The 4th Annual Research and Evaluation of Adventure Programs Symposium Programs, Process,

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The 4th Annual Research and Evaluation of
Adventure Programs SymposiumPrograms, Process,
Progress The March Towards Evidence-Based
Designation

• Matt Claybaugh, Ph.D.
• A. Scott Allred, LMFT
• Marimed Foundation

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Program

• Who we are and what we do.

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Process

• Data in Data Out
• Moving towards EBP designation

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Progress

• Where are we now
• Barriers to success

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Programs

• How many of you believe/know you are using an
  evidence-based model in your program(s)?
• How many of you are replicating a best
  practice, evidence-based or model program?

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Marimeds Residential Programs

• Kailana (Calm Seas) (est.1993 on Oahu)
• and
• Wahiolanonaopio (A Healing Place for Youth)
  (est. 2004 on Hawaii Island)
• Residential treatment programs for
  adolescents needing comprehensive treatment and
  education, including mental health and substance
  abuse services.

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Kailana Main Campus
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Kailana Voyaging Houses
Hale Hoohua House to Bear Fruit
Hale Kauoha Kakou House of Our Will
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Wahiolanonaopio Voyaging Houses
Wahiolanonaopio O Keaau Girls House
Wahiolanonaopio O Kapehu Boys House
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Integrated Services
Experiential
Marimeds Model
Clinical
Educational
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Culturally Aligned with Youth Population
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Mauka to Makai
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Loi Kalo, Animal Husbandry Farming
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Culinary Arts
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Ocean-Based Programming
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Small Boat Sailing
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Outrigger Canoe Paddling
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Kiakahi Sailing Canoe
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Hoailona Sailing Canoe
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S.S.V. Makani Olu(gracious wind)
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Five 5s

• Organizational Values
• Experiential Model
• Interwoven Phase and Level System
• CPI (Non Violent Crisis Intervention)
• Behavioral Supports

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1 Organizational Values

• Community
• Honesty
• Aloha
• Respect
• Teamwork

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2 Experiential Model

• Welcome Aboard / Preparing for Sea
• Departure / Commitment to the Voyage
• Challenge / Windward Leg
• Mastery / Wayfinding
• Reflection / Storytelling

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3 Phase and Level System

• Phases of Treatment
• I. Rapport Building Roles and Rules
• II. Accepting Responsibility and Expressing
  Needs and Issues
• III. Coping Skills
• IV. Dealing with Past Issues that Continue to
  Impede Progress
• V. Transferring Learning to New Life Settings

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4. Crisis Prevention Institute

• Non-Violent Crisis Intervention

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5. Behavioral Supports

• Making it Right
• Restorative Justice
• Cadet Council
• Positive Incident Reports

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(No Transcript)
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I Mua Mau Ohana IMO

• SAMHSA TCE Targeted Capacity Expansion
• Joint Program Enhancement Award 2002 Marimed
  Foundation and Maui Youth and Family Services
• Voyaging (For MYFS)
• 12 month Continuing Care (All Islands)

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Instrument

• Utilized the Global Appraisal of Individual Needs
  (GAIN) Core Version
• GAIN also contains SAMHSA Government Performance
  and Results Act (GPRA) Instrument

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Baseline Findings
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Demographics

• Gender 71 male, 29 female, 1 TG
• Average age 16 years old
• Ethnicity 62 Native Hawaiian, 41 Caucasian,
  37 Asian, 24 other Pacific Islander, and 24
  Hispanic (many multi-ethnic)
• Past 12 months living with 71 parent(s)
• Treatment prior to intake
• 58 received treatment before average1.2
  admissions
• 51 felt they needed treatment

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Criminal Justice Involvement

• 87 had lifetime arrests

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Education Employment

• 89 of youth were enrolled in school or training
• Only 5 reported engaging in some type of
  non-full-time work

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Substance Use at Intake
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Mental Health at Intake
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General Crime at Intake
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Outcome Findings
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Arrests Past 90 Days
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Days in Juvenile Detention Past 90 Days
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Education
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Employment
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Substance Use
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Substance Problem Scales
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Emotional Problem Scale
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Summary

• Youth mostly Native Hawaiian and other Pacific
  Islander
• Youth at intake showed high levels of criminal
  justice involvement, substance use, and both
  internal and external behavior problems.
• Significant reduction in arrests and days in
  juvenile detention
• Significant reductions in substance use and
  related substance problems
• Significant reduction in emotional problems

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Wahiolanonaopio

• Received SAMHSA TCE Earmark for Methamphetamine
  Treatment 2004

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Instruments

• Wahiolanonaopio Survey
• GAIN-Q
• Family Management, Family Bonding, Self-Efficacy,
  Cultural Pride, School Bonding
• Government Performance and Results Act (GPRA)
  Instrument

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Data Collection

• From July 1, 2004 to September 30, 2006
• 58 total admissions
• Baseline assessments
• 52 GPRA
• 46 Wahiolanonaopio surveys
• Three-month assessments
• 39 GPRA
• 34 Wahiolanonaopio surveys
• Six-month assessments
• 32 GPRA
• 27 Wahiolanonaopio surveys
• 12-month assessments
• 16 GPRA
• 11 Wahiolanonaopio surveys

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Demographics

• Gender 69 male 31 female
• Age range13-18, avg.15.7 years old
• Education range6th-11th grade, avg.9.2 years

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Ethnicity
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Baseline ATOD UsePast 30 Days Youth
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Qualitative Findings I

• Sample of participants from the residential and
  day treatment programs were interviewed
• Most participants felt they had changed
  positively, including increased acceptance of
  responsibility, honesty, problem solving, anger
  management, self-esteem, patience, positive
  attitudes, pro-social behaviors, academic
  performance, and remaining drug free
• Some participants also felt their families and
  their relationships with their families changed
  for the better

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Qualitative Findings II

• Participants felt staff gave them support, hope,
  and skills to deal with their problems
• Participants enjoyed the learning and experiences
  they acquired
• When asked what was difficult about working with
  staff, participants mentioned lack of consistency
  and organization
• Other concerns related to the location and living
  conditions of the home

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Limitations of Findings

• Small sample size
• Selection bias due to follow-up survey
  completion rate
• Cultural sensitivity of required measures
• Social desirability

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Summary I

• Substantial decreases in AOD use at all
  follow-ups and reduced impact of AOD use at both
  6- and 12-month follow-ups.
• Increasing improvements in high-risk behaviors at
  each follow-up.
• Although decreases in enrollment in school, there
  was increased school functioning for youth still
  in school and increased engagement in work for
  other youth. Qualitative data also suggests some
  improvement in academics.

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Summary II

• While some increases in psychological/emotional
  problems revealed, decreases in external behavior
  problems also revealed. By 12 months,
  improvements shown in both internal and external
  behavior.
• Increases in self-efficacy and cultural pride
  also shown at all follow-ups.
• Although family functioning scales showed only
  slight improvements, qualitative data suggests
  some improvements.
• Improvements in living conditions and number of
  youth receiving various types of treatment.

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Where Are We Now?

• Next Steps
• Barriers

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T. S. Eliot
We shall not cease from exploration And the end
of all our exploring Will be to arrive where we
started And know the place for the first
time. T.S. Eliot
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Thank You
Senator Daniel Inouye Mayor Harry Kim (Hawaii
County) Billy Kenoi Char Shigemura All Hawaii
Treatment Providers and Educators Richard Kim,
Ph.D., The Catalyst Group, LLC
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Mahalo

• The end