John NolanJohn NolanForensic and Clinical PsychologistForensic and Clinical Psychologist

Port Macquarie PsychologyPort Macquarie Psychology

john@pmfp.com.aujohn@pmfp.com.au

Issues in sentencing indigenous Issues in sentencing indigenous offendersoffenders

(to do with Alcohol and Drugs)(to do with Alcohol and Drugs)

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• for some alcohol and drug problems related to offending, Fernando(1992) called for more subtle remedies other than imprisonment

• Main alternatives proposed so far are AOD residential rehabilitation centres

• In those centres, the older group-style approach is founded on AA but it is possible to improve treatment delivery through specific psych groups and with the development of cognitive behavioural assessments

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• We don’t really have any good evidence base about what makes a good rehab in terms of treatment, client profile and even management style.

• Some still rely on AA and 12 step programs (often known as the ‘disease model’) – operating since the 1970’s with mixed success. AA has enjoyed good marketing by those recovered; it works for some but not all

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• AA based residential rehabs are good for learning the 12 steps and building the confidence to go to community AA groups, they encourage members to address their problems exclusive of race, legal history or any other competing issues

• AA programs also good for building public confidence by encouragement to share through public speaking

• The Share effect can be a powerful stimulus towards recovery and personal confidence

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• AA groups do not address histories of family chaos, violence, sexual violence, lack of parenting, lack of standards, lack of life education, lack of parental guidance

• Giving all Aboriginal people a tag of alcoholic (disease model) based on their problems with drinking or drugging fails to target their psychological problems which may be from family breakdown

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• If psychological problems are targeted, my experience is that it has been in a random way depending on the expertise of personnel running the treatment program

• I understand there is now a move towards new standards of treatment other than AA

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• My research at Benelongs Haven in 2005-7 supports new approaches.

• It reviewed 80 indigenous and non indigenous male participants’ psychological progress over three months. For those who stayed in treatment significant psychological improvement was found.

• It also found similar results for those who were voluntary and those coerced into treatment.

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• The research did not discriminate between the different treatment functions within the overall treatment program

• some of these are: AA sharing groups; life education groups; psychological intervention groups; individual psychological intervention; time structured living

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ASSESSMENT

• To design behavioural treatment programs it would help if cognitive and behavioural assessments were made to enable each patient to have their needs identified

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• Bugmy was not cognitively tested for alcohol or substance related brain damage;

• His substance use history was described from age 14

• His petrol sniffing prior to commencement of alcohol at age 14 was not considered nor was his possible brain damage

11Treatment• Aboriginal people from throughout Australia are

different in many ways.

• There is one factor we all have in common which is what psychological intervention is based on: That the majority of us like to talk about ourselves

• psychologists provide that opportunity for 30-50 minutes per session. This can be a long time for someone who has never had that opportunity. The session is private so that it avoids the gossip trail too often associated with group revelations.

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• Some groups have been found to work without the insidious effects of post group gossip. Parenting groups spoken in the third person are one example; these are discussion of case studies where the group participants are able to offer their life experience to help work out the problems of the fictitious client. Harold and Mildred may have one or six children or none and their problems change with different scenarios.

• The advantage is they are Not personally involved ; not judged and not blamed

• The other big factor in this type of group is life skills Education not found in textbooks (see Taylor)

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• Cognitive assessments and skilled psychological interventions cost money. In NSW a legal aid funded psychological assessment and report is paid at $585 + GST. I charge around $2000 based on $150 - $200 per hour.

• I would have found that Bugmy’s substance issues were also petrol sniffing before age 14.

14• Chenhall, R. Benelong’s Haven: Recovery from

Alcohol and Drug Use within an Aboriginal Australian Residential Centre. Melbourne (AUST): Melbourne University Press: 2007.

• Chenhall, R. Psychotherapy with Indigenous Australians: group work in a residential alcohol and drug treatment setting. Psychotherapy in Australia. 2006: 13(1); 62-8.

• Nolan, J., & Thompson, A. P. (2009). Psychological Change in Voluntary and Legally Coerced Clients of a Residential Drug and Alcohol Treatment Program. Psychiatry, Psychology and Law, Vol. 16, 458-472

• Taylor, K., Thompson, S., & Davis, R (2010). Delivering culturally appropriate residential rehabilitation for urban Indigenous Australians: a review of the challenges and opportunities. Australian and New Zealand Journal of Public Health, 34, S1.

• John Nolan Port Macquarie Psychology john@pmfp.com.au 8/2/14