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    AUGUST 2002

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  • Table of Contents Last of'Tables. iv Ust of Figures iv

    Acknowledgements • v

    Executive Summary vi

    1. Introduction Aims and Objectives of the Research 2

    Evaluating Effectiveness 2

    Choosing a Methodology 3

    Qualitative Data Collection 4

    Quantitative Data Collection 5

    Structure of the Report 5

    2. Adolescent Substance (Mis)use: A Review Introduction 6

    Prevalence of Adolescent Substance Mis(use) in Ireland— 7

    Patterns of Drug Mis(use) 10

    Risk Factors 11

    Vulnerable Groups 12

    Problems Presented by Adolescents Entering Treatment... 12

    Treatment for Adolescent Substance (Mis)users 13

    Summary 15

    3. Aislinn: Background and Programme Structure I n troduction 16

    AA 12 Step Programme 16

    Setting Up and Developing Aislinn 17

    Aislinn Staff 19

    * Programme Philosophy 20

    Programme Operation 22

    Admission 22

    Daily Routine 23

    Therapeutic Focus 24

    Family Involvement 25

    Aftercare 26

    Summary 26

    4. Aislinn Client Profile Treatmeni Population: 28

    Socio-Demographic Characteristics of Population. 28

    Drug and Alcohol Use 30

    Anti-Social Behaviour 32

    Health and Well-Being 33

  • C ûntact with Treatment Services 34

    Programme Completion 34

    Comments 36

    Sample Profile 37

    Socio-Demographic Characteristics 37

    Alcohol and Drug Use 38

    Problems Related to Drug and Alcohol Use 40

    Previous Treatment Contacts 41

    Referral Sources 42

    Parent's Perspectives on Treatment Contact 42

    Summary 43

    5. Programme Participants Perceptions of the Service Introduction 45

    Introduction to the Programme 45

    Expectations .". 45

    Screening Process.., 47

    First Impressions 49

    Family Involvemeni 49

    Settling into die Programme 50

    Programme Structure 50

    Group Work 50

    Step Work 51

    Family Day 53

    Lectures 55

    Art 55

    Recreauon 55

    Psychodrama 56

    Meditation 56

    Staff 57 m

    Confidentiality 57

    Views on Programme Philosophy 57

    Self Reported Behaviour Changes 58

    Best Things About the Programme 60

    Worst Things About the Programme 61

    Post Treatment 62

    Returning Home 62

    Staying Clean 64

    Aftercare 65

    AA/NA 67

    Lapses/Relapses 68

    Involvement in Crime 69

    Family Relationships 70

    Life After Treatmeui 70


  • Evaluation of Aislinn Adolescent Addiction Treatment Centre Final Document

    Summary 72 6: Linking Aislinn with Local Models of Drug/Alcohol Treatment

    Introduction 74 The Emerging Community Model of Treatment 74 Services for Young People 75

    Alcohol Problems 75 Drug Problems 76

    Common Elements of a Local Framework 76 Summary 84

    7. Conclusions and Recommendations 86

    Introduction 87

    Findings 93

    Bibliography 97


    2.1 N umber of Teenagers in Treatment in 1 reland by Year 7 2.2 Comparison of School/Youth Surveys of drug use: Lifetime Prevalence.. 9 2.3 Comparison of School/Youth Surveys of drug use: Last 30 days 9 2.4 Risk and Protective Factors 11 3.1 Typical Daily Routine: Aislinn Adolescent Addiction Treatment Centre... 23 4.1 County of Residents 29 4.2 Occupation of Young People (prior to entry into treatment) 29 4.3 Self Reported Drug Use 31 4.4 Charges Pending 33 4.5 Referral Sources 34


    4.1 Age Distribution of Population by Gender 28 4.2 Health Board Areas of Programme Participants 29 4.3 Last Consumed Alcohol 30 4.4 Last Consumed Primary Drug 31 4.5 Pattern of Use of Primary Drug 32 4.6 Ever Stolen for Drugs 33 4.7 Length of Time on die Programme 35



  • Acknowledgements Studies of this nature can only be made possible through the dedication and commitment of many

    individuals. To preserve the anonymity of the young people and families who were involved in the study,

    individuals who participated in the research have to remain nameless. However, we would like to express

    out gratitude to all who took part in the study, in particular the young people and families who were

    undergoing treatment at Aislinn Adolescent Addiction Treatment Centre, during the time of the

    fieldwork. Without their support and contributions, this research would not have been possible.

