1. health and fitness
2. addiction

ADDICTION 2015
The Australian & New Zealand Addiction Conference
Outrigger Surfers Paradise,
Gold Coast
20 - 22 May 2015
Alcohol,
Other Drugs,
Behavioural Addictions:
Prevention, Treatment
and Recovery
The Australian
& New Zealand
ADDICTION
www.addictionaustralia.org.au
CONFERENCE
Optional Workshops
Workshop 1
Dr Peter Kelly
Senior Research Fellow, University of Wollongong
Healthy Recovery: an opportunity to address smoking, diet and physical activity as part of
alcohol and other substance abuse treatment
On average, people with a history of substance abuse problems live between 20 to 30 years less
than people from the general population. This is largely the result of smoking and other poor
lifestyle behaviours that contribute to high rates of cardiovascular disease and cancer. For
example, people accessing Australian substance abuse services are 13-times more likely to be
smokers than people from the general population. They are also more likely to have poor
dietary habits and engage in low levels of physical activity. These findings highlight the pressing
need to target these lifestyle behaviours in order to improve the physical health of people with
substance abuse problems. There is an opportunity for mental health and drug and alcohol
workers to help address these unhelpful behaviours through delivering healthy lifestyle
interventions to those individuals at risk.
The workshop will provide an overview of the Cancer Institute NSW funded research that the
authors have been conducting. This research is focused on reducing smoking, improving diet
and increasing physical activity amongst people accessing drug and alcohol treatment services.
The workshop will involve providing a detailed overview of Healthy Recovery, an 8-session
healthy lifestyle intervention that was developed specifically for people accessing substance
abuse treatment.
People attending this interactive workshop will develop skills in delivering smoking and other
healthy lifestyle interventions with people who have alcohol or other substance abuse
problems. The workshop will involve a combination of presentation styles that will include
PowerPoint presentation, video demonstration of Healthy Recovery and experiential exercises.
Participants will be supported to use Healthy Recovery to support their own clinical practices.
Workshop 2
Dr Karen Fisher
A/Clinical Coordinator, Centre for Addiction Medicine, NBMLHD
Reframing Addiction: the impact of chronicity and ageing for models of care.
Women and Addiction:
Epidemiological studies over the past twenty years illustrate fascinating trends in substance
misuse and abuse by women. In an era where the value and need to access and use the very
best evidence available to guide clinical care, it is curious to reflect many of the accepted
theories and understandings informing our practices as clinicians in addiction, are based on
evidence gathered in males or in contexts that do not reflect the socio-economic context of
contemporary women.
Using the lens of gender to critically interrogate the development of substance misuse in
women, offers many new and important insights for those involved in addiction services. What
do the broader societal trends of ‘pinkification’, increasing participation by women in the
workplace and the rise of households headed by women, contribute to ensuring a more
nuanced and suitable approach to interactions with women by our field?
This presentation, using two examples of alcohol and over the counter codeine, analyses the
historical evolution of women as a market for both substances, examines trends in use by
women, and discusses the need for nuanced and specific interventions whether these are on a
population or individual level. Using case studies , the challenges for traditional modes for the
identification, assessment and management of substance misuse will be discussed and
highlighted.
As a service, we have begun to respond and reshape the modalities of care we offer to women.
The presentation will explore the failures and successes of different approaches and
innovations we attempted. What signals have we found for a more tailored and useful
approach to women and addiction?
Workshop 3
Ms Fiona Lewi
Benzodiazepine Counsellor, Reconnexion
Benzodiazepines: The Rocky Road to Recovery!
This workshop is for anyone working with people who are contemplating or wish to withdraw
from benzodiazepines.
Benzodiazepines are one of the most difficult drugs to withdraw from and helping clients
through this process can be extremely challenging. Nothing is black and white and everyone’s
experience is different. Unlike other drugs of concern, they carry such a high risk of
dependency that even at therapeutic doses tolerance and dependency can develop within a
few days. Coupled with other licit and illicit drugs they become life destroying and all too often
life threatening.
This interactive and informative workshop will be a chance to develop or refresh your
knowledge of the ways in which Benzodiazepines work, how they interact with other drugs
including alcohol and illicit drugs, reasons for prescribing and use, risks surrounding
dependency, understanding and managing this complex withdrawal.
The workshop will use case studies and small group discussions to help participants understand
how to assist their clients in identifying dependency and managing withdrawal, supporting their
clients to full recovery.
Workshop 4
Ms Carolyn Sullivan
Private Psychologist, Private Psychologist
Body Blame: Treating Emotional Eating with EMDR Therapy
Eye Movement Desensitization and Reprocessing (EMDR) therapy, developed by Francine
Shapiro in the nineteen eighties has extensive research supporting its use as an evidenced
based therapy for PTSD.
With the understanding of the Adaptive Information Processing model for how the brain
processes memories, therapists have expanded its use to treat many common psychological
issues. Robert Miller developed the EMDR Impulse Control disorder protocol for use with
addictive behaviours. Mrs Sullivan has developed a workshop format for applying the EMDR ICD
protocol to emotional eating. The first task for use of the protocol with emotional eating, is
identifying the foods that are involved in the emotional eating and the development of the
positive feeling states (PFS) that were created as a result in childhood. The second task is
identifying the negative beliefs about the self that created the need for the creation of the
Positive Feeling States in the first place. These negative self-beliefs have to exist in conjunction
with developing the Positive Feeling States for addiction to occur.
Mrs Sullivan lost 30kgs when she addressed her own emotional eating using the protocol. She
shares her journey and that of her clients in ways of identifying and processing those initial
Positive Feeling States (PFS) so that the foods are no longer wanted but easily resisted.
However, resisting food is an insufficient treatment for emotional eating. The third task is to
identify the underlying negative self-beliefs that have been re-activated in adulthood to allow
the client to fully recover, including treating the secondary set of negative self beliefs that have
resulted from the addiction. The protocol is easily adapted to other addictive behaviours.
Workshop 5
Mr Frank Borg
Forensic Service Manager, Caraniche
Dr Kara Granger
Senior Clinician, Caraniche
Working with clients that use methamphetamine.
Background
Caraniche is a Victorian based company that delivers a range of specialist psychological services
to the government, private and not-for-profit organisations. As part of their service, Caraniche
provides evidence-based alcohol and other drug treatment to over 6000 prisoners each year
across the Victorian public prison system. In recent years, Caraniche have seen a significant
increase in the reported use of methamphetamine among offenders in prison-based substance
use programs. Program evaluation data indicates that methamphetamine has replaced heroin
as the drug that reportedly caused the most serious problems for male prisoners. This trend is
also increasing for female prisoners. This increase in prevalence, as well as the specific effects
of methamphetamine use, indicates a need for a more in-depth understanding of
methamphetamine using clients and their management, and requires treatment to be tailored
their needs.
Who should attend
Attendees should include alcohol and other drug workers or mental health clinicians, who may
work with clients who use methamphetamine. Whilst Caraniche provide prison-based services,
this workshop will also assist those working in community settings with methamphetamine
using clients or offenders. Further, whilst information will be discussed in regard to offending
behaviour, it will not be the focus of the workshop.
Structure of workshop
Methamphetamine trends
Understanding the effects on brain & body
Acute intoxication
Withdrawal
Violence
Mental Health
Management and treatment suggestions
Intended outcomes
Participants will leave this workshop with an increased knowledge about the short and long
term effects of methamphetamine use, including the implications of these for treatment and
recovery. Participants will also learn appropriate management techniques, and treatment
targets for methamphetamine users, and develop increased confidence in their ability to work
with methamphetamine using clients.
Workshop 6
Ms Maria Pau
Director, Coaching With Substance
Inspirational Goal Setting Session for those with Alcohol and Drug Issues.
The toll of chemical dependency on human health and happiness is staggering. Considering the
financial drain of $195 billion in 1995 in the US (Yoder, 1990) and $56 billion in 2005 in Australia
(Collins & Lapsley, 2008), it is obvious that a different alternative is needed to lower the costs of
alcohol and drug use and abuse to any society.
Recovery coaching is an innovative approach to getting clients inspired about their lives by
steering them towards purposeful living while in a structured and inspirational coaching
environment. The workshop planned is a very hands-on goal setting session re-enactment. We
will then follow the workshop with the coaching series processes such as the strategy session
then the ensuing sessions are all about getting closer and closer to achieving the goals. The last
session is all about lessons learnt, insights gained, feedback for the coach to keep improving
their coaching skills and self-rating on how close the client thought they were on achieving each
goal from 0-100%.
Live coaching video sessions will be shown with consent from client to illustrate the recovery
coaching journey.
Background - How Recovery Coaching Focuses ATOD Clients on Wellness Instead of Illness
Who should attend - Those working with clients that want an alternative approach to engaging
with clients, inspiring them and keeping them accountable towards the goal of transforming
their lives
Structure of workshop
-Recovery Coaching and Its Processes
-Difference between recovery coaching and other treatment
-Why Recovery Coaching is a perfect as an adjunct to any program?
-Interactive Goal Setting Exercise
Intended outcomes
Learn how the Recovery Coaching Certification and Examination Process for further learning, if
needed. Also to learn how inspirational goals are set and how clients are kept accountable and
excited about them.
Concurrent Sessions
Ms Renee Brighton
Lecturer, School of Nursing, University of Wollongong
Co Authors - Professor Lorna Moxham, School of Nursing, University of Wollongong, Associate
Professor Victoria Traynor, School of Nursing, University of Wollongong
Giving women a voice – narratives on accessing (or not) drug and alcohol services
Aim The purpose of this project was to gain a greater understanding of why women with
alcohol-use disorders (AUDs) decide to engage (or not) with drug and alcohol services.
Background Although women drink less volume of alcohol than men, they have a higher risk of
developing alcohol-related harm than their male counterparts (NHMRC 2009). In Australia and
New Zealand, the rates of women drinking to excess has grown significantly over the past
decade, seeing a dramatic increase in the number of women experiencing alcohol-related
health conditions (NHMRC 2009, Ministry of Health 2009). Despite this, women are less likely to
engage with services that specifically support and treat people experiencing AUDs (Greenfield
et al. 2007). This is made all the more significant when considering that women who do engage
with treatment services generally have positive health outcomes and have a greater chance at
reducing alcohol-related harms when compared men.
Methods A phenomenological methodological framework underpins this project. Semistructured, in-depth one-to-one interviews with women experiencing alcohol-use disorders
formed the means of data collection. The themes and key findings from the analysis of these
interviews as to why women engage (or not) with specialist drug and alcohol services will form
the basis of the presentation.
Conclusion Given the fact that increasing numbers of Australian and New Zealand women
consume alcohol at harmful levels and are more susceptible to alcohol’s psychological and
physiological effects, it is important to establish the deeper meaning behind why they enlist the
help of drug and alcohol services. This project fills a gap in understanding in why engage
women with AUDs in these services. This research has the potential to inform the development
of more specific, targeted and gender-appropriate drug and alcohol services being provided to
these vulnerable populations.
Mr Tony Brown
Chairperson, Newcastle Community Drug Action Team
Who calls the shots?
A 2014 report by Shakeshaft et al examined 13 community based actions in NSW and found
little evidence that community action such as education etc significantly reduces risky alcohol
consumption and alcohol-related harms.
Shakeshaft suggested legislative measures beyond the direct control of local communities such
as availability and pricing may be more cost effective in reducing higher level harms.
This presentation suggests that there is a third way to achieve both genuine community
engagement and reduce more serious alcohol related harms. This involves the critical
consideration of the role of ‘political power’• - the relative capacity of a community(s) to
influence/persuade legislators and agencies compared with that of liquor industry
representatives..
This paper will present how a number of NSW communities successfully tackled the issue of
alcohol availability through the Alcohol Community Action Project (ACAP).
ACAP was a 13 month pilot project from 1 July 2013 which offered a free advisory service and
website for the NSW community to navigate the complex alcohol planning and regulatory
process.
It is difficult for ordinary community members to effectively and equitable participation in the
liquor regulatory systems because of legislative, resource and other barriers to entry.
The ACAP project demonstrated that with very little financial investment (compared with
$608,000 for the above study interventions), locally organised and informed communities can
become an effective instrument in preventing alcohol related harms.
This presentation discusses the success one community achieved challenging the development
of a high risk liquor outlet with the assistance of ACAP.
It will demonstrate the urgent need for a Community Defenders Office to assist communities
contest the proliferation of liquor outlets in their area and break down the barriers to local
communities achieving a fair say in liquor related outcomes impacting upon the safety, health
and well-being of their communities.
Mr Luke Butcher
Area Manager, Mission Australia
Delivery of an Offending Behaviour Intervention Program in a Youth Residential Drug and
Alcohol Rehabilitation program
The “What Works” Literature on young offenders identifies the “Big Four” key risk factors
associated with Juvenile Offending: Anti-social attitudes, Anti-social associates, History of Antisocial Behaviour, Anti-social Personality Pattern. Over half the juvenile justice detainees in NSW
indicate a history of trauma and being intoxicated at the time of the offending behaviour;
suggesting a role that substance use plays in deviant coping mechanisms.
