Building Bridges Across the Spectrum: How Prevention Connects with Addiction Treatment

1. Building Bridges Across the Spectrum: How Prevention Connects with Addiction Treatment Facilitated by: Jane Goble-Clark Center for Prevention Services

2. Agenda • Hour 1 - Welcome and Introductions - What is Prevention? - Prevention Strategies • BREAK • Hour 2 - Prevention 101 continued - Shared Skills: Collaboration - Experiential learning • BREAK • Hour 3 - Shared Skills: Cultural Competency - Experiential learning

3. Introductions WELCOME ! • Facilitator and Agency background • Audience -- Why is this topic important and relevant to the work you do?

4. What will we accomplish today? • Discussion of how prevention spans and is relevant to addiction treatment • Discussion of the differences between collaboration and compromise and how to use that to find unity in the diversity of professions • Discussion of cultural competency as a professional tool and as a bridge between the fields of prevention and treatment • Create new networking opportunities and provide links • Q & A

5. Norms for Today’s Training • Start and end on TIME • Ask for clarification • Each person is a resource to the whole group • Be respectful of each other’s opinions and expertise • HAVE FUN!!! • What else?

6. Group Activity Circle of Friends • Please form two circles with your classmates • Create a smaller circle of people to be the inner loop • Create a larger circle of people to be the outer loop • People in inner and outer circles face each other (like a dance!) • The facilitator will give quick Q & A, then • Each group moves to their left after specified time • Finishes when everyone has met each other!

7. Common Prevention Quotes • “An apple a day keeps the doctor away.” • “An ounce of prevention is worth a pound of cure.” • “Prevention is better than cure.” • “A stitch in time saves nine.”

8. CSAP’s Definition of Prevention • “Prevention is a proactive process. It empowers, individuals, and systems to meet the challenges of life events and transitions by creating and reinforcing conditions that promote healthy behaviors and lifestyles.” - William Lofquist, CSAP - Center for Substace Abuse Prevention

9. NCSAPPB’s Definition of Prevention • “Substance Abuse Prevention is the reduction, delay, or avoidance of alcohol and other drug use. Prevention promotes positive environments and individual strengths that contribute to personal health and well-being over an entire life span. Effective prevention strategies encourage individuals, families, and communities to take part in assessing and changing their lifestyle and environments.” NCSAPPB - North Carolina Substance Abuse Professional Practice Board

10. Who Does Prevention? Grandparents Parents Preventionists Youth Teachers Counselors Treatment Providers Aunts/Uncles You Community Members Me EVERYONE!!

11. Why Provide Prevention Services? “Drug use is not a national problem…it is a series of local epidemics.” ~ “Prevention is not about one program or activity…it is about making it part of the ground water—the way communities do business.”

12. The Continuum of Care Different levels of prevention are distinguished by the level of risk of disorder/distress in various populations groups targeted.

13. Types of Prevention on the Continuum • Individual / Familial • Indicated • Selective • Environmental • Universal

14. IOM Prevention Components Universal Prevention: • Addresses the entire population • Aim is to prevent/delay use of ATOD. Deters onset by providing individuals with information/skills Selected Prevention: • Targets subsetsof the population considered at risk by virtue of their membership in a particular segment of the population • Key Selected Prevention targets the entire subgroup regardless of the degree of risk of any individuals in the group Indicated Prevention: • Targets individuals who are exhibiting early signs or consequences of ATOD use. IOM - Institute of Medicine

15. Prevention Domains ►Individual/Peer ►Family ►School ►Community Substance abuse and mental illness are complex problems that develops in response to multiple influences. Each domain presents an opportunity for preventive action. Individual/Peer/Family = Individual-level strategies School/Community/Society = Environmental strategies

16. Prevention Domains • Individual • Family • Peer • School • Community • Society Why target each of these areas? • Experiential Learning: • Circle of Support • Begin with one person in the middle • Add additional members to the activity • How does this exercise answer the question below?

17. The Community Wheel

18. CSAP’s Prevention Strategies • Information Dissemination • Prevention Education • Alternatives • Problem Identification & Referral • Community Based Processes • Environmental Approaches What are some examples of these strategies?

19. Strategies: Information Dissemination • Media Campaigns • Brochures • Videos • Radio and Television Public Service Announcements • Lectures • Health Fairs • Resource Directories • Clearinghouses and other information centers • One Time Talks Got Questions? Call Drug Line 704-375-DRUG (3784) All calls are anonymous and confidential

20. Strategies: Prevention Education • Classroom and Small Group Sessions • Parenting and Family Management Classes • Peer Lead and Peer Helper Programs • Education Programs for Youth Groups • Groups for Children of Substance Abusers

21. Strategies: Alternatives • Mentoring Programs • Drug Free Social and Recreational Activities - Ex. SAAM Family Festival • Community Service Activities • Drug Free Dances and Parties • Youth and Adult Leadership Activities • Community Drop-in Centers SAAM FAMILY FESTIVAL

22. Strategies: Problem Identification and Referral • Driving-while-intoxicated Education Programs • Employee Assistance Programs • Student Assistance Programs

23. Strategies: Community Based Approaches • Building Interagency Collaboration • Training Community Members/Agencies in Substance Use Education and Prevention • Conducting Systematic Planning • Supporting Community Team-Building Piedmont Area Substance Abuse Provider Association Substance Abuse Training Series Hosted by: PASAPA and PBH 8:30 AM - 12:00 PM

