FORMAL INTERVENTION SERVICES FOR JUNEAU Quarterly Report July 1 October 30, 2014 Program Description NCADD received a CBJ SSAB block grant in FY14-15 to continue to provide ongoing intervention services. A modified Johnson Institute intervention model continues to be the selected approach and is the most effective protocol, both clinically and in terms of cost. Our target population for intervention services is the 29% of Juneau residents who are heavy drinkers or drug users, and their families and other concerned individuals. Annual target numbers include 60-70 families (about 100 individual family members) and 75 substance abusers, 50 of whom will enter treatment. 200-250 intervention inquiries are expected annually. Treatment for addictive diseases is rarely sought by patients voluntarily because of the strong denial component which characterizes addiction. Therefore, most recoveries must start with an intervention - a controlled, compassionate confrontation - usually done by family or significant others, with a trained interventionist facilitating the process. NCADD provides these interventions, with funding assistance from the CBJ SSAB block grant program. We receive inquiries almost every week from people worried about a significant other s substance abuse problem, both locally and elsewhere in the state. We schedule at least 50 interventions a year, and provide integrated behavioral health assessments, outpatient treatment, individual and family counseling, as well as continuing care. The way a typical intervention works is that a significant other (spouse, friend, employer, etc.) will telephone NCADD with a request for assistance for someone in trouble with alcohol or drugs. These telephone calls are fielded 24 hours a day, 7 days a week, and are answered either by the executive director or one of our counselors. An initial appointment is set up and suitable intervention participants are chosen who receive a series of trainings on addiction and on the intervention process. The patient is also seen by one of our counselors, if necessary, to determine the appropriate level of care. Most patients agree to be assessed, either by NCADD or another behavioral health provider. The intervention itself is then conducted, either at NCADD s offices or somewhere else convenient for the group. A treatment bed date will have been secured by NCADD staff by this time, and the patient either agrees to go to treatment, or refuses. However, all is not lost if the patient refuses. It is said that no intervention is ever a failure; once intervened on, a patient will never be able to engage in addictive behaviors again without remembering the impact this behavior has on all the important people in the patient s life. Concerned significant others always gain from interventions as well by coming to a new understanding of addictive diseases and learning healthy coping behaviors for themselves. Finally, NCADD will offer a series of continuing care groups, which provide support for patients after they return from inpatient treatment. A public outreach component to this program includes advertising of NCADD s intervention services, and at least one public presentation that describes the disease concept of addiction in general, and the intervention process in particular, will be scheduled. We look for speakers
who will engage as wide an audience as possible. NCADD staff also provides presentations on addiction and interventions as requested to various community groups such as clergy, employers, physicians, etc. Summary of Progress FY15 Quarter 1 New Developments: During Quarter 1 of FY15 we spent agency resources and focus toward developing practices as well as policies and procedures that meet CARF standards. CARF is the Commission on Accreditation of Rehabilitative Facilities. This is a national accrediting body. NCADD plans to file intent to survey by December 2014 to have CARF surveyors conduct a site visit during the spring of 2015. We are excited to expand our programming and way of conducting business to a level that meets national standards. The whole philosophy behind CARF s approach is that the business and services are personcentered. This means we are developing our practices based on the needs of our community, consumers, and stakeholders. NCADD Board of Directors will meet on October 17 th for a strategic planning session that will also revisit our mission and delivery of services in terms of meeting needs of the community. Outpatient treatment: NCADD s outpatient treatment program consists of individual, group, and family psychotherapy. Our treatment schedule is Monday, Tuesday, and Thursday evenings from 4:30 pm 7:30 pm for intensive outpatient level. The level one group meets Tuesday and Thursdays from 5:30 7:30. Individual and family psychotherapy is scheduled as needed and during the day or evening hours depending on individual s treatment plan needs. We average about 9 patients in our outpatient program. We also provide services to youth