Working with Aboriginal and Torres Strait Islander people: the - - PowerPoint PPT Presentation

Working with Aboriginal and Torres Strait Islander people: the Value of the Therapeutic Community Model

NIDAC Conference June 2010

Lynne Magor-Blatch, Carol Daws & Karen Ward

An introduction to the TC

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Acknowledgement

• We acknowledge the Aboriginal peoples and elders of

this land, and the families who are struggling with issues

• f substance use.
• We acknowledge that alcohol and other drug (AOD) use

among Aboriginal people is to a large extent intertwined with broader social issues resulting from the continuing impact of colonisation and dispossession, family dispersal and hardship.

• This, along with current underlying statistics that mark

Aboriginal people as the most disadvantaged of all Australians, challenges and motivates us in our work.

An introduction to the TC

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Introduction

• Brief overview of the Therapeutic

Community Model and its value in working with Aboriginal and Torres Strait Islander Peoples – Lynne

• The Cyrenian House Program –

Partnerships to provide better service – Carol & Karen

An introduction to the TC

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What is a Therapeutic Community?

A Therapeutic Community is a structured method and environment for changing human behaviour in the context of community life and responsibility

An introduction to the TC

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• A Therapeutic Community is a treatment facility in which

the community itself, through self-help and mutual support, is the principal means for promoting personal change

• In a therapeutic community, residents and staff

participate in the management and operation of the community, contributing to a psychologically and physically safe learning environment where change can

• ccur
• In a therapeutic community, there is a focus on the

biopsychosocial, emotional and spiritual dimensions of substance use, with the use of the community to heal individuals and support the development of behaviours, attitudes and values of healthy living (ATCA 2006)

An introduction to the TC

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“The development of small cohesive communities where the therapeutic decisions and functions are shared by the whole community, and where the status differences between staff and residents are greatly reduced though not abandoned” (Kennard 2000) “What creates membership of a community, what binds a group of individuals together and creates a sense of belonging, is a commitment to struggle together”

(Sarah Tucker 2000)

“The community is a network of relationships for support and being supported. All patients [sic] are expected to play a part as both supporter and supported and this is to some extent true to staff” (Hinchelwood 2002)

An introduction to the TC

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Cultural Respect

• The ‘recognition, protection and continued

advancement of the inherent rights, cultures and traditions of Aboriginal and Torres Strait Islander peoples achieved when the health system is a safe environment for Aboriginal and Torres Strait Islander peoples and where cultural differences are respected’, Australian

Health Ministers Advisory Council (AHMAC).

An introduction to the TC

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Cultural Respect

• It incorporates the following principles:

– An holistic approach to Aboriginal and Torres Strait Islander health; – Health sector responsibility; – Community control of Primary Health Care Services; – Working together; – Localised decision making; – Promoting good health; – Building the capacity of health services and communities; and – Accountability for health outcomes.

An introduction to the TC

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The Therapeutic Community

• Operates within a framework that is responsive to

the needs of Aboriginal and Torres Strait Islander people;

• Delivers quality services to Aboriginal and Torres

Strait Islander communities within an integrated and strategic policy framework;

• Embraces the diversity of Aboriginal and Torres

Strait Islander cultures; and

• Ensures that every aspect of the health service

provision is culturally safe for Aboriginal and Torres Strait Islander people.

An introduction to the TC

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The Therapeutic Community

• The method of treatment is particularly suited to

Aboriginal and Torres Strait Islander populations since it is based on family and a sense of community. It is a wholistic approach which embodies the need to pay attention to the connectivity of all aspects of life essential to improving overall wellbeing.

• Some TCs like Cyrenian House are providing programs

for indigenous Australians within the broader TC in an effort to provide a program that fits within the person’s culture and provides an evidence based framework that underpins effective treatment for addiction.

An introduction to the TC

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How we started

• Began from a shared

desire of the Drug & Alcohol Office (DAO) and Aboriginal Alcohol & Drug Service (AADS) to use resources for maximum benefit of Aboriginal people; Involved a tough decision to close the under utilised sobering up centre in Midland and re-use the funds to deliver much needed services for Aboriginal people;

• Required a visionary approach of AADS and their

service partners, Cyrenian House, which was clearly demonstrated.

