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Many people with dual diagnosis present with social complexity that impedes service access. The role of social work support in such service navigation is poorly understood. This study aims to characterise client presentations to an Australian telephone-based social work alcohol and other drug (AOD) service navigation and linkage program, with consideration of presentation complexity compared between those clients who present with or without self-reported mental health (MH) concerns and a history of MH diagnoses, to identify differences in baseline characteristics, and linkage outcomes.

A retrospective audit was conducted of routinely collected clinical information from a six-month period, selected to capture the social and health challenges experienced during the mid-pandemic period (mid-2021) in Victoria, Australia, during which a number of lockdowns resulted in a reliance on telephone-based services. The audit focused on client and presentation characteristics, and compared clients with and without a history of co-occurring MH and AOD concerns.

It was found that three in four people accessing an Australian telephone-based AOD service navigation and linkage program presented with dual diagnosis. Individuals with dual diagnosis required more support from the service compared to those without a co-occurring MH disorder; but overall, were just as likely to achieve a successful linkage to services, when offered holistic, long-term social work support.

This study focused on the role of social workers in this service navigation program in supporting individuals with complexity. It also highlights the challenges in operationalising social complexity factors alongside clinical MH and AOD diagnoses, and points to the need for further research to guide future service development for this vulnerable client group.

The purpose of this paper is to explore the applicability of the Australasian Therapeutic Communities Association (ATCA) Standard to Australian youth-specific modified therapeutic communities (MTCs). An Interpretive Guide for Youth MTCs and Residential Rehabilitation (RR) Services was developed and a pilot trial conducted with three Australian youth MTC services.

Using a mixed-methods design, this study included three components: a consultation process with residential youth MTCs (N=15), which informed the development of the ATCA Standard Interpretive Guide for Youth MTCs and RR Services; a pilot trial of the materials with three Australian youth MTCs (N=53); and an evaluation of the interpretive guide and assessment of applicability of the ATCA standard to youth MTCs through pre- (N=32) and post- (N=19) pilot trial administrations of the Survey of Essential Elements Questionnaires (SEEQ), and post-pilot trial focus groups (N=21).

Results indicate that the ATCA Standard is applicable to youth MTC settings when applied with the Interpretive Guide, although no significant differences were found between the pre- and post-pilot trial administrations of the SEEQ.

Future research is recommended to explore active mechanisms of youth-specific MTCs, differences between adults and youth MTCs, and the development of TC-specific training.

To date, no standard for youth residential substance use services in Australia has been developed, and this is the first study of its kind internationally to explore the efficacy of standards in a youth MTC.

The purpose of this study is to describe what a sample of men in prison believe works well for the delivery of prison-based group alcohol and other drug (AoD) treatment programs. The authors hope the findings will help inform future practise in AoD program delivery in prison.

A qualitative research paper reporting on a thematic analysis of in-depth interviews with 30 male prisoners on their perspectives on AoD group treatment approaches.

Results indicate that matching readiness and motivation to start treatment is important for group success. Program content must be relevant and delivered by empathic facilitators who maintain confidentiality. It would be advantageous if one of the program facilitators was a peer with personal experience of overcoming an AoD use disorder.

According to the authors’ knowledge, this is one of few qualitative studies into the delivery of AoD treatment for men in prison and the only study of its kind in Australia. The consumer perspective is an important element in improving quality of treatment provision.

Risky alcohol and other drug (AOD) use is ubiquitous in some workplace cultures, and is associated with considerable risks to health, safety and productivity. A workplace drug and alcohol first aid program was developed to support supervisors and managers to recognize and respond appropriately to AOD problems, increase knowledge of AOD and reduce the stigma associated with AOD. The purpose of this paper is to undertake an evaluation to assess the program’s efficacy.

A self-report survey was administered to program participants before (T1), immediately after (T2) and three months following program completion (T3). Changes in alcohol/drug-related knowledge, role adequacy, motivation and personal views were examined using repeated measures ANOVA.

