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Support Connections
People who experience drug dependence and/or have lived experience of drug dependence in the ACT experience stigma, discrimination and ongoing impacts of criminalisation. This leads to a wide range of social and health inequities and requires an integrated approach in providing appropriate health care. Many people experiencing alcohol and other drug (AOD) dependence need multidisciplinary approaches to providing comprehensive, specialist health care through integrated AOD counselling and case management. Furthermore, outreach services can improve access to health services for individuals unable to access services due to personal circumstances and/or risk of being identified in service settings.
CHN commissioned Marymead Catholic Care to provide AOD Support Connections. This outreach case management program works in partnership with anyone over 16 years of age wanting to stop or reduce their alcohol and other drugs use. The AOD Support Connections Case Manager can assist individuals to make meaningful and sustainable changes to their AOD dependence and broader lifestyles. This includes developing therapeutic alliance to provide holistic, person-centred care; developing crisis and relapse prevention plans; exploring harm reduction strategies to help individuals in gaining better control of their dependence; and connecting individuals with other community and health services to improve their health and wellbeing.
The AOD Support Connections Case Manager continues the provision of holistic support to clients who self-identify problematic use of alcohol and other drugs. This involves collaborative case planning that empowers clients to make changes to their alcohol and other drug use, connect with physical and mental health services, address legal; financial or housing problems, safety plan around domestic and family violence, build formal and informal support networks. The Case Manager has continued to work closely with housing and homelessness services, allied health providers and numerous community agencies to provide holistic and coordinated care for a highly complex client group.
Over the last year, 75 clients were assisted through over 400 occasions of service, 100% of which positively endorse the service through Catholic Care AOD Support Connections surveys completed. The Case Manager has maintained a caseload of 15-20 clients at any given time and high rates of service user engagement; and stronger stakeholder relationships with other community services.
Client story
The AOD Support Connections Case Manager has been assisting a 35-year-old male, Angelo* (not his real name) with a history of polysubstance use, recently struggling with alcohol and cannabis dependency. Angelo had previously attempted residential treatment, achieving extended periods of abstinence. Initially connected to AOD Support Connections through another program, Angelo was unemployed and heavily reliant on substances daily. With support from the AODSC team, he made progress, securing part-time work and accommodation with a family member. He also regained access to his children with the help of his ex-partner. During this time, Angelo successfully reduced his alcohol intake and ceased cannabis use.
A few months later, Angelo reached out to AODSC, explaining how his situation deteriorated when he lost his family support, resulting in a relapse, homelessness and disengagement with supports. Based on his positive experience in the past with AODSC and the wider Marymead CatholicCare teams, Angelo reengaged in AODSC through self-referral. The AODSC Case Manager developed a revised case plan with Angelo, where he identified his desire for detox, and securing permanent accommodation as he was couch surfing with friends.
Angelo was successful in his planned detox, seeking medical supports to ensure his safety. Once detoxed from AOD use, the AODSC Case Manager supported Angelo to apply for Priority Needs with Housing ACT. Angelo was excited to be approved within 6 weeks and offered a property in his preferred location. With support from his AODSC Case Manager, Angelo furnished his new home, providing him stability and the foundation to rebuild his life. Angelo reports having reconnected with his partner and children and has continued to maintain his abstinence from substance use. During a recent follow-up, Angelo expressed gratitude and optimism, describing his family life as wonderful and affirming his commitment to ongoing positive progress in his life.
Reaching Out
People who experience drug dependence and/or have lived experience of drug dependence in the ACT experience stigma, discrimination, and ongoing impacts of criminalisation. This leads to a wide range of social and health inequities and requires an integrated approach in providing appropriate health care. Many people experiencing AOD dependence need multidisciplinary approaches to providing comprehensive, specialist health care through integrated AOD counselling and case management. Furthermore, outreach services can improve access to health services for individuals unable to access services due to personal circumstances and/or risk of being identified in service settings.
CHN, ACT’s PHN, commissioned Marymead Catholic Care Goulburn to run the Reaching Out Program. Reaching Out provides Alcohol and Other Drugs (AOD) counselling through assertive outreach, with Counsellor’s meeting individuals where they feel most safe and comfortable, including in the privacy of their home. This person-centred, individualised approach can improve therapeutic alliance between Counsellors and their clients, and lead to more holistic and sustainable health outcomes. Due to the impacts of COVID-19, the counselling team also developed initiatives for providing more flexible delivery of services through telehealth and supporting clients to use digital apps where necessary.
Marymead Catholic Care Goulburn has continued to provide person-centred and comprehensive counselling services for people experiencing AOD dependence in the ACT. AOD Counselling includes a wide range of therapeutic approaches and harm reduction strategies, to empower individuals through strengths-based, person-centred care. The Reaching Out AOD Counsellors provide a high level of individualised support to clients with continuity of care and minimal disruption and it’s continued success and need in the community has been especially evident over the last 6 months with significantly increase in referrals (by 28%), with the service providing assistance to 113 clients between January – June 2024, in comparison to 89 clients between July – December 2023, a total of 202.
Additionally, 100% of service users surveyed continued to endorse the service positively. Of those surveyed, 54.2% of clients reported a significant reduction in their alcohol or other drug use, and 9.4% reported sustained abstinence. In October 2023, the Reaching Out Team piloted the Integrated Group Program (IGT). The IGT has been extensively researched and adapted by Marymead CatholicCare to address both substance use and mental health concurrently. It has been shown to improve long-term outcomes over and above sequential or parallel treatment. The program is designed so it can be attended as a one-off session, although it is still most beneficial to complete the program in its entirety. During the pilot, individuals were offered the opportunity to participate in the IGT, while they await to be allocated a Counsellor. The pilot was a success, and another is currently planned for the second half of 2024.
Client story
Layla* (not her real name) initially sought help through the Support Connection Program and was later referred to Reaching Out. Layla presented with challenges including high alcohol consumption, strained family relationships, low self-esteem, social isolation and mental health symptoms, such as psychosis. Layla migrated to Australia from Africa as a child but spent most of her teenage years in Africa.
Initially, Layla was reluctant to engage in face-to-face sessions and was supported through counselling sessions via FaceTime. During this time, Layla attempted rehab but left after one week due to mental health symptoms exacerbating her condition. Achieving abstinence from alcohol was a primary goal for Layla. Gradually, a therapeutic relationship developed, leading her to participate in face-to-face counselling sessions. Layla expressed trust and commitment in the counselling process. Narrative therapy facilitated exploration of childhood trauma, the client’s role as a primary caregiver in her family, and the impact of migration and cultural adjustment during her childhood and teenage years.
Grief counselling was conducted to address Layla’s feelings of loss, following the death of a family member, a significant trigger for relapse. Support was provided to help her to navigate feelings of guilt and shame, and strategies were explored to establish boundaries and practice assertive communication with family members. As treatment progressed, Layla reported improved self-esteem and healthier relationships with family members. Layla indicated developing the ability to manage triggers through consequential thinking and self-questioning.
Towards the conclusion of treatment, Layla demonstrated a noticeable sense of empowerment. Layla’s alcohol use decreased, and she has-maintained abstinence for 6 months up to the last contact. Continued therapeutic support and encouragement to apply counselling skills were crucial for Layla’s progress. Building trust gradually played a significant role in achieving a positive treatment outcome.