This research focusses on the delivery of an offence focussed program focussing on targeting
the "Big Four" risk factors in a residential drug and alcohol service for young offenders in
Western NSW.
Methods: The target group were young offenders who were accepted into treatment for in a
residential drug and alcohol service. Eligible residents were deemed to be medium to high risk
reoffenders using the YLSI. Residents completed a structured clinical assessment focussing on
sequential analysis of offending behaviour, exploration of early learning experiences and prooffending thinking to create a thematic analysis of offending behaviour. This information was
then translated into a risk management framework and behaviour modification program.
Results: All young people who completed the program indicated a history of being victims of
intra-familial violence. There were significant thematic similarities between the type of index
offence and associated psychological processes.
Conclusion This framework allows for the exploration of the nexus between maladaptive coping
mechanisms, substance use and offending behaviour in therapeutic residential environments
and tailor interventions accordingly.
Mr Gerard Byrne
Clinical Director, The Salvation Army
Training AOD staff in comorbid screening, case planning and evaluation. Does it work?
Residents of AOD Therapeutic Communities have high rates of co-occurring mental illness; a
study of residents of Australian Salvation Army TCs (SATCs) indicated a high presentation of cooccurring mental illness. To meet the needs of people with co-occurring mental illness there is a
need to train staff to appropriately screen for mental illness, and use this information to
develop integrated case plans addressing addiction and mental illness. SATCs provided training
to 111 Case Workers, aimed at improving identification and treatment of people with comorbid
presentations.
Drawing from recovery concepts and practices used in the mental health field screening and
case planning systmnes were developed and im0plemented. From a service delivery
perspective the new casework processes are supported by a comprehensive electronic client
file management system (SAMIS) which assists Case Workers to analyse screening data and
develop a case plan from that data.
The presentation will present results from an evaluation of the screening and case planning
procedures, including examining staff attitudes towards the use of evidence based practices,
and staff uptake of the new procedures.
Mr Tony Clarkson
Clinical Team Leader, Gamblers Help Southern
Psychodynamic Treatment Outcomes for Problem Gambling
For every man woman and child in Australia $1050 is lost every year to gambling. Gambling is
arguably the most financially ruinous behavioural addiction there is, contributing to relationship
breakdown, family violence, depression and, in some cases, suicide. Psychoanalytic
psychotherapy has not been widely used to treat problem gambling but is well placed to
address underpinning issues such as trauma, affect regulation andrelationship dysfunction.
The presentation will seek to outline the current state of gambling related issues in Victoria, the
typical problem gambling client seen by the service, and the psychodynamic treatment of those
clients and their outcomes. Content will comprise of 1 case study, subsequent clinical material,
and a brief overview of psychodynamic psychotherapy and psychodynamic interventions for
problem gambling treatment. The conclusion reached will be that problem gambling is often a
symptom of repressed trauma, unprocessed feelings of loss or damaged internal objects and
finds expression in relationship breakdown and gambling addiction.
The psychodynamic treatment approach will be shown to be particularly effective in bringing
about, through transference feelings about the clinician and the understanding of their origins,
a reduction in problem gambling behaviour.
Ms Carly Clutterbuck
Senior Clinician, headspace Meadowbrook
Co Author – Mr Jonathon Pitcher, Senior Practitioner – Gambling Help, Lives Lived Well
App’t – Addiction anywhere, anytime
This action research project was prompted by enquiries from the community about treatment
options for people experiencing issues with game apps like Candy Crush and Angry Birds. The
Lives Lived Well Gambling Help program operates in the Moreton Bay region and received a
number of requests from schools, service providers and parents for training and information
about this new addiction. This feedback highlighted a gap in current service provision and as
such was seen as an opportunity to identify the prevalence of problem app gaming, research
current best practice standards for intervention and develop information and education
packages for young people, parents and service providers.
The results of the study point to a marked proportion of respondents experiencing problems
with app gaming; people consistently spending more time and money than they had intended
on games and some significant relationships between gaming and other behavioural addictions.
Levels of addiction and engagement did not discriminate between age, gender or employment
indicating app gaming appeals to a broad cross-section of the community. Overall, app
addiction was most closely related to social media and online gaming addiction across all seven
aspects (salience, tolerance, mood modification, relapse, withdrawal, conflict, problems).
Males are significantly more likely to experience their first episode of gambling on a game app
than females and there is a slight yet non-significant relationship between age and first
experience of gambling being on a game app. While the relative risks associated with app
gaming may not necessarily be as harmful as those of an alcohol or drug addiction, there is so
much that is as yet unknown about the long term effects on brain structure in young people
who struggle to curtail their game use. We conclude by recommending clinicians are made
aware of the potential addictive nature of these games and provided with information on how
to best support and intervene on this problem behaviour, and that information is provided to
young people and parents about the presence of simulated gambling behaviour in game apps
and the potential for this to create problems with gambling behaviour later on in life.
Miss Ciara Donaghy
Program Manager, Network of Alcohol and other Drugs Agencies
Co Author - Mrs Edith Olivares, Network of Alcohol and other Drugs Agencies
Supporting non government organisations providing alcohol and other drug treatment to
women in NSW
The NADA Women’s Alcohol and Other Drug (AOD) Services Enhancement Program
commenced in July 2013 in response to a range of issues raised by the Women’s AOD Services
Network. The Network, consisting of 12 specialist women’s non government organisation’s
(NGO’s) in NSW who provide AOD treatment to women with and without children, was
established six months earlier. The Network facilitates collaboration, knowledge and
information sharing and works to further common strategic interests.
With the support of the Women’s AOD Service Enhancement Program, Network members have
enhanced individual organisation service delivery and become a strong, supportive and active
collective. Six Network members received seeding grants aimed to improve service delivery
across a range of self-identified areas. This includes improving relationships with Family and
Community Services, increasing the engagement and retention of Aboriginal women in
treatment, the development and implementation of aftercare, transitional, day, and trauma
informed care programs, the identification of the specific needs of women in pharmacotherapy
treatment, and the development of a program focused on choosing, and maintain healthy
partner relationships.
With expert advisory group input, the Women’s AOD Services Enhancement Program has
produced a needs analysis of women’s specific services providing AOD treatment to women
and their children and is currently finalising a practical resource aimed to improve service
delivery for women with AOD issues in mixed gendered services.
This presentation discusses the development and implementation of the program including
case studies, key learnings and recommendations across all the program components.
Ms Sharalyn Drayton
Principal/Senior Therapist, ARISE Counselling Solutions
The Silent Addiction - How do partners and families of sex addicts survive an addiction they
struggle to even talk about?
Sex addiction is one of the fastest growing addictions, largely thanks to the internet. It is a
private addiction. It is unseen and its consequences are slow to reveal themselves. Is it really an
addiction or is it just an excuse for bad behaviour? Negative comments such as this are
generally the primary responses on hearing the news that someone you know has been
impacted by sex addiction. For the partner it is generally easier to just keep quite and try and
deal with this nightmare alone. Finding someone to confide the horrifying reality that your
partner is acting out his sex addiction is almost impossible to deal with. How do you share the
knowledge that your partner is a sex addict? The idea itself is so staggering and involves such a
deep sense of betrayal that for some it seems even surviving the impact of this knowledge may
be too much.
By the time someone comes for help it is generally not because they are an addict but because
their primary relationship is falling apart. It tends to be the partners who drag their significant
other along for couples therapy in a last ditch attempt to hold on to something that started out
with such promise. Partners of sex addicts know for a long time before they seek help that
there is something very wrong. As with all addiction it gets worse before it gets better.
However there is hope. Both for the addict, their partners and also their families. In fact given
the right information, motivation and support recovery is not only possible but can be life
changing. It is in fact possible to not only survive the discovery that your partner is a sex addict
but find healing for both parties and build a relationship which is stronger and more resilient
than anything that has gone before.
Dr Sally Gainsbury
Senior Lecturer, Southern Cross University
Assessing the impact of interactive gambling and new technologies on gambling problems
New technology is changing the nature of gambling. Many concerns have been expressed about
the potential impact of increased use of interactive modes of gambling. This presentation will
share the results of the first nationally representative data on the use of Internet gambling in
Australia, including the impact of this technology on problem gambling. The aim of the research
was to understand who, what, when, why and how people are gambling using interactive
technology. This study included a nationally representative telephone survey of 15,006 adults,
an online survey of gamblers (N=4,594), interviews with interactive gamblers (N=50) and
gamblers seeking treatment (N=31), and collection of data from gambling help services.
Key questions to be examined include, whether Internet gambling increases gambling
participation overall, and decreases land-based gambling; whether youth are likely to gamble
online; and whether Internet gambling will increase rates of gambling problems. Results from
this multi-modal study demonstrate how research can inform important policy questions as
well as practice including guiding treatment and prevention initiatives for Internet gambling.
Co-authors: Alex Russell, Nerilee Hing, Robert Wood, Dan Lubman, Alex Blaszczynski
Ms Lisa Gibson
Senior Research Officer, National Cannabis Prevention & Information Centre
Co Authors - Dr Nicole Clement, National Cannabis Prevention & Information Centre, Prof Jan
Copeland, National Cannabis Prevention & Information Centre
Testing the Feasibility and Potential Efficacy of a Very Brief Intervention for Cannabis Users in
an Emergency Department Setting
Introduction: Contrary to historical belief, cannabis is addictive. Lifetime cannabis use disorders
(CUD) are reported to affect 7.5% of the Australian population, and the harms associated with
regular/heavy use of the drug pose important public health concerns. Although brief
interventions (BIs) have been successfully employed as a public health approach for reducing a
range of health-limiting behaviours, including substance use; very little research has been
conducted on the efficacy of BIs for cannabis use. This study aimed to develop and assess the
feasibility, acceptability, and likely efficacy of a very brief (5-10 minutes) intervention (VBI) for
cannabis users in an ED setting.
Method: This was a one-sample, pre-post feasibility study. Patients presenting to a Sydney ED
were screened for recent cannabis use. Participants were delivered a VBI consisting of brief
assessment and personalised feedback. Measures assessed included cannabis use (quantity and
frequency), motivation for change, dependence severity, and cannabis-related problems.
Follow-up phone assessments were conducted approximately one month later.
Results: Preliminary analyses (n=24) show a significant reduction in frequency of cannabis use
(T = 28, p = .02, r = -.33), and severity of dependence scores (T = 14, p = .02, r = -.32). Trends
towards reduced cannabis-related problems and increased motivation to reduce/quit use were
also noted but did not reach the .05 level of significance. Recruitment will conclude at the end
of 2014. Full analyses will be presented.
Discussion: These preliminary findings provide support for the potential efficacy of a VBI for
cannabis users. Further analyses conducted on the final sample (n~52) will be required to
confirm and expand upon these results. Establishing the efficacy of VBIs has important
implications for those at-risk of experiencing addiction and CUD by intervening early and
bridging the gap between prevention activities and treatment.
Mr William Gilmore
Research Fellow, National Drug Research Institute
The impact of licensed outlet numbers on short- and long-term effects of alcohol use
Aims: To assess the association between numbers of licensed outlets in Queensland
communities and hospitalisations among residents for both acute and chronic alcohol-related
conditions.
Methods: Counts of hospital separations for conditions known to be wholly alcohol-related
(acute and chronic) at postcode level formed the dependent variables. Counts of off-site and
on-site licensed outlets within a 2km and between a 2 and 5km radius of postcode centroids
formed the key explanatory variables. Multivariate negative binomial regression models were
constructed controlling for age and gender of hospital cases, demographic and socio-economic
factors, accessibility/remoteness and year (2008/9 and 2009/10).
Results: Both off- and on-site licensed outlet counts were positively associated with short-term
effects that are wholly alcohol-related (alcohol poisoning, acute intoxication, harmful use). Offsite outlets were positively associated with wholly alcohol-related long-term effects (alcohol
dependence and psychosis, degeneration of nervous system due to alcohol, alcoholic
myopathy, polyneuropathy, cardiomyopathy, cirrhosis, gastritis and pancreatitis) while on-site
outlets were negatively associated with these health outcomes.
Conclusions: Increased alcohol availability through higher numbers of alcohol outlets was
consistently and significantly associated with admissions related to acute intoxication which
arises from excessive episodic drinking. The role of off-site outlet numbers in relation to
chronic harms was expected. The observation that on-site outlets protect against chronic harms
is unexpected and not typically found in the literature. This is possibly indicative of heavy and
dependent drinkers having a reduced preference for on-site outlets due to the higher prices
when compared to off-site outlets. These findings strengthen the evidence-base for a
precautionary approach in relation to liquor licensing policy and practice in Australia.
Ms Kate Graham
Manager Withdrawal and Coordinated Care, Windana Drug and Alcohol Recovery
Working in partnership to implement a comprehensive service coordination initiative ‘“
Windana’s response to the Victorian AOD reform
In 2014 Windana initiated an internal review and re-structure of its service system to meet the
demands of the Victorian Statewide AOD reform.
