1.  ARC Under 18’s Substance Misuse Programme 160A Sunshine Industrial Estate Crumlin Road Crumlin Dublin 12 Presented by:Jimmy Norman

2.  Gender: Male53 Female23  Age : Range:13 – 19 Average16.6 Young Person Profiles (ARC Under 18’s - 2015)

3.  66%Cannabis (Weed)  12%Alcohol  10%Benzodiazepines  6%Ecstasy  4%Cocaine  2%Headshop powder (Mephedrone) Reason for Referral (Primary Drug)

4.  42%Family  22%Social Work Depts (incl Care Homes)  12%Self  8%Community Services  6%Justice/ Probation  4%A&E  4%GP  2%Schools Referral Pathway

5.  Full Needs Assessment using Teen – Addiction Severity Index (T-ASI)  Care Planning (individual needs, Inter Agency, Social Work)  Treatment  Family Support - Family Therapy  Complimentary Therapies (Acupuncture, Massage, Mindfullness)  Consultation with DR Bobby Smyth MRCPsych – YoDA  Aftercare  Onward referral to other relevant services Activities

6. Full Needs Assessment Life Areas covered in assessment: General Information Substance Use Education Employment /Training Family (Genealogy, Relationships) Peer/ Social Relationships Legal Status Psychiatric

7.  Bio, Psycho, Social Model (Philosophy)  Referral  Assessment (Young Person, Parent/Guardian)  Adolescent Community Reinforcement Approach (ACRA)  Motivational Interviewing, Cognitive Behavioural Therapy  Targeted drug prevention/education  Family Support (5 Step Method) – Referral > Family Therapy  Aftercare – Lapse Management, Life Coaching  Complimentary Therapies (Acupuncture, Massage, Mindfullness) Treatment

8. Adolescent Community Reinforcement Approach (ACRA) The Adolescent Community Reinforcement Approach (ACRA) acknowledges the powerful role of environmental contingencies in encouraging or discouraging drug use, and thus attempts to rearrange these contingencies.

9. ACRA The goals of working with the individual are:  Promote Abstinence/ Reduce Use from drugs (using a harm reduction approach)  Promote positive Social Activities  Promote positive Peer Relationships  Promote improved Relationships with Family

10. ACRA The goals of working with the Parents/ Caregivers are:  Motivate their participation in the ACRA process  Promote the adolescents Life Choices  Provide information about effective Parenting Practices  Offer Family Support

11. ACRA Treatment Modules  Functional Analysis of Substance Use  Functional Analysis of Pro-Social Activities  Happiness Scales > Goal Setting  Communication Skills Training  Problem Solving Skills Training  Caregivers Sessions (Information, Communication, Parenting)  Adolescent/ Caregiver Relationship Skills  Relapse Prevention  Life Skills Coaching

12. Thank You

13.  16 Year Old Male  Referred by father  Daily Cannabis User (on referral), Started age 13  Alcohol, Cocaine, Ecstasy, Benzodiazepine use past 30 days (during assessment) Started age 15  Drug debts to local dealers (intimidation - self and family)  Unstable accommodation (Living with mother + younger brother) Mother has mental health issues and problematic alcohol user - Father has access  Recent new peer group – Older (introduction to party drugs)  Final Year in school (place at risk due to non attendance)  Legal (recent caution for possession)  Psychiatric (suffers from session depression) Case Study 1 (Presenting problems)

14.  ACRA (26 weeks)  Complimentary Therapies (acupuncture, massage, relaxation, and mindfulness)  Body and Mind group  Aftercare (Lapse management)  Support for leaving cert exams (Life Coach + Local College)  Job Seeking Skills Case Study 1 (Treatment)

15.  5 Step Method (Coping Strategies)  ACRA (Caregivers sessions, - father)  Family Support  Consultation with Social Services Case Study 1 (Treatment – Family)

16.  Cessation of party drugs  Cessation of weed use – occasional hashish user  Change of peer group  Moved into Father’s home (Full Time)  Completion of leaving cert exams (Pass)  Increase in pro social activities  Started employment as airplane cabin crew Case Study 1 (Outcomes)