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Treatment of Substance Abuse and Recovery Support Services
Central Clinic/Court Clinic
A need was identified in Cincinnati, Ohio for sentencing alternatives for women, reduced recidivism, and decreases in jail overcrowding. A collaborative effort was formed to coordinate the criminal justice, mental health, and substance abuse systems to overcome system barriers and provide appropriate services for offenders. The Alternative Interventions for Women melds two evidence-based models - Helping Women Recover and Integrated Dual Disorders Treatment - to meet the unique needs of these female clients. A strong collaborative partnership is essential to the program's success. An integral component of this collaborative model is monthly data analysis and outcome measurement to maximize quality assurance and solve problems. A process evaluation assesses client improvement and program effectiveness at fixed intervals throughout the project and client outcomes are assessed at the beginning and completion of program. Rates of client recidivism are tracked for a three-year period. Outcome data show reductions in symptoms, decreased substance abuse, decreased recidivism, improved family functioning, and reductions in the number of children needing out of home care.
King County Mental Health Chemical Abuse and Dependency Services Division
The King County Mental Health and Substance Abuse Services Division in Seattle, Washington initiated a project designed to promote integrated, community based systems for delivering substance abuse interventions to youth. The Global Appraisal of Individual Needs (GAIN) was implemented in a system of care that consists of 15 independent non-profit treatment agencies providing substance abuse treatment and assessment services to over 450 youth at any given time. The GAIN is an evidenced-based chemical dependency assessment that supports a number of substance abuse treatment practices, including initial screening; brief interventions, and referrals to ancillary services. A "Science to Service Coordinator" position was created to exclusively work with the providers to implement this and other evidenced based practices, cope with daily implementation challenges, assure that programs are implemented with fidelity, and identify new and emerging needs/best practices for future implementation. King County has experienced a substantial increase in treatment completion and treatment retention rates. Seattle/King County now has the highest treatment completion and retention rates for youth in the state. With better data on youths served, providers are developing better treatment plans and providing better quality treatment, and system managers are able to identify gaps in service and additional evidenced based practices that may be needed.
The Life Link
The Life Link in Santa Fe, New Mexico provides substance abuse, mental health, and co-occurring services to a Hispanic, Anglo, Native American, and African-American population with a high percentage in lower socio-economic or indigent categories. Frequent calls from family and friends, desperately in search of direction and help for a loved one, led to a search for an evidence-based program designed specifically to encourage individuals with substance abuse problems to enter treatment, while simultaneously offering support to these concerned significant others. In Santa Fe, a community in which family bonds and support are lifelong priorities, it seemed that the odds of successfully engaging individuals who needed the help would improve dramatically through family involvement. On a grander scheme, we hoped it might also provide an opportunity to break the addictive familial cycles and impact future family health by intervening with a single courageous caller at the moment he or she reached out.
The Community Reinforcement and Family Training (CRAFT) program was selected to assist concerned significant others in motivating a person with a substance use disorder to enter treatment. Through partnership with Santa Fe County, a demonstration project was conducted with the goals of training local substance abuse providers in the CRAFT approach, decreasing substance abuse in treatment-resistant populations, and developing modifications of the CRAFT protocols to meet the specific local conditions and populations in our community. After 3 years and the successful engagement of 107 concerned loved ones, outcome data showed significant reductions in depression, anxiety, and anger among these family members, while simultaneously engaging 65% of the previously resistant identified patients into treatment, resulting in significant decreases in the frequency and intensity of drinking behaviors. In the four years since the conclusion of the demonstration project, The Life Link has made CRAFT a cornerstone of our own treatment programs, and has trained over 300 providers in seven countries on the implementation of CRAFT, helping bring hope, through science and service, to professionals, clients, and loved ones around the world.
Travis County Juvenile Probation Department
Within the last decade, there has been a substantial rise in the number of drug related juvenile offenses in Travis County, Texas with more than half of the juveniles referred to the Juvenile Probation Department having a substance abuse concern. The evidence-based "juvenile justice integrated substance abuse treatment network" emerged as a promising strategy for building a more integrated, community-based approach to working with substance abusing juvenile offenders. To develop the Network, the Travis County Juvenile Probation Department implemented a year-long planning process, which involved pulling together key stakeholders from the community, including substance abuse, mental health, juvenile justice, local schools, and other community-based services. The Department also initiated comprehensive in-service training across agencies to ensure understanding and consistency. The intense planning and coordination built a strong collaboration among the key partners. The Substance Abuse Services Division operates the integrated system of services designed to allow rapid access to alcohol and drug abuse education, intervention, and treatment services. Key programs include the Juvenile Drug Court, Day Treatment Program, Intensive Outpatient Drug Treatment, In-Home Family Services, and Intensive Substance Abuse Services Supervision. Outcomes include reductions in offenses, dropping out of school, using illicit substances, and engaging in other negative behaviors.
Substance Abuse & Mental Health Services Administration • 1 Choke Cherry Road • Rockville, MD 20857