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Clinical
Research/
Completed
Projects
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Clinical
Treatment Guideline - Case Management
TP Staff: Dr
Nicole Lee, Dr Madonna Devaney, Linda Jenner
Summary: As
part of a broader strategy to develop best practice in the
field, DPSB commissioned Turning Point Alcohol and Drug Centre
to develop and disseminate a set of clinical guidelines to
inform practitioners on the application of Case Management
(CM).
This project will produce a set
of clinical guidelines that will:
- Clearly define case management and its application
in the AOD sector
- Enhance the sector’s capacity to deliver
case management interventions that are consistent and evidence
based
- Outline the key component of sound case management
practice, noting key interface points with other interventions
(like ITPs and Assessment) and service types (like 4Cs,
withdrawal, residential rehab etc)
- Elucidate the application of case management
to key client populations in all of the relevant currently
funded drug treatment service types
Start date: October 2006
Completion date: July 2007
Contact person: Dr Madonna Devaney
Phone: 8413 8419
Email: madonna.devaney@turningpoint.org.au
Funding body: Drugs Policy
and Services Branch, Department of Human Services
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Psychostimulant
withdrawal: Natural history and options for intervention
TP Staff: Dr Nicole
Lee, Dr Adrian Dunlop, Lisa Johns
Summary:This comprehensive
study aims to understand the natural history of psychostimulant
use, dependence and withdrawal, focusing on pathways to dependence
and experiences of treatment; to develop withdrawal protocol/s
for the various psychostimulants and to examine the role and
efficacy of, and to develop guidelines for, psychosocial interventions
for psychostimulant users in withdrawal. In addition it will
examine the feasibility of using modafinil and dexamphetamine
during withdrawal as an aid for withdrawal and entry into
further treatment. The study uses a mixed methodology of literature
review, client and key informant interviews and case studies.
Start date:
August 2005
Completion date: December 2006
Contact person:
Dr Nicole Lee
Phone: 8413 8416
Email: nicole.lee@turningpoint.org.au
Funding body:
Illicit Drugs Branch, Department of Health and Ageing
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PsyCheck
- Implementation of screening and brief mental health intervention
in alcohol and drug treatment
TP Staff: Dr Nicole
Lee, A/Prof Alison Ritter, Jo Norman, Dr Kate Hall, Dr Fiona
Dann
Collaborators:
Linda Jenner (JenCo Consulting), Dr Amanda Baker (University
of Newcastle), Frances Kay-Lambkin (University of Newcastle),
Dr Leanne Hides (Orygen Youth Health)
Summary: This
project aimed to develop and implement a system of screening
and brief mental health intervention in alcohol and drug treatment.
During this study we implemented a stepped care approach to
screening and intervention with primarily non-psychotic disorders.
Clinicians were trained and provided with supervision each
week.
The project used a mixed method
evaluation including clinician, supervisors and manager interviews
and file audits. Clinicians reported an increased use of screening
tools, increased skills and confidence when screening as well
as thinking more about treatment and improved skills in treatment.
All site managers reported their staff were increasing the
detection of symptoms of anxiety and depression and 80% reported
increased ability in their clinicians ability to treat same.
The outcomes of the project included
comprehensive clinical guidelines, service guidelines, a training
and supervision package and a screening instrument (the PsyCheck)
and users guide.
Start date: 31/07/04
Completion date:
31/07/05
Contact: Dr Nicole
Lee
Phone: 8413 8416
Email: nicole.lee@turningpoint.org.au
Funding body:
Illicit Drugs Branch, Department of Health and Ageing
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Improving Victorian drug treatment outcomes through contingency
management
TP Staff: A/Prof
Alison Ritter & Jacqui Cameron
Summary: Contingency
Management in drug treatment is based on the principle that
if a good behaviour is rewarded, it is more likely to be repeated.
Contingency Management has proven to be a useful intervention
that encourages clients to engage in treatment through a system
of recognition and positive rewards. Some examples of rewards
might be - inexpensive vouchers, goods & services or other
privileges such as take home medication. Clients can earn
rewards for any behaviour that promotes their own recovery
e.g. drug free urine screens, attendance to counselling etc.
