Amphetamine Type StimulantTreatment Protocol

Developed by Lynne Magor-Blatch & James Pitts, Odyssey House McGrath Foundation

David Kelly

Manager, WHOS Hunter Valley

Background to the ProjectBackground to the Project

Dramatic rise in Amphetamine Type Stimulant usein Australia

1993-2007 5.4% of population to 9.1% in 2004 to 6.3%in 2007, 1.1million regular users

Background to the ProjectBackground to the Project

National Minimum Data Set (2005-2006)

23% of treatment episodes reported ATS as a drug of concern

20% with ATS as a drug of concern were treated in a TC

Consultation phase of ATS project found that in TCs, ATS was mostprevalent drug of concern.

Background to the ProjectBackground to the Project

Cogger, McKetin, Ross & Najman (2008) in an NDARC study found: ATS users 44% Major Depression, further 45% Substance Induced Major

Depression

83% had experienced psychosis

47% had experienced clinically significant suspiciousness, unusual thoughtcontent or hallucinations

Background to the ProjectBackground to the Project

Cogger, McKetin, Ross & Najman (2008) in the same study(unpublished results) found: ATS users who sought treatment in a TC were more likely to be using ATS

more often

More likely to have clinically significant psychosis

More likely to have panic disorder

More likely to have general impairment

than ATS users who had sought other treatment

Background to the ProjectBackground to the Project

Gunn and Rickwood (2009) study of 104 residents in Odyssey House(NSW), Karralika, Mirikai and Goldbridge TCs ATS users higher levels of impairment in global executive function

Difficulties with behavioural regulation, attention management andproblem solving

Difficulties with impulse control, holding attention to one task, monitoringsocial behaviour

Background to the ProjectBackground to the Project

Gunn and Rickwood (2009) cont. These areas of executive functioning shown to be most affected are related

to reflective functioning

Self monitoring, self evaluation

Inhibited reflection on behaviour

Inhibited impulse control, objectivity, and ability to learn from mistakes

Background to the ProjectBackground to the Project Funding through Australian Government’s Amphetamine Type Stimulants

Treatment Grants Program

Following Literature Review

Therapeutic Community and other consultations

Trials at Mirikai and Cyrenian House

Launch at the ATCA conference in Canberra (2009)

Research continues with 6 and 12 month data being collected ATS Sites (WHOS Hunter, WHOS Najara, Goldbridge, Cyrenian House and

Karralika) TAU Sites (WHOS Rozelle sites, Canberra Recovery Services, Central Coast Recovery

Services (Selah), Odyssey NSW, Odyssey Victoria, Palmerston and Logan House)

ATS Treatment ProtocolATS Treatment Protocol

Most Treatment Protocols and including ATS Treatment Protocolswritten with individual treatment in mind.

Require extensive re-working to be applicable to a group setting,particularly a Therapeutic Community setting

The ATS Treatment Protocol particularly designed for TherapeuticCommunity setting

ATS Treatment ProtocolATS Treatment Protocol

Combines

Mindfulness Based Cognitive Therapy and CBT

Acceptance and Commitment Therapy (ACT)

Motivational Interviewing

ATS Treatment ProtocolATS Treatment ProtocolPre Admissionor Assessment

Phase

Module 1:Building

Motivation

Module 2:Coping with

Cravings

TreatmentPhase

Module 3: HowThoughtsinfluenceBehaviour

Module 4:Understanding

Feelings

Module 5:Learning how todeal with anxiety

Module 6: CoreBeliefs and

Values

Flexible

Module 7:Relapse

Prevention

ATS Treatment ProtocolATS Treatment Protocol

Each Module contains

Facilitators Instructions

Worksheets

Tip Sheets

WHOS Hunter ValleyWHOS Hunter Valley 29 Bed Facility

2 6 bed support houses

Mixed gender

Regional area, very highprevalence ATS use (60%), veryhigh prevalence ATS combinedwith Cannabis use

Entrenched ATS use culture

ATS protocol at WHOSATS protocol at WHOS

Firstly had to change the name! (Treatment Protocol for use by staff andclinicians working with ATS clients of Therapeutic Communities doesn’texactly roll off the tongue) Foundations of Recovery Group (interim)

Implemented at the two sites with highest ATS use, two sites that werealready implementing Psycheck

At WHOS Hunter initially tried to divide groups up and makemodules 3-6 a closed group but proved unworkable

Presented to all clients

ATS protocol at WHOSATS protocol at WHOS

So what do the residents and staff think? Love the worksheets “Enjoyed the way they put metaphors to our drug

use”

ACT fits very well with TC ethos, focus on values and principles, goals andpositives

Very helpful for ATS clients in particular, focusing on recognising feelingsthrough bodily sensations then putting a label to them and developingstrategies for dealing with them

All clients benefited from the discussions around cravings, especially inview of our moves toward smoking cessation

ATS protocol at WHOSATS protocol at WHOS

Plans for the future? 6 month trial is over

Adapt a little for WHOS milieu

Present to other WHOS services, hope to become part of the WHOSgeneral program

Thank you!Thank you!