Aquarius An Overview Aquarius 2nd Floor 16 Kent Street Birmingham B5 6RD Tel: 0121 622 8181 Fax: 0121 285 2190 headoffice@aquarius.org.uk www.aquarius.org.uk February 2015
1 Who we are Aquarius was established in 1977 to run three residential services as part of a Birmingham University research project, to look at developing new and effective interventions for people with alcohol problems. We work with people to reduce their drinking to recommended safe levels, or to help them to achieve and maintain abstinence. Our theoretical framework is the social ecological model enabling us to see the issue of problematic alcohol, drug or gambling use not just as an individual problem but one that impacts on families, communities and society. The Aquarius approach, Personal Skills Training (PST) which is cognitive behavioural based, was developed from the research project. The main concepts that underpin our methodology are: a) that people use substances to cope with a variety of problems, b) that people are responsible for thoughts, feelings and actions and are capable of change, c) that people can change given the right support and alternatives to drinking. Aquarius has maintained its commitment to evaluation and research and the development of evidence based effective practice: - UKATT (United Kingdom Alcohol Treatment Trial) which explored effectiveness of MET and SBNT. - Involving Family Members current research project with Bath and Birmingham universities exploring the impact of involving family members in treatment. - AERC Route 50 current national research looking at community responses to excessive drinking and alcohol related disorder. - Everyone s Concern an evaluation of our outreach work in Kings Norton. - Alcohol Homelessness in Dudley evaluation of our initiative in working with homeless people. - Family Interventions evaluation of family focused work in Dudley. - Birmingham Family Alcohol Service four year CASE PhD studentship. - Alcohol Arrest Referral evaluation of the Dudley scheme. - Involving Family Members Training Strategy. Training all staff in family focused interventions, with a CASE Phd Studentship analyzing the impact of this on engaging with families. - Alcohol & Older People researching the needs of the over 60 s and how best to respond to their alcohol problems. 1
- Locality based work. We are funded by the Big Lottery to develop a local alcohol service in the Erdington constituency. We are evaluating this work to develop a best practice model for working with communities. - Grandparents as carers we have interviewed grandparents with a significant caring role because of their own son/daughter s use of alcohol or drugs to ascertain their needs and develop more responsive services. - Alcohol & the Deaf Community. This 12 month research project is funded by ARUK. - Alcohol & the Sikh Community funded by Aquarius. We are working with Sarah Galvani from Bedfordshire University to develop a community alcohol intervention model. - Time of our Life project funded by Big Lottery Silver Dreams. Fund to develop our work with older people and produce an intervention model that can be applied nationally. We currently employ 212 staff and have an annual turnover of 7 million. We have a strong Executive Committee with skills in research, addictions, management development, human resources, diversity and finance. We have service user representation on the Committee. 2 Our work We are located in: Birmingham Young People s Service Time of My Life (older drinkers) Kinship Care End of Life Care Gambling Coventry Service User Involvement and Carer Service DRIVE Rehabilitation Courses for drink/ drive offenders, a fee paying service Dudley Gambling Derby City Family Safeguarding Service 2
Adult Alcohol and Drugs (partnership Derbyshire Trust and Phoenix Futures) Northamptonshire Older people s alcohol service, providing training to tier 1 providers, and some complex casework Sandwell Carer and Kinship Carer s Service (we are currently reviewing viability of this service) Shropshire Adult Alcohol Service Solihull Adult and Young People s a alcohol and drug and gambling service (partnership BSMHFT, Welcome and Changes UK) Alcohol Employment Service to Jaguar Landrover Stoke on Trent Adult Alcohol Service (partnership BSMHFT providing home detox service) Wolverhampton Recovery Near You adult and young peoples alcohol and drug service (partnership NACRO, BSMHFT) Gambling We receive funding from: - Responsible Gambling Trust (RGT) for early intervention work in Birmingham and Solihull. This contract ends 31 st March 2015 and we are awaiting information about funding. - Gamcare for one to one work with complex gambling work across the organisation. This is paid on a spot-purchase basis. We are awaiting confirmation of funding available for 2015/ 16 - Solihull Local Authority (LA) : We will receive 20K pa for 3 years as part of the SIAS contract to deliver early intervention work in Solihull 3
Research We have 2 research projects: Evaluation of Time of My Life (ToML) by Professor Sarah Galvani, Manchester Metropolitan University, funded by Lottery and hopefully Alcohol Research UK (ARUK) Evaluation of End of Life Care by End of Life care Observatory, Lancaster University Training Contracts - Birmingham Safeguarding and Substance Misuse - Probation Substance Misuse and Mental Health - Coventry: Alcohol and Drug Awareness Training 3 Our interventions We provide early intervention services consisting of training, advice and brief interventions and services for people with complex needs. Early Intervention Services consist of: Alcohol, drug and gambling awareness training to professionals, agencies and community groups. Information on our website, including self-help materials. Advice & Information at health events, festivals and targeted promotional events. Screening & Brief Advice a short 10-20 minute information giving advice & information; on alcohol, drugs and gambling. Extended brief interventions offering up to 6 sessions of structured support and help accessing other services as necessary for alcohol, drug and gambling problems. Groupwork 6 session Life Change courses providing information on alcohol and advice about cutting down your drinking. Relaxation and Self Esteem groups. Family support providing advice and support for families affected by someone s drug, alcohol or gambling use. Debt/Legal Advice provided by Birmingham Law Centre. Brief advice for those arrested with alcohol related offences. Education & rehabilitation through our DRIVE Course for those convicted of drink driving. Advice & Support for Young People. Engagement & plan to work more effectively with BME communities, building knowledge and capacity and information. 4
