = Dual Diagnosis Enhanced Service

4 DDCAT Score Base line 5 4 Score IA IB IIA IIB Pr ogr am Pr ogr am Str uctur e Mi l i eu IIIA IIIB IIIC IIID IIIE IIIF Cl i ni cal Pr ocess: Assessment IIIG IVA IVB IVC IVD IVE IVF IVG Cl i ni cal Pr ocess: Tr eatment IVH IVI IVJ VA VB VC VD Conti nui ty of Car e VE VIA VIB VIC Staf f i ng VID VIE VIIA VIIB Tr ai ni ng

5 Janus Program Development and Objectives Janus program named after the Roman Mythology God, with two faces, can see both ways, looks back and forward Screening for Dual Diagnosis Systematic Assessment and Evaluation for DD Developing treatment options for DD clients applicable within TC Model Continuous Care after Residential Program for DD Clients Developing Policy and Procedures for sustained change

6 Odyssey House Finance Dept. Marketing Dept. Clinical Dept. MERIT Withdrawal Unit Progressive Learning Centre Parents & Children s Program Janus Program Admission & Intake Centre Assessment & Referral Residential Drug and Alcohol Rehabilitation After Care Program

7 Residential Program Team of Professionals Five Pillars Consultant Psychiatrist Love Visiting GP Honesty Psychologists Trust Concern Nurses Responsibility Qualified assessment staff Drug and Alcohol Therapists Family support worker Teachers Finance Dept and Other admin staff

8 Residential Program Program Features Various Groups Therapy Groups for each level (level I, II, II & IV) Male and Female Group Basic Rules Anger Management Group No alcohol or other drugs No violence Domestic Violence Group No sex No stealing Art and Craft Group Knowledge of any of the above Encounter Group etc. Mental Health Group (Ddig-its) Crisis Intervention/ Private Therapy

9 Janus Residential Program Clinical Features Psychological Assessment Psychiatric Consultation Dual Diagnosis Group Therapy, Education and Training Crisis Intervention Ongoing Support Clinical Policies Links to support services

10 Janus Residential Program Screening-Assessment-Evaluation Assessment Centre at Surry Hills Detoxification Centre (Modified Mini Screen (MMS)) Assessment Stage DSM-IV Pathological Gambling Diagnostic Form, K10, GHQ and PAI Level 2 - WAIS IV, GHQ (repeat measure) Level 3 Myers Briggs, GHQ (repeat measure) Level 4 - GHQ (repeat measure) Ongoing Psychiatric Assessment

11 Janus Residential Program- PAI 80% 70% Axis 1 60% 50% 40% % % 10% 0% Schizoaffectiove Diorder OCD Cyclothymic Diorder Intermittent Explosive Schizophrenia Social Phobia Somatoform Disorder PTSD Bipolar 1 & 2 Anxiety Major Depression Dysthymic Disorder

12 Janus Residential Program- PAI 80% 70% 60% 50% 40% 30% 20% 10% 0% Axis Anti Social Narcissistic Borderline Schizotypal Personality Personality Personality Personality Diorder Disorder Disorder Disorder Paranoid Personlity Disorder

13 WAIS 2009

14 Janus Residential Program Crisis Intervention and Counselling The Dual Diagnosis Group, provides: Range between residents Average number per week in group = 11 to 12 in last 4 weeks

15 Average rating of Satisfaction Surveys for Mental Health Group M a y -1 0 J u n -1 0 J u l-1 0 A u g -1 0 CBT M in d fu ln e s s T re e o f life T ru m a

16 Odyssey After Care Program Main Features Individual Counselling Relapse Prevention Course 8 Modules Lifestyle Group Art and Craft Group Fun Fridays Recreational Outings Family Support

17 Janus Aftercare Program Assessment and Treatment Features Phone Interview/Initial Assessment Standardised Interview Psychological Assessment PAS, PAI, DASS, AUDIT, GAF, MMS Mental Status Examination Depression Anxiety Stress Scale Treatment Plan Scott Miller Rating Scale Group Individual Session Outcome Rating scale

18 Janus After Care Program Some Numbers Number of Aftercare Clients : 64 Number of Janus Program Clients : 16 Number of Clients with Mental Health Diagnosis : 24

