1. The power of healing and empowering through poetry
Group 336, Hawke’s Bay Regional Prison Drug Treatment Programme
Valentina Teclici, Senior Practitioner, Te Taiwhenua o Heretaunga
Simon Browne, Clinical Manager, Te Taiwhenua o Heretaunga
Lucy Langeluddecke, Practitioner, Te Taiwhenua o Heretaunga
The poster ‘The power of healing and empowering through poetry’ represents a visual summary of the booklet Whanaungatanga – Together as one.
The booklet project was initiated and completed by Group 336 during a three-month DTP in Unit 4A DTU, Hawke’s Bay Prison. The idea sprang from a 10-minute creative writing exercise focusing on tika, pono and aroha values. The outcome, in short poems, revealed pro-social ideas, creativity, spontaneity and positivity that surprised the group members and the facilitators as to how far they had come.
The booklet includes the work of the 12 group members, a mentor and Valentina and Lucy as facilitators: 27 poems, 13 drawings and the booklet covers. Poem topics include the values of Te Taiwhenua o Heretaunga, self-discovery, change, New Zealand history and recent events.
The enthusiasm and commitment that the men from the 336 whānau group invested in this project, working together towards a common goal, strengthened their relationships and increased their creativity, confidence and mana. At graduation, every graduate received two copies of the poetry booklet, a copy to keep and a copy to give to a loved one. A couple of graduates read their poems in front of the therapeutic community and their whānau.
Valentina Teclici, born in Romania, is an AOD practitioner with more than 25 years’ experience in Romania and in New Zealand. Valentina has a PhD in Sociology and has researched different social aspects, coordinated social and reintegration projects, worked in prisons, developed and implemented holistic programmes based on CBT, DBT, strengths-based theory and Te Whare Tapa Whā.
Simon Browne: Ko Hikurangi te maunga, ko Waiapu te awa, ko Nukutaimemeha te waka, ko Te Aitanga o Materoa te hapu, ko Penu te Marae, Ko Ngāti Porou te iwi. Simon manages two Drug Treatment Units and After Care Services within a prison. His passion and leadership using counselling, music and drama skills helps people find a pathway to their potential.
Lucy Langeluddecke is Australian-born and raised. She began her AOD career recently by becoming a facilitator at the Drug Treatment Unit within the Hawke’s Bay Regional Prison. She is in her final year of Te Take Take Diploma in Applied Addictions. Lucy discovered her love of helping others seeking wellness through nursing, youth work, tikanga and personal experiences.
2. Te Wairua: It's not just about treatment, it's about the healing
Mohammed Anwaar, Clinical Manager, Te Wairua Counties Manukau, Odyssey
Alistair White, Clinical Manager, Te Wairua Royal Oak, Odyssey
The name Te Wairua was gifted to Odyssey’s Counties Manukau residence many years ago, and is now proudly worn by our three Te Wairua residences in Auckland and Whangarei. When thinking about wellbeing, wairua is often interpreted as our capacity to understand the link between ourselves, the physical environment and the spiritual world. Wairua is a compound word – made up of Wai meaning liquid or fluid, and Rua meaning two. In this sense, Odyssey’s Te Wairua services offer two streams of healing – providing an environment that supports emotional, spiritual, physical and social wellbeing. Many of our tāngata whai ora come to us for support to understand and to heal from, at times, many years of trauma, mental health and addiction challenges.
Te Wairua works with tāngata whai ora who have experienced historical trauma. We discover residents’ presenting vulnerabilities and together find coping strategies and pathways to wellbeing. Practitioners will share their insights into how they adapt therapeutic community to work with this highly stigmatised population. They will share tools and techniques shown to work with this group. We will offer case study vignettes of residents exploring their pathway from isolation and marginalisation to reconnection in the therapeutic community and with their whānau and communities.
Mohammed Anwaar is Clinical Manager of Odyssey’s Te Wairua residence at Counties Manukau, Auckland, a therapeutic community with 12 staff and 19 residents, who are seeking support for mental health challenges alongside their addiction issues.
