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EARLY INTERVENTION FOR YOUNG DRUG 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 1 st aim general prevention
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EARLY INTERVENTION FOR YOUNG DRUG 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 prevention The 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 care mobile team appropriate 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 school school 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 contact Client-social worker 3. First setting Decision single/group Evaluation: 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
Results of interviews with clients • Most of them would accept the program spontaneously • No more punishment because of drugs
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