‘I’ve got my old life back again’
Alan’s been in treatment with Swanswell since 2004.
He’d stopped using
illicit substances some time ago but found coming off his methadone
prescription a big challenge.
Before trying the newmodel, Alan had been attempting to reduce his
medication gradually, but had many anxieties about it. This meant the
reductions had been sporadic and slow, leaving him feeling further demotivated
and lacking in confidence in his ability to become medication free.
Using the model, Alan and worker from the recovery group were able to
explore different treatment options. He restated his recovery goals and
increased his confidence to achieve them.
A few months later, Alan successfully completed a community detox,
supported by his worker and GP. To date, Alan remains free from illicit
drugs and methadone, exiting drug treatment positively after eight years.
He said: ‘I didn’t realise being on methadone was like living your life
through a fog. I’ve got my old life back again. I have far more energy.’
April 2012 |
drinkanddrugsnews
| 21
www.drinkanddrugsnews.com
Treatment |
Shared care
FOLLOWING THE GOVERNMENT’S 2010 DRUG STRATEGY
, treatment in the UK is
changing. There’s a new emphasis on freedom from dependence, improved
mental and physical health and wellbeing, prevention of bloodborne viruses, and
improved relationships with family, partners and friends.
With this in mind, national drug and alcohol charity Swanswell has developed
a new recovery model. It builds on the ‘tidal’ model from the mental health field,
the core assumptions of which fit well with substance misuse recovery objectives:
l
Change is constantly happening, with even small changes ultimately
having a big effect.
l
Focus should centre upon the development of the client’s future and their
independence.
l
The client’s experiences are vital and need to be explored safely and
holistically.
l
The relationship between practitioner and client is collaborative, with
change occurring for both.
Swanswell has been delivering successful shared care services in Birmingham for
over a decade with substance misuse workers already well established in GP
practices, offering sessions that are integrated into existing surgeries. So this was
considered an ideal environment to develop and pilot the Swanswell Recovery
Model because strong collaborative relationships between clients, team
members, GPs and pharmacists are already working well.
Many existing models involve substance misuse practitioners translating the
client’s story into the third person and framing it against their own recognised
domains and indicators. Swanswell’s model advocates that the client tells their
story in their own words, using their personal experience to identify their
recovery objectives.
GPs have a vital role to play in the model, bringing their support networks into
the treatment process and enabling collaborative working with significant others
in the community. In addition, GPs with Special Interest (GPwSI) act as mentors to
other GPs and are often involved in service reviews at each practice.
Over a six-month period, Swanswell ran a pilot with more than 500 existing
clients accessing GP surgeries in shared care settings in Birmingham. They were
split into two teams – the ‘recovery group’ (309 clients) and the ‘control group’
(225 clients).
All practitioners involved with the recovery group were given full training in the
delivery of the new recovery model. Shared care GPs participating in the pilot were
also fully briefed and engaged and were very enthusiastic about using it.
Practitioners in the control group did not have access to the training, model or the
Swanswell detoxification and rehabilitation workbook, used alongside the model.
Following the six month pilot, Swanswell found promising evidence that this
new approach worked as a way of helping people move away from maintenance
Sarah Brighton
heads the team
that has developed
The Swanswell
Recovery Model
prescriptions, become drug free and make positive changes in their lives.
Findings showed a 168 per cent increase in clients accessing inpatient or
community detox programmes (compared to a 0 per cent increase in the control
group). Twice as many clients on the new programme came off methadone
maintenance prescriptions compared to those in the control group, and more
than twice as many clients reduced their dose levels of substitute medications.
In addition, clients trying the new model in shared care showed significant
positive behaviour changes in terms of their overall health and wellbeing as
measured by Treatment Outcome Profile data (an increase of 50 per cent on
average, compared with 16.5 per cent for the control group) and experienced a 54
per cent positive change (measured by clients who either detoxed or reduced
substitute medication dosage) – double that of the control group.
Swanswell is running a larger scale pilot to gather much more evidence of the
model’s effectiveness, rolling it out across all of the charity’s existing drug
services. We would also like to hear from other drugs services who would be
interested in taking part in a larger pilot.
Sarah Brighton is Swanswell’s business development manager who, along with a
team of service users, practitioners and managers, created the Swanswell Recovery
Model. For further information, please call Sarah on 01788 559400. An electronic
copy of the Swanswell Recovery Model evaluation report will be available shortly
at www.swanswell.org
Recovery in
PRACTICE
Putting people in charge of their
recovery and actively working with their
GPs, family and friends is a logical way
forward, writes Sarah Brighton