Christchurch Youth Drug Court - Youth Specialty Services role (CDHB)

1. Christchurch Youth Drug Court - Youth Specialty Services role (CDHB) Presenter Nigel Loughton

2. Outline: • Screening • Comprehensive Assessment • Collaboratively working with Y.D.C. Team • Treatment involvement • Case illustration

3. Screening process : referral sources • Previous YSS client • CYFS - YDC social worker/YJ social worker/FGC coordinators • Youth Advocates • Police Youth aid • Other - youth workers/parent in waiting room

4. Screening process:method • Seen at youth court on the day appearing • 10-15 minutes • significant other • semi structure interview • experience A&D clinician • DSMIV dependency criteria

5. Screening process:criteria • Moderate to Severe dependency • Link to offending • recidivist offender

6. Comprehensive assessment -with young person & significant other • Alcohol and Drug use • Mental state • Psychiatric history • Medical history • Cultural assessment if indicated • Developmental history • Scholastic history

7. Comprehensive assessment -(continued) • Forensic history • Family history • Current situation • Risk assessment • Diagnosis • Recommendations • report to YDC

8. Treatment plan : if accepted into YDC • Individual sessions - motivational enhancement therapy • Group work - weekly at YSS. Young person and parent group. • Facilitating the person into treatment - day, residential (both in Chch) or other • psychopharmacology - comorbity or methadone, Antabuse

9. Treatment plan(continued) • Drug testing - monitoring process • Liaison with other involved agencies • referral to other agencies i.e. needs assessment, MST • family work and therapy • YSS continues involvement while in YDC and at times longer

10. Case illustration : Client S • 16 yr old • Living with family friend • Working full time food processing (past 6 wks), Promising sports person • Previous seen at YSS late 2002: • Issues: Cannabis dependence (Mild - Mod), Alcohol abuse, Mild conduct disorder, difficulty with parent child relationship, not motivated to change -> dropped out treatment

11. Previous seen at YSS late 2002: (continued) • Strengths: Likeable personality, Responded well to Life skills program at miltary camp (Team player and enthusiasm), Hard worker.

12. Offending history:February 2004 • Dangerous driving, theft, unlawfully takes motor vehicle • Offending occurred under the influence of cannabis and alcohol • Previous offending : Assaults and burgarlies over several years - often occured under influence of A&D or to obtain money for A&D.

13. Alcohol and Drug History Cannabis • first use 9 yrs of age • regular use from 11 years - cannabis rich environment • daily use 14 - 15 years age • From friends • Significant amount crime for cannabis. • irritability and insomnia on withdrawal, dyscontrol acknowledged impact on sport and school but continued use, tolerance. • current use 4-5 times a week

14. Alcohol and Drug History Alcohol • first intoxicated 13 years • daily use 6 months 15 years age • from friends • significant amount crime for alcohol • tolerance, dyscontrol when starts drinking. • current use weekends 12-18 beers • aggression when drinking and offending Nicotine • no use -sport

15. Relationship Between Offending and A+D • Offending to pay for drugs/alcohol • Offending under the influence of drugs • Behaviour difficulties at home and school prior to regular A&D use • Dramatic increase in problems when regular A&D use began - offending began. • Diagnosis - Moderate Cannabis Dependence, Mild Alcohol Dependence and Conduct Disorder DSMIV

16. Other Relevant History • Family history extensive alcohol and drug history both side family • Schooling 9 primary schools bullying and fighting at school seen as at least average ability

17. Personal History • Normal birth and milestones • Parental separation at 3 years age - irregular contact with father • CYFS involvement from 9 years of age - difficulty control behaviour • Boxing involvement • FT employment - early starts • Supportive mother and step father - feeling tired of ongoing issues

18. Recommendations • Youth Drug Court • Clinical case management through YSS • A+D weekly group at YSS and individual motivational sessions - working around employment • Encouragement to continue boxing - attempt to link sports coach to support change • Build/strengthen family relationship • Monitior and support positive living environment

19. Progress I • Accepted YDC • Began attending group and individual session with long standing girlfriend • regular boxing training • continuing FT employment • relinked in with CYFS psychologist reenforce change and anger management • relationship ended • Living situation changed - flatting with brother, began missing group • re-offending excess breath alcohol, driving while disqualified, assault • drop off in sport involvement

20. Progress II • 6 week period difficulty engaging in treatment - Increased individual session home visits YDC social worker and YSS • Returned to irregular group sessions with brother • Regular sport training 3 time a week • Increasing insight into alcohol and drug impact -> motivation to change increased • Casual employment • Action work (IYB benefit) - encouraged into limited services course at miltary camp • Graduated with very positive comments and looking to join army • Remained absent from cannabis and limited alcohol use • Decided to leave Odyssey against court direction & paid for own flight back • Court directed to ChCh Odyssey Day programme • Failed to attend • Refused family session • DNA’d several individual sessions with CCM • Further charges = Burglary (x14), Using documents (x6), escaping custody • Discharged YDC → Youth court → Kingslea

21. Progress III • Moved back to living with mother, step father and younger siblings • Support to join miltary - assitance working out requirements • Relapse prevention work • Family and young person found employment till start date for army • Continued absence cannabis and limited alcohol use • Joined army