19 PAI Axis I Diagnoses 100% 90% 80% 68% 42% 32% 32% 26% 21% 21% 70% 60% 50% 40% 30% 11% 11% 11% 20% 10% 0%,Schizophrenia Paranoid Type Generalized Anxiety Disorder Schizoaffective Disorder Intermittent Explosive Disorder Major Depressive Disorder, SE, U Posttraumatic Stress Disorder Dysthymic Disorder Undifferentiated Somatoform Disorder Other Substance Dependence (PSA) Alcohol Dependence or abuse

20 PAI Axis II Diagnoses 25% 20% 16% 15% 11% 10% 5% 5% 5% Schizotypal Personality Disorder Avoidant Personality Disorder Paranoid Personality Disorder 5% 0% Antisocial Personality Disorder Borderline Personality Disorder

21 Change between Baseline DASS results and Repeat Measure results of Normal Category in Janus After Care clients % 57.14% 57.14% DASS 1 50% DASS 2 % O f C l e i t n s 42.85% 42.10% 40% 30% 20% 15.78% 15.78% 10% 0% Stress Anxiety Depression

22 Change between Baseline DASS results and Repeat Measure results of Ex. Severe category in Janus After Care clients % 57.89% 60% % O f C l e i t n s DASS 1 DASS 2 50% 40% 31.57% 30% 26.31% 20% 14.28% 10% 0.00% 0.00% 0% Stress Anxiety Depression

23 History of Primary Drug of Concern Only DD Clients

24 History of Secondary Drug concern Within DD Clients Benzodiazepine s, 5% Opioids, 10% No secondary drug of concern, 30% Amphetamines, 10% Cocaine, 10% Alcohol, 15% Cannabis, 20%

25 History of Drug Use within DD Clients

26 Janus After Care Program Family Support Brief 1 on 1 counselling Stress-Strain-Coping-Support Model Preparing family member 8 Modules Coping Skills Managing Emotions Conflict Management Self Care -Information -Stress Management -Communication -Information

27 Janus After Care Program Community Involvement Drug Action Week Mental Health Week Photographic exhibition/competition Rally against Violence Various presentation e.g. Macarthur Mental Health GP Conference Visited various organization

28 Janus After Care ProgramCommunity Involvement Argyle Housing Agreement DAWN Housing - MOU Campbelltown Drug Action Team Macarthur Mental Health Interagency Mental Health Network Macarthur Interagency Forum Sentencing

29 Janus Program Intern Psychologists Provided supervision to more than 8 intern Psychologists in two years Current 5 Intern Psychologist s Ongoing relationships with Australian College of Applied Psychology University of Western Sydney

31 DDCAT Score Year Score IA IB Pr ogr am Str uctur e IIA IIB Pr ogr am Mi l i eu IIIA IIIB IIIC IIID IIIE IIIF Cl i ni cal Pr ocess: Assessment IIIG IVA IVB IVC IVD IVE IVF IVG Cl i ni cal Pr ocess: Tr eatment IVH IVI IVJ VA VB VC VD Conti nui ty of Car e VE VIA VIB VIC Staf f i ng VID VIE VIIA VIIB Tr ai ni ng

32 DDCAT Score Year S core IA IB Pro g ram St ruct ure IIA IIB Pro g ram M ilieu IIIA IIIB IIIC IIID IIIE IIIF C linical Pro cess: A ssessment IIIG IV A IV B IV C IV D IV E IV F IV G IV H C linical Pro cess: Treat ment IV I IV J VA VB VC VD C o nt inuit y o f C are VE V IA V IB V IC V ID St af f ing V IE V IIA V IIB Training

33 Dual Diagnosis Capability in Addiction Treatment (DDCAT) Average over 3 years 5.0 Year 1 Year 2 Year Program Structure Program Milieu Clinical Clinical Continuity of Staffing Process: Process: Care Assessment Treatment Training

34 Dual Diagnosis Capability in Addiction Treatment (DDCAT) Total Average over 3 years Year 1 Year 2 Year 3

35 Odyssey Janus Program Vision for the future Separate Residential Program for clients with complex Dual Diagnosis needs Individual Counselling Early Intervention VS Crisis Intervention Program for PTSD Clinical Data Base and Research Sustained Change Positive Growth occurs in the soil of Knowledge and support

36 Questions Please!

DDCMHT Rating Scale Cover Sheet

DDCMHT Rating Scale Cover Sheet Cover Sheet Program Identification Date Rater(s) Time Spent (Hours) Agency Name Program Name Address Zip Code Contact Person 1) 2) Telephone FAX Email State Region Program ID Time Period Program Characteristics