Mohammed has a Master of Public Health from the University of Auckland, majoring in mental health, child and youth health. He has been with Odyssey for nine years, having previously worked in intellectual disability with a focus on autism and child abuse. He also holds a Diploma in CBT, a Certificate in Addiction and MH Supervision, and a National Certificate in Adult Education and Teaching.
Alistair White is Clinical Manager of Odyssey’s Te Wairua residence at Royal Oak, Auckland. Odyssey’s Te Wairua services are available for tāngata whai ora living with both mental health and addiction challenges. He has worked in the mental health and addictions sector for both NGOs and DHBs for more than 20 years. Prior to joining Odyssey in 2018, Alistair worked at CADS South for 12 years, initially in the opioid treatment team, then in a regional methamphetamine role. Alistair has a BSc in Psychology and a PG Cert in Mental Health and Rehabilitation.
3 The ‘why’ and ‘why’ of looking backward and moving forward
Paul Schreuder, Senior Lecturer, Weltec
Those who work in the addictions field need to explore the aetiological determinants that lead the person seeking help with their addiction to better understand the possible functions of the dysfunction. Before the relevant ‘what’ ‘when’ and ‘how’ aspects that facilitate the journey out of the addiction are explored, it is important that the ‘why’ of the past is understood by both the person seeking help and the practitioner. It is also important that the ‘why’ of the future, as discussed by Victor Frankl, the psychiatrist and seminal thinker behind logotherapy, is considered. This ‘why’, perhaps the more spiritual one, is the ‘why’ the person is meant to rise above their adversities. Looking backward and moving forward are of paramount importance in creating a bespoke therapy plan by the therapeutic dyad.
Paul Schreuder has been a senior lecturer in addiction studies for over 20 years. Prior to that he worked as an addictions practitioner, relapse prevention facilitator and co-odinator for living without violence. Paul was born in Holland and came to New Zealand in 1960 as a seven-year-old. In 2011 Paul recorded an album of original songs about addiction and recovery titled Sobertown. He has presented at international conferences and studied at Massey University, Waikato University and the Wellington Institute of Technology. He has degrees in Social Sciences and Psychology and has a Post Grad Dip in Education and Grad Dip in Addiction Studies as well as certificates from the New York Institute of REBT, where he was supervised by Albert Ellis. He is on the Dapaanz board. Paul’s research interests include the addictability of certain low-nutritious high-calorie foods and the integration of CBT/mindfulness and Narrative Therapy.
4. Walking backwards into the future
Ned Cook, Team Leader, Salvation Army Alcohol and Drug Awareness Centre, Tonga
‘Malo e lelei from the Kingdom of Tonga and warm Pacific greetings to you all.’
After 21 years of running educational programmes for those with alcohol and other drugs problems, and treating accompanying violent and criminal behaviours, Ned believes it is time to start walking back together into the future.
The Alcohol and Drug Awareness Centre (ADAC), founded 20 years ago, is the part of the Salvation Army services in Tonga. Ned will share his views on current AOD use/misuse in Tonga as opposed to 40 years ago, talking about what worked. He will also speak about his plans for future service provision. He hopes that the skills and knowledge he has learned, mainly in New Zealand, will help him improve services and provide the proper support needed to further develop and establish for services for his people.
He will also discuss the collaborative work begun with the Police visiting schools and communities to talk about the effects of AOD and violence.
Ned has worked in the addiction and violence-prevention fields for the past 25 years, mainly in New Zealand. He has a Bachelor in Counselling and a Bachelor in Alcohol and Drug Studies from Wellington Institute of Technology (Weltec), and has passed two post-graduate papers towards a Master in Health Sciences at Otago University. At present, he is working in schools, youth and community groups, court and psychiatric referrals and with inmates and self-referrals.