and average 2 youth this quarter. The youth are seen on an individual basis. If we get more youth we intend to implement group therapy for them. Primarily our patients are adults who are referred to us by the JASAP program, OCS, DVR, or they are self-referred. Continuing Care: Our continuing care group meets Monday evenings from 5:30 6:30. We have averaged 5 patients in this group. Primarily the referrals come from outside rehabilitation centers when patients complete treatment and are returning to Juneau they set up their aftercare with NCADD. Service Numbers In Quarter 1 we conducted 1 formal intervention. Our intervention service numbers are decreasing and we attribute this to perhaps the limited treatment options. Another level of intervention includes the 29 integrated behavioral health assessments we provided to individuals, and of those 25 individuals entered into some level of treatment that was recommended for them. We estimate that about half of those (12) complied with their treatment program as these chose NCADD as their provider, but many of them chose behavioral health providers outside of NCADD. We assisted in the coordination of care in getting them referred and ensuring they accessed those providers. The following table summarizes activities this quarter. ACTIVITIES THIS REPORTING PERIOD Goal: Provide substance abuse intervention services to greater Juneau area Objectives Activities Maintain 24/7 intervention helpline; calls referred Activity: Calls referred to staff cell phones after working hours to staff cell phones after hours. 250 calls/year. to provider 24-hour coverage. Measure: 5 calls per week estimated. Activity this quarter: 18 calls logged 2
Provide family intervention training as requested to 60-70 families (approximately 100 family members) annually. Provide professional assessments for 50 patients who need interventions annually. Conduct 50 formal interventions per year. Provide family counseling for all intervention participants (100 family members annually). Arrange for treatment for 50 diagnosed substance abusers; 40 will enter treatment. Offer continuing care curriculum Design followup survey for clients to measure treatment success. Design/modify media ads for prevention and intervention services. Provide public presentations on addiction and on interventions. Activity: Employ techniques including written study materials, videos, suggested scripts and group coaching. Measure: 1 training every 1-2 weeks on average Activity this quarter: 4 family members, 2 trainings Activity: Administer multiaxial assessment tools employing DSM-IV, ASAM criteria (SASSI, AUDIT, SBIRT, etc.) prior to intervention to determine appropriate level of treatment. Measure: 1 assessment per week on average Activity this quarter: 23 patients received an integrated behavioral health assessment Activity: Schedule venue, participants, treatment bed, and facilitate formal intervention for patient with significant others presenting rehearsed statements. Measure: 50 interventions/year (roughly 1/week) Activity this quarter: 1 intervention completed Activity: 1-on 1 or group counseling, referrals as appropriate. Measure: 100 family members per year Activity this quarter: 2 family members Activity: Contact treatment provider, arrange for bed date and travel as appropriate, obtain releases. Measure: at least 40 patients into treatment Activity this quarter: 1 interventions, 1 is waiting for tx bed to open Activity: Design/modify existing continuing care curricula to offer clients returning from treatment. Measure: 10 clients to complete continuing care per year. Activity this quarter: 15 referrals, 10 clients participating Activity: Design a followup telephone survey to determine treatment success 6 months and one year post-treatment Measure: none yet established Activity this quarter: We did not develop a phone survey yet. We mailed out 59 surveys to patients who have been enrolled in our program/received assessment and 120 to stakeholders including family members we have worked with. We received 4 from consumers, and 14 from stakeholders. We will continue to modify and develop measures for outcomes for this project. Activity: Modify existing or design new media ads for intervention services or presentations (print, radio, TV). Measure: none established Activity this quarter: with prevention/intervention print ads in Capital City Weekly Activity: Plan events, engage speakers and venues, provide media coverage, and report on attendance and other statistics. Measure: At least 2 events per year, attendance measure not established. Activity this quarter: No presentations this quarter Activity 1 st qtr 2 nd qtr 3 rd qtr 4 th qtr TOTAL GOAL Crisis calls logged 18 250 Assessments- adult 23 50 Intervention training family 3 100 members Formal Interventions 1 50 Adult Counseling family members 2 100 3
Successful referrals to treatment 16 16 from 40 assessments Public presentations 0 2 events per year Number of public presentation attendees 0 4