The aims were to ensure:
Timely and appropriate interface with the new central intake and assessment model
That clients were medically assessed pre-admission and appropriately prepared for their
withdrawal admission
Timely access to and improved management of withdrawal beds and stepped care models (non
residential withdrawal)
A comprehensive and seamless treatment journey (internally & externally) for all clients based
on the principles of Service Coordination
Access to sustainable medical, mental health and other identified services pre and post
withdrawal for all clients
The outcomes included:
The establishment of an interdisciplinary team (Admissions & Care Coordination team) to
manage incoming referrals for the adult and youth residential withdrawal services.
The team brings together a range of clinicians and services including:
Admissions Coordinator
Withdrawal Assessment Nurse
Service Coordinator (improved identification of family & family violence issues)
Dual Diagnosis Clinician
Care & Recovery Coordinator
Methamphetamine (ICE) Coordinator
As part of this model, Windana has formed a partnership with a specialist AOD community
based General Practice clinic to provide pre-admission and day of admission medical
assessments, medical monitoring of withdrawal episodes, interdisciplinary post withdrawal
discharge planning and secondary consultation with addiction medicine specialists.
This model facilitates pre and post withdrawal therapeutic groups for clients based on ACT
principles. This aims to increase the number of clients following through with admission to
residential withdrawal along with providing supportive after care options and engagement with
the objective of reducing recidivism rates.
Additionally, this model provides for a more robust response to methamphetamine use by
employing an ICE coordinator who engages with clients on intake and provides care
coordination from screening through admission and post withdrawal.
Mrs Martina Greenaway
District Drug & Alcohol Service Clinical Nurse Con, Murrumbidge Local Health District
"Do We Have To Bare Our Very Soul"
For the purpose of this paper Clinical Supervision (CS) is considered to be the process of which
two or more professionals formally meet, to reflect and review current caseloads in relation to
complex clients. The author examined the evidence base through a literature review and a
surveyed clinician’s to explore the challenges to participation including barriers, resistance and
reluctance which prevent some members of the workforce participating.
The author draws on her experience of CS in Belfast, Northern Ireland and Community Mental
Health Drug and Alcohol (CMH D&A) Wagga. CS requires important part of a willingness and
commitment by the practitioner to be open, honest and engage fully in reflective practice using
models of reflection which really doesn’t involve “the baring of ones very soul”. If it is not
possible for the clinician’s then they “may have to bear their very souls” which will be difficult
and unpleasant
There are some major differences within the structure and location of the workforce in Wagga
CMH D&A compared to that of Belfast. In Belfast the workforce is predominately Nurse led,
with small numbers of allied health professionals.
In Wagga the location is rural and in contrast, the majority of the workforce within CMH D&A
are Allied health Professionals as opposed to Nurses. CS appears not to be so strongly
embedded within education establishments as like it is in Belfast.
The author was able to establish that there are many barriers to commencing CS both
organisational and personal. The organisational barriers result from political and professional
conflicts, lack of understanding, constraints on clinician’s time and limited resources of health
care. Personal barriers relate to the way in which individuals perceive themselves in relation to
CS including emotions such as fear of change, lack of confidence, knowledge, skills or
understanding.
It is suggested that the way forward is to build on what we have and use that expertise around
communication and interpersonal skills to share the knowledge with the workforce as a whole.
Dr Ashleigh Guillaumier
Post-Doctoral Research Associate, The University of Newcastle
Co Authors - Dr Amanda Wilson, University of Newcastle, Prof Anthony Shakeshaft, National
Drug and Alcohol Research Centre
Smoking cessation in drug and alcohol treatment settings: insights from focus groups with
staff and clients
Issues: In Australia 77-95% of people entering drug and alcohol treatment smoke tobacco.
Tobacco treatment guidelines recommend smokers with dependence be offered help to quit.
However, drug and alcohol services rarely address tobacco smoking. In order to design
interventions to help increase delivery of smoking cessation care within the drug and alcohol
setting, and to increase uptake by clients, it is important to understand barriers and facilitators.
The aim of this study was to explore the barriers and facilitators for the implementation of
smoking cessation care in drug and alcohol treatment setting from the perspective of staff and
clients.
Approach: A qualitative study was conducted in four government-funded drug and alcohol
services in NSW, Australia. In-depth interviews were conducted with 20 staff and two focus
groups with 11 clients who smoke were held. Key Findings: Staff indicated they do not routinely
speak to clients about quitting smoking. Staff believed that tobacco was a serious health
concern and an appropriate part of their role. Barriers identified were largely related to the
system of care: a lack of acknowledgement that tobacco is a drug like other illicit drugs, lack of
resources and lack of dedicated time. Clients reported previous attempts to quit, and a desire
to quit but no offer of help from the treatment services. They reported they would like to
receive assistance from staff.
Conclusion: This study found that drug and alcohol treatment clients would accept an offer of
help to quit smoking from staff. Staff need organizational support to address their clients
smoking.
Implications: The study has important implications for the introduction of routine and
systematic provision of smoking cessation support for drug and alcohol clients. The results
suggest that strategies that build the capacity of drug and alcohol treatment services and staff
to address client tobacco use are needed.
A/Prof Leanne Hides
ARC Future Fellow, Queensland University of Technology
Co Authors - Professor Sharon Dawe, Griffith University, Dr Rebecca McKetin, Australian
National University
Primary and substance-induced psychotic disorders in methamphetamine users
There is extensive evidence indicating that a sufficiently high dose of methamphetamine (MA)
will result in psychotic symptoms.
This study investigates the rates of primary psychotic disorders (PPD) and substance induced
psychotic disorders (SIPDs) in MA users accessing needle and syringe programs (NSPs).
The aim was to determine if there are systematic differences in the characteristics of MA users
with PPDs and SIPDs compared to those with no psychotic disorder. Participants were 198 MA
users reporting use in the previous month. Diagnosis was determined using the Psychiatric
Research Interview for DSM-IV Substance and Mental Disorders (PRISM-IV). Current psychiatric
symptoms and substance use were also measured. Just over half (N=101) of participants met
DSM-IV criteria for a lifetime psychotic disorder, including 81 (80%) with a SIPD and 20 (20%)
with a PPD. Those with a younger age of onset of weekly MA use were at increased risk of a
lifetime SIPD. A current psychotic disorder was found in 62 (39%), comprising 49 SIPDs (79%)
and 13 PPDs (21%).
MA users with a current PPD were more likely to have received psychiatric treatment in the
past month than those with a current SIPD, despite a similar level of psychotic symptom
severity. A high proportion of MA users accessing NSPs have psychotic disorders, the majority
of which are substance-induced.
Miss Ashleigh Hilder
Occupational Therapist, Windana Drug and Alcohol Recovery
The Sensorium: Sensory Modulation Within a Residential Treatment Setting
Sensory modulation is defined as ‘the capacity to regulate and organise the degree, intensity
and nature of response of sensory input in a graded and adaptive manner.’ This allows the
individual to achieve and maintain an optimal range of performance and to adapt to challengers
in daily life.
Research has shown that individuals whom have had experience with addictions, trauma,
mental health and problematic behaviours find it more challenging to regulate sensory needs
and stressors.
As the majority of residents at Windana Therapeutic Community suffer from traumatic histories
in relation to their substance use, they require assistance to learn what sensory modulation
techniques will aid them to reduce the severity of disruptive and aggressive behaviour.
This presentation will explain a new therapeutic intervention which has particular relevance to
the AOD sector as the inability to regulate sensation can impair behavioural responses within
this population.
Dr Suzie Hudson
Program Manager, Network of Alcohol and other Drugs Agencies (NADA)
NADAbase: Unlocking the potential of client outcome data collection.
In an ever evolving alcohol and other drug (AOD) treatment environment, routine collection of
client outcomes have become key in informing quality service provision to clients and securing
ongoing funding. In 2008 the Network of Alcohol and other Drugs Agencies (NADA) undertook
the development of an online client outcome measures database for use by their non
government AOD treatment organisations. ‘NADAbase’• now holds over 5500 client outcome
surveys for 53 treatment services and has been instrumental in the movement of the NSW AOD
treatment sector into client outcome informed service provision. NADA member organisations
have used client outcome data collected via NADAbase to inform innovative projects, and a
selection of these will be presented to demonstrate the possibilities of this kind of data in
improved treatment for clients and AOD worker-driven research.
The value of NADAbase as a central repository for NSW non government AOD sector client
outcome data is also beginning to be explored ‘“ specifically in relation to the potential for
benchmarking. AOD industry benchmarking is gaining interest in the context of changed
funding environments, and NADAbase has the potential to explore benchmarking at a service
level (between services), at a sector level (across non government and government domains)
and across Australia at a state level.
Outcomes from the presentation will be an overview of the NADAbase client outcome
measures management system and its implementation, examples of innovative projects that
have harnessed client outcome data and, aggregated data that will provide some insights into
who is accessing treatment in NSW and the impact of AOD treatment on their substance use,
mental health and general wellbeing.
Mr David Hunt
Area Coordinator for SA, TAS and VIC, SMART Recovery Australia
SMART Recovery is putting the ‘mutual’ in mutual-aid: Digital and research innovations that
will help connect clients, communities and treatment services with effective longer-term
support
Depending upon the state you live in, 2015 sees AOD sector reform either undergone,
underway or on the horizon. Change is being felt or anticipated. Though the implications for
clients and organisations will vary, a lack of funding for longer-term support appears a reliable
constant.
Led by peers or professionals, SMART Recovery Australia’s (SRAU) CBT-focused mutual-aid
groups are free and ongoing. They offer an opportunity to build a network of cost-effective
support consistent with evidence-based practice. SMART Recovery Australia is developing
online services to compliment face-to- groups and make this adaptive, person-centered support
increasingly relevant and accessible to everyone. At the same time, research projects are being
undertaken to develop the evidence-base and forge mutually beneficial relationships with
clinical services.
SRAU’s online developments in 2015 will connect people challenged by addiction, helping them
help each other. The SMART Online Community’s discussion forums will offer a chance to
engage with others 24/7. Online ‘real-time’ groups will help those living in rural and/or remote
areas access addiction support. Trained SRAU facilitators will have their own forums to share
ideas and experiences. The online space will also mean better and more frequent contact with
facilitators, and create avenues for feedback and data collection.
Researching and evaluating community-based ‘mutual-aid’ or peer-driven interventions has
historically been difficult. In 2014 SRAU established the Research Advisory Committee (RAC).
Comprising renowned experts in the field of AOD research, the committee has settled upon 3
key aims in 2015. 1: To collate and review existing research on SMART Recovery alongside other
addiction peer-support modalities such as 12-step. 2: To conduct a census of who attends
SMART Recovery, and 3. To begin a collaborative experimental pilot study to evaluate
outcomes from linking clients involved with AOD services in Victoria with SRAU groups.
Dr Mofizul M Mofizul Islam
Lecturer/Research Fellow, Australian Primary Health Care Research Institute
Co Authors - Mr Peter Jack, University of Sydney, Prof Katherine Conigrave, Royal Prince Alfred
Hospital and Sydney University
Which alcohol screening tool is likely to be suitable for routine use in primary health care
services targeting Aboriginal and Torres Strait Islander Australians?
Objective
The sensitivity, specificity and optimal cut-off score of alcohol screening tools may vary
according to the population screened. Given the considerable differences between Indigenous
and non-Indigenous cultures and histories, and often differing drinking patterns, a screening
tool effective in other populations may not be accurate and acceptable among Indigenous
populations. However, to date there have been few investigations on this. This study examines
brief alcohol screening tools that are likely to be suitable for routine use in primary healthcare
services targeting Indigenous Australians, and provides an overview of available evidence which
can inform the choice of tool.
Methods
A review of available literature (up to end July 2014) was undertaken using the following steps:
(i) identification of appropriate brief alcohol screening tools containing no more than 10
questions based on clinical performance, cultural and practical criteria, (ii) assessment of
systematic reviews, meta-analyses, and descriptive reviews on those brief screening tools,
following AMSTAR guidelines, (iii) a narrative synthesis of Indigenous Australian-specific
literature on alcohol screening, and (iv) synthesis of results from the above steps, based on
their strengths/quality and authors’ clinical and public health experience of working with
Indigenous clients, Aboriginal community controlled agencies and with Aboriginal health
professionals.
Results and conclusions
Based on available literature on key instruments which have been validated in broader
communities, in several cultural groups, and in some cases, among Indigenous Australians, we
recommend the 3-item AUDIT-C. Plain English translations of this tool, and assistance (by visual
aids, clinicians or technology) should be available to assist in accurate description of quantity
and frequency of consumption. To increase opportunity for sensitive and empathic discussion
of unhealthy drinking, we recommend a relatively low screening cut-off, 3+ for women and 4+
for men, with the option of administering remaining AUDIT questions for those who screen
positive for AUDIT-C.