5. WRAPPED and READY
Murray Edgar, Clinical Leader, MASH Trust, Addictions Recovery Service
Nadine Dawson, Programme Facilitator, RN, MASH Trust, Addictions Recovery Service
MASH Trust has run the Monarch Programme for several years alongside individual counselling and other more informal groups. Over the last two years Murray and Nadine have seen two particular issues emerge: relentlessly increasing waiting lists leading to a loss of opportunity to engage at a time when clients were primed and ready, and clients struggling with the cognitive and emotional demands of group therapies because of substance use, withdrawal or other cognitive challenges.
To address this, they developed the WRAPPED progeramme, Wellness Recovery Action Planning and Psycho-education, using established content and methods. Through integrating pre-existing processes and modifying content, a stand-alone six-session programme was developed.
This was made available immediately on referral to minimise waiting time. Abstinence was not a requirement as long as people arrived in a state able to participate effectively, thereby allowing those who were contemplative to attend and see if they wished to go further with their recovery.
This presentation outlines the content of WRAPPED and its delivery. Murray and Nadine will present outcome data and discuss some of the gains made through a programme suited to those who may yet to have committed to a recovery journey.
Murray is a Registered Psychiatric Nurse of more than 40 years’ experience in several fields. He has teaching qualifications and a Master of Philosophy. During the past 2½ years he has specialised in the addictions field, bringing a complementary skill set.
Nadine is a Registered Nurse who has worked at MASH Trust Addictions Recovery Service for over two years, having come to the role from a job carrying out pre-school health checks. Nadine has been involved in group therapy work, individual counselling, and developing programmes and resources for MASH.
6. Reduce your alcohol and see the benefits
Acknowledgements: Paul Hanton, Jennifer Lai, Angela Jury, Charito Tuason
The Alcohol and Drug Outcome Measure (ADOM) is a self-rated measure that is used to feed back to people accessing alcohol and other drug services in the community. It is used by 77 organisations and 230+ teams across New Zealand. The data from ADOM collections is stored anonymously in the Programme for Integrated Mental Health Data (PRIMHD). The research question arose as to whether reduced days of alcohol use was associated with improved lifestyle and wellbeing. This was examined using matched pair data from treatment start and treatment end collections of the Alcohol and Drug Outcome Measure (ADOM) held in PRIMHD. The resulting paper has been accepted by the New Zealand Medical Journal.
Findings show decreased days of alcohol use was, on average, positively associated with self-rated lifestyle and wellbeing. Even a one-day reduction in alcohol use may lead to small positive changes in wellbeing. Results were similar for amount and total volume of alcohol consumption.
The practice messages that might be delivered in the sector are explored in this presentation as well as acknowledging the research. Looking back at tāngata whai ora alcohol days of use and lifestyle and wellbeing scores at start and end of treatment show, on average, positive changes in lifestyle and wellbeing. This enables practitioners to give a clear message that the greater number of days reduction of alcohol use, the better one’s lifestyle and wellbeing is likely to be.
7. Just Leadership: A relational values-based approach
Wendy Talbot, Director, Adventurous Conversations Ltd
Leadership quality affects everyone at all levels of organisations. Often a range of leadership approaches co-exists in teams, with varying degrees of effectiveness. As leadership is a key contributor to the quality of workplace culture and relationships, it is an important topic for discussion and reflection.
This presentation outlines Just Leadership, an approach I have created for people wanting to enhance workplace relationships, communication and culture. It is values-based and draws on both Māori and Western principles. It provides a framework that individuals and teams can adapt and shape to fit their unique workplace environments.
Participants will be introduced to the framework, which consists of four categories – relationship, power, organisational culture and perspective. The principles of each category will be presented along with practical activities for demonstrating leadership. There will also be an opportunity for participants to reflect on their personal leadership experiences and how these have shaped their ideas about leadership.
Wendy ‘No Ngāti Rongowhakaata me Ngāti Pākehā nga iwi’ leads Adventurous Conversations Ltd, an organisation focused on effective, values-based communication and relationships through consultancy, training and supervision. She spent 20 years as a counsellor, family therapist, trainer and professional supervisor and 10 years teaching counselling and professional practice in undergraduate and postgraduate programmes. As part of her doctorate, she developed Reflexive Audiencing, a process for couples to reflect on and review their relationship conversations. The value of reflection as a means of refining personal and professional practice is a continuing interest of Wendy’s, particularly in counselling, training, supervision and organisational contexts.
