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Nicola Singleton Director of Policy & Research, UKDPC. Recovery-focused treatment: the challenges for research and outcome measurement. www.ukdpc.org.uk. Coverage of this presentation. The consensus process Why and how we did it Our “vision of recovery” The measurement challenges for

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nicola singleton director of policy research ukdpc

Nicola SingletonDirector of Policy & Research, UKDPC

Recovery-focused treatment: the challenges for research and outcome measurement

www.ukdpc.org.uk

coverage of this presentation
Coverage of this presentation

The consensus process

Why and how we did it

Our “vision of recovery”

The measurement challenges for

research

practice

accountability / performance management

why did we do it
Why did we do it?

Negative background

  • Polarised debate – artificial, political & potentially damaging treatment system & users
  • Dissatisfaction & uncertainty over goals

Opportunity for positive change

  • “Recovery” ripe for consideration (possible lessons from mental health field) impressed by Betty Ford Foundation Consensus Group
  • Opportunity of new drug strategies
the consensus group process
The Consensus Group process
  • Invited group of 16 people from different backgrounds & perspectives across UK (+Dr Tom McLellan).
  • Deliberate cross-section of:
    • perspectives (users, families, practitioners, commissioners, researchers)
    • characteristics (eg age, sex, ethnic background)
    • types & philosophy of provision (rehab, substitute prescribing, GP care, support groups)
    • disciplines (GP, psychiatry, psychology, nursing, management, layman)
  • “Locked away” for 2 days
  • Considered other relevant work:
    • Betty Ford Foundation Consensus, SACDM Integrated Care project, TOP
  • “Validation” phase
key features of the process
Key features of the process

A focus on …

  • the overarching goal not the means of achieving it;
  • identifying areas of agreement, while accepting some areas of disagreement may remain;
  • the experience/perspective of the individuals in recovery and the diversity of these experiences.
key features of the statement
Key features of the statement

It is intended to be:

  • a working definition of recovery …
  • … from the harm, distress and life problems directly-related to a person’s substance use

Which we hope can:

  • Reflect the lived experience of users and families
  • Provide an organising vision for individual services and the treatment system as a whole
  • Provide a focus for developing outcome measurement for research & accountability
key features
Key features

Individual in nature

About the accrual of positive benefit not just reducing or removing harms caused by drugs

Requires the building of aspirations and hope in individual, families and services

May be associated with a number of different types of support and intervention or none

consensus statement
Consensus statement

The process of recovery from problematic substance use is characterised by voluntarily sustained control over substance use which maximises health and wellbeing and participation in the rights, roles and responsibilities of society.

slide9
The process of recovery is characterised by voluntarily sustained control over substance use which maximises health and wellbeing and participation in the rights, roles and responsibilities of society.
slide10
The process of recovery is characterised by voluntarily sustained controlover substance use which maximises health and wellbeing and participation in the rights, roles and responsibilities of society.
slide11
The process of recovery is characterised by voluntarily sustained control over substance use which maximises health and wellbeing and participation in the rights, roles and responsibilities of society.
slide12
The process of recovery is characterised by voluntarily sustained control over substance use which maximises health and wellbeing and participation in the rights, roles and responsibilities of society.
slide13
The process of recovery is characterised by voluntarily sustained control over substance use which maximises health and wellbeing and participation in the rights, roles and responsibilities of society.
challenges
Challenges
  • Communicating the complexity and clarifying the goal of treatment
  • Developing measures:
    • for a range of uses research – practice – accountability
    • that encourage a recovery-focus in treatment services, systems and research
    • that improve outcomes
measurement issues
Measurement issues
  • Different perspectives Individual – family – services – society
  • Variability in:
    • Start and end points
    • Priorities
    • Process
    • Time periods
measurement challenges
Measurement challenges
  • The whole versus the parts

Health

Substance use

Wellbeing

Rights, roles & responsibilities

Rights, roles & responsibilities

Substance use

Health

Wellbeing

measuring contributions across the whole recovery process
Measuring contributions across the whole recovery process

Recovery process

Substitute prescribing

Motivational intervention

Residential rehab

Support group

Family

Employment services

Needle exchange

Increase in recovery-related benefit

Decrease in drug-related harm

Established recovery

Sustained recovery

Full recovery

Early recovery

conclusion
Conclusion
  • Measuring a complex phenomenon like recovery will be difficult
  • There is a tension between the need to represent this complexity and the need for simplicity in use & communication
  • But failure to do it will leave the field open to simplistic attacks
thanks to all the panel members

Thanks to all the panel members:

Bob Campbell John Marsden

Alex Copello Soraya Mayet

Robin Davidson Tom Philips

Kate Hall Roy Robertson

John Howard Louise Sell

Dot Inger John Strang

Brian Kidd Ian Wardle

Tim Leighton

and our facilitator: Tom McLellan

www.ukdpc.org.uk