Mr Dave Kelly
Clinical Liaison Consultant, Peninsual Health Alcohol and Other Drug Services
Screening for AOD use in Emergency Department Setting the Standard
Screening for Alcohol and Other Drug (AOD) use within community settings provides an
essential pathway into treatment that can be utilised to identify hazardous use and
dependence among individuals who wish to address their use. When examining acute settings
such as Emergency Departments, a number of studies have concluded that screening for AOD
use should be built into the triage system as clinicians perceive it as a critical component of
hospital management for the patient.
Commencing in May 2014, staff at Peninsula Health Emergency Department commenced AOD
screening of all persons over the age of 18. The screening is short, achievable and provides
both staff and patients with further AOD treatment options such as inpatient, residential or
community programs. Preliminary data sets are indicating that screening provides early
detection of hazardous use and better pathways into treatment for those who present to the
ED.
In March 2015 Peninsula Health will unveil a new and expanded ED at the Frankston Hospital. In
the first quarter of 2014-2015, the current department treated a total of 22254 presentations.
This is an increase of 8.4% on the previous year. The high number of presentations means that
an effective intervention developed and implemented within the Frankston ED could be readily
adapted within other Victorian Emergency Departments. The Frankston ED is also an ideal site
to evaluate an early intervention because an electronic screening system utilising the AUDIT-C
has recently been embedded into routine care. Utilisation of electronic screening for alcohol
use has been found to significantly increase compliance.
Dr Peter Kelly
Senior Research Fellow, University of Wollongong
Co Authors - Prof Amanda Baker, University of Newcastle, Prof Frank Deane, Illawarra Institute
for Mental Health
Understanding the active ingredients of SMART Recovery: perceptions of group members and
group facilitators
Mutual support groups are the most widely accessed form of alcohol or other substance abuse
treatment. Self-Management and Recovery Training (SMART Recovery) is a not-for-profit
organisation that provides mutual support groups for people experiencing problematic
behaviours. There are currently over 120 active SMART Recovery groups in Australia, with more
than 700 groups being delivered worldwide. Whilst the theoretical framework used by SMART
Recovery was intentionally developed to reflect current evidence based approaches, there has
been a lack of published research specifically examining SMART Recovery. The current study
aimed to explore the perceptions of both group members and group facilitators regarding the
active ingredients of SMART Recovery.
A cross sectional survey was developed and distributed within SMART Recovery groups
throughout Australia. The participant survey examined the participants self reported use of
cognitive behavioural skills, group cohesion and the quality of group facilitation. Both the
participant and facilitator surveys specifically examined perceptions regarding the most helpful
active ingredients associated with SMART Recovery.
One hundred and twenty four group members and 65 group facilitators completed a crosssectional survey. Regression analyses indicated that group cohesion significantly predicted use
of cognitive restructuring, but that only provision of homework at the end of each group
session predicted self-reported behavioural activation. Participants identified the ‘group
process’• and the specific ‘tools and strategies’• recommended as part of the groups as being
the most helpful aspect of SMART Recovery. Facilitators rated ‘tools and strategies’• and the
‘underlying philosophy of SMART groups’• as being the most helpful aspects of SMART
Recovery.
SMART Recovery is an important component of the drug and alcohol treatment field.
The current research helps to highlight the active ingredients of this approach. It is important
that future research examine how these active ingredients influence substance use outcomes in
the longer-term.
Ms Michelle Kent
Mental Health Specialist Pharmacist, Barwon Health
Co Author - Ms Anna Treloar-Tanner, Barwon Health
Smoking & You' - A unique Pharmacist & Occupational Therapist co-facilitated inpatient client
education group in an acute mental health unit
Introduction: It is well established that Mental Health consumers have a higher smoking rate
than the general population. There is a drive from government and healthcare professionals to
reduce the smoking rate to prevent and reduce comorbidities. In response to this imperative, as
well as client requests a multidisciplinary smoking reduction education group was established
on the 32 bed acute inpatient mental health unit at Barwon Health.
Aim: To empower inpatients with information about smoking reduction and to provide support
with interventions specific to the individual needs of MH clients.
Method: A fortnightly client group was established on the acute ward covering pharmacological
interventions, sensory modulation techniques and social factors. The interactive discussion
group structure is flexible and can be modified to meet the individual needs of the clients
choosing to attend.
The group provides the opportunity for inpatients to trial sensory modulation techniques with
the support of a MH OT, as well as nicotine replacement therapy options and other medications
with a MH pharmacist. Clients have access to SM items and NRT to trial during the group, and
variety of multilingual client educational material is available. Ward nursing and medical staff
are encouraged to attend to provide further support and improve follow-up.
The participating clients benefit from a group co-facilitated by specialist clinicians based on the
acute ward who provide follow-up to optimise utilisation of new skills and uptake of
medication. Clients have the option of being referred to an outpatient clinic after discharge.
Outcome: Inpatient uptake of the recovery orientated group has been consistent with positive
feedback from consumers, carers and clinicians. Ongoing evaluation of the group through
feedback as well as smoking rates on the ward ensures that the content of the group continues
to be relevant to consumer needs.
Dr Anna Kokavec
Senior Lecturer, University of New England
Contribution of personality, motives, coping and licit drugs to illicit substance use in
university students
University students routinely report consuming licit drugs (e.g. tobacco, alcohol) at rates
greater than those of their non-student peers. Moreover, young adults in the 18-25 year age
range also report illicit drug use (e.g. cannabis, amphetamine-type stimulants) at rates greater
than those of other age groups.
Previous research has revealed personality, sensation seeking, self-reported motives, and
coping style to be important considerations. However, more work is required in this area. The
aim of the present investigation was to identify the significant predictors of substance use and
explore the potential interactions between predictors and their effect on reported substance
use rates. Data from a total of 324 university students was available for analysis. Participants
were required to complete a series of self-administered questionnaires relating to personality,
mood, motives, coping, demographic factors and consumption of licit and illicit substances.
The results showed that consistent with what is already known university students report
consuming alcohol at hazardous and harmful levels and their reasons for doing so is based on
social/enhancement factors. Sex differences were noted with males consistently scoring
significantly higher than females on measures of alcohol, cannabis, and amphetamine-type
stimulant use. Personality factors, in particular sensation seeking was identified as a significant
predictor of alcohol, cannabis and amphetamine-type stimulant use. Coping style was a
significant predictor of alcohol and cannabis use and a significant interaction was noted
between increased smoking while drinking and sensation seeking with respect to illicit
substance use (only).
It was concluded that there is a link between licit and illicit substance use. However, the link is
more likely associated with a combination of alcohol and tobacco consumption, similar to what
is observed in social smoking, rather than regular tobacco consumption or alcohol consumption
alone.
Prof Lawrence, T. M. Lam
Professor, The Hong Kong Institute of Education
Co Author - Dr Emmy M. Y. Wong, The Hong Kong Institute of Education
Parental Internet behaviour, stress and Problematic Internet Use in adolescents: A parentchild dyad study
Purpose
Based on the theoretical framework of Problem Behaviour and Stress reduction theories for
Problematic Internet Use (PIU), this study aimed to investigate the relationship between
parental PIU and the PIU among adolescents taking into consideration the stress levels of young
people.
Methods
This was a population-based parent-and-child dyad health survey utilising a random sampling
technique. PIU for both parents and their children was measured by the Internet Addiction Test
(IAT) designed by Young. The stress level of children was assessed using the Stress sub-scale of
the Depression, Anxiety, Stress Scale (DASS). Data were analysed using logistic regression
modelling techniques with adjustment for potential confounding factors with analysis on the
modification effect of stress level on the relationship between parent-and-child PIU.
Results
A total of 1098 parent-and-child dyads were recruited and responded to the survey providing
usable information. For PIU, 263 (24.0%) students and 62 (5.7%) parents could be classified as
moderate and severe users. About 14% (n=157) of students could be classified with moderate
to severe stress. Regression analysis results suggested a significant interaction between
parental PIU and children’s stress level on children PIU. Stratified regression analyse by stress
level resulted in a significant parent-and-child PIU relationship in the low stress group (OR=3.18,
95%C.I.=1.65-6.14). On the other hand, the association between parent-and-child PIU in the
high stress group became insignificant.
Conclusions: Results suggested there was a significant parent-and-child PIU relationship,
however, this relationship is differentially affected by the stress status of the child. These
results have direct implications on the treatment and prevention of mental problems among
young people.
Mr Harry Mayr
Principal Psychologist, St Marys / Penrith Psychological Services Pty Ltd
The ‘Circles Concept’ of Addiction ... an empowered framework for change.
The ‘Circles Concept’ of Addiction ... an empowered framework for change.
In this simple, yet practical, therapeutic approach to assisting those with addiction issues, the
reasons for such behaviour, potential alternatives, and recovery from such problematic escape
behaviours are concentrated upon and illustrated.
People chose to 'escape' from their lives, to distance themselves from reality and certain
presenting issues, to 'feel good', to achieve power and a sense of control. Some of these
chosen escape behaviours become problematic (addictions) and some do not. Those that do
not seem to provide a positive escape space, renewed energy, motivation and encouragement
to the individual - to actively understand and address their presenting life issues, and effectively
adapt to or resolve them. Escape behaviours that become problematic seem to occur because
the short-term escape they provide from life issues, the associated pain relief and denial, and
the associated sense of disempowerment to address and resolve anything become habitual and
consuming (of the individual's time, thinking and behaviour).
The 'Circles Concept of Addiction' allows a simple yet effective visual representation of the
process just described, and a means to understand, prevent and overcome it. It is a simple yet
effective diagnostic, educational and treatment tool and approach.
Therapeutic recovery begins with an understanding of the above, and a want to change. The
'circle' of the addict then becomes the 'circle' of the non-addict. Psycho-education, valid
alternatives, a minimisation of accessibility and a reduction in problematic behaviour and
thinking begin this process. Further effective 'filling' of the life circle with support, counselling,
employment, time structuring and more, complete it.
Ways in which the 'Circles Concept of Addiction" can be utilised in assisting the addict as well as
their support systems, professionals, the media, associated venues, the community at large and
future research is also presented.
Ms Joanne Mazzola
National Prevention Officer, Drug Arm Australasia
AOD Prevention: Theory into Practice
"In theory, theory and practice are the same. In practice, they are not." Albert Einstein.
Introducing myAODPrevention.org.au a new national AOD prevention resource for workers
launched in early 2015.
In 2012, DRUG ARM Australasia secured funding from the Department of Health and Ageing
under the Substance Misuse Prevention and Service Improvements Grants Fund for a national
prevention resource project. The rationale for this project has been recognition for the AOD
Prevention workforce in Australia, and an increase in connectedness and access to best-practice
models, resources and strategies for primary, secondary and tertiary AOD prevention.
The website is broken into theory, knowledge and practice sections, covering a vast range of
skill development and contribution opportunities. This includes theoretical foundations, AOD
prevention best practice, key strategies, documents, readings and resources, and, a practice
workspace covering AOD prevention project write ups, information topics and perspectives by
prevention workers, best practice approaches, problem solving, and learnings through peer
support forums.
Dr Tania McMahon
Senior Research Officer, Queensland University of Technology
Co Author - Professor David Kavanagh, Queensland University of Technology
Internet Use Disorder: A better category for diagnosis than Internet Gaming Disorder?
Aims: This study compared potential diagnostic criteria for ‘Internet Use Disorder’ with those of
DSM-5 Section III ‘Internet Gaming Disorder’, to determine whether the two should be separate
nosological entities.
Design: Online survey.
Setting: International.
Participants: 430 Internet users.
Measurements: Time spent online, self-rated problems, distress, 14 potential Internet Use
Disorder criteria (adapted from DSM-IV and DSM-5 substance use and pathological gambling
criteria), and 9 DSM-5 Section III Internet Gaming Disorder criteria.
Findings: Twelve Internet Use Disorder criteria, including Neglect of hygiene and responsibilities
showed strong internal coherence. The 12 criteria were able to significantly predict distress
even after control for fulfilment of DSM-5 Internet Gaming Disorder criteria and after removal
of participants who said their distress was unrelated to Internet use. The number of proposed
Internet Gaming Disorder criteria that were fulfilled predicted only 6% of the variance in the
number of Internet Use Disorder criteria that were fulfilled, suggesting little overlap between
these categories.
Conclusions: Our findings provide support for Internet Use Disorder as a separate nosological
entity and evidence for further refinement of potential diagnostic criteria.
Ms Sheridan Meulblok
Psychologist, Western Region Alcohol and Drug/Sophrosyne Psychol
Control, Escape and Men's pain: Practice Based experiences of working with Male Comorbid
Eating Disorders and Substance Abuse
The author aims to raise awareness to clinical and practice based issues relating to males
presenting with comorbid conditions of substance abuse and eating disorders through a shared
account of her therapeutic experience with this population. Specifically the author would like to
flag to her colleagues the surprisingly high volumes of adult males she has seen over the last 18
months with both issues related to disordered eating and co-occurring substance abuse, after
commencing private practice in a bulk billing medical clinic that is also co-located with a drug
and alcohol service.
