Alcohol: Considering Change: a model for alcohol diversion programs?
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Presented at the Australasian Drug and Alcohol Strategy Conference (March 2013). Considering the lack of alcohol diversion programs in Australia and ReGen's Alcohol: Considering Change? program.
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Alcohol: Considering Change: a model for alcohol diversion programs?
- 1. Alcohol Considering Change: A model for alcohol diversion programs? Matt Gleeson, Senior Education & Training Officer, UnitingCare ReGen ADASC 2013 http://www.facebook.com/ReGenUC @regenuc
- 3. Context • National Drug Strategy 2010 – 2015 • National Illicit Drug Strategy (NIDS)
- 4. Context • Alcohol related harm • Australian Guidelines to Reduce Health Risks From Drinking Alcohol
- 7. Evaluation Methodology The evaluation form was designed to measure: • The overall quality of the program • Participant’s self reported development of skills and knowledge that supports the reduction of potential alcohol related harms • The impact of the program upon participant’s motivation to change their alcohol use
- 8. Registrations & Demographic Data January to December 2011... 138 113 85% 52% E.O.I. Attended Court Directed Under 24 11Sessions 3Facilitators
- 9. Findings Overall Quality of program...
- 10. Findings Knowledge of alcohol and potential harms increased...
- 11. Findings Knowledge of how to reduce harms of drinking...
- 12. Findings Understanding of a number of strategies that can assist change...
- 13. Findings 86% Confident in making changes... Considering reducing or ceasing alcohol use... 57%
- 14. Limitations • Self reporting • Questions regarding future behaviour change does not measure change outcomes
- 15. Summary • ACC meets an otherwise unmet demand • Appears to be effective in delivering information about alcohol related harms and strategies for reducing these harms • May be effective in supporting behaviour change • Further evaluation is required
- 16. Questions
- 17. References Klimas J, Field CA, Cullen W, O'Gorman CS, Glynn LG, Keenan E, Saunders J, Bury G, Dunne C. (2012). Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users. Cochrane Database Systematic Review. CD009269. Epub 2012 Nov 14.
Editor's Notes
- Who is ReGen?
- The National Drug Strategy 2010 – 2015 addresses all drugs including alcohol and tobacco. While the strategy is written to encompass all drugs both legal and illicit, a number of the actions including diversion and ‘first offence’ programs target illicit drugs specifically. Currently ReGen offers:Cautious with Cannabis – A Cannabis cautioning program – A police diversion programThe cannabis cautioning program is a police diversion program that involves the provision of a cautioning notice for simple use/possess cannabis offences to offenders 17 years and over. The offender must only be in possession of a small (non-trafficable) amount of cannabis, admit to the offence and consent to being cautioned. A voluntary cannabis education program is available to accompany the caution. The Drug Education for First Offenders Service (FOCiS)for first time offenders found in possession of a small (non commercial) quantity of illicit drugs other than marijuana. The offender is released on an undertaking to attend the program as part of their conditions. Upon completion of the education, the court will no longer deal with the matter. If the offender fails to attend scheduled sessions, a rebooking process is followed and attendance documented for the court. If the offender repeatedly fails to attend, a breach process may be evoked and the matter referred back to court.It should be mentioned that the National Drug Strategy does identify that successful diversion programs targeting illicit drugs should be extended to apply to alcohol or other drugs where indicated.
- Lastyear Australian’s 15 years and over consumed just under 10 litres of pure alcohol per capita. (ABS accessed 2012) There is of course ample evidence regarding the harms associated with the use of alcohol, both in terms of short term risks and harms associated with longer term use of alcohol. It is the measure of these risks both in the short and long term that the National Health and Medical Research Council have used in formulating the Australian Guidelines to Reduce Health Risks From Drinking Alcohol In terms of short term risks there is of course the question of alcohol related crime. Attribution of alcohol as a factor attributable to the causation of violence or other criminal activity is not straightforward. There are a range of other characteristics that come into play such as the environment, social determinants and personal characteristics that can all contribute to the likelihood of someone offending. Regardless of this, research appears to indicate that the use of alcohol, particularly in large doses is a contributing factor to the likelihood of an offence occurring.According to the Australian Institute of Criminology related (citing Dearden & Payne 2009),around half (47%) of all homicides in Australia between 2000 and 2006 were alcohol related. In 2010, around 8.1 per cent of Australians aged 14 years or older were the victim of physical abuse by someone who had consumed alcohol.A further 15.8 per cent of Australians had been ‘put in fear’ by someone who had consumed alcohol—an increase from 14.1 per cent in 2007.This figure climbed to almost one in four Australians when verbal abuse was examined. National Drug Strategy 2010 Household Survey)..Adherence to the guidelines reduces the probability of short term harms to 1 in 100
- Alcohol Considering Change was developed by Julie Bowen (then Manager of Education and Training) and Venetia Brissenden (Senior Education and Training Officer) in 2008. A pilot of the program was announced that year and the program has been delivered on a monthly basis since that time. The drivers for the development of such a program included the development of new national guidelines regarding low risk drinking coupled with the identification that while brief intervention programs existed for cannabis (Cautious with Cannabis) and other illicit substances (Focis), their were no such programs currently being delivered in relation to alcohol.In 2010 Moreland Hall made the program materials freely available to other AOD agencies, via the Heads Together website and it is understood that that Alcohol Considering Change has been delivered by a number of agencies across the state.Alcohol: Considering Change? is a two hour education program designed to inform participants’ decision making regarding their use of alcohol. The program is consistent with a key strategy, ‘better, earlier healthcare for alcohol problems’, outlined in - Reducing the Alcohol and Drug Toll: Victoria’s Plan 2013-2017 (DOH 2012). Delivered in an interactive and engaging style, the program provides information on alcohol, its effects and the long and short term harms associated with different patterns of drinking. Participants are encouraged to consider the risks associated with their own drinking, with the aim of increasing their motivation to reduce their alcohol consumption to safer levels. The program is based on evidence that early and brief motivational enhancement interventions are associated with better alcohol use outcomes (Klimas et al. 2012).