Contingency management principles have been used successfully
in a variety of treatments setting including drug free, residential
and methadone maintenance.
Contingency management has been
demonstrated to be effective in improving treatment outcomes
for heroin users in methadone maintenance programs in the
USA. In methadone maintenance programs, abstinence is reinforced
through incentives such as take-away doses, higher doses,
or monetary reward. Contingency management has also been studied
with cocaine, alcohol, tobacco and other impulse control disorders
such as gambling.
Interestingly there has been no
attempt to introduce contingency management into Australian
drug treatment programs, it is important that the treatment
sector in Australia explore whether contingency management
has a role to play in our own treatment context as it is widely
used in the USA but is it relevant for our treatment services?
The study uses a mixed methodology which will included:
- Review of the contingency management literature,
with particular emphasis upon the applicability to Victorian
drug treatment services
- Qualitative interviews with a range of staff
from Victorian drug treatment services in relation to their
attitudes towards contingency management
- Quantitative survey sent out to all Victorian
drug treatment services in relation to their attitudes towards
contingency management
- Comparison of quantitative dataset
results to USA data
The study is now in its final phase
with commencement of data analysis and report writing the
final report will be submitted to DHS at the end of July 2005.
Start date: February
2005
Completion date: July 2005
Contact person:
Jacqui Cameron
Phone: 8413 8433
Email: jacqui.cameron@turningpoint.org.au
Funding body:
Victorian Department of Human Services
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Youth
Alcohol and Drug Outreach Guidelines
TP Staff: Dimitra
Petroulias, Julie Bowan, Meredith Butler, Emily Gillespie,
Maria Papadontas
Collaborators:
Youth Substance Abuse Service - Andrew Bruun (Manager of Research),
Ipsita Roy (Manager, YSAS Springvale/Dandenong Team)
Summary: The Youth
Alcohol and Drug Outreach Guidelines aims to provide current
and future workers and services with guidance on best practice
AOD outreach to young people.
A systematic literature review
has been conducted to determine the available evidence for
effective interventions for youth AOD outreach workers. Due
to the lack of outcome evidence for youth AOD outreach interventions,
a consensus-based approach was applied to the development
of the guidelines. This involved establishing a development
team of clinicians, trainers and researchers with expertise
in youth AOD outreach and conducting extensive key informant
interviews and reviews of the guidelines. Thus ‘best
practice’ is based on the available practical and theoretical
knowledge of experts and key informants in the area.
Start date: 4th
October 2004
Completion date: 29th July 2005
Contact person:
Dimitra Petroulias
Ph: 8413 8466
Email: dimitra.petroulias@turningpoint.org.au
Funding body:
Victorian Department of Human Services
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Methamphetamine
Clinical Treatment Guidelines
TP staff: Dr Nicole Lee, Lisa Johns, Kieran
Connolly, Dr Adrian Dunlop, Dr Kate Hall, Rebecca Jenkinson,
Jenn Johnston
Summary: The Clinical Treatment
Guidelines for Alcohol and Drug Clinicians series has been
developed as a reliable and practical resource in the treatment
of people with alcohol and other drug problems. The series
combines the knowledge and experience of Turning Point clinicians
and researchers with the latest information form the wider
field. The guidelines combine practical and theoretical knowledge
that can be adapted to specific work environments where necessary
and are suited to a variety of professional settings.
Methamphetamine– Dependence and Treatment,
will be published as part of the Clinical Treatment Guidelines
series developed by Turning Point Alcohol and Drug Centre.
