The modalities through which youth AOD practitioners engage young people and either deliver interventions or facilitate the delivery of interventions are:
- Clinic based settings
- Outreach / casework
- Day programs
- Short-term residential units with a focus on respite and withdrawal
- Long-term residential services that provide supported accommodation and rehabilitation
Each of these modalities provides a context that shapes how intervention matching and treatment planning is conducted. Each has its own opportunities and limitations for practitioners seeking to form an understanding of a client’s motivation for change and their capacity to enact it. These differences are explored below:
Clinic based settings are contained environments that provide a private space for young people to share intimate details regarding their substance use, their gaols and their readiness to change. This affords practitioners an opportunity to make a thorough assessment that informs treatment planning and the best approach to adopt. The limitation is that practitioners rely mainly on conversation and review of experiences, having limited opportunity to intervene with the young person between sessions.
Through Outreach, practitioners have the opportunity to establish relationships with young people and families in environments where they feel comfortable. This provides opportunity to combine dialogue with observation of shared experiences and life context to develop an understanding of each client’s motivation for change and their capacity to enact it. Issues often need to be discussed in a less structured way and at times the lack of contained private space can make it difficult to fully explore relevant issues. The advantage of outreach is that practitioners can ‘walk alongside’ young people as they make changes and constantly modify interventions to best facilitate change; in the short and long term.
Day programs vary both in purpose and in the services and/or resources that are offered but generally provide a blend of structured activities, direct care and an opportunity for unstructured participation. They are safe, contained environments for groups of young people but finding time for private conversation can sometimes be difficult. Even so, young people know they can access practitioners in day programs when needed rather than waiting for an appointment. This is likely to mean that a young person attending is more open to sharing ‘where they are at’ with practitioners and communicating what they need, particularly in the short term.
In all Residential services the pre-admission period offers an opportunity to begin the determining a young person’s readiness to make changes and to make plans for treatment in line with their goals. To decide to enter an AOD residential program requires a commitment to change in some way. Even young people who just want a break from their drug use and associated lifestyle have made a decision to take action for their own benefit. Young people attending longer term, residential rehabilitation services will be in the action or maintenance stages. All programs have young people residing with them 24 hours a day. This means that residential practitioners very quickly gain a lot of information about a young person and their life circumstances. This is helpful for ongoing treatment planning as practitioners can be ready to respond as young people’s motivation and their AOD related goals change. Because residential programs are time limited there is a need to facilitate young people’s engagement with other helpful services and constructive relationships that can continue to help them pursue their goals post their stay.
Please note that ‘family focussed interventions’ are applicable for assisting young people across all stages of change but are not specifically identified within the following practice aspects.