EARLY INTERVENTION FOR YOUNGEARLY INTERVENTION FOR YOUNG DRUG FIRST OFFENDERSDRUG FIRST OFFENDERS

Structure of Carinthia

• Southern federal state of Austria• About 650.000 citizens• Increasing number of young drug users• Care facilities only for adults• 1 prevention institution

1st aim general preventionThe need of development of selective

prevention

Difficulties / Facts

• Young people in a rural environment are not mobile

• Establishing care centers in small towns is expensive

• Need of specific counselling for young people (regarding personal situation, peer-group, family, needs + demands)

• Special law for drug using first offenders:„help instead of punishment“

• Special law for pupils (school director and school medical officer decide in cooperation with parents how to deal with the problem, no denunciation by judge)

• Only probation service „Neustart“ is specialised

single + group caremobile teamappropriate infra-structure

Project partners

• Prevention unit of Carinthia (Governmental Organisation)

• Department of Carinthian Government / Sub-Department Addiction

• Neustart Carinthia (Private Organisation, probation service)

• Center of Evaluation + Research / University of Klagenfurt

Financing: Health Department of Carinthian Government

What is „Way out“

• Offers counselling and care facilities for young people

• Structured support over a short period of time

The concept of „Way out“

• Young people charged by police or noticed at schoolschool medical officer or public health officer

• Special diagnosis form to work out a „risk-profile“• More risk-factors than resources „Way out“• Age 14 – 21 years• Counselling for single persons (approx. 15 meetings at

50 minutes) and groups (12 meetings at 2 hours)• Support over a period of 6 months• Meetings can be arranged near to place of residence

General aims

• Encouraging abstinent behaviour concerning illegal drugs

• Controlled behaviour concerning legal substances and

• avoidance of drug-related problems

Specific aims

• Increasing social competence• Imparting knowledge on health risks,

development of addiction, effects of substances and legal situation

• Reflection of personal consumption and grappling with norms and values of their peer-group

• Developing personal strategies for solutions by integrating experienced and alternative strategies

• Testing different models of conflict management

• Improving communicative abilities• Heightening the awareness of one‘s own

resources• Supporting the ability to reach self-imposed

aims

Risk-profile indicators (pretended)

• Environment: profession, family constellation, childrearing practices, consumer behaviour of family + friends

• Personality: coping, self-esteem, psychological comorbidity, self-efficacy, comunicative competence, delinquency

• Substance: beginning of abuse, consumer habits, alcohol abuse

Most participation criteria - Indication

• Incomplete families –Step-parent/-partner- Divorced parents- Death of one parent- Severe illness of one parent

• Addiction or co-addiction in the family system

• Problematic debonding between mothers and daughters (mothers detach too early from their daughters)

• Style of upbringing:– Laissez fair– Spoiled, overprotective

• High pressure of expectations and pressure of performance by the parents

Young people who are in the program

• Most of them are continuously using one or more psychoactive substances:„leading drug“ cannabis„additional drug“ XTC

• Age group 14-16: „trying consumption“• Age group 17-18: „continuous drug use“• Relationship male: female = 7 : 1• Profession: apprentices, pupils, unemployed

Care - Management

• General procedure:- social worker gets into contact with clients- written invitation – several telephone calls- within 2 weeks date of 1st setting- 1st setting within 4 weeks- deciding if the client will be in the single or

group session

Work-base of single-session

• Casework-method• Sometimes only a few sessions are needed• Sometimes they are sent to a more

appropriate setting

Group-session

• Method of Theme-Centered-Interaction (TCI) according to Ruth Cohn

• 2 social workers (male/female)• max. 12 group-settings• min. 10 group-settings are obligatory• group size 6–12 participants• max. 6 months• final examination including urine-testing

Measures of quality management

• 2 urine tests during care period• positive test results are reported to social

workers• regular case-meetings between social-

workers + physicians• documentation + evaluation

 

Evaluation

 

  1. Assessment (according to § 11+13 SMG)

2-4 weeks

2. First contactClient-social worker

3. First settingDecision single/groupEvaluation: pre-testing with standardized psychological tests

6 months

4. care

End of care

5. Evaluation: standardized psychological test

4 months later

6. Evaluation: retrospective interview

Results of evaluation using standardized psychological tests

• Increased drug-related attitudes towards - the danger of drug-abuse- reflected motivation

• Slight changes towards a better ability for- problem solving- decision-making (less influence of peer-group)

• About the need to take drugs (open questions)- no positive attitude to drug abuse any more- an increase in resistence to drug abuse

Care-results – group settings

94,10%

5,90%

abstinence from illegal drugs no declaration

Care-results – single setting

18,20%

18,20%

63,60%

abstinence from illegal drugs transfer to a more appropriate care no effect

Results of interviews with clients

  

 

• Most of them would accept the program spontaneously

• No more punishment because of drugs

60%

5%

35%

positive program was too excessive agreeable

Effects of attending „Way out“ 2004 to 2006

• 2004: 85 clients left the program:- 74 finished the counselling/reached the achieved aims- 3 aborted the counselling process early- 8 others

• 2005: 113 clients left the program:- 87 finished the counselling process/reached the achieved aims- 4 aborted the counselling process early- 22 others

• 2006: 67 clients left the program:- 52 finished the counselling process/reached the achieved aims- 5 aborted the counselling process early- 10 others

Experiences:

• A program for youngsters needs clear structures

• Constant communication between counsellors and the medical attendant is important

• The project offers must be flexible, to fit the youngster‘s needs

• Voluntary participation is not necessarily needed

• A basis of trust between the counsellor and the client is very important

• The period of attendence (normally 6 months) needs to be extendable if crisis situations arise (e.g. sudden unemployment)

• Many youngsters only needed 3 months of attendence

• Occasionally police charges were filed again, but the patterns of cannabis consumption had changed (reflected usage)

• Average time of care per client, including times for documentation and travel, approximately 21 hours

Thank you for

your attention