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2 Structure of Carinthia Southern federal state of Austria About 650.000 citizens Increasing number of young drug users Care facilities only for adults 1 prevention institution 1 st aim general prevention The need of development of selective prevention

3 Difficulties / Facts Young people in a rural environment are not mobile Establishing care centers in small towns is expensive Need of specific counselling for young people (regarding personal situation, peer- group, family, needs + demands) Special law for drug using first offenders: „help instead of punishment“

4 Special law for pupils (school director and school medical officer decide in cooperation with parents how to deal with the problem, no denunciation by judge) Only probation service „Neustart“ is specialised single + group care mobile team appropriate infra-structure

5 Project partners Prevention unit of Carinthia (Governmental Organisation) Department of Carinthian Government / Sub- Department Addiction Neustart Carinthia (Private Organisation, probation service) Center of Evaluation + Research / University of Klagenfurt Financing: Health Department of Carinthian Government

6 What is „Way out“ Offers counselling and care facilities for young people Structured support over a short period of time

7 The concept of „Way out“ Young people charged by police or noticed at school school medical officer or public health officer Special diagnosis form to work out a „risk-profile“ More risk-factors than resources „Way out“ Age 14 – 21 years Counselling for single persons (approx. 15 meetings at 50 minutes) and groups (12 meetings at 2 hours ) Support over a period of 6 months Meetings can be arranged near to place of residence

8 General aims Encouraging abstinent behaviour concerning illegal drugs Controlled behaviour concerning legal substances and avoidance of drug-related problems

9 Specific aims Increasing social competence Imparting knowledge on health risks, development of addiction, effects of substances and legal situation Reflection of personal consumption and grappling with norms and values of their peer-group Developing personal strategies for solutions by integrating experienced and alternative strategies

10 Testing different models of conflict management Improving communicative abilities Heightening the awareness of one‘s own resources Supporting the ability to reach self-imposed aims

11 Risk-profile indicators (pretended) Environment: profession, family constellation, childrearing practices, consumer behaviour of family + friends Personality: coping, self-esteem, psychological comorbidity, self-efficacy, comunicative competence, delinquency Substance: beginning of abuse, consumer habits, alcohol abuse

12 Most participation criteria - Indication Incomplete families –Step-parent/-partner -Divorced parents -Death of one parent -Severe illness of one parent Addiction or co-addiction in the family system

13 Problematic debonding between mothers and daughters (mothers detach too early from their daughters) Style of upbringing: –Laissez fair –Spoiled, overprotective High pressure of expectations and pressure of performance by the parents

14 Young people who are in the program Most of them are continuously using one or more psychoactive substances: „leading drug“ cannabis „additional drug“ XTC Age group 14-16: „trying consumption“ Age group 17-18: „continuous drug use“ Relationship male: female = 7 : 1 Profession: apprentices, pupils, unemployed

15 Care - Management General procedure: - social worker gets into contact with clients - written invitation – several telephone calls - within 2 weeks date of 1 st setting - 1 st setting within 4 weeks - deciding if the client will be in the single or group session

16 Work-base of single-session Casework-method Sometimes only a few sessions are needed Sometimes they are sent to a more appropriate setting

17 Group-session Method of Theme-Centered-Interaction (TCI) according to Ruth Cohn 2 social workers (male/female) max. 12 group-settings min. 10 group-settings are obligatory group size 6–12 participants max. 6 months final examination including urine-testing

18 Measures of quality management 2 urine tests during care period positive test results are reported to social workers regular case-meetings between social- workers + physicians documentation + evaluation

19 Evaluation 1. Assessment (according to § 11+13 SMG) 2-4 weeks 2. First contact Client-social worker 3. First setting Decision single/group Evaluation: pre-testing with standardized psychological tests 6 months 4. care End of care 5. Evaluation: standardized psychological test 4 months later 6. Evaluation: retrospective interview

20 Results of evaluation using standardized psychological tests Increased drug-related attitudes towards -the danger of drug-abuse -reflected motivation Slight changes towards a better ability for -problem solving -decision-making (less influence of peer-group) About the need to take drugs (open questions) -no positive attitude to drug abuse any more -an increase in resistence to drug abuse

21 Care-results – group settings

22 Care-results – single setting

23 Results of interviews with clients Most of them would accept the program spontaneously No more punishment because of drugs

24 Effects of attending „Way out“ 2004 to 2006 2004: 85 clients left the program: -74 finished the counselling/reached the achieved aims -3 aborted the counselling process early -8 others 2005: 113 clients left the program: -87 finished the counselling process/reached the achieved aims -4 aborted the counselling process early -22 others 2006: 67 clients left the program: -52 finished the counselling process/reached the achieved aims -5 aborted the counselling process early -10 others

25 Experiences: A program for youngsters needs clear structures Constant communication between counsellors and the medical attendant is important The project offers must be flexible, to fit the youngster‘s needs Voluntary participation is not necessarily needed A basis of trust between the counsellor and the client is very important

26 The period of attendence (normally 6 months) needs to be extendable if crisis situations arise (e.g. sudden unemployment) Many youngsters only needed 3 months of attendence Occasionally police charges were filed again, but the patterns of cannabis consumption had changed (reflected usage) Average time of care per client, including times for documentation and travel, approximately 21 hours

27 Thank you for your attention


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