1 / 27

An Intervention Model for the High Rate User -SAPs-

An Intervention Model for the High Rate User -SAPs-. Presentation to the California County Coordinators January 20, 2005 Presented by: Joël L. Phillips Community Prevention Institute (CPI) (CARS, Inc.). What we have learned… about underage AOD use/users. . AOD use/Binge Drinking

bandele
Download Presentation

An Intervention Model for the High Rate User -SAPs-

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. An Intervention Modelfor the High Rate User-SAPs- Presentation to the California County Coordinators January 20, 2005 Presented by: Joël L. Phillips Community Prevention Institute (CPI) (CARS, Inc.)

  2. What we have learned… about underage AOD use/users. AOD use/Binge Drinking Despite emphasis on AOD prevention, percentage of students who report high rate use has been relatively constant over past decades. • A substantial percentage of California secondary school students report they are high rate users (30% for EAUs, 20% for HRUs) • Excessive alcohol use is more prevalent than high risk drug use • Approximately a quarter of 11th graders binge once a month, 12% binge 3 or more times per month. For 9th graders, 11.5% binge once a month, 7.2% binge 3 or more times per month.

  3. Consequences of Binge Drinking • Social Harm • Binge drinkers are more likely involved in gangs and potential violence than students who do not binge • One third of binge drinkers have reported being in a drink/drive situation three or more times (nearly triple the rate of the total sample) • Binge drinkers are more likely to be involved in relationship violence than non-binge drinkers

  4. Consequences of Binge Drinking(continued) • School Related Harm • Binge drinkers are more likely to use substances at (23.6%), or before school (30.4%) • Some are more likely to engage in violent or destructive behavior at school • Much more likely to skip school or cut class (one estimate is 3.7 million missed days for California high rate users) • Tend to have lower connectedness to school

  5. High Risk Drug Users (HRU)Profile – 11th Grade • One quarter: • Used marijuana and alcohol at school, past 20 days • Drunk/high at school 7+ times • One third: • 3 or more dependency indicators • 2 or more use-related problems • Drinking/driving 3+times • One half or more: • Regularly (c. weekly) binge drink (5+ drinks/row) • Weekly marijuana use • High on drugs 7+ times • Sold drugs *Source: West Ed 12/2/2004

  6. New Analysis (West Ed) • Document clear association between a number of student AOD • risk factors and overall school performance. FINDING Higher rates of AOD use resulted in lower levels of academic performance measured by changes in SAT 9

  7. Summary of HRUCharacteristics • Endemic and resistant heavy alcohol and drug use • Poorer school attendance and performance • Multiple risk factors in lives, including early onset • High correlation with violence on and off school • Less positive response to prevention • Open to cessation but little follow through and low perception of help from school *Source: West Ed 12/2/2004

  8. Program Implications • Efforts to raise test scores and improve schools – as well as create safe and drug free campuses – need to address needs of heavy substance users • Different approaches from standard prevention • Early intervention addressing multiple risk factors • Need to address wide range of substance use behaviors and other problems • Need to identify, support cessation, and provide referral to services – Student Assistance * Source: West Ed 12/2/2004

  9. Estimating Need for Services HRU Plus: (HRU +2 or more consequences (WestEd ) 4.5% 9th 8.6% 11th Binge Drinkers Plus (BDP): (Binge Drinking Plus 2 or more problems) 4.4 % 9th (2.3% binged 3+ times) 10.7% 11th (6.4% binged 3+ times) Overlap: HRU Plus, Binge Drinkers Plus 75% 9th (BDP) were also HRU Plus 60% 11th (BDP) were also HRU Plus Result: We estimate 6.1% of 9th graders and 13.1% of 11th graders ARE IN PARTICULAR NEED OF INTERVENTION

  10. Summary of the Estimates • High School Binge Drinkers: 356,000 • High School Problematic Use: • (2 or more problems/issues) 114,700 • Serious Alcohol Use (GW) • 16-17 yrs 83,750 • Dependent/Abuse (National Household Survey Extrapolations) • Alcohol Dependency 12-17 yrs 50,000 • Alcohol Dependency/Abuse 12-17 yrs 138,000 • Alcohol or Illicit Dependence/Abuse 12-17 yrs 221,000

  11. Issues • Who do we target? • How do we screen? • What intervention services can we use? • SAP’s, others • How can we structure service delivery?

  12. None Mild Moderate Substantial Severe Specialized Treatment Brief Intervention Primary Prevention Who do we Target? -Points of Intervention Individual Needs and Levels of Service: Exhibit 1 Needs Services IOM Model Universal – everyone Selected – sub-groups Indicated – Individuals with risks/problem behaviors

  13. Points of Intervention (cont) Implications: • IOM categorization at selected/indicated requires screening and identification Question: What are we doing in our schools to screen students before they participate in one of our Model Programs designated “selective” or “indicated”? • Based on our estimates there are thousands of youths in need of intervention services

  14. Promising Interventions • Project Brief Interventions – K. Winters • 2-3 sessions • Strong Points • For adolescents • Can be used by paraprofessionals • Good evaluation results • Student Assistance programs (SAPs) • Project SUCCESS • A SAP program, but has some solid evidence, experience • Recovery High Schools • More intensive option

  15. The SAP Model What is a Student Assistance Program? • SAPs are a school-based approach to providing focused services to students needing interventions for substance abuse or other problems. • SAPs are a process (not a curriculum or treatment center) that connects education, programs, and services within and across systems to aid students and their families.

