Matt Talbot Services Presentation


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  • I think we suffer from a crises of ideas, but the young people are full of ideas
  • Most effective treatment outcomes.
  • Young people find it impossible to navigate with multiple agency involvement.
  • Tracked outcomes in four key domains.
  • Its CBT based with a focus on coping skills and life changes.
  • Matt Talbot Services Presentation

    1. 1. <ul><li>“ Growing up is trying to find the right </li></ul><ul><li>substitute for your thumb” </li></ul><ul><li>Milkman H. (1990) </li></ul>
    2. 2. <ul><li>They don’t operate out of the same rules as we do. </li></ul><ul><li>They have great sense of justice no sense of law. </li></ul><ul><li>There only crime is getting caught. </li></ul><ul><li>They’re always on alert and in full battle mode. </li></ul><ul><li>They’re tough, loyal to their gang, streetwise, well known to the Gardaí, extremely anti-authority. </li></ul><ul><li>They give us a hard time just to get a rise out of us. </li></ul><ul><li>They manipulate, run scams, tell fibs and sometimes bold faced outrageous lies. </li></ul><ul><li>They came from poor neighbourhoods and early school leavers. </li></ul><ul><li>They shared everything, lived in the now, very loyal to their friends, have a great sense of humour and great sense of fair play. </li></ul>
    3. 3. Matt Talbot Services is a voluntary organisation providing drug and alcohol treatment services to young people and their families.
    4. 4. Service Design <ul><li>Designing treatment programmes that attract, engage and hold hard to reach young people.(96% retention rate 2010) </li></ul><ul><li>Therapeutic Relationship is key dynamic. </li></ul><ul><li>The building blocks to programmes based on rights and needs. </li></ul><ul><li>Young people/families have a voice in all matters that effect them and they are actively involved in our developments- service user’s forums. </li></ul><ul><li>Authority is democratic. A bottom up approach to everything. </li></ul><ul><li>A fresh start for all young people recognising wild loose qualities as providing added value. </li></ul><ul><li>Social justice and a strong advocacy role. </li></ul><ul><li>Our effective and meaningful integration at local level is central to service development. </li></ul>
    5. 5. Day Treatment Services Cork City Supported by H.S.E. South, Drug/Alcohol Services. Probation Services, Y.P.F.S.F., S.R.D.T.F, Dormant Accounts, Irish Red Cross Cara Lodge Residential Treatment Centre West Cork Supported by: Interdepartmentally Funded, Dept. of Health, Dept. of Justice, Dept. of Education, The SRDRTF, Mercy Solidarity Fund Day Programme Youth Enterprise. Training/Activity Supported by Probation Services, FÁS.VEC . What we provide
    6. 6. THE PEOPLE WE SERVE: Young People and Families Multi Disciplinary Teams Manager Trabeg Services Manager Cara Lodge Manager YES Day Programme Chairperson Research and Development Director of Services Executive Committee Chief Executive Officer Financial Board of Directors
    7. 7. MULTI-DISCIPLINARY TEAM Social Care Team Psychotherapist Cognitive Behavioural Therapist Addiction Counsellors Practical Instructors Art Therapist MA Student Family Counsellors Consultant Psychiatrist Forensic Psychologist Teachers Computers Arts/ Crafts Horticulture
    8. 8. Policy Context <ul><li>National Drugs Strategy 2010- 2016 </li></ul><ul><li>Action 49 – The need to develop a protocol for working with U18s with serious drug problems. </li></ul><ul><li>Action 59 - The need for easy access to Counselling Services for U18s </li></ul><ul><li>Action 60 – Treatment Services for young people to include family involvement and community integration. </li></ul>
    9. 9. <ul><li>The Report on the Working Group for Treatment of U18s presenting to treatment services with serious drug problems. 2005 </li></ul><ul><li>“ a need for a Service design that attracts, encourages and </li></ul><ul><li>retains hard to reach young people in treatment services”. (pg 51) </li></ul><ul><li>“ A four-tier model of Service Delivery was recommended” </li></ul>
    10. 10. <ul><li>2010 National Rehabilitation Framework. </li></ul><ul><li>Alcohol to be included in a new Substance Misuse Strategy. 2011 </li></ul><ul><li>MTS Services are guided by :- </li></ul><ul><li>The UN Convention on the Rights of the Child; The Child Care Act, 1991and 2001;The National Children’s Strategy Our child, their lives; The Health Strategy Quality and Fairness – A Health System for You </li></ul>
    11. 11. Numbers young people referred in last 3 years 2008 2009 2010
    12. 12. Sources of Referral 2010 .
    13. 13. Profile of Young Poly Drug User 2010 72 % presented with mental health issues 93% Involved in the Juvenile Justice System 60% From socially excluded designated areas of disadvantage 70% using substances by age 11 68% of young people experienced trauma 54 % Early school leavers no formal qualification 58% Combination of alcohol and benzodiazepines 4% In Care 35% Violent Crime 73% From one parent families 38% Involved with Youth Homeless Services
    14. 14. Poly Drug Profile 2010 % % % % % % % % % %
    15. 15. Profile of Crimes Committed by Young People 2010 % % % % % % %
    16. 16. <ul><li>Working with adolescent </li></ul><ul><li>Is it Science with Art? </li></ul>Listen!!