Our complex needs services consist of: Comprehensive assessment and care planning using a case management approach. Assessment and referral for detoxification and residential rehabilitation. A structured 12 week programme of interventions and one to one support. Healthcare Reviews to co-ordinate and inform all agencies working with individuals about the progress and ongoing needs ensuring there is a coordinated and planned approach. Aftercare support and groups including Relapse prevention. Self-help and mutual aid groups. Activity groups including gardening, walking and art. Accredited Offender Management Programmes (LIAP, DID and OSAP) and Alcohol Treatment Requirement (ATR). Intensive Family Support for families where there are child protection concerns and alcohol is a significant factor. 4 The Recovery Agenda The original Aquarius intervention model, Personal Skills Training (PST) has the principles of recovery at its heart. Aquarius adopted the functional model of drinking seeing drinking as an act that a person does, rather than helplessly suffers and that drinking behaviour is learned and maintained in the context of the person s whole life. This includes their biological predisposition, cultural background, family, employment, housing and personal and social issues (Aquarius PST 1984). Aquarius has always held the view that clients could resolve their problems with support and guidance and that people have the ability to find their own solutions to their problems. Getting a person to stop drinking is only the start of the recovery process to help people effectively in the long term, it is necessary not just to cope with a current set of problems, but to enable them to deal with future problems. The aim is to help people to help themselves, by enabling them to learn a range of useful skills, applicable to their personal lifestyle (Aquarius PST 1984). Aquarius uses the model of change, developed by Prochaska & DiClemente, identifying the stages of change as Pre-contemplation, Contemplation, Action, Maintenance and Relapse. Aquarius recognises that relapse is a common occurrence but the PST model enables clients to cope with relapse, learn from it and return quickly to maintenance and ultimately freedom from dependency. The Drug Strategy 2010, Reducing demand, restricting supply, building recovery, supporting people to be drug free places more responsibility on individuals to seek help and overcome dependency. And an emphasis on providing a more holistic approach, by addressing other issues in addition to treatment to support people dependant on drugs or alcohol, such as offending, employment and housing. 5
We are very comfortable in working with the concept of recovery. Our methodology puts the person with the problem at the centre, recognises that they are the experts, and that service user involvement is integral to service delivery development. For those harmful drinkers advice, information and short structured interventions may be sufficient for them to moderate their drinking and alter their lifestyle. They will be responsible to harm minimisation information and information on controlled drinking. They may also want to consider abstinence as a goal. However for those dependent drinkers with serious health and complex social issues they will be supported to recognise that abstinence is the most appropriate goal for them. Aquarius literature now has the clear statement If you have had an alcohol detoxification and/or if you have serious physical or mental health problems, you are strongly advised not to drink at all. Our view is that we will support and encourage people to be free from the dependency on alcohol, for some people this may mean controlled drinking, for other with severe dependency, this will ultimately mean abstinence. We recognise that in the drug treatment world recovery may be used to refer to an abstinence model. However we feel that alcohol treatment is about supporting people to have a different relationship with alcohol and that could be abstinence or cutting down to controlled levels. To achieve this Aquarius adopts a holistic, whole person planning approach which takes into account not only a person s drinking problem but also housing, employment, family, education, personal relationships, offending and debt. 5 Service User & Carer Involvement Aquarius is committed to involving service users in the development and delivery of service users and carers at every level. This is achieved by: All services developing service user and carer groups. Regular service user and carer meetings attended by senior management. Regular service user satisfaction surveys. Establishing a Service User Board with representation on the Executive Committee. Providing training and support to enable service users and carers. Involving service users and carers in the delivery of courses, eg assessment, effective engagement. Facilitating service users to access or establish mutual aid groups such as AA and SMART Recovery. We employ Participation Workers to lead on the involvement strategy. 6
6 Volunteers & Peer Mentors We recognise that many people who have used our services are highly motivated and want to give something back through volunteering and peer mentoring. Peer mentors and volunteers make a valuable contribution to the organisation and promote the following: Meeting and greeting and hospitality Administrative support Assisting with structured groups Staying Stopped, Life Change, DRIVE. Running social activity groups music, art, gardening, social outings Befriending home visits, accompanying people to the shops, hospital, GP Accompanying staff on initial home visits Providing one-to-one support All volunteers and peer mentors undergo training and are supervised and supported by Volunteer and Peer Mentor Co-ordinators. Admin/Reports&Papers/AquariusAnOverview/Nov14 7