Search results

The purpose of this paper is to examine the strategies utilised to facilitate the wellbeing of workers of an alcohol and other drug (AOD) therapeutic community (TC)

This paper reports on the findings of a qualitative study that involved in-depth interviews with 11 workers from an Australian AOD TC organisation that provides both a residential TC program and an outreach program. Interviews were analysed using thematic analysis

Three main interconnected themes emerged through analysis of the data: the challenges of working in an AOD TC organisation, including vicarious trauma, the isolation and safety of outreach workers and a lack of connection between teams; individual strategies for coping and facilitating wellbeing, such as family, friend and partner support and self-care practices; organisational facilitators of worker wellbeing, including staff supervision, employment conditions and the ability to communicate openly about stress. The analysis also revealed cross-cutting themes including the unique challenges and wellbeing support needs of outreach and lived experience workers.

Rather than just preventing burnout, AOD TC organisations can also play a role in facilitating worker wellbeing.

This paper discusses a number of practical suggestions and indicates that additional strategies targeted at “at risk” teams or groups of workers may be needed alongside organisation-wide strategies.

This paper provides a novel and in-depth analysis of strategies to facilitate TC worker wellbeing and has implications for TC staff, managers and researchers.

The purpose of this paper is to demonstrate how social identity change can support the TC objective of promoting “right living”. This is compatible with the literature on addiction recovery which has shown that identity change is central to this process. While much of the earlier literature focussed primarily on an individual analysis of change, there is a growing body of research showing the important contribution that social networks, social group membership and associated social identities make to sustainable change.

The paper describes baseline data for a multi-site prospective cohort study of 308 clients entering therapeutic community (TC) treatment and characterizes the presenting profile of this cohort on a range of social identity and recovery measures at the point of TC entry.

The sample was predominantly male with a mean age of 35 years, with the large majority having been unemployed in the month before admission. The most commonly reported primary substance was methamphetamine, followed by alcohol and heroin. The sample reported low rates of engagement in recovery groups, but access to and moderate degrees of social support was also reported in the period prior to admission.

The paper highlights the important role that TCs play in facilitating identity change and in promoting sustainable recovery.

The paper discusses opportunities for working with social identities both during residence and in community re-integration, and highlights what TCs can do to support and sustain recovery.

The paper brings to light the potential contribution of social group membership and social identity change to management of recovery in TC settings.

The study described provides an innovative way of assessing TC effectiveness and testing novel questions about the role of social identity and recovery capital as key predictors of change.

There is considerable literature indicating the importance of social connectedness and its relationship to wellbeing. For problem substance users, a similar literature emphasises the importance of the transition from a social network supportive of use to one that fosters recovery. Within this framework, the therapeutic community (TC) is seen as a critical location for adopting a transitional identity (i.e. from a “drug user” to a “member of the TC”), as part of the emergence of a “recovery identity” following treatment. The purpose of this paper is to outline a model for conceptualising and measuring identity based on the theories of social identity and recovery capital, and pilots this model within a TC setting.

A social identity mapping was used with TC residents to test their identification with “using” and “TC” groups, and their relationship to recovery capital.

The network mapping method was acceptable to TC residents, and provided valuable insights into the social networks and social identity of TC residents.

This paper explores issues around mapping social identity and its potential in the TC and other residential settings.

The paper integrates a number of conceptual models to create a new framework for understanding transitions in social networks during treatment and reports on a novel measurement method underpinning this.

Integrated care is widely supported as a means of improving treatment outcomes for people with co-occurring mental health and substance use disorders. Over the past two decades, Australian state and federal governments have identified integrated care as a policy priority and invested in a number of research and capacity building initiatives. This study aims to examine Australian research evaluating the effectiveness of integrated treatment approaches to provide insight into implications for future research and practice in integrated treatment.

This narrative review examines Australian research evaluating empirical evidence of the effectiveness of integrated treatment approaches within specific populations and evidence from initiatives aimed at integrating care at the service or system level.

Research conducted within the Australian context provides considerable evidence to support the effectiveness of integrated approaches to treatment, particularly for people with high prevalence co-occurring disorders or symptoms of these (i.e. anxiety and depression). These have been delivered through various modalities (including online and telephone-based services) to improve health outcomes in a range of populations. However, there is less evidence regarding the effectiveness of specific models or systems of integrated care, including for more severe mental disorders. Despite ongoing efforts on behalf of the Australian government, attempts to sustain system-level initiatives have remained hampered by structural barriers.

Effective integrated interventions can be delivered by trained clinicians without requiring integration at an organisational or structural level. While there is still considerable work to be done in terms of building sustainable models at a system level, this evidence provides a potential foundation for the development of integrated care models that can be delivered as part of routine practice.

The purpose of this study was to assess whether a multifaceted intervention could improve mental health literacy, facilitate help seeking and reduce psychological distress and alcohol misuse in staff of a multi-campus university in Australia.

In this cluster randomised trial (ACTRN12610001027000), nine campuses were paired, with one of each pair randomly assigned to either intervention or control. Interventions (which were whole-of-campus) included e-mails, posters, campus events, factsheets/booklets and mental health first aid training courses. A monitoring sample of staff were recruited from each campus. Participants had a 20-minute computer-assisted telephone interview at baseline, and at the end of academic years 1 and 2. The interview assessed mental health literacy, help seeking for mental health problems, psychological distress and alcohol use. The primary outcomes were depression and anxiety levels and alcohol use and pertained to the individual level. Six campuses were randomised to intervention and three to control and all campuses were included in the analysis.

There were no effects on depression and anxiety levels and alcohol use. Recall of intervention elements was greater in the intervention group at the end of the two-year assessment period. Staff in the intervention group showed better recognition of depression, greater knowledge of the National Health and Medical Research Council guidelines for safe levels of drinking and a greater intention to seek help for alcohol misuse from a general practitioner.

Future interventions should involve more focused interventions that include consideration of working conditions and their influence on mental health, as well as addressing mental illness among employees, regardless of cause.

The problematic surrounding patients' prioritization decisions are currently at the centre of political leaders' concerns. How to define whom to treat when there are not enough resources to treat everybody is the key question. This exploratory study aims to investigate the views of Bulgarian citizens regarding the relevance of the information concerning eight individual health-related behaviours in priority setting decisions: smoking, excess of alcohol, illegal drug use, overweight/obesity, speed driving, extreme sports practice, unsafe sex and overuse of internet and/or mobile devices.

Data were collected through a questionnaire where 322 respondents faced hypothetical rationing dilemmas comprising option pairs of the eight risky behaviours. Descriptive statistics and non-parametric tests were performed to define the penalization of each of the risky behaviours and to test for the association between this penalization and the respondent's health habits and sociodemographic characteristics.

Most respondents would refuse to grant access to healthcare based on patients' personal responsibility for the disease. Nevertheless, respondents were more willing to consider illegal drug use, excessive alcohol consumption, engagement in unsafe sex behaviours and smoking. Respondent's own interest or advantage seems to be somehow relevant in explaining the penalization of risk behaviours in priority setting.

This study shows that most respondents support the lottery criterion and thus do not want to see lifestyle prioritization in action.

This study is the first attempt to awaken attention to the impact that personal responsibility for health may have on intergenerational access to healthcare in Bulgaria.