A total of 109 participants took part in the program, with only 26 completing scores at all three time points. Mean scores increased significantly (p<0.05) between T1 and T2 for knowledge (12.7–16.0), role adequacy (11.8–17.4), motivation (9.7–10.4) and personal views (9.0–9.6). Significant improvements were maintained at T3 for knowledge (15.1) and role adequacy (17.3).

Drug and alcohol first aid programs offer a potentially valuable initiative to improve the knowledge, skills and understanding of managers and supervisors in tackling workplace AOD risks, associated stigma and improving help seeking.

Workplace programs for managers can facilitate organization-wide responses to the reduction of AOD-related problems, increase implementation of appropriate policy and interventions, minimize associated harms and stigma and reduce negative imposts on productivity and profit.

The purpose of this paper is to determine reconviction outcomes for 2,882 male and female offenders with significant alcohol and other drug (AOD) criminogenic needs, serving custodial sentences in New South Wales, between 2007 and 2011, who participated in the Getting SMART and/or the SMART Recovery® programs.

A quasi-experimental research design utilized data from 2,343 offenders attending Getting SMART; 233 attending SMART Recovery© and 306 attending both programs, compared to a propensity score-matched control group of 2,882 offenders. Cox and Poisson regression techniques determined survival times to first reconviction and rates of reconvictions, adjusting for time at risk.

Getting SMART participation was significantly associated with improved odds of time to first reconviction by 8 percent and to first violent reconviction by 13 percent, compared to controls. Participants attending both programs (Getting SMART and SMART Recovery©), had significantly lower reconviction rate ratios for both general (21 percent) and violent (42 percent) crime, relative to controls. Getting SMART attendance was associated with significant reductions in reconviction rates of 19 percent, and the reduction for SMART Recovery© attendance (alone) was 15 percent, the latter figure being non-significant. In all, 20 hours in either SMART program (ten sessions) was required to detect a significant therapeutic effect.

Criminal justice jurisdictions could implement this two SMART program intervention model, knowing a therapeutic effect is more likely if Getting SMART (12 sessions of cognitive-restructuring and motivation) is followed by SMART Recovery© for ongoing AOD therapeutic maintenance and behavioral change consolidation. SMART Recovery©, a not-for-profit proprietary program, is widely available internationally.

Getting SMART and SMART Recovery© have not previously been rigorously evaluated. This innovative two-program model contributes to best practice for treating higher risk offenders with AOD needs, suggesting achievable reductions in both violent and general reoffending.

The purpose of this paper is to elicit clinicians’ and workers’ knowledge, experiences and opinions of key issues pertaining to comorbidity service needs of people aged 12 years and over in a metropolitan region of South Australia.

As one component of a participatory action research project, this qualitative study used semi-structured interviews with mental health (MH) and alcohol and other drug (AOD) clinicians and workers (n=20).

The participants expressed concerns involving stigma towards their clients. They highlighted lack of adequate MH and AOD comorbidity service accessibility and models, regularly available clinical comorbidity workforce development, and practice supervision and skills training. These factors influenced participants’ and their colleagues’ capacity and ability to access and provide appropriate help for people needing integrated treatment and care of their co-existing comorbid conditions.

Findings highlight the need for coordinated and integrated, individualised holistic comorbidity services, including treatment and care best suited to Aboriginal people and refugees.

This study emphasises the importance of government and non-government MH and AOD services ensuring that comorbidity is responded to collaboratively and systemically. It also demonstrates the importance of professional development.

A structural model was proposed and tested concerning the impact of background and psycho‐social variables on high school seniors’ (N = 2,731) reported substance use and educational outcomes. The findings indicated that interpersonal variables (e.g., school adjustment, delinquency, relationships with parents and community) primarily affected reported substance use. Intrapersonal variables (e.g., self‐concept, attitudes toward school), however, were unrelated to substance use. Moreover, background, psycho‐social variables and substance use were also related to a variety of student perceptions about their educational experiences and future aspirations. The results are discussed in terms of their implications for school personnel working with high school students.