- Increasing participants knowledge regarding potential alcohol related harmsIncreasing participants knowledge about how to reduce alcohol related harmsIncreasing the understanding of strategies that assist changed behavioursIncreasing participant knowledge of services that can provide assistance with alcohol related problemsIt is delivered in a presentation style format complete with group discussion, and activity sheets.Reduce the direct acute and long term harms of hazardous levels of alcohol consumptionEducation about Reduced risk guidelinesAUDITIdentification of harms already experiencedStrategies reducing pace of drinking and overall doseIndividuals - are primarily young (early 20’s male)Acknowledgement of risk taking as a feature of this age group/genderPre contemplative about alcohol use (anecdotal)Generally treatment naive (anecdotal)Non judgemental engagement acknowledging these two factors importantEnvironmentVenues and violence and expectations
- All participants complete a 10 question evaluation form designed to measure:The overall quality of the programParticipant’s self reported development off skills and knowledge that supports the reduction of potential alcohol related harmsThe impact of the program upon participant’s motivation to change their alcohol useData collected as part of routine evaluation of the program was collated covering the period Jan 2011 to December 2011 and reviewed against these aims.Need to find out from Rita how many sessions and trainers were involved
- 138 expressions of interest with 113 attendeesOver the course of three sessions 3 different facilitators delivered the training over this time
- Participants were asked to rate the overall quality of the program against a five point likert scale ranging from very poor to excellent.The majority of participants (95%) found that the over quality of the program was either good or excellent. No participants reported the program was of a poor or very poor quality.
- 94% either agreed or strongly agreed that their knowledge regarding alcohol and the potential harms had increased as a result of attending the education session.
- 97% either agreed or strongly agreed that their knowledge of how to reduce the harms of drinking had increased.
- 98% of participants agreed or strongly agreed that they had an understanding of a number of strategeies that can assist change
- 86% either agreed or strongly agreed that the program had contributed to an increase in confidence in making changes to their drinking, however only 57% either agreed or strongly agreed that they were considering ceasing or reducing their intake of alcohol.
- While the evaluation results demonstrate that participants knowledge regarding alcohol related harms are increased substantially, the impact of the program upon motivation to change alcohol using behaviours is less clear. The majority of participants have identified an increased confidence in making changes to their behaviours. Regardless of this a much smaller proportion of the sample group identified that they were considering reducing or ceasing alcohol use. As motivation is an attribute that is always subject to change and fluctuation such measures may in fact be flawed anyway. A more accurate measure of the Alcohol Considering Change Program’s impact upon participant motivation to reduce or cease alcohol use would require post program evaluation models that measured actual changes in behaviour. Regardless of this the current data indicates that at the very least participants are more aware of the change process and that a significant number of program participants have identified that they wish to make changes to their alcohol consumption patterns at the time of completing the program.
- ReGen is currently meeting a demand within the criminal justice system for alcohol specific diversion programs that is not currently being met by the national frameworks for drug diversion. The program is consistent with recently announced Victorian Government policy directions to expand diversion options for young alcohol and/or drug affected offenders.Alcohol: Considering Change? is effective in increasing participants’ knowledge of alcohol related harms and strategies for reducing these harms.Based on the research literature, it would be expected that Alcohol Considering: Change? would have positive impacts on participants motivation to change and the brief evaluation indicates that this may have been achieved for many participants. A more comprehensive evaluation would be required to determine whether changes in knowledge and motivation are associated with changes to drinking behaviour.Klimas J, Field CA, Cullen W, O'Gorman CS, Glynn LG, Keenan E, Saunders J, Bury G, Dunne C. (2012). Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users. Cochrane Database Systematic Review. CD009269. Epub 2012 Nov 14