None listed
Conditions
Brief summary
The study aims to evaluate an evidence based approach to the design of a new treatment service for users of methamphetamine. Traditionally, services were designed for heroin or alcohol using clients who have different treatment needs and problems to methamphetamine users. Holyoake will implement an intensive case management model including medical, peer and family support for methamphetamine users at one site (Northam) but will offer its standard service at other regional sites (Narrogin and Merredin). We will compare outcomes for the new and standard programs (target to recruit 120 people in total) in terms of changes in substance use, mental health, wellbeing and social indicators (i.e. employment and housing status). Participants will be followed up by telephone at 4 weeks and 6 months and by record linkage at 12 months. We hypothesize that those receiving the intensive intervention will show greater improvement in key measures that the standard care group. We also plan telephone interviews with a close family member (e.g. partner, parent) to evaluate improved wellbeing for that person.
Interventions
Those in the intervention arm will receive counselling based on cognitive behaviour therapy (drawing on the approaches of Baker et al 2003 “A Brief Cognitive Behavioural Intervention for Regular Amphetamine Users” and Lee et al 2007 Turning Point clinical guidelines on “Methamphetamine dependence and treatment”). The intervention is delivered face-to-face and is a combination of individual counselling and / or group counselling sessions. The program will typically offer weekly contact, with 60 m
Those in the intervention arm will receive counselling based on cognitive behaviour therapy (drawing on the approaches of Baker et al 2003 “A Brief Cognitive Behavioural Intervention for Regular Amphetamine Users” and Lee et al 2007 Turning Point clinical guidelines on “Methamphetamine dependence and treatment”). The intervention is delivered face-to-face and is a combination of individual counselling and / or group counselling sessions. The program will typically offer weekly contact, with 60 minute sessions as required, although initial sessions may be shorter if the cognitive deficits commonly found during methamphetamine withdrawal necessitate shorter sessions. The first 4 sessions are based on the Baker 2003 manual and cover commitment to change, coping with cravings, controlling thoughts and relapse prevention. Subsequent sessions have greater flexibly based on client needs. The total number of sessions will be based on the counsellors experience and clients requirements, with the expected minimum duration of treatment being 1 month to a maximum of 6 months. Assertive follow-up occurs in standard care for those who opt to receive this: in the new intervention, assertive follow-up is a constituent part of the new intervention and will be used to contact those who relapse or drop out of treatment early. Staff will attempt to contact clients after any missed sessions both through their own telephone number and also numbers of family members provided by the client as contact points. Those in the intervention arm, but not the control group, will also be offered and have access to additional services facilitated. These include an in-house clinician (GP) and clinical nurse with alcohol and other drug expertise to treat both general health and specific drug related problems. Holyoake will also undertake intensive case management to link people with other key services such as accommodation, legal and employment services as required. All of these additional services will be offered as required, based on the individual decision of the counsellor and client during treatment. Peer- and family-support workers will also be available outside counselling sessions to encourage engagement with the service and to model self-advocacy and empowerment. Family support workers provide these services to family and significant others of the client. Other than the number and type of sessions, plus use of additional services, fidelity of intervention content is not evaluated. However, clinical review of cases by the counselling team will occur after session 4 to consider the progress to date and future direction for each case plus any other services required. Each client is subsequently reviewed every 4-6 weeks thereafter. Counselling is delivered in a clinic setting. All counsellors (in both the active and control arms) have relevant tertiary qualifications (e.g. Psychology, Counselling, Social Work) and are experienced alcohol and other drug counsellors.
Sponsors
Curtin University
Study design
Allocation
Non-randomised trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
To be eligible for entry into the research project, participants must be aged 18 years or older or if aged 16-17 years can enter the study with just their consent if they have been deemed as mature minors by Juvenile Justice. In addition, they must report methamphetamine as their primary drug of concern or significant methamphetamine use disclosed during initial counselling sessions, have either a mobile phone, a landline phone or arrange telephone access at clinic. Clients must be new to the service or not have received service from Holyoake in the last one month. Due to the difficulty of retaining them in treatment and research, not currently experiencing acute mental health issues..
Exclusion criteria
Not currently receiving key types of pharmacotherapy (e.g. naltrexone, bupropion/Zyban, modafinil, or mirtazapine which are currently under investigation for methamphetamine dependence), or receiving any other treatment for stimulant use (e.g. alcohol or other drug counselling from another service).
Outcome results
None listed