Poster Presentations Thursday 1 September 1.00pm 1.45pm Friday 2 September 12.00noon 12.45pm

Transcription

1 Poster Presentations Thursday 1 September 1.00pm 1.45pm Friday 2 September 12.00noon 12.45pm Poster 1 Compulsory Treatment Orders Changes to the ADA Act what do they mean for the sector? Vanessa Caldwell, Matua Raki The new Act aims to provide stronger legal safeguards, and while applicable to only a small number of people, the effects of the changes on the sector are wide ranging. Matua Raki is working closely with Ministry of Health. Our role is to ensure that the workforce is well prepared and resourced to respond when the new Act is passed. While the project is in its very initial stages, Matua Raki aim to have the sector prepared for when the new Act goes live. The new Act will require a number of changes, including up-skilling of relevant treatment staff and also of sector partners. This includes investing in up-skilling current DOAs and training new ones to meet need. There will likely be changes in operational and capital requirements of compulsory treatment facilities; the scale of change being dependant on if the facility currently provides compulsory treatment or if new facilities wish to accept persons under the new Act. Treatment centres will need to form effective networks and adapt to the needs of the people admitted under the Act. There will be changes to access criteria and a need for standardisation across the sector and allied services. Detoxification services will need to liaise with hospital and transitional services. Community treatment services will be active in developing long term treatment plans and ready to receive these complex persons, on an ongoing basis. Importantly, all facilities will have to acknowledge the implications of the right of extension by Courts extensions, for a further three months, are applied if a person appeared to have an alcohol/drug related brain injury. Poster 2 Coexisting Disorders - Clinical Solutions! Skills Based Framework. A Pilot Project by CEDS Wellington, supported by Matua Raki and the MOH Andrea Maier, Capital & Coast DHB, Coexisting Disorders Service, Wellington Dr Tom Flewett, Capital & Coast DHB, Coexisting Disorders Service, Wellington Wendy Tait, Capital & Coast DHB, Coexisting Disorders Service, Wellington The Coexisting Disorders Service (CEDS), Wellington, designed a Pilot project to evaluate the effectiveness and practicability of a skills framework for assessing coexisting disorders clinicians. This poster explains the various components of the project as well as some early findings to generate a platform for information, feedback and discussion. Clinicians working in addiction or mental health services have traditionally developed expertise of clinical skills primarily in either, mental health or addiction. In 2010 the Ministry of Health New Zealand published two important documents Te Ariari O Te Oranga and Integrated Solutions. These documents outline the requirement that all addiction and mental health practitioners need to be at least coexisting disorders capable to provide integrated care to clients with coexisting problems and their whanau. The Pilot project is a response and hopefully a constructive solution for implementing best practice evidence based services. We hope that the pilot will be a future resource for assessing levels of clinical skills in the workforce, to identify and support clinical learning needs where they arise, to ensure safe, integrated quality care and to

2 enhance positive outcomes for tangata whaiora with coexisting disorders and their whanau. The Pilot may demonstrate the usefulness of the Coexisting Disorders Skills Based Framework. Poster 3 AOD Peer Support a new approach to an age old problem Connect AOD Peer Support Service Background: Directly stemming from the steady and vocal insistence of Consumers in the Counties Manukau area (and a DHB with some foresight) the first dedicated AOD Peer Support Service was born in the Counties Manukau area in July Aims: To announce our service s presence to the wider Addictions sector; both as a pioneering service AND as a consumer led and driven initiative. To provide a background to Connect Supporting Recovery, and their experience in delivering peer support in the Mental Health Sector before landing the RFP. To introduce the "peer support" model to the addictions sector from an experiential perspective. To provide an insight into the journey so far, of those who have been part of this pioneering service since it began. To talk about the experience of being part of a "Consumer led" service in the Addictions and Mental health sector. To share some of our team s experience as peers, and the rewards and pitfalls of peer relationships. To detail and acknowledge that our service's arrival is due in large part to a number of people and services, covering a fair number of years. Poster 4 Recovery and Wellbeing Tom Docherty, CADS Part of the definition for Recovery from Mental Health and Addictions Standard states: "Recovery happens when we regain our personal power and a valued place in our communities" The Standards also state: "Recovery focused Mental Health and Addiction Services live the values of choice and partnership. Coercion has the effect diminishing rather than strengthening individual consumers". CADS Offender Team in the Auckland Area completed a pilot programme over a 28 month period in partnership with Northern Region Corrections. The Pilot demonstrated how interagency partnerships and an integrated management and service delivery framework can work effectively to deliver services to offenders coerced or mandated to attend for assessment and treatment and achieve positive outcomes. Is coercion an essential component of addiction treatment for certain client groups Alcohol and Drug Studies? The Poster shows the treatment model, outcomes and client feedback.

3 Poster 5 Monarch Modular Program Wayne Cameron, MASH Trust Colette Bain, MASH Trust Rodger McLeod, MASH Trust We have been delivering a program to people with addictions for some years and although changes were made to the program, outcomes did not improve significantly and referrals increased at a rate that strained resources. In response to the demand on services and consumer feedback we restructured the program and all the systems associated with it to streamline entry and exit processes and improve program outcomes. The program is outcomes focused and measureable. It is content structured with the Core topics themed. It is structured to identify problematic behaviour and move participants towards self-efficacy, self-esteem and futurity. The nine core components are: 1 Addiction 2 Anxiety / State management 3 Relapse prevention 4 Mental Health 5 Self Esteem 6 Family and Relationships 7 Anger Management 8 Assertiveness 9 Social skills Although still in its infancy the program is already showing significant increases in completion rates from 30% to 75%. Poster 6 Are You A Parent? Parenting, recovery and wellbeing Trish Gledhill, Kina Trust Anna Nelson, Matua Raki The relationship between substance use, parenting, recovery and child wellbeing is complex and influenced by several inter related factors. This presentation outlines the evidence supporting the implications for both parents' recovery and child outcomes. It highlights effective responses to parents accessing alcohol and other drug treatment to support both child and parent wellbeing. New resources will be showcased that support alcohol and drug practitioners in their work with parents.

