Part Two. Part Three. Drug Treatment Courts Training Workshop Montego Bay Jamaica February The Drug Treatment Court Client

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1 Drug Treatment Courts Training Workshop Montego Bay Jamaica February James Budd jbudd@rideauwood.org Robin Cuff robin_cuff@camh.net The Drug Treatment Court Client Part Two Treatment Considerations Part Three Finding and Restoring Internal Motivation

2 The Drug Treatment Court Client

3 Long criminal record Most or all associates are drug users and/or criminals Family members may also be drug users and/or criminals Antisocial personality disorder (oppositional defiance disorder) Crack cocaine/meth/opiate users Intravenous drug users Poor problem solving skills Few formal or informal pro-social supports Homeless or high-risk housing Mental health and/or trauma issues Late stage addiction HIV+, Hepatitis C No employment history Education/literacy Poverty Other health/dental issues Lack of social, life, and other skills

4 Working, paying taxes, etc. is for suckers Me and my friends are not suckers The system is corrupt they are worse than me They deserved what they got They have insurance I look out for Number One Victims? I m the one in jail Never mind tomorrow, what can I get today Morality = I got busted I got away They never learned, or have forgotten, how to participate in non-using, non-criminal society and they lack the skills and confidence to reengage.

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6 Part Two WARNING: this treatment may cause an increase in drug use and criminal activity

7 Intensive case management that addresses needs Frequent brief interventions Harm reduction strategies Treat addiction and criminality concurrently criminogenic trx introduced Recidivism rate change in Ottawa DTC

8 add routine to their lives

9 Motivational interviewing Goal setting in treatment High risk identification skills Structured relapse prevention Aftercare Methadone maintenance Trauma treatment Life skill training Social skill training Problem solving skills Peer refusal skills Employment skills Education/training Contingency management Psychiatric medications Frequent and random urine drug testing Treatment + court = TEAM

10 Part Three Finding and Restoring Internal Motivation

11 Principles to consider: All behaviour is purposeful We behave to get what we want Our wants are a reflection of our needs All behavior is more or less effective We all want happiness so, what went wrong? I DON T want to be in jail! The problem is: In the beginning, most DO want to use drugs and many also DO want to be involved in the activities and excitement surrounding the obtaining and using of drugs. We need to be patient with the process...

12 Five basic needs: 1. Survival 2. Love and belonging 3. Freedom 4. Fun 5. Power What I want is a reflection of the level of my need in each of these areas. My wants are the relationships, things, experiences and belief systems that, to me, create a quality of life. I have a high need for fun I probably did not even think of my need when I formed the picture of the vehicle I want. But I have the picture because it helps satisfy a need and if my needs are satisfied, I will feel HAPPY

13 you had been neglected, abused, bullied, traumatized you had failed and people had failed you you were weighed down by grief and anger your dreams had turned into nightmares you lacked the skills to effect positive change would you be happy?

14 Because we are internally motivated to do so But... If you did not have the skills to be more effective, then less and less effective behaviours would be used. Something that could... make you feel good, make you feel better, and even make you feel nothing at all?

15 Drugs temporarily: make you feel good, make you feel better, and even make you feel nothing at all In the absence of happiness, people choose a poor substitute Pleasure! More and more, the drug becomes the focus... instant gratification excitement brain chemicals are impacted everything gets blocked out mood and mind altering easy to get cravings and pain pull you back

16 Nothing else matters Relationships are sacrificed Jobs are lost Priorities become skewed Drugs and drug activities become an obsession and nothing is too great a price The pictures of a quality of life without drugs have all but disappeared Help restore the old pictures Help create new pictures Teach skills for more effective behaviour Provide options for behaviour Promote responsibility and self-evaluation

17 Is what you are doing getting you what you want? Is it getting you closer or further away from what you want? What can you do to get closer to what you want? Not much will matter until the pictures become clear. We can encourage compliance but true change comes from a strong internal desire finding a picture of a quality of life that is wanted more thananything but cannot possibly be attained with current behaviour.

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19 Stuck in emotions and physiology (back wheels) Get them grounded and moving forward on their front wheels doing and thinking differently behaving more effectively

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