Prior to this, despite offering specialist treatment in the eating disorder field, the author found
in her experience that males rarely presented for treatment. The paper offers practical insights
drawing from rich therapeutic experiences with these men in relation to issues including
delayed detection and diagnosis of eating disorders, engagement, diversity of presentations
and background stories.
The application and benefits of the trans-diagnostic treatment model Acceptance Commitment
Therapy is discussed with the suggestion that it provides both an adaptive and effective way to
address multiple clinical issues concurrently whilst providing a meaningful link between the
client’s relationship with food and substances through concepts such as experiential avoidance,
conscious awareness and willingness.
Whilst ethical dilemmas such strengthening the clients ability to regulate substance urges may
in turn inadvertently give them the tools to override hunger cues is considered. A model of
collaborative care in the rural sector between drug and alcohol, private practice and medical
services is briefly overviewed.
Ms Suzy Morrison
Consumer Project Lead, Matua Raki
Co Author - Anna Nelson, Matua Raki
AOD and Older People – A view from Aotearoa/New Zealand
There is growing evidence that problematic substance use is poorly diagnosed in older people.
When it is accurately diagnosed, referral to services is less likely than for other problems (Royal
College of Psychiatrists, 2011; Centre for Substance Abuse Treatment, 1993).
Older people may show more complex patterns of substance use such as alcohol combined
with inappropriate use of prescribed or over-the-counter, medications. According to Centre for
Substance Abuse Treatment, (1993) problematic substance use, particularly of alcohol and
prescription drugs, among older adults (60+) is one of the fastest growing health problems.
Despite this the Centre for Substance Abuse Treatment (1993) note that even as the number of
older adults diagnosed with this disorder climb, the situation remains underestimated, under
identified, under diagnosed and untreated. Until relatively recently, the problematic use of
alcohol, prescription drugs and/or over the counter medications was not discussed in either
substance use disorder and/or gerontological literature.
An adequate knowledge of substance use disorder in older people is essential. Addressing
stigma, grief and loss and social exclusion are very important when working with this
demographic. Skills in screening, assessing, engaging and delivering an intervention are core
competencies for best practice in supporting and making visible these often unrecognized and
unacknowledged members of our society.
Matua Raki, the national addiction workforce development agency in Aotearoa/New Zealand
responded to this need for specific training. An Introduction to working with AOD & Older
People was developed and delivered to the addiction and mental health workforce. This was
followed by the development and delivery of an advanced training for working with AOD &
Older People.
Ms Anna Nelson
Anna Nelson-Programme Lead, Matua Raki
Addiction Workforce Development - The Aotearoa New Zealand experience
Matua Raki are Aotearoa New Zealand’s National Addiction Workforce development centre.
Developed in 2004 as a result of recommendations by the Ministry of Health, Matua Raki work
to build the capability and capacity of the specialist addiction sector, as well as others who may
work with people with problematic substance use.
Addiction workforce development in Aotearoa New Zealand utilises a comprehensive approach
that includes initiatives at infrastructure and organisational levels, as well as training,
education, recruitment and retention activities aimed at workforce planning and individual
practitioner competency. Matua Raki also work closely with dapaanz (Addiction Practitioners
Association Aotearoa New Zealand) the professional body for addiction practitioners (including
problem gambling and smoking cessation practitioners).
This session will look at the role of workforce development in supporting the AOD workforce,
cover a number of Matua Raki’s projects and offer some considerations for future addiction
workforce development internationally.
Dr Latha Nithyanandam
General Manager, ADFNSW- Kathleen York House
The Theory and Practice of Yoga as a treatment module for Addictive Disorders
Yoga for wellbeing is gaining popularity universally. Its acceptance as a complementary form of
treatment for many physical as well as psychological problems is being recognized by many
health professionals all over the world. Especially it has been researched in the treatment of
addictions for several decades. One study performed by the Harvard Medical School found that
yoga was as effective as traditional psychotherapy in assisting clients who were part of a
methadone program (Shaff er, LaSalvia, & Stein 1997).
However not many people know that Yoga is much more than the popularly known physical
stretches and poses. It promulgates a practical theory for emotional as well as physical
wellbeing.
The term Yoga literally means ‘union’; in a broad sense it implies the union of the body and the
mind. It is based on a theory that includes 8 aspects. Body postures and stretches, breathing
techniques and meditation are the three most commonly known aspects of Yoga. The other
aspects relate to relationships and communication with others as well as with oneself, attitude,
the spirit of enquiry, state of relaxation, restraint especially withdrawing from engagement
through the senses etc.
The use of this technique as a method of psychological intervention is slowly gaining ground in
the field of mental health. It offers a long-lived method to overcome suffering and reach higher
consciousness. Nespor (2001a) incorporated yoga practices of meditation, postures, breathing,
with attention to the 8 aspects to help people overcome their addictions. Yoga uses each of
these tools, and through their practice improves regulation of the mind-brain-body system, it
enhances self-direction through self-awareness. The result is an accessible set of invaluable
interventions for overcoming psychological problems. As per contemporary interventions for
addiction., it also runs closely to the 12 steps programme as well as the Jim Maclaine Self Help
Therapy Programme.
Dr Julie Nos
Psychologist, Lives Lived Well; Private Practitioner
A Longitudinal Study Investigating the Bi-directional Relationship of Impulsivity and
Substance Use in Australian Adolescent Males and Females
Adolescence is a period of development characterised by risk taking typically involving the
initiation and escalation of alcohol and drug use. Adolescence is also a critical period of
neurobiological change behaviourally manifested as increases in impulsivity. Contemporary
models of personality conceptualise impulsivity as a trait with at least two related but distinct
factors. This model assumes that personality influences substance use however it is also
possible that substance use may influence the development of personality.
The current study investigated the bi-directional relationships between reward drive and rash
impulsivity, and alcohol use and substance use problems in males and females, whilst taking
into account known risk factors.
A prospective longitudinal design was used involving 1059 Australian adolescents (males = 526,
females = 533) followed up annually for 5 years from Grade 8 to Grade 12. Using Latent Growth
Modelling (LGM), the results of this research provided support for a two-factor model of
impulsivity. Further, evidence was found for a bi-directional relationship between personality
and substance use. As expected, reward drive and rash impulsivity both contribute differentially
to the escalation of substance use.
The converse of this relationship was also found where substance use influenced personality
development. These findings highlight the importance of early detection and intervention for
high risk adolescents.
Dr George O'Neil
Medical Director Fresh Start, Fresh Start Recovery program
The Development of a Naltrexone Implant Service for Opioids, Amphetamines and Alcohol in
Western Australia
The Fresh Start Recovery Programme in Perth, Western Australia over the past 17 years has
developed a naltrexone implant service for the treatment of opiate, alcohol and amphetamine
addiction. Currently in Australia, Western Australia is the only State with a well established
Government supported service with naltrexone implants for opioid, amphetamine and alcohol
treatment.
At the Fresh Start Recovery Programme, we have established best practice for the provision of
naltrexone implant services.
The talk will outline the following best practice protocols from the work carried out in Perth,
with discussion on the outcomes associated with this practice.
1. Abstinence from opiates, alcohol and amphetamines are targets
2. No waiting lists for patients presenting for detox from all three substances.
3. The use of buprenorphine detox 24-48 hours prior to naltrexone implant for opioids.
4. Naltrexone implant prior to detox for most alcohol patients.
5. Providing naltrexone implants prior to admission to our rehab facilities.
6. The provision of treatment to all patients without financial barriers
7. The understanding of higher blood levels of naltrexone required for amphetamine patients.
8. The addition of flumazenil services may be helpful with benzodiazepine addictions, ADHD,
anxiety disorders and in those recovering from amphetamine and alcohol disorders.
A review on implant vs. oral naltrexone established that detox without implants had 25 times
the opioid overdose mortality rates.
In Perth for 17 years the state government has provided funds to our naltrexone service while
no other Australian state government has provided support for a similar service. The cost
efficiency of the service will be discussed. This talk will answer question relating to why this
service has improved the range of options available to West Australian’s. Results from the past
17 years of research, including 2 RCT's will be discussed. Our publications on new treatments
for opioids, alcohol and amphetamines will also be discussed.
Dr Christine Palmer
Lecturer, Flinders University
Co Author - Ms Maria Maver
The good, the bad and the ugly: A personal story of recovery
Recovery from substance addiction is a challenging and tortuous process; a journey of faltering
small steps forward and tumbling falls backwards. This process is never the same for everyone.
For the non-drug user, the benefits of drug use are difficult to understand while the benefits of
drug abstinence on lifestyle and health seem obvious. Despite the often severe impacts on
physical and mental health, discontinuing drug use is extremely complicated, representing
enormous challenges to the person, their significant others and to the people who work
alongside them.
This is a presentation of Maria’s personal story of addiction to speed and her ultimate recovery.
Despite a traumatic childhood characterised by abuse and disrupted attachment, Maria came
late to substance addiction. This story aims to highlight the very personal nature of addiction,
the stigma that continues to frustrate attempts at recovery, and the key factors that enabled a
positive outcome for Maria. Not only has Maria discontinued illicit drug use, she has more
recently stopped using tobacco/nicotine after a lifetime of use.
Mr Kieran Palmer
Clinical Services Manager, Ted Noffs Foundation
Co Author - Leki Mafoe, Manager, CALM and Youth Homelessness Services, Noffs Foundation
Healing through Facebook: Social Media as a therapeutic tool for young people and their
families
Since 2010, the Noffs Foundation has been utilizing social media (Facebook) as a therapeutic
tool to connect with young people who may require assistance and/or support. Facebook has
been used for therapy (counselling), assessment, education and engagement with at-risk young
people. The advantages of using social media over more traditional forms of contact mean that
young people can access support worldwide, the service is free for the consumer and the host
organisation, conversations can be recorded if needed and it has been reported by clients as a
less threatening way of reaching out and seeking support than traditional methods of
communication.
A further advantage of using social media is that events and information that may be shared
with a larger audience, can also be published to service users via Facebook. CALM Sydney has
found since using Facebook, it has become the primary form of communication with clients and
continues to grow each year. Through the success of CALM using social media with clients, the
PALM (Program for Adolescent Life Management) residential treatment program has developed
a Facebook page for parents, guardians and other family members of service users who may
require support, guidance and education.
Through this presentation the audience will gain a practical understanding of the application
and benefits of using social media tools in the treatment, evaluation and follow up of young
people suffering AOD, mental health and associated concerns. Ethical and policy issues will be
discussed and solutions offered to counter any potential ethical considerations.
Mr David Peters
Policy Officer, Mental Health Carers ARAFMI NSW Inc
Social Exclusion & Addiction
The negative effects of social exclusion caused by addiction and methods of combating these
effects by developing hope and a sense of purpose.
Objective/Introduction:
Drug-related social exclusion can be approached in three ways:
as a risk factor for drug use and other harmful behaviours;
as a consequence - direct or indirect - of drug use;
social exclusion and drug use as co-occurring phenomena (EMCDDA, 2008).
People do not recover from addiction in isolation. Recovery is closely associated with social
inclusion and being able to take on meaningful and satisfying social roles within local
communities. Hope is central to recovery and can be enhanced by each person seeing how they
can have more active control over their lives (Manchester Mental Health, 2015).
In attempting recovery, a person needs to cultivate and nurture a new purpose in life, one that
can replace the previous purpose of a drug-related lifestyle, thus developing hope for the
future.
Method:
Using specific elements from various models of recovery, a program has been developed
directed at people at risk of homelessness, where AOD and mental health issues are prevalent.
The aim is to encourage participation, inclusion and a sense of belonging. The objective is to
assist in achieving a sense of purpose in each participant’s life, thus creating hope for
something new in which to build upon.
Results:
There is a core group of people that willingly attend the program each week, and a number of
these people have found volunteer and paid employment, alternative accommodation and feel
less socially excluded. This has resulted in a reduction of drug use of these participants.
Conclusion:
It is possible to reduce the effects of addiction by promoting social inclusion and a sense of
belonging, therefore developing a new sense of purpose and creating hope.
References:
European Monitoring Centre for Drugs and Drug Addiction (2008). Drug-related social
exclusion. Accessed 15 January, 2015 at
http://www.emcdda.europa.eu/themes/monitoring/social-exclusion
Manchester Mental Health (2015). The Principles of Recovery. Accessed 15 January 2015 at
http://www.mhsc.nhs.uk/services/recovery-education/the-principles-of-recovery.aspx
Mr Timothy Piatkowski
PhD Candidate, Queensland University of Technology
Body image and recreational drug use among young men in the 'Bruss' subculture
Introduction: An Australian subculture of young men - deemed ‘Brusses’ - spend a great deal of
time accumulating muscle mass to maintain a particular appearance (deemed to be attractive),
characterised by appearance-related identifiers such as suntans, minimum clothing, and their
own terminology/slang. The common use of anabolic-androgenic steroids (AAS) and/or other
body image drugs by young men who identify as part of this subculture is concerning,
particularly when combined with other illicit substances. This study aimed to gain a more indepth understanding of body image and recreational drug use in the ‘Bruss’ subculture.
