Treatment of Substance Abuse and Recovery Support Services - 2010 Winners
Centerstone of Tennessee, Inc.
Centerstone of Tennessee, Inc. located in Nashville, Tennessee, is Tennessee’s largest not-for-profit provider of community-based behavioral healthcare, offering a full range of mental health services, substance abuse treatment and related educational services, annually serving over 56,000 individuals and families across the state. Since 2004, Centerstone has been faithfully implementing the Matrix Model of Intensive Outpatient Treatment, serving 6 Tennessee counties, and making this evidence-based practice accessible in a high-need region of the state.
By 2004, methamphetamine had become "the most dangerous drug problem of small-town America", and Tennessee ranked 3rd in the nation for meth lab seizures; still in 2010, Tennessee is one of two states responsible for most meth lab seizures in the Southeast US. In 2004, Centerstone implemented a project called Methamphetamine Evidence-based Treatment and Healing (METH), which initially integrated the Matrix Model into Centerstone’s services, a model that is now sustained as an element of the agency’s care continuum.
Centerstone’s Matrix Model implementation has consistently shown positive results for consumers, with the rigorous METH project evaluation producing the most, to-date, comprehensive results. By 6 months, treatment results showed a statistically significant 50% reduction in drug use scores. Staff also found a significant increase on the Government Performance and Results Act (GPRA) scores from intake to 6-month follow-up for program participants who: 1) did not use alcohol or illegal drugs, 2) had no past 30 days arrests, 3) were currently employed or attending school, and 4) who experienced no alcohol or illegal drug related health, behavioral, or social consequences. From baseline to 6- and 12-month follow-ups, all program clients reported statistically significant improvements in all 8 areas of physical and mental health domains.
Crosswinds Youth Services, Inc.
(321) 452-0800, ext 100
Located in Cocoa, Florida, Crosswind Youth Services has been dedicated to helping Brevard County’s vulnerable youth and their families get the immediate services and support they need. Crosswinds’ first program, the emergency shelter, opened in 1974 out of a local commitment to address the tragedy of children without a safe place to live. Since that time, Crosswinds has grown to provide 11 programs developed in response to some of the most serious issues facing the area’s youth and their families.
Brief Strategic Family Therapy is an evidence-based intervention for adolescent populations, developed at the Center for Family Studies in the University of Miami. Brief Strategic Family Therapy™ (BSFT™) is a structured, problem-focused, directive, and practical approach to the treatment of conduct problems, associations with antisocial peers, early drug use and their accompanying maladaptive family interactions. BSFT™ successfully reduces behavior problems including substance use in adolescents and strengthens their families by providing families with the tools to overcome individual and family risk factors. Brief Strategic Family Therapy is conducted in approximately 12 - 16 weeks, depending on the severity of the problems. The clients served are from the Department of Juvenile Justice. The therapist reviews video with the team during weekly supervision. The family interactions are observed and rated to determine if the family system has been changed in a positive and permanent way.
The Crosswinds BSFT™ program began accepting clients in December, 2007. Since inception, this program has worked with 172 clients. 73% of these clients have been closed successfully. The benchmark is 70%. In order for a case to be deemed successful, the client’s record is reviewed to ensure that no new charges have been filed, and a drug screen is administered to determine whether the substance using behaviors have ceased, or have been reduced. All successful cases are then reviewed at 6 months and one year intervals to determine if new charges were filed, or if there has been a violation of probation. During the 2008-2009 fiscal year 77.6% of all clients discharged were discharged successfully. The benchmark is 60% of successfully closed cases will not have a new adjudication.
Denver Juvenile and Family Justice Integrated TASC Project
The Denver Juvenile Probation - Juvenile and Family Justice Integrated TASC Project (DJFJ TASC) with collaboration from the Denver Police Department, the Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, the Colorado State Court Administrator and the Denver Juvenile Court developed a pro-active approach designed to integrate prevention and treatment efforts for substance abusing parents and their children. The collaboration of these agencies and the realization of the overlap in families with involvement in multiple related agencies let to the creation of the Justice Initiative for Drug Endangered Families (JI-DEF).
JI-DEF seeks to identify drug endangered families and provide high quality care using evidence based prevention and treatment models, including Community Outreach Program Esperanza Model (COPE), the Matrix Model, Functional Family Therapy, Seeking Safety and Safe Care. JIDEF provides opportunities for parental substance recovery, the prevention of child maltreatment, and reduction of child welfare involvement and out of home placement when appropriate through a highly aggressive initiative recognizing that all systems play an overlapping role in supporting children and families while keeping the community safe.