8. Reaching out to the hard-to-reach: Odyssey’s pou whānau connectors
Shona Langdon, Clinical Manager, Te Wairua Northland, Odyssey.
A joint initiative between Northland District Health Board and the NZ Police, the Te Ara Oranga (The Path to Wellbeing) methamphetamine harm-reduction pilot, was co-designed with Te Tai Tokerau communities and became operational in October 2017. It has resulted in closer working relationships between communities, health services and the police in Northland with its aim of ensuring that anyone who would benefit from treatment is offered the opportunity and contacted within 48 hours of referral.
The introduction of these new referral pathways has seen more than one third of whai ora not previously known to these services referred to mental health and addiction services. As one of the health service providers working with Te Ara Oranga, Odyssey employs two pou whānau connectors (based in Dargaville and Whangārei), who work with individuals and whānau to foster engagement with treatment and other support services.
This poster will illustrate the pou whānau model at Odyssey and explore how the role works as a bridge between communities to engage hard-to-reach clients, those who would not otherwise seek support or treatment, including clients with complex trauma. Shona will share data from the model’s first 18 months as well as details of the pou whānau approach, including assertive outreach, community engagement and connecting clients to a range of services that work for their community.
Shona has worked in the mental health and addiction sector in Northland for nearly 20 years, and has spent the last eight years at Odyssey. She oversees its Te Wairua service and community programmes in Northland, and has led the organisation’s participation in the Te Ara Oranga methamphetamine demand-reduction partnership with NZ Police and Northland DHB. She is passionate about supporting clients in recovery and challenging stigma and discrimination.
9. Harnessing the flow
David Mellor, Senior Clinical Psychologist, Specialist Addiction Service (SAS)
Mark Greco, Registered Nurse/Clinician, Specialist Addiction Service
Heath Te Au, AOD Clinician, Specialist Addiction Service
For the past 10 years, the Dunedin Specialist Addiction Service (SAS, formerly CADS-Dunedin) has been utilising a ‘walk-in’ system to manage admissions. The presenters will attempt to summarise the process and the ‘feel’ of this endeavour in providing a timely, readily accessible and engaging experience for consumers. The introduction of (now five) weekly walk-in opportunities has been wedded to a system of groups which continue to change and evolve according to need, staff availability and interest. The story of these developments, in addition to some of the data which has been collected along the way, will be presented.
Mark is a Registered Mental Health Nurse from Dunedin. Originally from the UK, he began working for the addiction services at CADS Pitman House In-Patient Detoxification Unit. Mark has postgraduate addiction training and has completed two years of Transactional Analysis through the Phyllis Institute. Since joining the Specialist Addiction Service, Mark has held several roles, co-facilitating group work, screening new clients though the ‘walk-in’ clinic, liaising with probation services, as an OST case manager and he is a South Island SACAT Duty Officer.
Heath has worked in the Dunedin AOD sector since the early 2000s, first as a volunteer at DIVO (Dunedin needle exchange, 2002-2006) before managing the Hepatitis C Resource Centre (2006-2012). He worked as an addictions counsellor and groups co-facilitator at CareNZ’s Drug Treatment Unit at Otago Corrections Facility (2012-2017) and currently co-facilitates groups, BA/BI via walk-in clinic and manages OST and AOD caseloads at SAS (2017-present). Heath has a lived experience of addiction and has been on his own journey of wellness/recovery since December 2008. Dapaanz (Reg Prac.); BSS (Couns) dist; PGCertHealSc (ADCO).
10. The trauma of learning difficulties and addiction services
The trauma of learning difficulties is a major predictor of addiction, imprisonment and poorer outcomes across the life span. However, treatment services are often not well-equipped to cater for people with learning difficulties. Callan’s first experience in treatment was to be given a pen and paper and asked to write something. He wanted to run away and use. He experienced shame, not fitting in and over-the-top anxiety. He managed to tough it out for two days before leaving. This poster is about how services can better respond to the trauma of learning difficulties and provide people with the tools they need to assist them on their recovery journey.
