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Christchurch Youth Drug Court - Youth Specialty Services role (CDHB). Presenter Nigel Loughton. Outline:. Screening Comprehensive Assessment Collaboratively working with Y.D.C. Team Treatment involvement Case illustration. Screening process : referral sources. Previous YSS client

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Christchurch youth drug court youth specialty services role cdhb l.jpg

Christchurch Youth Drug Court - Youth Specialty Services role (CDHB)

Presenter

Nigel Loughton


Outline l.jpg
Outline: role (CDHB)

  • Screening

  • Comprehensive Assessment

  • Collaboratively working with Y.D.C. Team

  • Treatment involvement

  • Case illustration


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Screening process : referral sources role (CDHB)

  • Previous YSS client

  • CYFS - YDC social worker/YJ social worker/FGC coordinators

  • Youth Advocates

  • Police Youth aid

  • Other - youth workers/parent in waiting room


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Screening process: role (CDHB)method

  • Seen at youth court on the day appearing

  • 10-15 minutes

  • significant other

  • semi structure interview

  • experience A&D clinician

  • DSMIV dependency criteria


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Screening process: role (CDHB)criteria

  • Moderate to Severe dependency

  • Link to offending

  • recidivist offender


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Comprehensive assessment - role (CDHB)with young person & significant other

  • Alcohol and Drug use

  • Mental state

  • Psychiatric history

  • Medical history

  • Cultural assessment if indicated

  • Developmental history

  • Scholastic history


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Comprehensive assessment - role (CDHB)(continued)

  • Forensic history

  • Family history

  • Current situation

  • Risk assessment

  • Diagnosis

  • Recommendations

  • report to YDC


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Treatment plan : if accepted into YDC role (CDHB)

  • Individual sessions - motivational enhancement therapy

  • Group work - weekly at YSS. Young person and parent group.

  • Facilitating the person into treatment - day, residential (both in Chch) or other

  • psychopharmacology - comorbity or methadone, Antabuse


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Treatment plan role (CDHB)(continued)

  • Drug testing - monitoring process

  • Liaison with other involved agencies

  • referral to other agencies i.e. needs assessment, MST

  • family work and therapy

  • YSS continues involvement while in YDC and at times longer


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Case illustration : Client S role (CDHB)

  • 16 yr old

  • Living with family friend

  • Working full time food processing (past 6 wks), Promising sports person

  • Previous seen at YSS late 2002:

  • Issues: Cannabis dependence (Mild - Mod), Alcohol abuse, Mild conduct disorder, difficulty with parent child relationship, not motivated to change -> dropped out treatment


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Previous seen at YSS late 2002: (continued) role (CDHB)

  • Strengths:

    Likeable personality, Responded well to Life skills program at miltary camp (Team player and enthusiasm), Hard worker.


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Offending history: role (CDHB)February 2004

  • Dangerous driving, theft, unlawfully takes

    motor vehicle

  • Offending occurred under the influence of

    cannabis and alcohol

  • Previous offending : Assaults and

    burgarlies over several years - often

    occured under influence of A&D or to

    obtain money for A&D.


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Alcohol and Drug History role (CDHB)

Cannabis

  • first use 9 yrs of age

  • regular use from 11 years - cannabis rich environment

  • daily use 14 - 15 years age

    • From friends

    • Significant amount crime for cannabis.

  • irritability and insomnia on withdrawal, dyscontrol acknowledged impact on sport and school but continued use, tolerance.

  • current use 4-5 times a week


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Alcohol and Drug History role (CDHB)

Alcohol

  • first intoxicated 13 years

  • daily use 6 months 15 years age

    • from friends

    • significant amount crime for alcohol

  • tolerance, dyscontrol when starts drinking.

  • current use weekends 12-18 beers

  • aggression when drinking and offending

    Nicotine

  • no use -sport


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Relationship Between Offending and A+D role (CDHB)

  • Offending to pay for drugs/alcohol

  • Offending under the influence of drugs

  • Behaviour difficulties at home and school prior to regular A&D use

  • Dramatic increase in problems when regular A&D use began - offending began.

  • Diagnosis - Moderate Cannabis Dependence, Mild Alcohol Dependence and Conduct Disorder DSMIV


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Other Relevant History role (CDHB)

  • Family history

    extensive alcohol and drug history both side

    family

  • Schooling

    9 primary schools

    bullying and fighting at school

    seen as at least average ability


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Personal History role (CDHB)

  • Normal birth and milestones

  • Parental separation at 3 years age - irregular contact with father

  • CYFS involvement from 9 years of age

    - difficulty control behaviour

  • Boxing involvement

  • FT employment - early starts

  • Supportive mother and step father - feeling

    tired of ongoing issues


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Recommendations role (CDHB)

  • Youth Drug Court

  • Clinical case management through YSS

  • A+D weekly group at YSS and individual motivational sessions - working around employment

  • Encouragement to continue boxing - attempt to link sports coach to support change

  • Build/strengthen family relationship

  • Monitior and support positive living

    environment


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Progress I role (CDHB)

  • Accepted YDC

  • Began attending group and individual session with long standing girlfriend

  • regular boxing training

  • continuing FT employment

  • relinked in with CYFS psychologist reenforce change and anger management

  • relationship ended

  • Living situation changed - flatting with brother, began missing group

  • re-offending excess breath alcohol, driving while disqualified, assault

  • drop off in sport involvement


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Progress II role (CDHB)

  • 6 week period difficulty engaging in treatment - Increased individual session home visits YDC social worker and YSS

  • Returned to irregular group sessions with brother

  • Regular sport training 3 time a week

  • Increasing insight into alcohol and drug impact -> motivation to change increased

  • Casual employment

  • Action work (IYB benefit) - encouraged into limited services course at miltary camp

  • Graduated with very positive comments and looking to join army

  • Remained absent from cannabis and limited alcohol use

  • Decided to leave Odyssey against court direction & paid for own flight back

  • Court directed to ChCh Odyssey Day programme

    • Failed to attend

    • Refused family session

    • DNA’d several individual sessions with CCM

    • Further charges = Burglary (x14), Using documents (x6), escaping custody

  • Discharged YDC → Youth court → Kingslea


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Progress III role (CDHB)

  • Moved back to living with mother, step father and younger siblings

  • Support to join miltary - assitance working out requirements

  • Relapse prevention work

  • Family and young person found employment till start date for army

  • Continued absence cannabis and limited alcohol use

  • Joined army