    17. 17. <ul><li>These are interventions for which there is consistent scientific evidence showing young people’s treatment outcomes. </li></ul>Evidence Based Practices
    18. 18. <ul><li>Our interventions have a strong basis of scientific evidence:- </li></ul><ul><li>Cognitive Behavioural Therapy </li></ul><ul><li>Motivational Interviewing </li></ul><ul><li>Brief Intervention </li></ul><ul><li>Relapse Prevention </li></ul><ul><li>Family Systems Approach- Strengthening Families Programme. </li></ul>
    19. 19. <ul><li>Clearly Measured Outcomes </li></ul><ul><li>Our Treatment programmes rely on </li></ul><ul><li>outcome data to determine treatment </li></ul><ul><li>efficacy. </li></ul><ul><li>Our treatment practice is supported </li></ul><ul><li>from both a theoretical and </li></ul><ul><li>outcomes based position. </li></ul>
    20. 20. <ul><li>Care Co-ordination is an evolving partnership between stake holders and treatment providers that results in better outcomes and more efficient use of Treatment resources. </li></ul>
    21. 21. Young People need Case Managers who can advocate for them across the entire treatment continuum.
    22. 22. Harm Reduction Approach <ul><li>We offer services regardless of the level of motivation. </li></ul><ul><li>It is an approach of pragmatism rather than purism – an acceptance that it may sometimes be better to go for a probable silver than a possible gold. </li></ul><ul><li>Empowers some young drug users to develop healthier live styles even when they are ambivalent regarding stopping their drug use. </li></ul><ul><li>HR recognises that drug use is multi-faced and sits on a wide continuum from severe use to total abstinence. </li></ul><ul><li>It engages drug users in a way that reduces the negative consequences and meets the young person earlier in the dependency continuum. </li></ul>
    23. 23. Developments 2010 – Enhancing Best Practice Bio Psycho Socio-legal <ul><li>Dept. of Pharmacology </li></ul><ul><li>University College Cork </li></ul><ul><li>3yr PhD Benzodiazepine abuse among young people </li></ul><ul><li>Educational Seminar with GP’s </li></ul><ul><li>Health Literacy Study </li></ul><ul><li>Staff Training </li></ul><ul><li>-Dept. of Psychology </li></ul><ul><li>University College Cork </li></ul><ul><li>Ma in Applied Psychology </li></ul><ul><li>Mapping life paths </li></ul><ul><li>- Ongoing research and support </li></ul><ul><li>Dept of Law </li></ul><ul><li>University College Cork </li></ul><ul><li>- Law Lectures </li></ul><ul><li>Ma Students research in Sept. </li></ul><ul><li>Law Clinics </li></ul>
    24. 24. Other developments…. Accreditation Forensic Psychologist Family Therapist Networks & Partnerships Networks & Partnerships Quads and CHKS (Caspe Healthcare Knowledge Systems-UK Accreditation Body) Interventions with young people and staff training Evaluation of family programmes Family therapy <ul><li>University College Cork: Law. Psychology, Pharmacy, Social Work, Art Therapy </li></ul><ul><li>Youth Justice Service Northern Ireland. </li></ul>3. Rutgers University, USA Centre for Drug and Alcohol Research
    25. 25. <ul><li>Towards engagement, relationships </li></ul><ul><li>and connection </li></ul><ul><li>It isn’t what you do that counts, it’s what you are! </li></ul><ul><li>You gotta have a heart being present to pain. </li></ul>Art
    26. 26. Why are young people difficult to work with? <ul><li>Normal Adolescent Development. </li></ul><ul><li>Drug Abuse. </li></ul><ul><li>Multiple Diagnosis </li></ul><ul><li>Difficult Family situations/living situations. </li></ul>
    27. 27. <ul><li>Normal adolescent development. </li></ul>
    28. 28. <ul><ul><ul><ul><ul><li>Individuation </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Separation </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Autonomy </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Co-operation </li></ul></ul></ul></ul></ul>
    29. 29. Individuation <ul><ul><li>“ Who am I ” </li></ul></ul>
    30. 30. Separation <ul><li>“ I have to separate from my family to develop independent thought and action ” </li></ul>
    31. 31. Autonomy <ul><li>They don’t accept everything their parents say just because they say it. </li></ul>
    32. 32. Co-operation <ul><li>They begin to master the skills of successful integration with peers and a wider community. </li></ul>
    33. 33. To Sum Up Mastering the developmental tasks of adolescents is a very frustrating process…. for adults.
