early intervention for young drug first offenders drug first offenders
TRANSCRIPT
Structure of Carinthia
• Southern federal state of Austria• About 650.000 citizens• Increasing number of young drug users• Care facilities only for adults• 1 prevention institution
1st aim general preventionThe need of development of selective
prevention
Difficulties / Facts
• Young people in a rural environment are not mobile
• Establishing care centers in small towns is expensive
• Need of specific counselling for young people (regarding personal situation, peer-group, family, needs + demands)
• Special law for drug using first offenders:„help instead of punishment“
• Special law for pupils (school director and school medical officer decide in cooperation with parents how to deal with the problem, no denunciation by judge)
• Only probation service „Neustart“ is specialised
single + group caremobile teamappropriate infra-structure
Project partners
• Prevention unit of Carinthia (Governmental Organisation)
• Department of Carinthian Government / Sub-Department Addiction
• Neustart Carinthia (Private Organisation, probation service)
• Center of Evaluation + Research / University of Klagenfurt
Financing: Health Department of Carinthian Government
What is „Way out“
• Offers counselling and care facilities for young people
• Structured support over a short period of time
The concept of „Way out“
• Young people charged by police or noticed at schoolschool medical officer or public health officer
• Special diagnosis form to work out a „risk-profile“• More risk-factors than resources „Way out“• Age 14 – 21 years• Counselling for single persons (approx. 15 meetings at
50 minutes) and groups (12 meetings at 2 hours)• Support over a period of 6 months• Meetings can be arranged near to place of residence
General aims
• Encouraging abstinent behaviour concerning illegal drugs
• Controlled behaviour concerning legal substances and
• avoidance of drug-related problems
Specific aims
• Increasing social competence• Imparting knowledge on health risks,
development of addiction, effects of substances and legal situation
• Reflection of personal consumption and grappling with norms and values of their peer-group
• Developing personal strategies for solutions by integrating experienced and alternative strategies
• Testing different models of conflict management
• Improving communicative abilities• Heightening the awareness of one‘s own
resources• Supporting the ability to reach self-imposed
aims
Risk-profile indicators (pretended)
• Environment: profession, family constellation, childrearing practices, consumer behaviour of family + friends
• Personality: coping, self-esteem, psychological comorbidity, self-efficacy, comunicative competence, delinquency
• Substance: beginning of abuse, consumer habits, alcohol abuse
Most participation criteria - Indication
• Incomplete families –Step-parent/-partner- Divorced parents- Death of one parent- Severe illness of one parent
• Addiction or co-addiction in the family system
• Problematic debonding between mothers and daughters (mothers detach too early from their daughters)
• Style of upbringing:– Laissez fair– Spoiled, overprotective
• High pressure of expectations and pressure of performance by the parents
Young people who are in the program
• Most of them are continuously using one or more psychoactive substances:„leading drug“ cannabis„additional drug“ XTC
• Age group 14-16: „trying consumption“• Age group 17-18: „continuous drug use“• Relationship male: female = 7 : 1• Profession: apprentices, pupils, unemployed
Care - Management
• General procedure:- social worker gets into contact with clients- written invitation – several telephone calls- within 2 weeks date of 1st setting- 1st setting within 4 weeks- deciding if the client will be in the single or
group session
Work-base of single-session
• Casework-method• Sometimes only a few sessions are needed• Sometimes they are sent to a more
appropriate setting
Group-session
• Method of Theme-Centered-Interaction (TCI) according to Ruth Cohn
• 2 social workers (male/female)• max. 12 group-settings• min. 10 group-settings are obligatory• group size 6–12 participants• max. 6 months• final examination including urine-testing
Measures of quality management
• 2 urine tests during care period• positive test results are reported to social
workers• regular case-meetings between social-
workers + physicians• documentation + evaluation
Evaluation
1. Assessment (according to § 11+13 SMG)
2-4 weeks
2. First contactClient-social worker
3. First settingDecision single/groupEvaluation: pre-testing with standardized psychological tests
6 months
4. care
End of care
5. Evaluation: standardized psychological test
4 months later
6. Evaluation: retrospective interview
Results of evaluation using standardized psychological tests
• Increased drug-related attitudes towards - the danger of drug-abuse- reflected motivation
• Slight changes towards a better ability for- problem solving- decision-making (less influence of peer-group)
• About the need to take drugs (open questions)- no positive attitude to drug abuse any more- an increase in resistence to drug abuse
Care-results – single setting
18,20%
18,20%
63,60%
abstinence from illegal drugs transfer to a more appropriate care no effect
Results of interviews with clients
• Most of them would accept the program spontaneously
• No more punishment because of drugs
60%
5%
35%
positive program was too excessive agreeable
Effects of attending „Way out“ 2004 to 2006
• 2004: 85 clients left the program:- 74 finished the counselling/reached the achieved aims- 3 aborted the counselling process early- 8 others
• 2005: 113 clients left the program:- 87 finished the counselling process/reached the achieved aims- 4 aborted the counselling process early- 22 others
• 2006: 67 clients left the program:- 52 finished the counselling process/reached the achieved aims- 5 aborted the counselling process early- 10 others
Experiences:
• A program for youngsters needs clear structures
• Constant communication between counsellors and the medical attendant is important
• The project offers must be flexible, to fit the youngster‘s needs
• Voluntary participation is not necessarily needed
• A basis of trust between the counsellor and the client is very important
• The period of attendence (normally 6 months) needs to be extendable if crisis situations arise (e.g. sudden unemployment)
• Many youngsters only needed 3 months of attendence
• Occasionally police charges were filed again, but the patterns of cannabis consumption had changed (reflected usage)
• Average time of care per client, including times for documentation and travel, approximately 21 hours