Post on 01-May-2018
Amphetamine Type StimulantTreatment Protocol
Developed by Lynne Magor-Blatch & James Pitts, Odyssey House McGrath Foundation
David Kelly
Manager, WHOS Hunter Valley
Background to the ProjectBackground to the Project
Dramatic rise in Amphetamine Type Stimulant usein Australia
1993-2007 5.4% of population to 9.1% in 2004 to 6.3%in 2007, 1.1million regular users
Background to the ProjectBackground to the Project
National Minimum Data Set (2005-2006)
23% of treatment episodes reported ATS as a drug of concern
20% with ATS as a drug of concern were treated in a TC
Consultation phase of ATS project found that in TCs, ATS was mostprevalent drug of concern.
Background to the ProjectBackground to the Project
Cogger, McKetin, Ross & Najman (2008) in an NDARC study found: ATS users 44% Major Depression, further 45% Substance Induced Major
Depression
83% had experienced psychosis
47% had experienced clinically significant suspiciousness, unusual thoughtcontent or hallucinations
Background to the ProjectBackground to the Project
Cogger, McKetin, Ross & Najman (2008) in the same study(unpublished results) found: ATS users who sought treatment in a TC were more likely to be using ATS
more often
More likely to have clinically significant psychosis
More likely to have panic disorder
More likely to have general impairment
than ATS users who had sought other treatment
Background to the ProjectBackground to the Project
Gunn and Rickwood (2009) study of 104 residents in Odyssey House(NSW), Karralika, Mirikai and Goldbridge TCs ATS users higher levels of impairment in global executive function
Difficulties with behavioural regulation, attention management andproblem solving
Difficulties with impulse control, holding attention to one task, monitoringsocial behaviour
Background to the ProjectBackground to the Project
Gunn and Rickwood (2009) cont. These areas of executive functioning shown to be most affected are related
to reflective functioning
Self monitoring, self evaluation
Inhibited reflection on behaviour
Inhibited impulse control, objectivity, and ability to learn from mistakes
Background to the ProjectBackground to the Project Funding through Australian Government’s Amphetamine Type Stimulants
Treatment Grants Program
Following Literature Review
Therapeutic Community and other consultations
Trials at Mirikai and Cyrenian House
Launch at the ATCA conference in Canberra (2009)
Research continues with 6 and 12 month data being collected ATS Sites (WHOS Hunter, WHOS Najara, Goldbridge, Cyrenian House and
Karralika) TAU Sites (WHOS Rozelle sites, Canberra Recovery Services, Central Coast Recovery
Services (Selah), Odyssey NSW, Odyssey Victoria, Palmerston and Logan House)
ATS Treatment ProtocolATS Treatment Protocol
Most Treatment Protocols and including ATS Treatment Protocolswritten with individual treatment in mind.
Require extensive re-working to be applicable to a group setting,particularly a Therapeutic Community setting
The ATS Treatment Protocol particularly designed for TherapeuticCommunity setting
ATS Treatment ProtocolATS Treatment Protocol
Combines
Mindfulness Based Cognitive Therapy and CBT
Acceptance and Commitment Therapy (ACT)
Motivational Interviewing
ATS Treatment ProtocolATS Treatment ProtocolPre Admissionor Assessment
Phase
Module 1:Building
Motivation
Module 2:Coping with
Cravings
TreatmentPhase
Module 3: HowThoughtsinfluenceBehaviour
Module 4:Understanding
Feelings
Module 5:Learning how todeal with anxiety
Module 6: CoreBeliefs and
Values
Flexible
Module 7:Relapse
Prevention
ATS Treatment ProtocolATS Treatment Protocol
Each Module contains
Facilitators Instructions
Worksheets
Tip Sheets
WHOS Hunter ValleyWHOS Hunter Valley 29 Bed Facility
2 6 bed support houses
Mixed gender
Regional area, very highprevalence ATS use (60%), veryhigh prevalence ATS combinedwith Cannabis use
Entrenched ATS use culture
ATS protocol at WHOSATS protocol at WHOS
Firstly had to change the name! (Treatment Protocol for use by staff andclinicians working with ATS clients of Therapeutic Communities doesn’texactly roll off the tongue) Foundations of Recovery Group (interim)
Implemented at the two sites with highest ATS use, two sites that werealready implementing Psycheck
At WHOS Hunter initially tried to divide groups up and makemodules 3-6 a closed group but proved unworkable
Presented to all clients
ATS protocol at WHOSATS protocol at WHOS
So what do the residents and staff think? Love the worksheets “Enjoyed the way they put metaphors to our drug
use”
ACT fits very well with TC ethos, focus on values and principles, goals andpositives
Very helpful for ATS clients in particular, focusing on recognising feelingsthrough bodily sensations then putting a label to them and developingstrategies for dealing with them
All clients benefited from the discussions around cravings, especially inview of our moves toward smoking cessation
ATS protocol at WHOSATS protocol at WHOS
Plans for the future? 6 month trial is over
Adapt a little for WHOS milieu
Present to other WHOS services, hope to become part of the WHOSgeneral program
Thank you!Thank you!