Methods: Participants consisted of 14 young men aged 16 to 30 years who engaged in (1)
bodybuilding 3+ times per week, (2) daily use of bodybuilding supplements, and (3) had used
AAS or other body image drugs in the past/present. Semi-structured interviews were
conducted, ranging in length from 30-70 minutes. Interviews were recorded and then
transcribed. A content analysis was then utilised to identify the most common themes among
the group.
Results: Preliminary themes include: Body image issues in childhood and/or adolescence, low
self-confidence, lack of peer-group acceptance, unstable pattern of relationships, social media
pressures, 'Bruss' culture, sense of control, alcohol and recreational drug use, body image drug
use. Results suggest young men in this subculture are faced with the competing demands of the
rigidity of a strict weekly training, dieting and body image drug use versus a desire to escape
into illicit drug use at nightclubs and festivals.
Conclusions: Ecstasy and methamphetamine use in Australia is on the rise, particularly in the
nightlife and electronic-music festival scene. These data provide support for concurrent
recreational drug use among AAS users. This phenomenon is concerning as simultaneous use
would provoke different, and possibly more dangerous, physiological reactions than those
experienced by regular use of ecstasy, methamphetamine, or AAS alone.
Miss Vikki Prior
Owner & Principal Psychologist, Ringwood Psychology
Treating Pornography Addiction with Trauma-Focused Therapies
The rapid rise in individuals seeking treatment for Internet pornography addiction reflects
descriptions of pornography as the drug of the new millennium. As with other addictions,
excessive and dependent use of pornography is wreaking havoc on the social, occupational and
recreational lives of afflicted individuals. The detrimental impact on relationships and sexual
functioning is most notable, often presenting as an avoidance of engaging in sexual activities
with intimate partners, erectile dysfunctions and/or an inability to achieve orgasm in the
presence of partners, but not with solitary viewing of pornography. The never before seen rise
of erectile dysfunction in young adult males has also been attributed to excessive pornography
use, and research indicates that an earlier age of first viewing pornography is associated with
prolonged and less effective treatment outcomes. Such findings cast a bleak outlook with
research revealing the average age of first viewing pornography in Australian males is 9 years
old. The rise in pornography addiction presentations necessitates ensuring that therapists are
equipped with the tools and knowledge to effectively treat this condition. Unfortunately, there
is still no researched best-practice solution to pornography addiction, and what does exist has a
strong CBT focus.
This presentation explores trauma-focused therapies to resolve negative childhood experiences
and the subsequent emotional shut-down and avoidance of anger, sadness and anxiety ‘“
emotional states escaped via Internet pornography. Drawing on 8 years of data from private
practice clients identifying themselves as pornography addicts, this presentation will consider
risk factors in the form of traumatic childhood events and the impact of impaired attachment
formation, comorbid disorders, the escalation from pornography use to using sex services and
relationship infidelities, and the impact on intimate relationships and sexual functioning. In
summary, relapse prevention and positive treatment outcomes for problematic Internet
pornography use are enhanced by treating unresolved traumas and teaching techniques to
manage emotional states.
Ms Susan Russell
Clinical consultant, Clinical Counsultancy Service, NSW FACS
Co Author – Ms Michelle Ridley, Clinical Consultancy Service, NSW FACS
Aligning colliding worlds - A collaborative practice between addictions services and child
protection
Addictions services and statutory child protection services have traditionally had difficult
relationships. Child protection agencies are child focussed, requiring parents to engage with
services in a mandated capacity and request abstinence based outcomes to address the child
protection risks. Drug and alcohol services traditionally are adult focussed, require willingness
on behalf of the parents and use a harm minimisation approach. Historically both services have
worked independently due to different organisational cultures defined by values, norms,
beliefs, and policies, regulations and language.
These divergent views make it hard to engage and provide intervention to parents with
addiction issues and to address the safety and protection of their children. It also increases the
difficulties for services to meaningfully collaborate in order to improve outcomes for the child
and their parent(s).
The Clinical Consultancy Service in NSW Family and Community Services (FACS) was established
in 2007 in response to these difficulties to assist FACS caseworkers to bridge the gap between
child protection and parents with issues relating to drug and alcohol or domestic violence
and/or mental health. The service provides clinical guidance, access to research, information,
resources and case planning support to caseworkers to better assess parenting capacity and
improve their knowledge and practice in working with substance using parents.
Caseworkers are supported to improve their understanding of the risks and impact on children
of their parent(s) drug use; what services, supports or collaboration with others will reduce the
impact of serious and persistent drug use and in time frames that are both realistic for the
parent’s addiction and dependant upon the age of the child.
Case studies will be presented to reflect the complexities for these clients and how
collaboration and case planning can move from individualistic perspectives to a holistic,
multidisciplinary, multisystemic view of child protection to improve outcomes for families.
Ms Kristen Smith
Research Fellow, University of Melbourne
Co Authors - Professor Marcia Langton, University of Melbourne, Dr Richard Chenhall, University
of Melbourne
Alcohol policy and assemblages of intervention: Managing alcohol in Indigenous communities
Alcohol management plans are used as a central device in government policies for reducing
alcohol-related harms among Indigenous Australians, particularly in remote locations. AMPs
have been viewed as a viable way of creating a new and effective means to combat a range of
alcohol problems through the use of local community control over alcohol availability and
management of alcohol-related problems. However, there are many challenges in developing
and implementing AMPs in Australia. At a policy level, there are key challenges in balancing the
interests and principles of different, competing actors and sectors within society. The need for
informed understandings of how to ensure AMPs effectively address alcohol misuse and related
harms in the population increases as more AMPs are implemented across Australia,
predominantly in the northern jurisdictions.
This paper discusses some of the more critical factors impacting on AMP effectiveness through
addressing the complex contextual environments of AMPs and exploring their weaknesses and
strengths in specific settings. The paper sets out the findings from an ethnographic study of
AMPs conducted in the Northern Territory, based on qualitative, semi-structured, in-depth
interviews and focus groups conducted with a range of key stakeholders in Alice Springs,
Darwin, Katherine and the community of Jilkminggan. Some of the key themes explored in the
research include issues associated with complex and intersecting, multi-tiered government
policy and legislation, local implications for the contested interests of industry, public health,
communities and government, the need for integrated, regional responses, and factors that
have led to success within this increasingly volatile context.
The paper concludes with an exploration of how these findings can inform local, State, Territory
and Federal policy in developing more effective, inclusive AMPs, particularly within Indigenous
community contexts.
Ms Jo-ann Stenton
Secretary/Researcher, Ethnic Communities Drugs Taskforce
The Impact of Problematic Drinking On Family Members And Close Associates
This paper draws heavily on information in the exploratory study by Stenton, Best and Roberts
(2014)*, which sought information about the challenges to the health and well-being of family
members and close associates of a problem drinker, their access to support and satisfaction
with it. This included the awareness of health care professionals about the issues confronting
family members and referrals to mutual aid programs.
The data for his study was collected via a cross-sectional survey incorporating open-ended
questions for qualitative analysis and close ended questions for the quantitative analysis was
obtained from statistical information regarding age group, employment status, relationship to
the problem drinker, support programs attended, their level of satisfaction with them and their
subsequent perception of the impact on their state on their health and well-being. Respondents
were diverse, with many reporting problematic drinking in more than one close associate.
The results of this study demonstrated that the breakdown of relationships and lack of trust
was the most frequently recurring theme about the impact of close association with a heavy
drinker. Almost half of the respondents mentioned this whereas just under a third said that fear
of aggression and poor financial circumstances were major factors in their life becoming
miserable as a result of another person’s addiction.
In conjunction with the perceived seriousness of participants’ problems, the overwhelming
response to what effect belonging to a support program had on their lives was positive. Their
quality of life was perceived to have improved, many had a changed attitude to the drinker.
However the majority thought there was inadequate information about support programs in
the wider community, including health care professionals, hence access to them was restricted.
It is of interest to note that CALD (culturally and linguistically diverse) communities are
underrepresented in this study.
*JGAR 9:3, 199-221
Mr Robert Stirling
Director, Planning and Strategy, Network of Alcohol and other Drugs Agencies (NADA)
Policy development to support drug treatment services respond to the possession of illicit
substances on premises
Issues: Given the contentious nature of illicit drug policy, drug treatment providers have not
been provided with sufficient policy guidance to respond to clients who present to treatment
who are in possession of illicit substances. Providers are challenged by duty of care, staff safety,
legal obligations for diversion clients and providing a therapeutic environment rather than a
punitive one.
Approach: A survey was conducted with non government drug treatment providers in NSW
seeking information about existing policy and practices, prevalence and frequency of the issue,
and any perceived impact on the therapeutic relationship with clients. A literature and policy
search was conducted to support the development of an appropriate policy.
Key Findings: 51 organisations responded to the survey, with almost three quarters of
respondents reporting an incident in the previous 12 months. Just over half reported having a
written policy to guide staff in this area, with a range of different approaches to respond to the
issue. A review of literature and policy found very little published literature to assist drug
treatment providers, with most literature and policy related to the use of substances in
psychiatric or mental health units in the UK. Implications: The lack of policy guidance provides
poor direction for the workforce, can create additional organisation risk, and results in varying
responses to clients seeking treatment.
Conclusion: A review of the literature and consultation with drug treatment providers in NSW
indicate the need to develop organisational policy to support providers respond to the
possession of illicit substances on premises. This presentation will highlight the findings from
the survey, literature and policy review, and the development of an organisational policy
template.
Mr Steve Stokes
Program Director, South Pacific Private
Addiction, affect regulation and attachment treatment: "Soothe, Contain and Move on""
Pia Mellody states that when we enter treatment we will be confronted with the reality of
doing ‘Two’• Recoveries. One from our secondary symptoms, the other from our history.
Our Developmental Model of Immaturity states that childhood lack of nurturing, trauma, abuse
and neglect through enmeshment and or abandonment causes Developmental Immaturity. It is
the effect of this trauma on our attachment system, and the resulting development of the brain
that leaves us with regulation issues. It is the Functional Adult’s role in our Recovery to start to
build an ongoing Recovery Plan that addresses these issues by reparenting the self.
"Soothe Contain and Move On" is an opportunity we have to learn how to practice soothing the
self when we get triggered into a regressive reaction. Trauma hold’s itself within the body, and
to heal it, we need a remedy that goes to the body, to Soothe our nervous system, to practice
regulation skills, bringing the executive function of the brain back on line. One way we can
assist this process is with ‘Butterfly Hands’•, and diaphragmic breathing. When we go into a
limbic Freeze reaction and chaos of that Wounded Child, we need to Soothe our nervous
system. Firstly placing our hands, one over our heart, the other over our diaphragm, with the
thumb and the little finger touching. Then we focus on our breath mindfully, tuning into our
body and its sensations, bringing coherence to our state which helps lift us into regulation, and
from here we have access to our Functional Adult Skillset.
When our defence mechanisms are triggered and we experience the rigidity of our Adult
Adapted Child as a response to Developmental Trauma, it can trigger us into a ‘flight or fight’•
state. From here our Contain skills are essential to keep us and others safe, and help us identify
what is our Reality . Our Reality awareness will help us set boundaries so we can protect and
contain ourselves as well as identify our unspoken needs and wants.
The next phase is to Move On, taking responsibility for our recovery. It is the role of the
Functional Adult to witness our internal reality and re-parent our Inner Child. When we move
into our ongoing recovery plan, we can use our sponsor or therapist for support with our reparenting. 12 Step Fellowships, ongoing therapy and therapy groups can also be used.
The brain is an amazing ally in the recovery process. We are powerless over the effects of the
Developmental Trauma, and the dysfunctional patterns that followed. Recovery is about and
making functional choices. By using the Mindfulness practice of Soothe Contain and Move On
we can focus our awareness, and develop Functional Adult tools. Every time we utilize the
tools, we are forming new neuro pathways in recovery through neuroplasticity, as well as
affecting the wiring of the existing connections due to neuro malleability. When this is all done
in a safe secure environment, then these new neuropathways become super highways leading
to the new way of life.
Mr Steve Stokes
Program Director, South Pacific Private
Changing the Family Legacy of addiction - Changing lives, healing families and supporting
children
The family legacy of addiction is well known - the child of a parent who is struggling with
alcoholism is adversely impacted in so many ways that we are able to predict their likely issues
in adulthood. Adult children of alcoholics are likely to have dysfunctional patterns of relating
and are more likely to have addiction issues themselves or have long-term relationships with
people who have an addiction.
The more members of the client's family and home environment that have an understanding of
the disease of addiction, and the signs, symptoms and progression of mental illness, the
underlying issues and family dynamics, and who are actively developing new skills and
awareness around these factors, the more supported the client is likely to be in early Recovery
and the risk of relapse is significantly reduced.