24. Environmental Approaches • Community laws that prohibit alcohol and tobacco advertisements in close proximity to schools • The establishment and review of school drug policies • Technical assistance to communities to help them maximize law enforcement efforts to govern the availability and distribution of drugs • Community policies regarding access to alcohol and tobacco products • Community laws that increase punishments for DUIs

25. BREAK

26. Experiential Learning Planning A Community Center Rules: • Each person gets to make one line on the board • No conversation allowed • Complete the plan • The group processes the shared work

27. Public Health Model • Individual Prevention: Focuses on trying to change the host • Environmental Prevention: Focuses on trying to change the agent and the environment

28. Why Plant the Seed of Prevention? • Those who consume alcohol before the age of 15 are 5 times more likely to have an alcohol problem later in life. • Youth drug use is associated with suicide, violence, unwanted pregnancies, school failure, delinquency, and transmission of sexually transmitted infections

29. The Role of Prevention To create communities in which people have a quality life: • Healthy environments at work & in school • Supportive communities and neighborhoods • Connected to families and friends • Alcohol, tobacco, and other drug-free lifestyles • Addiction and crime-free individuals and communities

30. The Roots of Prevention • 1950s • Scare Tactics • 1960s • Scare Tactics and Information • 1970s • Drug Education and Alternatives to Drug Use • 1970s-1980s • Education, Alternatives, and Trainings • 1980s-1990s • Parent, School, and Community Partnerships • 1990s • Use of Evidence-based “Model Programs” • 2000s • Strategic Prevention Framework and focus on cultural competency and sustainability

31. New Growth • Strategic Prevention Framework • Assessment, Capacity, Planning, Implementation, Evaluation, Sustainability, and Cultural Competence • Risk and Protective Factors • Community, School, Family, and Peer/Individual

32. Profile population needs, resources, and readiness to address needs and gaps Sustainability & Cultural Competence Monitor, evaluate, sustain, and improve or replace those that fail Mobilize and/or build capacity to address needs Implement evidence-based prevention programs and activities Develop a Comprehensive Strategic Plan SAMHSA’s Strategic Prevention Framework Steps Assessment Evaluation Capacity Planning Implementation

33. SPF: A shared framework Benefits of the Strategic Prevention Framework: • Creates an objective community profile • Identifies how to effectively and efficiently use resources • Assists in the selection and implementation of effective strategies • Unifies the power of individual citizens and institutions • Create a comprehensive plan in which everyone in the community has a stake • Holds community institutions accountable

34. Risk & Protection Approach • In past century, doctors have discovered factors that: • Put people at risk for such things as heart disease and diabetes. • Protect people from such conditions • This Risk and Protective Factor approach follows the same model for prevention for our communities’ children

35. Risk Factors are listed to the left. What are some Protective Factors?

36. Risk & Protection ApproachA Simple Premise What are Risk Factors? • Conditions or situations that increase the likelihood that a child will develop one or more health and/or behavior problems in adolescence. What are Protective Factors? • Conditions or situations which decrease the likelihood of future behavior problems. Where are they found? • In four domains Community, School, Family, Peer/individual

37. Prevention:Where We Are Now • Prevention planning is strategic • Based on risk and protective factors • Prevention movements, rather than individual programs • Strategies are evidence-based • Addresses the whole community culture • “Prevention is Health Reform”

38. Science-Based Prevention Programs • Identified and or substantiated through an expert consensus or analytical process using commonly agreed on criteria • National Registry of Effective Practices and Programs (NREPP) www.nrepp.samhsa.gov • Why is science-based important?

39. Past and Present Prevention

40. Prevention Services • Prevention Agencies or Programs • Centers for Prevention Resources • Prevention Policy Alliance • TRU • Specialty Contracts • Youth Suicide Prevention • Methamphetamine Prevention Initiative

41. Prevention Services • Safe and Drug Free Schools and Communities • Fetal Alcohol Spectrum Disorders Prevention • Underage Drinking Prevention • Early Interventions • Bullying Prevention • Violence Prevention • Suicide Prevention • Juvenile Crime Prevention

42. Community Prevention • 24/7 • Social Host • Youth Leadership • Community Policing • Alcohol Compliance Checks • Tobacco Reward/Reminder Visits • Responsible Beverage Sales and Service

43. Prevention Outcomes • Youth Drug Survey • Tracks trends in use and abuse • Covers 40 years • 2010 data is most recent • Synar • Decrease in sales of tobacco to minors from 48.3% to 8.2%

44. Things to Remember about Prevention • It is a process, it doesn’t happen overnight • Environmental prevention is more effective than an Individual approach • It spans SA, MH and DD

45. What Can You Do? • Call your local prevention service providers • Become active in your local coalitions • Call your school board members, city officials and state officials asking them to support prevention initiatives • Talk to your children, grandchildren, niece, and nephews • Be active in your community and in children’s lives • Raise awareness in your own profession • Share resources with clients

46. BREAK

47. Crossing the Bridge • Relationship-building • Collaboration vs. Compromise • Cultural Competency

48. Strategies for Relationship-building Experiential Learning: The Head-band Activity Volunteers Needed! You won’t look as “stylish” as this guy. . . but you will have fun!

49. Strategies for Relationship-building The Head-band Activity: DISCUSSION • What observations do you have about the actions and behaviors in the role play? • How does this scenario exemplify the process of creating collaborations? • Other questions?

50. Strategies for Relationship-Building • Active listening • Ask questions • Be open to suggestions • Willingness to learn new perspectives without judgment • Respect • Focused body language or tone of voice • Authentic desire for collaboration