4 Poster 7 The Best Things About Geese a year of groups David Mellor, CADS In 2009, two new treatment options were introduced to CADS Dunedin. These were a 4-session Getting Started group and an 8 session Education and Support group. Both were open groups. The pre and post psychological measures administered were: Depression, Anxiety and Stress Scales (DASS), Acceptance and Action Questionnaire (AAQIII) and a classification of substances used in the last week (SAb). In addition, the Outcome Rating Scale (ORS) and Session Rating Scale (SRS) were used each group session. The poster will present brief details about the content of the groups and outcome data over the first year of operation. Some observations about the utility of group work for this service will be offered as well as information about more recent developments. Poster 8 STRAIGHT UP a therapeutic workshop David Brown, CADS STRAIGHT UP a therapeutic writing workshop. The French philosopher Jean-Francois Lyotard maintained: We write before knowing what to say and how to say it, and in order to find out Straight Up is an innovative writing workshop tailored for people in early recovery from alcohol and drug dependence, in which the participants are encouraged to express themselves in writing and share their work. A series of focused exercises prompted by a Powerpoint presentation of aphorisms, inspirational quotes and images encourages them to address the nature and implications of their condition. This workshop provides a supportive forum for examination, reflection and affirmation. Straight Up also offers a therapeutic alternative to mental health service consumers in that it allows these clients a credible voice. Many of these people have been marginalised and therefore silenced. This workshop provides a respectful audience to their stories. Many A & D and mental health service clients are intelligent and talented individuals. These capacities are rarely catered for in NZ treatment programmes. Straight Up taps into the creative potential which may enable the client to gain an unprecedented insight into his/her situation. At the end of each workshop the writings are collated into an anthology which is presented to the contributors and the agency sponsoring Straight Up. This programme incorporates elements of Cognitive Behaviour Therapy, Strength Based Approaches, Motivational Interviewing and Narrative Therapy. It has been trialled at Wings Trust and Toi Ora Live Art Trust with extremely positive outcomes. Straight Up is currently running at CADS Mt Eden.

5 Poster 9 Ibogaine Treatment in Aotearoa / New Zealand: Comments on two recently prescribed treatments for opioid withdrawal Tanea Paterson, IbogaiNZ Trust A discussion of the first two prescribed ibogaine treatments for opioid dependence (methadone) in Aotearoa. The steps necessary for identifying clients suitable for ibogaine treatment and carrying out treatments with the support of relevant professional treatment and medical support are discussed. Background In 2010 Medsafe gazetted ibogaine as a non-approved medicine, for prescription by GPs. This has had a significant impact on Aotearoa s ibogaine treatment landscape. Prior to this a number of treatments had occurred under a peer-based approach (e.g Alper, 2008), prompting discussions concerning risk and safety, e.g. at national fora during 2009 (NZDF, 2009). This debate continues (Galea et al., 2011). Ibogaine Treatments in Aotearoa / New Zealand The two treatments discussed in this presentation occurred subsequent to the above law change, thereby involving formal contacts with a prescribing GP, a pharmaceutical importer and a local pharmacist. Pre-treatment protocols included comprehensive assessments and medical tests (e.g. cardiac function, full blood and liver panel) as specified by the Manual for Ibogaine Therapy (Lotsof & Wachtel, 2003). Treatment occurred outside of a clinical setting, with GP visits and emergency psychiatric support being available. Treatments lasted six days, with the treatment provider remaining on-site for the first four, supported by experienced peers and whanau. In this model, peer treatment and support is considered a core component of treatment provision. Post-treatment follow up and aftercare In the two cases discussed the provider has remained in contact with the clients. Linkages have been made with local continuing-care providers. At three months post-treatment random urine screens carried out by the local CADS indicated both clients remained opioid-free. Poster 10 Social Work Is Effective AOD Work Phil Williams, Waitemata DHB Suzy Morrison, Waitemata DHB Val Sharpe, Waitemata DHB Bill Holland, Waitemata DHB Defining Social Work in the context of Addictions The personal and the political domains encompass both the experience of the human condition, and the arena within which the human condition is expressed. One can not exist without the other. At the cross roads of the personal and the political, are the realms of social expression, social understanding, social conflict and social wellbeing. Human beings are social animals. We exist in both inter personal and intra personal realms, both of which are an integral part of well being and in the context of AOD work, ongoing recovery. Social work theory and practice locates the client, their family, whanau, and the service, within a (constantly changing) power structure. It also brings the potential to work holistically, incorporating client centered theory, client-empowerment, cultural awareness, the recovery-paradigm, a strengths perspective as well as CBT, task-centre practice, motivational interviewing, among others.

6 Social work is aware of the relationship existing between all facets of the personal and political and recognises the value of seeing people in their context. In the context of AOD addiction services such as CADS, social work allows for a number of theories. An effective AOD intervention must recognise the context that addiction occurs in, plus understand how we as professionals can respond in a manner that is relevant. We explore the social work identity and provides a strong starting point for establishing and defining the role of social workers within the field of addictions. The above group, all qualified and experienced Social Workers, currently work in various Waitemata DHB AOD services. Services include, CADS Counselling, Methadone Service, Family Services, Youth, and Te Atea Marino. All are concerned with promoting the benefits of a social work approach within the AOD field.