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Assertive Outreach: What Works Best for Young People?

Assertive Outreach: What Works Best for Young People?. Jonathan O’Neill Counsellor Youth Focus. Provides counselling to young people at risk of depression, self harm & suicide 12 to 18 years old Non-government Not-for-profit. Free service

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Assertive Outreach: What Works Best for Young People?

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  1. Assertive Outreach:What Works Best for Young People? Jonathan O’Neill Counsellor Youth Focus

  2. Provides counselling to young people at risk of depression, self harm & suicide 12 to 18 years old Non-government Not-for-profit Free service Not a crisis service – offers ongoing counselling Additional services: Family Counselling Peer Support Program Mentoring Youth Focus

  3. Youth Focus • Counselling is provided in a number of locations: • Central office in Burswood • Co-location offices/rooms in Joondalup, Rockingham, Kwinana, Mandurah, Bunbury and Collie • Outreach services • Can be offered at schools, community centres, local areas

  4. Assertive Outreach • Assertive Outreach has evolved significantly over the past 30 years • The phrase is often used when working with ‘high-risk’ or ‘hard-to-engage’ clients in a community setting • e.g. Clients experiencing mental health issues, homelessness • Assertive Outreach aims to provide services to these clients in an effective yet flexible way

  5. Assertive Outreach • The first version of assertive outreach was developed in the USA • PACT / ACT Model – Assertive Community Treatment (Stein & Test, 1980) • This model was created as an alternative to hospital admissions and other inpatient services for clients with severe mental health issues • Has been widely researched and discussed in literature

  6. Assertive Outreach • Features of Assertive Outreach (ACT Model): • A multi-disciplinary team that delivers all services • Low staff to client ratio (maximum 1:12) • Caseload shared amongst clinicians/workers • Interventions provided in community settings • Emphasis on engagement • Service is time-unlimited if there is evidence/support for continuation of care

  7. Assertive Outreach • Assertive Outreach has since been used throughout the world where services allow for low worker-client ratios • However, the original ACT Model has been adapted by service providers to suit the needs of their clients • This has lead to confusion & debate between researchers, practitioners & funding bodies despite the continued effectiveness of the model

  8. Youth Focus Outreach • Youth Focus counselling services: • Ongoing development – changes as needed • Combination of in-house and outreach counselling • An adaptation of Assertive Outreach • Client load = 12 sessions per week minimum • Agreed venue within community setting excluding home • Strong emphasis on engagement

  9. Strengths: Individual needs Flexible & accommodating Collaborative approach Part of therapeutic process Free service Weaknesses: Expensive Travel – time, efficiency, stress & risk Appropriate venues??? 9 to 5, Monday to Friday DNAs Youth Focus Outreach

  10. Youth Focus Experiences • Staff views • Like the flexibility of service delivery • Schools & co-location offices/rooms very helpful to have • Client feedback • “They can come to us” • Increased access • Less intimidating

  11. What Works Best…??? • Accessing & servicing young people can be difficult • Do they need help, and do they want help? • Collaboration – involvement in decision-making • A joint agreement of all aspects of service delivery • Acknowledging the reasons why an individual is in contact with your service – these are a strength & a skill • An interest in discussing and discovering change

  12. Conclusions and Suggestions • As an agency, know your limitations • Who is your client??? • Provide a quality service (rather than quantity) • “We cannot be everything to everyone” “The challenge is to explore new ways of going about the business of delivering creativity and flexibility in response to the real needs articulated by the individual service user” (Morgan, 2008)

  13. Questions???

  14. Thank Youand enjoy the rest of the YACWA Fairground Conference

  15. References • Barry, K. L., Zeber, J. E., Blow, F.C., & Valenstein, M. (2003). Effect of strengths model versus assertive community treatment model on participant outcomes and utilization: Two-year follow-up. Psychiatric Rehabilitation Journal, 26 (3), 268-277. • Dixon, L. (2000). Assertive community treatment: Twenty-five years of gold. Psychiatric Services, 51 (6), 759-765 • Lobo, R., Brown, G., & Edwards, J. (2007). Developing locally relevant outreach programs for same sex attracted youth in regional areas. Health Promotion Journal of Australia, 18, 109-112. • Morgan, S. (2008). ‘Strengths’ assertive outreach: A review of seven development practice programmes. The Mental Health Review, 13 (2), 40-46. • Phillips, S. D., Burns, B. J., Edgar, E. R., Mueser, K. T., Linkins, K. W., Rosenheck, R. A., Drake, R. E., & McDonel Herr, E. C. (2001). Moving assertive community treatment into standard practice. Psychiatric Services, 52 (6), 771-779. • Stein, L., & Test, A. (1980). Alternatives to mental hospital treatment: Conceptual model, treatment program and clinical evaluation. Archives of General Psychiatry, 37, 392-397.

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