    We are particularly indebted to the Director and all the staff at Aislinn Adolescent Addiction Treatment

    Centre for their commitment to this evaluation, and for their complete cooperation throughout the course

    of the research.

    We would like to thank Willie Collins (SHB) Declan Roche (SHB) Tony Barden (SEHB) Tony Whelan

    (SEHB) and the following members of the Aislinn Management Committee, John McDermot, and Cyril ?

    for giving of their time.

    We hope that the study findings are a fair and accurate reflection of the accounts and experiences of the

    young people who have participated in the Aislinn Adolescent Addiction Treatment Centre.

  • -xecutive Summary7 THE STUDY

    • The Aislinn Adolescent Addiction Treatment Centre is the only dedicated residential drug free centre for male and female adolescents between the ages of 15 and 21 years in the country. This document reports on the evaluation of Aislinn. The primary aims of the report is to fully define the therapeutic processes involved in the Aislinn Adolescent Addiction Treatment Centre and to examine the effectiveness of the programme in achieving its aims and objectives. Young peoples understanding of the programme and their subjective experiences of progressing through residential treatment and aftercare are integral components of the evaluation.

    • In presenting this document we are however mindful that while the health boards have commissioned this report with specific reference to an evaluation of the Aislinn Adolescent Addiction Treatment the interests of the health boards in terms of how Aislinn fits into its existing and prospective services must also be taken into account.


    " Traditionally, evaluation studies have been based on treatment outcomes, where clients are assessed at intake and at one or more follow-up period. Such evaluations pay little attention to the process of treatment, failing to account for client involvement in different aspects of treatment, the quality of treatment provided, and the amount of support provided to clients. Thus a qualitative methodology was employed in this study to provide descriptive accounts of individual perspectives of the programme and the perceived effectiveness of the programme. Rather then relying solely on aggregated summary measure of outcomes, the study focuses on the processes of change during the period of contact. However, ultimately the chosen methods reflect the information needs of the evaluation audience. For this reason quantitative methods were incorporated into the study, in the form of client records analysis and two short surveys.

    • At the outset four key stakeholders were identified; the young programme participants, the participant's parents/guardians, the service providers, and health board representatives. Interviews were carried out will a sample of stakeholders from each group regarding their experiences of the programme. To this end 13 young people who were residence in Aislinn at the time of non- participant observation were interviewed and 9 of these young people completed a follow-up interview approximately three months later. In addition, five young people who were in the post treatment aftercare programme were interviewed. In-dept interviews were also conducted with a sample of parents/guardians (n=7) who were participating in the programme at die time of the fieldwork. All Aislinn staff that work directly with clients were interviewed (n=?), as were two members of the Board of Managers. Finally three representatives of the health boards were interviewed. The retrospective experience of programme participants and their parents/guardians were examined by short postal questionnaires.


    • Adolescent substance misuse differs from adult misuse in many ways. Their drug and alcohol consumption often stems from different causes, and they frequendy have multiple and complex difficulties such as depression, poor school attendance, delinquency, current or past histories of abuse and family dysfunction. In treatment, adolescents must be approached differendy then adults because of their unique developmental issues, differences in values and belief systems, and environmental considerations, such as strong peer influences.

    • Available Irish data illustrates that tobacco and alcohol are die most widely used drugs. Cannabis is the most commonly used illicit drug, with lifetime prevalence rates ranging from 37% (ESPAD) to 21.7% (National Health and Lifestyle Survey). This is followed by amphetamine and XTC.


  • • Little is known about the pattern of adolescent substance misuse in Ireland. Research in