aiatsis national indigenous studies conference: young and...

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Duthie, Debbie(2011)Urban Indigenous AOD treatment programs : addressing the lack of eval-uative research of culturally appropriate youth services. InAIATSIS National Indigenous Studies Conference: Young and old - Con-necting generations, 2011-09-19 - 2011-09-22. (Unpublished)

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Queensland University of Technology

CRICOS No. 00213J

Urban Indigenous AOD treatment

programs: Addressing the lack of

evaluative research of culturally

appropriate youth services

Deb Duthie

Social Work and Human Services Program

QUT Faculty of Health

CRICOS No. 00213J a university for the world real R

Aim and purpose of evaluation

Assess the progress of Goori House and identify

issues preventing a sustainable organisational

future

Also recognised the limited research on:

• Urban Indigenous AOD rehabilitation service

evaluations

• The effectiveness of residential AOD programs for

Indigenous people (Wilson, Gray, Stearn & Saggers, 2010)

• Cultural appropriateness


Cleveland Qld


Stradbroke Island

http://www.google.com/imgres?imgurl=http://www.djibnet.com/photo/2613641157-north-stradbroke-island-fishing.jpg&imgrefurl=http://www.djibnet.com/photo/pacific/north-stradbroke-island-fishing-2613641157.html&usg=__MbE6NK4TNC8TSfvvxre0Fze0Lko=&h=333&w=500&sz=95&hl=en&start=22&sig2=9xhFm4mvTBmkGOSn0vcoFA&zoom=1&tbnid=VZTObCjok7QhpM:&tbnh=87&tbnw=130&ei=fX5xTqGOGaaLmQXjpcmECg&prev=/search%3Fq%3Dstradbroke%2Bisland%26start%3D21%26hl%3Den%26sa%3DN%26gbv%3D2%26tbm%3Disch&itbs=1


Goori Men’s

Recovery Centre

Three (3) phases of program:

1.Galangoor Residential Treatment Program

2.Supported Accommodation

3.Community Outreach: Transition / reconnection to the

community


Principles and values

The family unit and traditional roles of individuals within it

remain a fundamental social and economic anchor for

Indigenous peoples and their culture

These traditional values are a critical element of our program

framework and provision of services

Sober up the man ~ the wife wins

Sober up the wife ~ the child wins

Sober up the child ~ the family wins

Sober up the family ~ the community wins

Sober up the community ~ the Nation wins


Service users

Service user group

Indigenous (67%) and non-

Indigenous men (37%) (18+)

Complexity of issues:

• Family /social relationships

• Lack of self-esteem and pride

• Low levels of literacy

• Increases in comorbidity

Referrals: ‘the hard cases’

• Self/family members

• Correctional centres (approx.

90%)

• Drug Court diversions (Qld

and Northern NSW)

• Remote area clients (Palm

Island; DOGIT communities)

• Medical centres

• Aboriginal Legal Centres


First, second and third substances of choice

Substance First preference Second preference Third preference

Alcohol 38.7% 10.8% 31.0%

Amphetamines 25.8% 23.4% 14.3%

Heroin 20.9% 9.9% 2.4%

Cannabinoids 11.6% 44.1% 19.0%

Metamphetamine 02.7 6.3% 7.1%

Morphine n/a 0.9% 4.8%

MDMA n/a 3.6% 11.9%

Methadone syrup 0.4% 0.9% 2.4%

Buprenorphine n/a n/a 2.4%

Diazepam n/a n/a 2.4%

Other drugs n/a n/a 2.4%


Model of Service: Stage 1

Galangoor Residential Treatment

Addiction Big Book Studies

Treatment Plan

Anger Management

Cultural Reconnection

Access to Specialist Services

Life Skills

Relapse Prevention

Work Skills 1


Model of Service: Stage 2

Supported Accommodation

Case Managed

Mentoring

Relapse Prevention

Career Mapping

Healthy Lifestyles

AA & NA

Support

Drug Testing

Work Skills 2


Model of Service: Phase 3

Community Outreach

Case Managed

Mentoring

Relapse Prevention

Career Mapping

Healthy Lifestyles

Work Skills 3


Phase 1 Galangoor

Addiction & Lifestyle

Treatment Program

Tools provide:

•The means for self-analysis &

self-awareness of adjustments

they have made

•Provides choices to replace

addiction lifestyle & strategies to

maintain new lifestyle

•Allows responsibility for selves

& for change to occur

Provision of Facilitators Guide ©

©


Practice tools: The Stickman © & Workbooks ©


Culturally embedded program

• Elders regular visitors and attend group

meetings

• Cultural camps – Stradbroke Island

•Understanding Aboriginal and Torres Strait

Islander history & timeline

–Traditional life

–Colonisation, dispossession, assimilation

–Impacts on contemporary families

Taking pride in being an Aboriginal and/or Torres Strait

Islander


Evaluation Method Model of Service

Extensive literature

review (200+ sources)

•Government and NGO

reports; peer reviewed

literature

Process Evaluation

•Analysis of human

resource information,

policy and procedures

•Qualitative: Interviews

with staff (all levels)

– Thematic analysis

Impact Evaluation

Quantitative: Client data


Commendations: Model of Service

Underpinned by best practice

guidelines (National and

International) including a harm

minimisation and abstinence

approach

Emphasis on workforce participation

Treatment model: holistic, client

involved, self-awareness

enhanced, culturally embedded

Staffing

‘Life coaches’ w/ own past

experience of AOD

Skills-based knowledge

Resources

Effective practice tools developed

specifically

Specific reference to Aboriginal &

Torres Strait Islander history

Focus on cultural connectivity,

Indigenous pride


Recommendations

Enhanced community engagement

(kinship networks, community

and non-Human Service

agencies)

Further specification of Phases 2 &

3 + strategies for building

community engagement / support

Staff training in mental health,

poly-drug use, disability

Encouragement of staff to gain

tertiary qualifications

Increased outreach to families

and key sources of support


Commendations: Processes

Organisational

Robust Indigenous identity

Reciprocity and obligation guide behaviour – strong

organisational value

Addressing staff conflict and reasserting constructive and

inclusive culture

Restructuring of organisational human resource processes

including staff performance measures, employment

practices


Recommendations

Funding to ensure viability &

continuation of Goori House

Review of overall strategic direction

in view of more diversified

services

Clarity re: succession plan

Career development plans for staff

(up-skilling & educational

pathways, increased

responsibility, etc)

Re-positioning Goori House with

relevant education providers

(student placements)

Ongoing development of

management systems &

training in system

requirements


Commendations: Impact

Comprehensive policies & procedures

Satisfactory relationships between Goori House & external

stakeholders


Recommendations: Impact

Review & rationalisation of

database to capture detailed

data for funding purposes &

accurate analysis

Clarity of information type to

capture impact of program

(attitudinal, behavioural,

emotional, quality of life

changes)

Post-discharge client survey to

demonstrate longevity of

program effect

Develop a standardised report

format & produce routine

reports produced

Internal communication enhanced

Undertake skills audit; review

practitioner roles, increase

case management training

Increase in female practitioner

presence


In conclusion ...

Goori House is a successful

Indigenous AOD program with

particular focus on:

• Ceasing and managing addiction on

return to the community

• Understanding how the past

influences the present & future

• Rebuilding confidence & pride in

Indigeniety and the importance of kin

and culture


Where to from here?

• Continued development of program second & third

phases

• Human Resource development

• AOD service specifically for Aboriginal and Torres

Strait Islander women

– Redevelopment of program structure


Questions?

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