Torque non-residential rehabilitation program evaluation

Torque Program

A Catalyst non-residential

rehabilitation program

Origins

• Catalyst is a community non residential rehabilitation program for people wanting to address their alcohol use, the program was piloted from 2009-2011 and received funding from 2012 -2016

• In 2011 Catalyst won the National Drug and Alcohol Award for Excellence in treatment and Support

• Torque is for people involved in the justice system, and is modeled on the Catalyst program

• There is no restriction regarding alcohol or drug type

• The Torque pilot is funded by Department of Justice & Department of Health.

• Torque is being Piloted from July 2013 - June 30th 2015

• The model is designed as an alternative treatment option for Victorians involved in the justice system for whom residential services are an inaccessible or unsuitable post withdrawal, but who require more intensive support than individual counselling.

Suitable clients need to be, capable of self-management, and have at least a moderate level of intellectual functioning

Considerations

• The environmental space

• Staff attributes and characteristics

• Evaluation

• Host agency support needs

• Introduction of the model to the AOD and Corrections industry

• The model being flexible and adaptive to meet the cohort needs

Torque Program Development

• The unique partnership with ReGen’s Education and Training team has resulted in high quality psycho – education program, and professional resources for participants and facilitators

Inclusion Criteria

• Currently engaged with forensic services and have a current ACSO assessment

• A recent withdrawal treatment episode completed prior to Torque start date

• Capacity to commit to abstinence for duration of the program.

• Stable accommodation

• Stable mental state.

• Basic English literacy skills

• Client must not have a significant intellectual or cognitive impairment

Sample Timetable

Overview & Program Description

• Torque is an evidence based structured program comprising of a range of individual and group interventions

• It is a 6 week non-residential rehabilitation program for people who have completed a withdrawal episode and who have made a decision to stop use (at least for duration of the program)

• The program operates from Monday to Friday. Most activities are scheduled between 9:30am and 3:30pm with some evening sessions

• There are up to 12 participants in the group at any one time

• There is no charge for participating in the program and all participants will be provided with public travel cards for the duration of their attendance in the program

Compulsory UnitsCognitive Behavioral Therapy and motivational enhancement

• The participants must have attended 80% of the session hours of the compulsory components to complete the program

• 4 x Motivational enhancement sessions (Individual counselling sessions)

• 10 x Cognitive behavioral coping skills training • 4 x Mood management sessions (Anxiety, depression and anger)• 4 x Skills practice sessions• 18 x Check In & Outs

Treatment Adjuncts

The program also offers a range of educational, complimentary and therapeutic session that supports retention and specific needs

Challenges

• Implementing and marketing

• Short time period

• Initial low forensic referrals

• Client experiencing withdrawal symptoms after completing a withdrawal episode

• Managing intoxication

• Adapting the content, timing and sequence of sessions

• Low attendance to non compulsory sessions

Strengths of the program

• Non-residential, Cost Effectiveness• Client centred, Evidence based and consistent with best practise• A suitable intervention for meth-amphetamine users • No cost to client, public transport, gym membership and lunches provided• Priority treatment for individuals involved in the justice system• Utilising a harm minimisation approach• Reduction of community work hours • Pharmacotherapy maintenance accepted • Aftercare component (momentum peer group)

Evaluation of the Torque program: 12 months on…

Methodology - overview

Torque at 12 months:Between October 2014 and mid November 2015:

• Torque delivered 8 x 6-week treatment episodes

• 137 referrals were reviewed = 119 individual clients

- 70% of referrals from ReGen services

- External referrals from 18 separate services

•53% of referrals (n=72) were accepted into the program

•60 participants commenced the program; 5 people attended more than once

•Overall average of 8 participants commencing each program group (ranging 5-12)

Who is attending Torque?

Average age 37 years (range 21-74 yrs)

Gender - male 72%

Preferred Language- English100%

ATSI 5%

Living arrangement:with family – 61%with others- 21%alone – 18%

Any history mental health symptoms/diagnosis: 97%

Average age 37 years (range 21-74 yrs)

Gender - male 72%

Preferred Language- English100%

ATSI 5%

Living arrangement:with family – 61%with others- 21%alone – 18%

Any history mental health symptoms/diagnosis: 97%

Referral and assessment data - Participant characteristics (N=60)

Current Justice system contact:

Community Corrections order 43%NIDS Diversion 20%Pre-sentencing (e.g. Bail,CISP) 17%Drug Court/Parole 3%None- Community clients 17%

Primary drug: Alcohol 38%Amphetamine-type stimulant 35%Opioids 17%Cannabis 8%Sedatives 2%

Current Justice system contact:

Community Corrections order 43%NIDS Diversion 20%Pre-sentencing (e.g. Bail,CISP) 17%Drug Court/Parole 3%None- Community clients 17%

Primary drug: Alcohol 38%Amphetamine-type stimulant 35%Opioids 17%Cannabis 8%Sedatives 2%

Key client outcomes

Treatment Engagement & completion • 52% (n=34) of all participants who began in Week 1 successfully

completed the Torque program

• average attendance of 18 days (range 1-30)

Offending behaviours •From 21 clients responding at weeks 1 and 6 of treatment - decreased prevalence of past month property, drug dealing, fraud and/or violent offending – 9 clients reduced to 3 in week 6

Quality of Life (QOL)• Overall improved QOL, health & life satisfaction, sustained or

further improved at three month follow-up

Key client outcomes

.Substance use outcomes

• Reduced rates of substance use at program completion &

significant increases in confidence to manage high risk situations

Key client outcomes - AOD

Reduced rates of substance use at program end:

At 3 month follow-up (n=10): sustained abstinence from heroin, and reductions in cannabis and methamphetamine use still evident

Any use in past 4 weeks: Week 1 N=25

Week 6 N=25

Injecting drug use 3 2

Alcohol mean days used (range)

103.1 (0-21)

90.9 (0-7)

Cannabismean days used (range)

71.8 (0-18)

41.8 (0-28)

Methamphetaminemean days used (range)

104.3 (0-28)

50.7 (0-8)

Heroin mean days used (range) 0 0

Benzodiazepines- non-prescribed

41.3 (0-28)

1(0-1)

Other pharmaceutical – non prescribed use

20.5 (0-12)

2(0-1)

“Being able to go every day; meeting up with other people in the same situation as I was; filling in the day and getting something out of it”

Torque participants

Client feedback

“I really liked the CBT and the way it made you challenge your thoughts and everything - and the way they implemented strategies to keep you clean and keep you safe. Its a really good program that’s run”

What’s next?

- The pilot completes in June 30th 2015

- The external evaluation continues until December 2015

For further information or to view the evaluation reports:

http://www.regen.org.au

Shannon Bell [email protected]

Angela Harney [email protected]