The publication will provide a range of useful information
for working with amphetamine users, including practical tools
and strategies, information sheets and work sheets. More
information
Start date: November 2005
Completion date: April 2006
Contact person: Lisa Johns
Phone: 8413 8446
E-mail: lisa.johns@turningpoint.org.au
Funding body: Victorian
Department of Human Services
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Evaluation
of an Opportunistic Alcohol Screening and Brief Intervention
in St Vincent’s Hospital Emergency Department, Melbourne
TP Staff: Amy
Pennay
Collaborators:
Dr Andrew Dent (St Vincent’s Health)
Summary: This
project aims to implement alcohol screening and train staff
to deliver brief intervention in the Emergency Department
and then evaluate the efficacy of the screening and brief
intervention procedure in reducing Emergency Department re-presentations
and hazardous alcohol consumption. The difficulties associated
with the introduction of such a program in an emergency setting
will be analysed, and an assessment of the validity of the
PAT as a measure of hazardous drinking will also be undertaken.
The preliminary results show that
Emergency Hospital staff have, by and large, displayed capability
and competency at administering brief interventions in the
ED. With PAT testing currently taking on average 1.26 minutes,
and brief interventions currently taking 7.09 minutes, the
time/resources and financial implications of the testing are
showing signs of being viable.
Start date: June
2004
Completion date: January 2006
Contact person:
Amy Pennay
Phone: 8413 8460
Mobile: 0400 105 614
Email: amy.pennay@turningpoint.org.au
Funding body:
Alcohol Education and Rehabilitation Foundation
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Treatment
for depression: A qualitative exploration of the experience
of alcohol and drug users
TP staff: Jacqui Cameron
Collaborators: Beyondblue
Summary: The association between
mental health problems and substance use is well established,
with previous research finding comorbidity rates of 28-59%.
Depression is the most prevalent mental health disorder among
alcohol and drug using populations. There is a large amount
of evidence concerning the effectiveness of treatment for
depression and substance use individually. However, poorer
treatment outcomes are often noted in comorbid populations.
Treatment for depression and substance use has traditionally
been delivered by separate systems. This study proposes to
explore alcohol and drug treatment clients’ experiences
of their depression being addressed within that sector, the
mental health sector, or not at all.
Start date: August 2005
Completion date: September 2006
Contact person: Jacqui Cameron
Phone: 8413 8433
E-mail: jacqui.cameron@turningpoint.org.au
Funding body: Beyondblue
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The
Australian Treatment Outcome Study (ATOS): Alcohol, Cannabis
and Polydrug
TP staff: Sanja
Pahoki, Nicola Thomson
Collaborators:
Not applicable
Summary: The aims
of ATOS: Alcohol, Cannabis and Polydrug are to describe the
characteristics of people seeking treatment for problems associated
with alcohol, cannabis and polydrug dependence, describe the
treatment received, and examine treatment outcomes (drug use,
physical/mental health and criminal behaviour) at three and
12 months after commencement of treatment. 188 participants
were recruited to the study at entry into treatment (withdrawal,
residential rehabilitation or counselling) and they interviewed
again 3 and 12 months later. A report on the baseline characteristics
of these clients has been produced, and 3 and 12 month outcomes
reports will follow shortly.
Start date: January
2003
Completion date: May 2006
Contact person:
Nicola Thompson
Phone: 8413 8428
Email: nicola.thomson@turningpoint.org.au
Funding body:
Victorian Department of Human Services
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The
Australian Treatment Outcome Study (ATOS): Youth Outreach
TP staff: Sanja
Pahoki, Nicola Thomson
Summary: The aims
of ATOS: Youth Outreach are to describe the characteristics
of young people seeking outreach treatment for problems associated
with alcohol or other drug dependence, describe the treatment
received, and examine treatment outcomes (drug use, physical/mental
health and criminal behaviour) at three and 12 months after
commencement of treatment. Recruitment of 50 participants
commenced in February 2005. Participants will be interviewed
on entry to outreach treatment and then 3 and 12 months later.
Reports on the baseline characteristics and 3 and 12 month
outcomes will be produced within the next 18 months.
Start date: January
2005
Completion date:
January 2007
Contact person:
Nicola Thompson
Phone: 8413 8428
Email: nicola.thomson@turningpoint.org.au
Funding body:
Victorian Department of Human Services
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