An introduction to the TC

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WHAT WE DID

• Committed to early action;
• Closed Midland SUC but ensured a safety net;
• Assured AADS that the resources were protected for

Aboriginal people;

• Agreed to use the resources to open 12 new beds for

Aboriginal people in established therapeutic communities; and

• Ensured AADS would be central to any new partnership,

with a real role in the therapeutic community services and outpatient services before and after admission.

An introduction to the TC

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WHAT WE DID

• Primary focus to be on client with a view to offering a

continuum of care;

• The process would involve skills transfer;
• Employed existing staff where possible; and
• Built genuine new partnerships.

An introduction to the TC

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HOW WE DID IT

• DAO brokered the initial meetings but stayed out of

the detailed discussions between the partners;

• Everything was documented in agreements.
• Partners developed trust through frank and open

discussions;

• DAO funded partners to visit other services in

Australia;

• A leap of faith and a real commitment to “give it a

go”;

• Faster than many thought possible.

An introduction to the TC

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An introduction to the TC

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Road Trip to Research Indigenous Treatment Options

• We visited a number of

locations;

• Broome –
• Milliya Rumurra and the

Kimberley Community Drug Service Team

• Darwin -
• CAAPS – Facility for 30

clients, mostly indigenous with partners and children.

• FORWARD 12 Step facility

for adults

Alice Springs –

DASA and the Central Australian Aboriginal Alcohol Program unit

An introduction to the TC

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An introduction to the TC

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Referral & Assessment Process

Sources of referral

• Self referred to Cyrenian House
• Referred by AADS
• Other agencies

Information Session

• Cyrenian House Group
• AADS – Individually
• Telephone/other agencies

This session provides accurate and current information about the Cyrenian House Therapeutic Community. Will include, but not limited to : cost, confidentiality, structure, assessment and exclusion criteria.

An introduction to the TC

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ASSESSMENT PROCESS

Decision from client:

• If the client says no - the client is referred to AADS, Cyrenian

House Non-residential or/or another appropriate agency.

• If yes – client attends assessment interview (telephone

assessments are provided for clients residing in remote areas)

Factors Involved in Assessment

• Information collection, follow up and clinical judgment
• Joint decision through the assessment team
• Book admission if appropriate for TC
• Ongoing support and monitoring (via AADS, Cyrenian House N/R
• r other agency
• Client admitted (ultimately decided by Manager of TC).

An introduction to the TC

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Assesment Process

Client Referral Pool

Ready for Assessment (i.e. attending Information group or given Individual counselling session) Assessment: Cyrenian House, AADS or other

• Mangers of TC & Non Residential

& AADS staff

APPROVAL APPROVAL

• NOT

SUITABLE NOT SUITABLE

DETOX DETOX CYRENIAN HOUSE CYRENIAN HOUSE

An introduction to the TC

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The importance of Aboriginal Staff

All Cyrenian House staff have undertaken Cultural Security training and supported by three Aboriginal workers employed within the Therapeutic Community. Six Aboriginal-specific beds are allocated within the Mixed Gender Program to ensure the service is more culturally secure for Aboriginal populations engaging in treatment. Within the Cyrenian House Saranna Women’s & Children’s Program, approximately 50% of families are from Aboriginal or Torres Strait Islander populations.

An introduction to the TC

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• Mainstream counselling is often

not conducive to Aboriginal people and can often be a silencing factor to their treatment.

• To ensure the environment is

culturally secure, a Meeting Place was erected within the Cyrenian House TC. This enabled Aboriginal clients to tell their ‘stories’ without trauma often through art form. Empowering Aboriginal partnerships by sharing ownership of the TC ensures the rights and entitlements of the service are equally distributed to all its residents.

An introduction to the TC

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An introduction to the TC

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Benefits

• Best use of scarce resources and able to deliver

services NOW;

• New rehabilitation services that are much needed

and cost-effective;

• New and important partnerships;
• Improved cultural security of mainstream services;
• Capacity building and skills transfer for AADS;
• Improved sector collaboration.

An introduction to the TC

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Thank you Any questions?

Lynne Magor-Blatch atca@atca.com.au www.atca.com.au Carol Daws CEO, Cyrenian House carol@cyrenianhouse.com.au www.cyrenianhouse.com