REHABILITATION The Great debate

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REHABILITATIONThe Great debate

• Noreen Oliver MBE
• Founder CEO The BAC OConnor Centres
  Staffordshire
• Trustee - FDAP ( federation drug Alcohol
  professionals
• Co- Chair Recovery Group UK

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Divide RuleConquer None

• Abstinence V Harm Minimisation/ Methadone
  Trivial Outdated
• Medical V Social Model
• Separate Tier System Teams
• Separate System for Criminal Justice
• Competitive Tendering
• Limited Resources
• Dysfunctional, nervous, uninspired and fearful
  workforce
• Unmotivated, uninspired and fearful service user
  group

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Together We Can Conquer Win, Win for All

• Stop competing work together
• Balanced Treatment System
• Seamless Service
• Respect the importance part that each Tier
  plays within the treatment Journey
• Respect Choice
• Recognise challenge individual agendas and
  blockages to the treatment system
• Promote equality by providing a menu of services
  available for all not the chosen few.

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Community Rehabilitation A Partnership Model

• Never in isolation
• Shared Ownership of all Delivery Partners
• Assessment Care planning should cite
  Rehabilitation as an Option from the onset
• Shared Agreement how it can be accessed
• Agreed Assessment Referral Routes
• Agreed Sharing of Information
• Joint Reviews
• Update on progress Care plan

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A Community Model with Ownership of all Partners

• Commitment in Treatment Plan
• Where does it fit within the Treatment plan
• Commitment from Partners
• What partners do you convene
• Has to be Sustainable
• How would you commission it
• Spot purchase / Block Contract
• What elements of the programme would you class as
  essential
• What elements of the programme can be delivered
  by outside agencies

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What Rehabilitation is not

• Alternative to Housing - NFA
• Get out of Jail free Card
• Easy option
• Snap Decision
• A parking place for service users who you have
  tried everything with - Last Chance Saloon
• Expensive and a one off chance
• A behind closed doors episode of the treatment
  journey

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WHEN ?

• WHEN DO YOU REFER TO REHAB ?
• What triggers your referral to rehab ?
• At what stage in the care plan do you consider
  rehab ?
• How seriously do you take a request for rehab
• Those you think will often dont !
• Those you think wont often do !
• Its Individual !

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THE SERVICE USER - MOTIVATION

• Are they making small changes
• Attending Appointments
• Dental/ Optician Appointments
• Debts
• Family
• Reduction in use
• Regular Drug Screens
• A willingness to begin a reduction in prescribed
  medication
• Are they ringing you on a regular basis for
  updates
• Attendance at facilitys pre Rehab groups
• HMP Are they on a drug free wing
• HMP Voluntary drug testing
• HMP Attending groups/Courses

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A Community Partnership Model A
Community Partnership Model

• Recognises what we/ you do best
• Individual expertise not jack of all trades
• Avoids duplication
• Ensures clients are able to tap into an array of
  Community services to meet their individual needs
• Enable us to share information, work together,
  sing from the same hymn sheet and shares success
• Ensures public money is wisely spent

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Why Community, ?Why not ship them all out ?

• Choice
• Research 340 Service Users Out of County Myth
• Family programme research
• HMP releases
• Partnership Model All Tiers
• Community Ownership _ Breaks barriers not a
  local resident
• Recognises importance of the recovery journey
  together
• Care pathway back forwards
• Allows sharing of resources
• Ownership of Commissioners, regional NTA, DAATs,
  PCTs, Social Care, police, probation, GPs
  hospitals
• Ownership partnership of housing, education,
  employment, work placements

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DETOXIFICATION

• We provide medically supervised detoxification
  services in this unit. For individuals who
  require a medically supportive environment as
  opposed to specialist unit. For those undergoing
  rehabilitation.
• In close co-operation with referring agencies,
  GPs and specialists, we provide a supportive and
  safe environment in which recovery can be
  facilitated.
• Shared Care with Community Drug Alcohol Team
  reducing down Accessing Pre Rehab, Recovery
  Champions and family Support
• Within this unit clients will receive a range of
  interventions to aid the detoxification process
  using an holistic approach. These include
  motivational sessions, relapse prevention,
  complementary therapies such as massage,
  relaxation, auricular acupuncture, health
  screening along with nutrition advice and peer
  support.

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Therapeutic Rehabilitation 14 weeks

• The therapy provided at the BAC OConnor Centres
  is evidence based. It is designed to provide
  clients with the maximum opportunity to develop
  improved independent living skills and increase
  overall enjoyment of life.
• A collective range of therapy delivered in a
  structured programme
• CBT, Gestalt, Reality Therapy, client Centred,
  Rational Emotive, Behavioural, Transactional
  analysis, Ego States, Neurolingustic.
• Structured one to one, Group Therapy,
• Educational workshops, _ Denial, responsibility,
  causes effects of substance misuse,
  consequences, relationships
• Specialised fields Abuse, Bereavement, Family,
  Anger management, Gender Issues, Relationships,
  Assertiveness

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REHABILITATION -cont

• Complimentary Therapy acupuncture, Reflexology,
  Relaxation, meditation, Reiki, massage
• Nutrition, Physical fitness Health
• Social development Network outside support
  groups, sports activity, Social activities,

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Family Programme

• Weekly family therapeutic group
• One to one therapy
• Client and family co-joints

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RESETTLEMENT

• Housing Good Tenancy modular programme Trent
  Dove
• Managing Debts- Budgeting - CAB
• Independent Living Skills in house / Trent
  Dove
• Assertiveness/ Motivation in House
• Social/ Support Network AA/NA Ex service
  users group
• Nutrition/ Healthy living/ - East Staffs PCT
• Self Esteem in house
• CVs Interviews Role play - in house
• Literacy Numeracy skills, Collage, NVQs and
  recognised qualifications Derby Collage
• Life Skills Derby Collage
• Voluntary/ Work placements- Voluntary Bureau/
  YMCA/ Staffordshire County Council
• Outside activities sport, social activities
  YMCA/ COORS/ Probation, police.

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SEMI INDEPENDANT LIVING

• Semi independent flats 2- 6 months licence
• Semi integration into the community
• Service users live independently pay their own
  bill, Electric metres, food, cooking etc
• Have the support of the rehabilitation unit
• Weekly Aftercare/ one to ones
• Work placements/further Education
• Use of facilities i.e. Gym
• Participation in Social activities
• Floating Support to support individuals with the
  preparation and transition into independent
  living in the community in (Trent Dove) with
  follow up in the community for 2 years

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AFTERCARE BEYOND

• Weekly aftercare evening programme
• Floating Support
• One to Ones if required
• Relapse prevention
• Long term aftercare plan identified individual
  triggers to possible relapse.
• Out of hours telephone support
• Unit follow up where are they/ what are they
  doing 12 months later ?
• Confidence in the unit that if service users
  experience difficulties they can receive help and
  are not labelled as failures

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A SHARED MODEL OF GOOD PRACTICE

• A Model that does not divide the treatment
  system.
• A Model that is inclusive, not exclusive
• A Model that seeks out and exposes personal
  hidden agendas that ruin our field
• A Model that together unites us and actually
  shows commissioners that as professional we do
  work well together, with the service user at the
  heart of the system.
• A Model that will enable us to move the Drug
  Alcohol treatment debate forward in that no
  one size fits all and the Recovery Journey
  begins when a service user walks through any of
  our doors
• A Model that supports and evidences that
  treatment works and Mr Politician we deserve
  your sustained and improved investment !
• A Model for the Individual, Family and Community
  !