  16. What do SAPs do? • SAPs… • Identify troubled students • Assess students’ needs • Provide support and referral to school, family, and community resources to address these needs • The overarching goal of SAPs is to remove barriers to education so that a student may achieve academically.

  17. What does a SAP look like?There are several possibilities….. • Core Team Model, which is founded on a central group of school personnel, including: • Student Assistance Coordinator • Vice Principal • School Counselors • School Social Workers and Psychologists • Classroom and Special Ed Teachers • Student Services Staff • The Core Team works collaboratively to identify and assist students. • Counselor Model, which is founded on an outside contracted body serving as the source for SAP services. • It requires a certified, experienced counselor to serve as program coordinator. • It effectively removes the SAP from the hands of school personnel. SAP’s can be: • School-based model, where each school has an independent SAP • District-based model, where a centralized SAP serves schools throughout the district

  18. Identification of Services How are students identified for SAP services? • Referral of students comes from classroom teachers, school counselors, through school disciplinary processes, by parents, and occasionally by students themselves. (Ideal: Behavioral checklist) • Students then proceed through the SAP process in a typical manner. Who delivers SAP services? • Services are delivered by acore group of individuals, typically a combination of school personnel (administrators, nurses, counselors, teachers) and external service providers (community-based organizations, community health providers). What services are provided? • Services provided include educational support groups, referral to outside agencies, tutoring, after-school activities, peer mediation and conflict resolution, and career services an family conferences, which are the heart of some SAP’s. What issues are addressed? • Issues addressed by many SAPs are: • prevention (AOD, tobacco, drop-out, pregnancy, & STDs), • violence/bullying, • academics/attendance, and/or • behavior and mental health (grief, anger management, relationships, self-harm).

  19. What have we learned…about SAPs in California? Survey/Site Visit Results: • Not sure about numbers – identified 100 plus schools with SAPs – 40 High Schools offering SAP type services (CDE estimates: 353/1298 LEA’s had a SAP in 2003-2004) • Multiple Names • Problems (Top 3 co-equal) at 92% • AOD • Mental Health • Academic • 20 plus other issues addressed by 1 or more schools • Services Offered • Support Peer Groups 97% • AOD Problem Identified 94% • School Counselor Consults 86% • Prevention Education (classrooms) 83% 11 plus additional services

  20. What have we learned…about SAPs in California? (cont) • SAPs (80%) work with community agencies • Students are referred through 4 ways: Use Account for Teachers 100% of schools 41% of referrals Self Referral 89% of schools 32% of referrals Counselor 97% of schools 24% of referrals Parent 97% of schools 7% of referrals • Service size varied greatly (from small numbers 6-32 youth to district size

  21. What have we learned…about SAPs in California? (cont) • Participation: • Most reported engagement (42%) 4-12 weeks • 12% - all school year, 12% 1-4 weeks • Problems: • Funding – low, piecemeal • Staffing – burdened teacher staff • Program awareness/buy-in • Minimal evaluations – most process oriented • Need: • Better statewide sharing of information between SAP providers

  22. Evaluations of SAP’s • 13 times fewer physical assaults • 7 times fewer threats to staff by students • Half the physical threats to students by other students • Fewer fights and weapon carrying A reduction in school infractions, including: • Less than half the disciplinary actions • Less vandalism A reduction in incidences of substance use, including: • Almost half the suspensions for drug use and drug sales by students • Four times more student self-referrals for drug use • Less drinking • We found only one rigorous study of a SAP. • We did find three statewide studies of SAPs. • Vermont (comparative study) • - Having a SAP counselor: A reduction in violence, including:

  23. What did we learn about evaluation? (continued) Pennsylvania (3 year retrospective) 83-90 % referred were linked to a service 73-90 % assessments completed 60 % of referred students had no further disciplinary suspension 63-68 % of SAP students either were promoted or graduated from high school Washington State Increased protective factors (i.e., self-esteem, self-control, assertiveness, cooperation and bonding) Reductions in 7 anti-social behaviors – including truancy, fighting, and vandalism Reductions in use of 7 substances - 33 % reduction in marijuana use - 40 % reduction in amphetamine use Positive school behavior and academic “dramatic long-term improvements in attendance and grades”

  24. What did we learn about evaluation? (continued) • 37 % decrease in substance use 23 % of those using, stop Second Year Project SUCCESS • 33 % no longer used alcohol • 45% no longer used marijuana • 23 % no longer used tobacco Other Evaluation Results - Vermont evaluators cited the following: Schools with SAPs experience: • Reductions in overall substance use (Washington) • Reductions in alcohol and marijuana use (New York, Wisconsin) • Increases in school attendance (New York, Wisconsin, California) • Decreases in drop-outs (California, Pennsylvania) • Decreases in disciplinary actions (Wisconsin and Pennsylvania) and vandalism (Wisconsin) • Project SUCCESS (continued) • One SAP model rigorously evaluated – Project SUCCESS (control • study).

  25. What did we learn about evaluation? (continued) Conclusions: Evaluations used varying methodology (some better) but a consistent picture of positive outcomes emerge for youth participating in a SAP type program.

  26. Issues Do we know enough to feel comfortable with recommending SAPs? How can we support more rigorous studies? More technical – do SAPs work better with certain problems/populations? Other issues? What are the key service components of a SAP?

  27. Summary Points • Serious problems with high rate AOD users in our High Schools • A population in need of intervention services. • Intervention services requires individual screening • Two promising program models • Brief Intervention Services (K. Winters) • SAP’s

More Related