Substance use plays a significant role in the perpetration of much intimate partner violence (IPV). However, responses to these two issues are rarely integrated. Single focus programme responses can lead to poor outcomes for men as well as their families experiencing these intersecting issues. This scoping paper aims to establish the current state of knowledge on contextual factors influencing the development and implementation of combined programmes.

Four electronic databases were systematically searched in May 2021 and December 2021. Twenty-one peer-reviewed studies reporting on ten programmes were included.

This scoping review revealed that combined programme responses are an underdeveloped area of research and evaluation. The limited evidence base indicated systemic barriers hindering services’ capacity to expand this field of work, affecting implementation and outcomes. Support is required from the wider service systems to intervene in men’s perpetration of IPV in the context of substance use.

Findings in this scoping review demonstrate the importance of fostering a coordinated and collective response to IPV in the context of substance use. Combined programmes have the potential to reduce siloed practices, enabling more holistic responses for men with intersecting issues. However, researchers and policymakers must also address contextual issues hindering or enabling combined programmes’ implementation and development.

Mapping the evidence based on combined programmes provides direction for further development and research to expand this field of inquiry.

The purpose of this paper is to analyse the clinical outcome data collected as part of an 18-week, abstinence-based residential therapeutic community (TC) programme, Higher Ground Drug Rehabilitation Trust (Higher Ground) in New Zealand. Lessons and implications for routine collection of clinical outcome data are identified.

Higher Ground collects longitudinal data on all consenting clients using a battery of validated psychometric tools, with repeated measures at up to nine points in time from first presentation through to 12-month post-discharge follow up. Data analysis covered clients who entered Higher Ground between 1 July 2012 and 2 June 2015 (n=524).

Clients presented with histories of addiction which often had significant negative associations with their physical and psychological health, their relationships, work, accommodation and criminal behaviour. By the time they exited the programme, clinically and statistically significant improvements were seen across multiple indicators including: substance use and abstinence; symptoms of post-traumatic stress disorder, depression, anxiety and stress; and a range of social indicators.

Attrition in follow-up research is a significant challenge, with people completing the TC programme being more likely to participate than those who do not. This limits generalizability in post-discharge data. There was no control group, making causal attribution a challenge. Identifying suitable benchmarks from the literature is challenging because of the variety of outcome measures and research methodologies used.

Tracking client outcomes longitudinally using psychometric tools is potentially valuable for TCs and their funding bodies, as it provides insights into patterns of client recovery that can inform ongoing service improvements and resource allocation decisions. However, significant challenges remain.

The study demonstrates the value, and practical challenges, of collecting high-quality outcome data in a TC setting.

Developing therapeutic community (TC) programs in Australia for individuals on opioid substitution treatment (OST) has been a process spanning 16 years for the We Help Ourselves (WHOS) organization. Supported reduction of OST and stabilization services for those remaining on OST are offered to this population and continue to break down barriers of discrimination in offering the same services to all drug using populations. The paper aims to discuss these issues.

A number of research projects have been undertaken with the WHOS Opioid Treatment Program (OTP) TC services profiling clients accessing the services; looking at health benefits whilst in the programs; looking at retention and completion rates and conducting an evaluation post-treatment for one of the two programs currently being offered.

The excerpts from the research findings are presented identifying the complexity of individuals accessing WHOS services; highlighting the benefits for individuals on OST and assessing the effectiveness of the TC model for the client groups.

Working with multiple complex needs clients on OST in a residential TC environment offers many challenges and opportunity to work with an array of issues that present before during and after the residential stay. Provision of a history and overview of the WHOS OTP TC services and recent enhancements to these programs highlight a continuum of care for the individual on OST.