Short term outcomes resulting from the implementation of these interventions include; increased identification and early intervention for drug endangered children, prevention and/or reduction of child welfare involvement, decreased out of home placement, increased parental engagement & retention, decreased parental substance, and lowered criminal recidivism. Interim long term outcomes are increased availability and effectiveness of methamphetamine treatment programming within Denver, alleviation of the strain of methamphetamine addiction on the city’s court, human service, child welfare and law enforcement systems, and the return of participating families to positions of recovery and strength.
New York State Office of Alcoholism and Substance Abuse Services
The New York State Office of Alcoholism and Substance Abuse Services (OASAS), based in Albany, New York, oversees one of the nation’s largest addiction services systems, serving 110,000 New Yorkers on any given day. In 2008, New York became the first state to implement regulations that prohibit tobacco use in all 1,550 certified prevention, treatment and recovery programs.
Every provider must assess each client for tobacco dependence, integrate assessment findings into the client’s treatment plan and provide nicotine replacement therapy (NRT) as indicated. Additional EBP’s used include motivational interviewing (MI) to resolve client ambivalence and engage the client in becoming tobacco free and cognitive behavioral therapy (CBT) to assist in developing tobacco free coping skills.
Compliance is assessed during program recertification reviews to ensure that there is a written tobacco-free policy and procedure for clients, staff, and visitors. This policy must include communication, staff training, verification that the treatment of tobacco is integrated into the context of treating all other addictive disorders and a plan to address relapse. Since 2008, tobacco free program compliance has steadily increased to 91 percent. Moreover, system-wide admissions have not decreased and OASAS data indicates that 23,000 clients are no longer using tobacco upon discharge.
Old Pueblo Community Services and the Center for Applied Behavioral Health Policy
This project is this result of a partnership between Old Pueblo Community Services, a non-profit organization with over twelve years of experience providing transitional housing and outpatient treatment services for homeless persons in Tucson, Arizona, and the Center for Applied Behavioral Health Policy, a research center at Arizona State University’s College of Human Services. From 2004-2009 the CSC Project served 575 clients, primarily individuals being released from Arizona jails and prisons, in a structured, 90-day, transitional housing and treatment program. This program included interventions based on Motivational Interviewing (MI), the Community Reinforcement Approach (CRA), and Contingency Management (CM), all of which were selected due to their proven track record of improving outcomes in substance abuse treatment.
Six months post discharge clients experienced an increase in employment (42% to 82%) wages ($315 to $1222), and stability in housing (1.9% to 42.3%) along with sustained abstinence (12%) and a 40% reduction in consequences due to alcohol and drug use. In addition, clients increased their average length of participation in the program from 54 days to 90 days.
In addition to outcome data, fidelity data were collected and analyzed across all three interventions. The process for ensuring implementation encompassed multiple approaches including; the uses and adherence to a standardized manual, training, review of client data, and recoding of incentives provided. In addition, to help ensure fidelity across the programs and attend to programmatic processes, biannual focus groups were held. Participants provided feedback on their experience, and made suggestions that would help shape policy and enhance client experience.
Synergy, Addiction Research & Treatment Services (ARTS), University of Colorado Denver School of Medicine
Addiction Research & Treatment Services (ARTS) is a comprehensive addictions and behavioral health treatment provider within the Division of Substance Dependence, Department of Psychiatry, University of Colorado Denver School of Medicine. Based in Denver, Colorado, the mission of ARTS is to improve the life and productivity of individuals and families affected by substance abuse, dependence and co-occurring mental health disorders through the application of scientifically supported prevention, education and treatment services. ARTS offers an array of residential and outpatient treatment services that are grounded in promising and evidence-based practices and closely monitored for fidelity of implementation .Synergy is the continuum of treatment services within ARTS for adolescents and their families.
The data for youths in Denver reveal a significant substance abuse problem for young people. Based on this need, Synergy decided to focus on Multi-Systemic Therapy (MST) with adolescents and their families, integrated with the Community Reinforcement Approach (CRA) plus vouchers for some of their clients. MST is a multidimensional intervention that aims to decrease adolescent antisocial behavior and substance abuse, and to improve functioning within the family and community. It is a cost-effective, sustainable family-oriented intervention that is implemented in non-residential settings; therapy generally is provided in the client’s home or other community settings
Measurements of fidelity are taken regularly using the MST Institute Enhanced Web site; Synergy has been implemented consistently with high average or above scores. Based on an assessment of 636 clients served from 2002 through 2008, 13.9% were identified as clearly unsuccessful in their outcomes, 74.9% had no legal recidivism while in MST treatment, and 58.3% of all clients and 78.8% of those who completed the program had no substance use during the last 30 days of treatment. A follow-up evaluation interviewed 460 clients (66.1% of the total sample), finding that 67.8% of these clients had sustained their successful discharge status.
Last updated: 11/25/2010