11. Fetal Alcohol Spectrum Disorder - The Plan of Action
Kayleen Katene, Senior Project Manager, Child and Family Programmes, Population Health, Ministry of Health
Klare Braye, Principal Clinical Advisor, Mental Health and Addiction Directorate, Ministry of Health
Fetal alcohol spectrum disorder (FASD) is an umbrella term used to describe a range of effects that can occur when a fetus is exposed to alcohol during pregnancy. These effects can include lifelong physical, mental, behavioural and learning difficulties. Fetal alcohol spectrum disorder is essentially damage to the central nervous system and is often described as a ‘neuro-disability’.
There are significant health, early development, diagnostic service and support gaps for people affected by FASD and neurodevelopmental issues, particularly children and young people, their families and caregivers. In endeavouring to address this gap, the Ministry of Health submitted a Proceeds of Crime proposal that would provide a package of initiatives to develop a prototype service pathway for children and young people affected by FASD and neurodevelopmental issues, and an effective system wide response to FASDacross the life-course.
The package of initiatives in the proposal focus on the early identification, support and evidence priorities in Taking Action on Fetal Alcohol Spectrum Disorder 2016 – 2019: An action plan. The Action plan has progressed significantly since its inception (looking back) and collaborative relationships are well established to further promote this work (looking forward). Whilst the Action Plan in itself has come to an end in 2019, the mahi has not. It is timely to review the initiatives of the Action Plan, share the progress made to date and collate ideas and initiatives and support to further enhance this work.
12. Aggression and the Addiction Workforce: A proposed survey
Christopher Gale, Senior Lecturer, Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, and Consultant Psychiatrist, Specialist Addiction Services, Southern District Health Board.
Michelle MacDonald, Consultant Psychiatrist, Specialist Addiction Services, Southern District Health Board.
Maria Baby, Clinical Nurse Specialist, Intellectual Disability Services, Southern District Health Board.
Nicola Swain, Associate Professor, Department of Psychological Medicine, Dunedin School of Medicine, University of Otago.
Aggression within the workplace in NZ is a significant problem (McKenna, Poole et al. 2003) (Gale, Arroll et al. 2009, Gale, Hannah et al. 2009, Swain, Gale et al. 2014), as well as internationally (Phillips 2016). Although there are no direct surveys, to our knowledge, of aggression among substance service workers, it is worth noting that the NZ mental health and addiction workforce has an ongoing problem with patient aggression, and there is an ongoing problem with staff burnout. The most recent inquiry found that many workers in mental health and addictions were placing their own health at risk, from burnout and assault (Paterson, Durie et al. 2018).
We propose a pilot survey of all pharmacists, General Practitioners with prescribing authority, specialist addiction workers and NGO workers within the Southern District Health Board. The proposed instruments in the survey will be: The Perception of Patient Aggression Scale New Zealand Revision (POPAS-NZ) (Nijman, Bowers et al. 2005); The Kessler 10 (Kessler, Andrews et al. 2002); The Abbreviated Maslach Burnout Inventory (aMBI) (McManus, Gordon et al. 2000); Short Post-Traumatic Stress Disorder Rating Interview (SPRINT) (Connor and Davidson 2001). We will also ask for demographics, including age, gender, professional group, ethnicity, rurality, years experienced, hours per week worked, and if involved in opiate substitution therapy.
We wish to demonstrate that this is feasible and acceptable: if so, we may re-survey the wider workforce and test then implement interventions to modify the risk of aggression to workers.
Christopher Gale is a general adult psychiatrist and clinical epidemiologist. He has been researching patient aggression for two decades, to the point of supervising clinical trials to minimize aggression in community support workers. He works in rural psychiatry and specialist addiction services. His other research interests include anxiety disorders, critical appraisal, and research methodology.