    34. 34. <ul><li>We need pre-treatment programmes for pre-contemplative Young People! </li></ul>
    35. 35. Two things in common 1.They had no choice about coming to our service. 2. They had no level of acceptance that they had a drug/alcohol problem
    36. 36. <ul><li>Goal of the pre treatment process </li></ul><ul><li>Engagement </li></ul><ul><li>Perception shift </li></ul><ul><li>Agree to enter appropriate treatment. </li></ul>
    37. 37. <ul><li>Drugs </li></ul>Ak 47 Devil's Dandruff Finger Cocaine Best Buzz of All!! The Dove is back...but stronger!! Charge Sheet Stimulants Depressants Hallucinagenics
    38. 38. <ul><li>Young People who use drugs to dull their senses or avoid reality have something inside that hurts. </li></ul><ul><li>The self hurts- the drugs work! </li></ul>
    39. 39. <ul><li>Serious Drug Use often reveals a complex interplay of biological, psychological and social difficulties. </li></ul>
    40. 40. Gang Neighbourhood Family Young people’s choices to use drugs are often made as a result of their wider experience of society. Young Person
    41. 41. Enhancing Outcomes through Client Driven Treatment <ul><li>Matt Talbot Services </li></ul>
    42. 42. <ul><li>Quantum of Services </li></ul>Engagement Pre-Treatment Programme <ul><li>Initial/Comprehensive Assessment </li></ul><ul><li>Day Treatment Programme </li></ul><ul><li>Relapse Prevention </li></ul><ul><li>Harm Reduction </li></ul><ul><li>Individual Counselling </li></ul><ul><li>Psycho/educational Groups </li></ul><ul><li>Fathers/Mothers Support Group </li></ul><ul><li>Family Counselling </li></ul><ul><li>Aftercare Support </li></ul><ul><li>Aftercare Support </li></ul><ul><li>Onward Referral </li></ul><ul><li>Psychiatric Consultation </li></ul><ul><li>Brief Interventions </li></ul><ul><li>Crisis Intervention </li></ul><ul><li>Community Support </li></ul><ul><li>Multi-Agency Collaboration </li></ul><ul><li>You Can Heal Your Life – Louise Hay </li></ul><ul><li>Service Users Forums. </li></ul><ul><li>Training and Activities </li></ul><ul><li>Empowerment Life Skills </li></ul><ul><li>Educational Skills </li></ul><ul><li>Personal Development </li></ul><ul><li>Strength Focused Skill Groups </li></ul>
    43. 43. <ul><li>Cara Lodge </li></ul><ul><li>Residential Treatment Centre </li></ul><ul><li>National Winner of Children Act Advisory Board Awards for Services to Young People </li></ul>
    44. 44. CARA LODGE <ul><li>Is a drug free programme for boys 14 to 18 years who are enmeshed in a subculture of chaotic substance abuse with coexisting psycho/social challenging behaviour. </li></ul><ul><li>Capacity for 6 young people </li></ul><ul><li>The length of stay is determined by a young person’s presenting needs/treatment goals. </li></ul><ul><li>The programme is divided into 3 phases: settling in, laying foundations and community re-integration. </li></ul>
    45. 45. “ One size fits all” treatment only works for the client who happens to fit that modality – the rest are square pegs being forced to fit through round holes.
    46. 46. <ul><li>Tailoring Treatment to Young People. </li></ul>
    47. 47. More is not necessarily better and, in fact, can produce diminishing returns.
    48. 48. Engaging the young person in Treatment requires us to focus on the client's strengths, resiliency, and what motivates him.
    49. 49. The important treatment question is “What does the young person want?” The challenge is to create an ethical balance between what the client wants and what is clinically determined
    50. 50. A Day at Cara Lodge… Hi Counsellor
    51. 51. Weekend Activities include: Fishing, hill walking, horse riding, cinema, outdoor adventure, pitch and putt, soccer and football .
    52. 52. <ul><li>Young People get a good kick start in Treatment but it is continuous work and </li></ul><ul><li>support of the family/ carers and strong community links that will make the real difference. </li></ul>
    53. 53. Cara Lodge Residential Treatment Service Outcomes 2010 3 16 6 6
    54. 54. After Care <ul><li>Discharge Graduation ceremony when treatment goals have been completed. </li></ul><ul><li>Each Young Person has his Individual Relapse Prevention Programme. (Marlott got and Gordon’s). </li></ul><ul><li>Services User Research in 2009 – </li></ul><ul><li>Young People not happy with After Care Service. </li></ul><ul><li>Looked for a full-time outreach worker. </li></ul>
    55. 55. Structured Training/Activity Day Programme
    56. 56. Y outh E nterprise S cheme Low self esteem Alcohol Misuse Boys 16-18 years Who have……. Poor Health Difficulties engaging Ongoing involvement with Justice System Drug Misuse Difficulties in sustaining relationships Lost opportunities of education Ambition Positive mental well being Reduced offending Increased positive relationships Increased Self Esteem Reduction in alcohol and drug misuse Certification in education Why? Outcomes In Partnership with the Probation Service
    57. 57. <ul><li> Thank You </li></ul><ul><li>If you have the courage- love the young people you work with, so they may learn to love themselves. </li></ul>