The Family Treatment Program at South Pacific Private was specifically designed to support
families to explore the difficult and challenging issues that may not have been addressed
effectively in the past, within the family. The Family Program works to reduce denial in these
families and helps them recognise when there is a problem, or when there is a risk of relapse,
making it an opportunity to engage people in treatment earlier than the average “time to
treatment― which is currently 18 years from the first onset of problems.
To complement this program, we are also launching our first Children's Program in 2015 to
support children in homes affected by addiction or mental health concerns. These issues can
harm all family members, but children are particularly impacted. Youngsters simply can't
comprehend what is happening and, consequently, the seeds of addiction can be sown in
childhood. This children's program will assist children in the recovery process through
understanding that they are not at fault and not alone.
Ms Jenni Thompson
Manager, Knox Social and Community Health
Co Author - Mr Steve Adams, Knox Social and Community Health
Project HOPE - Hearing Other Peoples Experiences
This presentation will showcase the outcomes of Project HOPE, a federally funded project that
has the ambitious aim of changing culture to reduce stigma associated with substance misuse
and or co-occurring mental health concerns. By employing a Peer Support worker and
implementing the Minkoff and Cline Comprehensive Integrated System of Care.
Project HOPE has held annual Celebrating Recovery events where our clients presented their
stories and experiences, a Project HOPE bus where our clients led orientation tours of AOD and
MH services in the local area, Community Forums where clients gave feedback on services and
Peer Support activities to support recovery oriented program. Our Peer Support worker has cocreated newsletters with clients called Walk a Mile in my Shoes to share the lived experience
perspective and create better understanding of mental health, addiction and recovery.
The launch of our Walk a Mile in my Shoes DVD and Book created together with our clients will
be held in April and we hope to share these across the country so that those with a lived
experience can have their voices heard.
Dr John Toussaint
CEO, ProCare Alliance
Treating Addiction as an Attachment Disorder
Addiction appears in a myriad of forms. From the more recognisable abuse of substances such
as alcohol and drugs, to the more subtle and cunning instances of compulsive sexual behaviour
and addictive relationships, the reality of addiction can be found in every corner of society.
Equal in variety to manifestations of addiction, are sundry psychological theories that attempt
to explain and treat the problem.
An approach to understanding and treating addiction that has produced much interest in recent
years, and which shows great promise for effective treatment of those who suffer with
addictions, has come from attachment theory. Advances in the field of neuropsychology and
brain development have made even clearer the primary nature of attachment for human
beings. The process of attachment early in life can affect gene expression and neural structure
that will shape a person’s emotional experiences later in life.
Addiction is seen as an attempt to regulate the attachment system. Empirical studies have
looked at this conceptualisation and found significant correlations between attachment style
and addictive behaviours, and have shown that addictions are more likely to occur in individuals
who have disruptions in their early attachment system. Attachment representations show
predictive associations with a wide range of pathological behaviour including personality
disorder, mood disturbance, vulnerabilities in the sense of self and others, relationship
problems, psychopathology and addiction.
Attachment theory has significant implications for treatment in terms of the conceptualisation
of addictions, the use of attachment style in treatment, listening for attachment narrative in
client’s dialogue, and in developing and maintaining the therapeutic alliance.
This presentation will articulate those aspects of attachment theory relevant to understanding
addiction from its theoretical perspective, define addiction in terms of attachment, and
examine the effectiveness of attachment-oriented psychotherapy in the treatment of
addictions.
Mr Michael Vacaru
Doctoral Candidate/ Graduate Teaching Assistant, University of Auckland
Co Authors - Associate Professor Janie Sheridan, University of Auckland, Dr Robin Shepherd,
University of Auckland
Developing a Problematic Mobile Phone Use Questionnaire using a Youth Participation
Approach
Aims: Problematic (including ‘addictive’) mobile phone use (PMPU) has been given increasing
attention by the international research community. It has been linked to physical harm, as well
as social and psychological consequences. However, most studies have employed a DSM
focused, addiction based perspective, which may be problematic when exploring adolescent
behaviours. This study aimed to develop a youth-informed Problematic Mobile Phone Use
questionnaire, using Cognitive Behavioural Theory as a theoretical foundation.
Methods: A modified Nominal Group Technique (NGT) was employed in this study. One
hundred and nine participants were recruited from several youth-oriented organisations in the
Auckland area, and allocated across 10 NGT sessions. Participants were asked to produce and
evaluate statements relating to PMPU. Expert input was also sought regarding the content and
wording of the statements.
Results: The final questionnaire comprised 60 statements which could be grouped into a
number of PMPU-related themes, including Behavioural Preoccupation, Cognitive
Preoccupation, Positive Expectancies, and Harmful Effects.
Conclusion: The study produced a comprehensive and ‘youth informed’ questionnaire which
aims to explore PMPU behaviour from a solid theoretical foundation. This is the only PMPUrelated study known to the authors which adopted a youth-participation approach, and thus
represents a novel perspective on the subject. The authors are in the process of testing the
questionnaire in a sample of New Zealand young people.
Mr Micheal Vacaru
PhD Student, University of Auckland
1st Author – Dr Robin Shepherd, Lecturer/Researcher, University of Auckland
Swinging the Pendulum: Ambivalence during recovery from Psychic Hotline Addiction
This study examines ambivalence during recovery from psychic hotline addiction. This cohort in
recovery have gone into debt, spent their rent money, inheritance, or have gone into overdraft
to fuel their addiction to ringing psychic hotlines. They ring psychic hotlines to alleviate
ambivalence. Sometimes the ambivalence is exacerbated through mood disturbance or anxiety.
There is limited help specifically for this self reported behavioural ‘addiction’. Currently, there’s
online support, individual counselling and a 12 step support group by telephone.
Ambivalence is a reoccurring theme in the development of addiction to ringing psychic hotlines
as well as an important feature in recovery. This study focuses on those who are abstinent from
tinging psychic hotlines. Themes drawn from the narrative accounts of recovery and data from
the ambivalence survey in relation to ambivalence will be discussed.
Ms Belinda Volkov
Senior Counsellor, Manly Drug Education & Counselling Centre (MDECC)
Co Author - Ms Susan Watson, MDECC
Planting seeds of change in the drug affected family
(A multidisciplinary approach working with young people and SUD)
Manly Drug Education and Counselling Centre (MDECC) is a non-government organisation that
provides an innovative multidisciplinary, family inclusive approach to working with young
people and their families. Evidence identifies family inclusive practice as the gold standard in
treating SUD with young people.
For every 1 person affected by their own SUD an additional 2 family members are affected.
Treating the families is important for several reasons 1. There is a cost to the family (in terms of
distress, family breakdown etc.) 2.Treating the family can reduce the harms and risks to the
family, encourage the person with SUD into treatment and improve treatment outcomes for
the person with the SUD and this reduces significantly the impacts on the wider society.
MDECC has found that working with parents of young people is pivotal as parents often
unknowingly contribute to enabling specific behaviours that are indicative to SUD
Even if the parents contact the service when their son/daughter is refusing to engage, MDECC
will work with the family. In many cases this has resulted in their son/daughter presenting to
MDECC as a result of the shift in family dynamics.
At MDECC parents and young people are allocated their own individual counsellor. When both
the parents and their son/daughter are clients of the service the family is presented at clinical
case reviews.
The clinical team, including a Case Manager, Senior Counsellor – Mental Health, Senior
Counsellor – Addictions and a Family Therapist assess the family system and consider the
appropriate treatment. Outcome measures including DASS21, Severity of Dependence Scale
and the Family Adaptability & Cohesion Evaluation Scale IV are collected and reviewed for both
the parents and young people. This presentation will include the MDECC model, outcomes data,
case reviews and how ethical areas such as confidentiality are maintained to keep young people
engaged in the service.
Mr Adrian Webber
Lecturer in Counselling, University of New England
Co Authors - Dr Jane Clark, University of New England, Mr David Kelly, St Vincent de Paul
Support Services
An analysis of clients perceptions of improved mental health wellbeing when receiving
treatments designed to address symptoms related to substance misuse.
Background: Traditionally, mental health concerns and the treatment thereof has remained the
domain of community mental health teams and specialist mental health practitioners. NonGovernment alcohol and other drug treatment programs, on the other hand, have focused
purely on the treatment of the symptoms of substance misuse, and the behaviours inherent in
maintaining dependence. Funding bodies, increasingly seeking broader outcomes for their
investment, have begun to encourage non-government AOD treatment programs to narrow the
chasm. Outcomes measurement, increasingly implemented by AOD treatment programs, focus
primarily upon the collection of quantitative data relating to client outcomes on substance
dependence scales, and for psychological wellbeing.
Objective: The aim of this paper is to present a framework for conducting a mixed methods
approach to measuring clients’ perceptions of how their own mental wellbeing was addressed
during their stay in a longer term residential treatment program for substance misuse.
Method: A combination of results from a quantitative psychological wellbeing measure along
with a narrative enquiry focusing upon the clients self-report of what, in their own opinions,
was most beneficial to their mental wellbeing during their stay will be analysed.
Results: It is anticipated that the results of the study will serve to inform non-government
agencies when designing programs aimed at target populations presenting with substance
misuse and mental health comorbidity.
Keywords: Mental health, substance misuse, comorbidity, narrative enquiry.
Dr Martin Whitely
Senior Advocate, Health Consumers Council of WA
Western Australia’s experience of the relationship between ADHD prescribing and
amphetamine abuse
Proponents of Attention Deficit Hyperactivity Disorder (ADHD) medications contend that the
‘under-recognition’ of ADHD is a cause of illicit drug abuse. They argue that early identification of
ADHD and subsequent medication prevents undiagnosed individuals using illicit drugs to selfmedicate. Critics of ADHD prescribing critics counter that the amphetamine and amphetamine-like
drugs most commonly used to treat ADHD are often abused or diverted for illicit us.
Western Australia’s (WA) history as the world’s first ADHD child prescribing hotspot to see a significant
decrease in ADHD child prescribing rates offers a unique insight. Per capita child prescribing rates for
ADHD dropped 50% in WA between 2002 and 2008. Over the same period there was a 51% reduction in
self-reported amphetamine abuse by 12 to 17 year olds. The WA experience of a positive correlation
between amphetamine abuse rates and the prescribing rates for amphetamines for the treatment of
ADHD supports the proposition that prescribing amphetamines facilitates the abuse of amphetamines.
Ms Maria Yap
Project Manager, MonashLink Community Health Service
Service User Journey Mapping at an Outpatient AOD Counselling Service
Service User Journey Mapping (SUJM) is a process whereby Service Users (SUs) are encouraged
to tell their 'stories' or experiences thereby tracking and describing the impact of their
experience, as well as testing preconceptions, all of which can possibly be used as a vehicle to
drive organisational change. As a continuous quality improvement activity in an Alcohol and
Other Drug (AOD) service, the SUJM can assist with the development of initiatives around the
provision of client centred care and tailor aspects of the service to improve health outcomes.
The AOD and Mental Health capacity building project at MonashLink Community Health Service
conducted 6 journey mapping activities. The SUs (substance using individuals and carers) were
interviewed by a former MonashLink SU and a registered volunteer. The results of the journeys
were used to develop two documents, a booklet to inform other service users and a formal
report with recommendations to management.
Mr Edward Zarnow
Professor, Macau Polytechnic Institute
Client Management Software for Enhanced Drug and Alcohol Service Delivery and Outcomes
Measurement
Lyndon Community is a small not for profit organisation specialising in high quality drug and
alcohol services to rural NSW communities. Lyndon relies on government funding and like other
similar organisations faces the challenge of measuring outcomes of the work we do. Strategies
and systems to collect good information are critical aspects underpinning outcome
measurement. In 2012 we decided to identify how we could best collect the information we
needed to monitor client needs, pathways and outcomes with the aim of developing a client
management system.
This presentation describes the client management system we have developed, tested and
implemented over the past 3 years. Implementation processes, staff training strategies,
selection and use of outcome measures and examples of the way the system is used to inform
our practice today are demonstrated.
A staff survey evaluating our client management system reported a 95% user satisfaction
rating. The benefits of a comprehensive electronic client record that includes outcomes
measures are accountability in drug and alcohol service delivery to individual clients,
compliance with accreditation and quality processes and consistent work processes for staff.
Prof Zhonglu Zeng
Professor, Macau Polytechnic Institute
A study of factors affecting problem gambling of the high rollers from Mainland China to
Macao
High rollers (high stake gamblers) are most important contributors of Macao’s gambling
industry. In 2013, 66% of the Macao’s gaming revenue is from these gamblers. High rollers are
more likely to become problem gamblers because of their heavy gambling. Their problems are
more harmful to society because their gambling involves large sums of money. But so far there
are few studies about them, even fewer studies on the factors leading to their problem
gambling.
