Transcript 8-Barbara Drobesch

EARLY INTERVENTION FOR YOUNG
DRUG FIRST OFFENDERS
Structure of Carinthia
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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 prevention
The 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, peergroup, 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 care
mobile team
appropriate infra-structure
Project partners
• Prevention unit of Carinthia (Governmental
Organisation)
• Department of Carinthian Government / SubDepartment 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 school
school 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 socialworkers + physicians
• documentation + evaluation
Evaluation
1. Assessment (according to § 11+13 SMG)
2-4 weeks
2. First contact
Client-social worker
3. First setting
Decision single/group
Evaluation: 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 – group settings
5,90%
94,10%
abstinence from illegal drugs
no declaration
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
35%
60%
5%
positive
program was too excessive
agreeable
• Most of them would accept the program spontaneously
• No more punishment because of drugs
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
Thank you for
your attention