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Springhill is a modified Therapeutic Community TC

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... with serious addiction issues most of whom smoke, identify with that sentiment. Traditionally, 'lets deal with one addiction at a time' ... – PowerPoint PPT presentation

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Title: Springhill is a modified Therapeutic Community TC


1
Springhill Smoke Free Therapeutic Community
2
Background
  • Giving up is easy, Ive done it a thousand
    times Mark Twain
  • People with serious addiction issues most of whom
    smoke, identify with that sentiment
  • Traditionally, lets deal with one addiction at a
    time
  • Hawkes Bay DHB and Addiction Services first to
    take up the challenge.

3
Inspiration
  • Springhill is 3 month residential substance
    addictions treatment/rehabilitation service for
    15 adults.
  • A therapeutic community provides an environment
    and a close knit peer group that promotes
    healing.
  • A smoking culture exists at rehab as most smoke.
  • Why would you encourage smoking?
  • Springhill Mission Enabling people whose lives
    are affected by addictions to come to terms with
    and gain freedom from their dependencies.
  • Many people have respiratory disorders.

4
First Steps
  • Began to promote smoke free by
  • Pre entry encouragement
  • Initial interview with smoke free worker
  • NRT
  • Support group and counselling
  • After six months, up to half of residents smoke
    free, but they could not maintain the change
  • Smoking culture still strong and relapse norm

5
Smoke Free Decision Made
  • Research supports giving up at rehab.
  • May actually reduce relapse risk.
  • Planning day September 07 decided to go smoke
    free no smoking allowed.
  • Enlisted help of Totally Smoke Free DHB Project
    Manager Carleine Receveur

6
Systems Firstmodel of organisational change
Education
Policy
Systems
Evidence
Patient
Intervention
Roles
7
  • Six Principles
  • Do no harm
  • Recognition of the adverse health and
    social effects of tobacco use
  • Recognition of the addictive quality of
    tobacco
  • Alignment with HBDHB smoke free policy and
    intent
  • Alignment with other healthy living strategies
    at Springhill
  • Normalising smoke free lifestyles

8
Key Milestones
  • Project initiation
  • Position Statement for Smoke free Springhill
  • Smoke free Systems Design
  • Communication Plan
  • Staff Education Plan
  • Risk assessment
  • Smoke free Systems Implementation
  • Go live Totally Smoke free Springhill
  • Monitoring / Reporting

9
What We Did
  • We surveyed referrers and clients for their
    opinions. Two negative responses from
    referrers-Clients mixed
  • We spent months preparing referrers and
    prospective clients including countdown posters
  • We trained four staff in NRT support
  • We planned for following changes
  • Shorter breaks
  • Healthy snacks
  • Decommissioning the Fly Pit
  • Continued the smoke free support group
  • Daily relaxation
  • We planned for the transition including launch

10
(No Transcript)
11
What Happened?
  • I gave up smoking for a week and then they
    untied me!

12
The Transition
  • Considerable resistance/difficulty for 5 smokers
    in last smoking week
  • Not everybody prepared well
  • Launch very inspiring to all
  • First week too good to be true?
  • Major relapse by week 3 behind the shed
  • 3 residents discharged 2 others also left

13
Advantages
  • Clients more focused on recovery
  • Clear health benefits
  • No more smoking cliques which were sometimes a
    negative influence
  • No unhelpful smoking behaviours
  • Some family members also give up
  • Smell of smoke gone from house

14
Going Forward
  • Some risks were realised
  • Waiting list healthy but reduced
  • People smoking in an unsafe way (fire)
  • Referrers preparing clients haphazardly
  • Problem when clients go on leave
  • Expect that risks will reduce as time passes
  • We work with honest lapses
  • Current clients not smoking
  • New Clients seem motivated and pleased
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