This study will make up this gap. The study has collected 213 reports about problem high
rollers. By analyzing these reports, the study finds that the following factors are important
contributing factors to high rollers problem gambling:
1. easy money (the problem high rollers have owned a lot of money themselves or can
access large sums of money because of their power or work positions in organizations)
2. junket operators- they extend vast amounts of credit to high rollers, making the latter
gamble beyond their means)
3. loose control of casinos ( so far Macau’s casinos have no effective mechanism to
monitor and stop problem gambling behaviors in casinos)
4. easy access of casinos (the provinces with more problem high rollers are those close to
Macau or easy to travel to Macao)
5. cognitive biases of the gamblers
The study can narrow the gap in the research of problem high rollers and the findings can be
used to reduce the problem gambling of high rollers to Macao.
Posters
Miss Belinda Goodwin
PhD Student, Central Queensland University
Why gamblers eat more salt: Explaining covariance in the consumption of reward-oriented
stimuli using a latent trait model.
A diverse class of stimuli; including certain foods, substances, media, and economic behaviours;
may be described as ‘reward-oriented’ in that they provide immediate reinforcement with little
initial investment. For this reason, such stimuli are amenable to promoting addictions.
Neurophysiological and personality concepts, including dopaminergic dysfunction, reward
sensitivity and rash impulsivity, each predict the existence of a latent behavioural trait that lead
to increased consumption of all stimuli in this class. Whilst bivariate relationships (comorbidities) are often reported in the addiction literature, to our knowledge, a multivariate
investigation of this possible trait has not been done.
We surveyed 1,194 participants (550 Male) on their typical weekly consumption of 11 types of
reward-oriented stimuli; including fast food, salt, caffeine, television, gambling products, and
illicit drugs. Confirmatory factor analysis was used to compare models in a 3x3 structure; based
on the definition of a single latent factor (none, fixed loadings, or estimated loadings), and
supplementary covariance structure (none, a-priori / literature based, or post-hoc / datadriven). The inclusion of a single latent behavioural ‘consumption’ factor significantly improved
model fit in all cases. Also confirming theoretical predictions, estimated factor loadings were
uniformly positive in each of the three covariance scenarios.
The findings support the notion of a single behavioural trait leading to increased consumption
of reward-oriented stimuli across multiple modalities. We discuss implications regarding the
concentration of negative lifestyle-related health outcomes in certain individuals who are prone
to over-consumption and various forms of substance and behavioural addiction, putting their
health and wellbeing at risk.
Ms Samantha Hall
Consumer representative, Partners in Recovery
Looking beyond the addiction...You don’t know what you don’t know
The difficulties a person faces when recovering from a mental illness and a drug addiction are
complex and tightly interwoven. The focus on these two issues separately can mean important
information and opportunities are missed. By acknowledging and treating both issues together,
better options can be found to enter the space of recovery.
When I sought help, the stigma of being a “stoner― kept me from being honest with my
psychologist. No one really knew what was going on for me. When my sessions ran out and I
didn’t have enough money for more, I had a relapse with my mental health, my drug addiction
increased and I ended up homeless, on heroin and “circling the drain―. Eventually ending
up in hospital a support worker came to see me and I was linked to a mental health services.
This was the start of the steep climb to recovery.
It was not until I admitted that I was an addict and had a problem did my life change for the
better.
The support I received from the service I was connected to in Melbourne to make our move to
the Gold Coast to be closer to family was really important. Through the ongoing support of
MIFQ my partner and I are now 2 ½ years clean and doing well.
Recently I was invited to partake in the Partners in Recovery Voicebox project. I jumped at the
chance to learn how to use digital story telling and other methods to share my story, in the
hope that it will help someone else to avoid what I went through.
I am passionate about raising the awareness of dual diagnosis and the importance of having
both issues treated together. I hope that my video and visual arts will help professionals to
think differently about the people they are working with, and to reflect on the things they may
not know.
Ms Isabella Ingram
Researcher/Provisional Psychologist, University of Wollongong
Measuring client satisfaction in residential substance abuse services.
Individuals who are satisfied with their mental health care often experience better clinical
outcomes in the long-term. Likewise, participants who are dissatisfied with services tend to
demonstrate poorer mental health outcomes. While there are established methods to evaluate
client satisfaction in mental health settings, there has been little consideration given to the
implications of client satisfaction in substance abuse settings. This study sought to evaluate the
utility of the Client Satisfaction Questionnaire (CSQ-8) as a measure of general satisfaction
within the substance abuse population, and examine the relationship between client
satisfaction and other established outcome measures.
Participants were 1,378 residents from one of fourteen medium to long-term residential
substance abuse facilities located across multiple Australian states. Participants completed the
CSQ-8, along with other measures of outcome (e.g. symptom distress, cravings, recovery
process). Satisfaction was found to be associated with length of time in treatment but not with
client descriptive characteristics. Significant associations were found between satisfaction and
process measures, particularly functioning and perceptions of self.
These findings support the use of the CSQ-8 in residential substance abuse settings and in
identifying populations at risk of poor experiences. This research has implications for the
improvement of substance abuse services, particularly as part of quality improvement
initiatives. The current study provides a framework for future research to explore the
relationship between client satisfaction and improved client functioning and self-perception.
Dr Latha Nithyanandam
General Manager, ADFNSW- Kathleen York House
A Strengths Based Family Oriented approach
On recognising and responding to the vulnerability, victimization, stereotyping and overall
difference in the bio-psycho-socio-spiritual component of women with substance misuse issues,
the importance of considering the family as a unit has come to the focus. While the family and
their role in supporting the client during treatment and whilst integrating her back into the
community is being addressed, yet for long term recovery a total understanding of family
dynamics and empowerment to move beyond merely coping is paramount.
Addiction affects not only the client but the whole family leading to a dysfunctional pattern of
functioning where family members, including children, adopt survival behaviours and roles
which could unwittingly sabotage the recovery of the client. Understanding family dynamics is
crucial to treatment. Hence a comprehensive approach encompassing interventions not only
for the clients addressing their substance abuse and any associated medical, psychological,
social, vocational, and legal problems but also the family including the children is important
where the members are equipped to change the patterns that work against family recovery and
at the same time empowering them irrespective of the client’s recovery.
The focus of intervention on the family is twofold - focusing on their own growth and the
changes they need to make in themselves as well as learning to support the client in her
recovery. This is the model with which Kathleen York House operates
Kathleen York House is a 24 hour residential service supporting women and their children,
experiencing substance dependence issues and wanting to overcome them. In order to be
inclusive and reach out to more people KYH follows a long term (nearly 2 years), Through Care
model accommodating women at various levels of change and interventions focussed on the
entire family
Mr Omkar Patkar
PhD Student, TRI AT QUT
Pindolol, a FDA approved drug for hypertension attenuates ethanol consumption in mice
following long but not short-term ethanol exposure
Numerous studies in the past have shown that stressors play an important role in alcohol
dependence. Long term alcohol consumption simulates chronic stress-like conditions that
facilitate changes in brain regions that control behavioral responses to stressful stimuli. Such
neurobiological changes lead to maladaptive behavioral manifestations like enhanced
sensitivity to negative emotional states of alcohol withdrawal including stress, anxiety and
depression.
Stress induced changes in brain norepinephrine signaling has been shown to contribute to
alcohol consumption and studies have shown that & blockers including propranolol, which
inhibit the activity of norepinephrine at beta-adrenoceptors, reduce ethanol consumption in
animal models. We have extended these studies using a series of & -blockers to determine their
effect on short and long term ethanol consumption using the drinking in the dark (DID) protocol
in mice.
Briefly, C57BL/6J mice were housed individually in a reverse light-dark cycle room and given
access to 1 bottle of 20% ethanol (v/v) and 1 bottle of filtered water for a 2 hour period, 5 days
a week, 3 hours into the dark cycle. Bottles were weighed 30 min and 2 hours after
presentation to determine daily ethanol consumption. Following 4 or 12 weeks of ethanol
exposure, the mice received drugs or vehicle via sub-cutaneous/intra peritoneal injection. Our
results show that pindolol, a FDA approved drug for the treatment of hypertension, having dual
pharmacological activity at both noradrenergic and serotonergic receptors, produces robust
decreases in ethanol consumption in mice following long but not short-term exposure.
These results implicate changes in noradrenergic and serotonergic signaling following long term
alcohol use. We are performing drug infusion experiments to identify specific brain regions
where noradrenergic/serotonergic activity is altered. Since pindolol is FDA approved, we have a
great opportunity to advance this drug to a small scale clinical trial in humans as a potential
pharmacotherapeutic treatment option for alcohol dependence.
Mr Dave S.
Public Information Coordinator, Alcoholics Anonymous
Alcoholics Anonymous wants to work with you.
Alcoholics Anonymous is a not for profit organisation. We are self supporting through our own
contributions, and are not allied to any sect, denomination, politics, organisation or institution.
We do not wish to engage in any controversy, neither endorsing nor opposing any causes. We
have no other purpose but a dedication to helping other alcoholics discover a better way of life.
Nothing is asked of the alcoholic except a desire to stop drinking.
Alcoholism was declared an allergic disease in the 1950s by the W.H.O. This incurable condition
has two faces. The physical compulsion, and the mental obsession. Although there is no
known cure for the disease, it may be arrested at some point, if the sufferer is willing to follow
our simple program of recovery.
The impact to the alcoholic's family, friends, and standing in the community, can be
devastating. Loving families are shattered, jobs are lost, health deteriorates, and the alcoholic
is scorned by society for his/her failure to shape up to expectations. Unfortunately society does
not appreciate that where alcoholism is concerned, willpower is not the answer, and the
thought of the conditions being a disease is not readily considered.
The disease is completely indiscriminate. Race, colour, creed, or social standing is no protection
from the ravages of its progress. Occupation, upbringing or religious devotion is not match for
this insidious disease. It takes away good men and women every day, through illness, and
accidents, particularly motor accidents, and criminal activity perpetuated in alcoholic blackout.
Alcohol is an addictive substance for those predisposed to excessive behaviour, which recently
announced science suggests may be predetermined by genetics. The effects of alcoholism is so
debilitating the mental and physical health of the sufferer is severely compromised.
Low self esteem, self worth, and self loath in can leave many alcoholics fearing the spectre of
hopelessness. Physical disabilities, of which are voluminously recorded by the medical
fraternity, only add to the misery and anguish that the alcoholic endures daily. Unfortunately
many find suicide an agreeable substitute.
Mr Robert Stirling
Director, Planning and Strategy, Network of Alcohol and other Drugs Agencies (NADA)
Mapping of the NSW Non Government Alcohol and other Drugs Sector
Issues: The NSW non government alcohol and other drug sector continues to be subjected to
significant reform at both the state and commonwealth level. Whilst there is much information
on the sector, a detailed understanding was needed to enable government to make informed
decisions about the future policy and funding of the non government sector.
Approach: A mapping exercise was conducted with specialist non government drug and alcohol
providers in NSW. This involved development and analysis of an organisational survey, a
workforce survey, key informant interviews, as well as sector and stakeholder consultations.
Key Findings: The exercise resulted in the development of an organisational profile that
describes the governance, operation, services and client profile of the sector. This informed the
development of a sector taxonomy that describes the continuum of care services being
provided, from harm reduction, through to health promotion and harm prevention, treatment,
and extended and continuing care. In Addition, a workforce profile that describes the staff
providing services in the sector was produced. The findings also informed areas for future
development as well as recommendations for funders and policy makers. Implications: The
sector mapping and taxonomy provides a useful tool to government, the peak body supporting
the sector, as well as service providers themselves. It outlines funding principles and
recommendations to further develop the existing specialist NGO drug and alcohol sector.
Conclusion: The report is a part of a collaborative working relationship between the NSW
Ministry of Health and the NSW AOD peak body and should be used as a tool to inform future
policy and funding of the sector. The presentation will be provide an overview of the taxonomy,
organisational and workforce profile, as well as a snapshot of the clients that are accessing
these services.
Ms Maria Yap
Project Manager, MonashLink Community Health Service
The Chinese First Response – An innovative treatment intervention for families with
substance abuse issues
When families contact an Alcohol & Other Drug (AOD) service, they want solutions that are
immediate, brief and informative. They need constructive and effective strategies. Historically,
the AOD Family Sector lacked a forum to address these needs outside of the counselling realm.
The Eastern Drug & Alcohol Service Family Focus Project (Commonwealth funded) has
developed the ‘First Response’ module an innovative alternative for engaging families in
treatment using a group intervention. First Response is an educational discussion forum that:
explores the impact of substance use on the family; introduces the service sector; and offers
treatment options for the family and the substance user.
In partnership with the another Commonwealth funded project called the AOD/MH Capacity
building @ MonashLink, which targeted the Chinese speaking community, the First Response
module was translated in Cantonese and Mandarin. The Chinese version was developed
through a series of focus group discussions and piloted in December 2014.
This paper will describe: the model of care and the rationale behind the original First Response
module; the development of the Chinese version and the outcomes of its pilot program; and
future plans for both the English and Chinese versions.