Contents Page No
Chairpersons’ Statement 2
Overview & Context 4
Policy Context 5
Mission Statement 6
Social Ideology 6
Range of Services on Offer 6
Structured Day Programme
Community Alcohol Detox
Counselling Support
Outreach
Family Support
Empowering Women in Sobriety
Review & Update 2010 – 2014 Strategic Plan 9
Core Areas for Development of Service 14
Priority Actions 17
Outcomes for Service Users 20
Testimonials 21
References 25
Chairpersons Statement
Turas Counselling Services Ltd is a Community Based Addiction Service which has since its inception in 2005 continued to develop its supports to target evolving needs. It offers a range of Support Services in a community setting for problem and recovering substance users. Turas aims to offer a continuum of supports which are person-centred, offering emotional, psychological and practical supports to aid the person in their journey to a substance free lifestyle.
This Strategic Plan for 2015-2017 puts forward a concise and focused approach for all areas of the Organisation aligning itself with the National Drugs Strategy 2009-2016. This plan is of shorter three year duration, compared to the previous five year strategy. This has been deemed prudent by the Board of Management of Turas based on prevalent financial constraints and impediments that are impinging on the Service at this time. It is of paramount importance to sustain and continue the supports that are already in existence at the highest level possible.
There has been much good work and development of supports over the last strategic period. The counselling capacity of the service has steadily increased so that now nine counsellors operate on a part-time and sessional basis some in a voluntary capacity. A pilot six week Motivational Programme carried out jointly with Dundalk Simon Community has proved very successful in encouraging and engaging service users to utilise initially some of the supports on offer within Turas and the HSE Addiction Services. The Community Detox Programme has received some increased funding to develop a Community Benzodiazepine Protocol in tandem with the existing Community Alcohol Detox Initiative. There have also been greater linkages, partnerships and protocols created with the Probation Service and with local GP’s. This will undoubtedly bare greater fruit in the future.
There are many challenges and aspirations for the service in the short to mid-term future. Both the Managers and Board of Management of Turas hope to ensure that Turas Counselling Service Ltd becomes fully QuADS compliant during this timeframe. It is envisaged that a Human Rights Based Approach will be developed and integrated into all areas of practice also. There is a definite need to enhance and formalise collaboration further with the HSE Addiction and Mental Health Services where there is clearly cross-over of supports and interventions for service users. The Board of Management have recently formed a working group to focus on governance issues within Turas and to identify areas that may need change to come in line with Codes of Governance for the Community and Voluntary Sector. Fundraising and the continuous need to source other streams of funding will undoubtedly play a greater part in services provision in the future.
Over the last decade Turas Counselling Service Ltd has become embedded in Dundalk and the greater North-East Region. This has not happened by accident, many elements act in unison for this to occur, Managers, Counsellors, Volunteers, Fundraisers, Board of Management to name but a few. The diligence, level of service and adherence to best practice by all, have in my opinion as Chairperson enabled the Service to offer a more effective and positive support mechanism to those in need.
Like all ventures, we cannot rest on our laurels. The purpose of a Strategic Plan is to set goals, outcomes and create a focused roadmap for the future. The Strategic Plan 2015-2017 for Turas Counselling Service Ltd, if adhered to will ensure a continued level of effective service to meet the needs of those in recovery in the North East Region who wish to engage with the Structured Day Programme and associated supports and to meet the needs of those in distress due to substance abuse in the greater Dundalk area.
Overview and Context
It is important to place the service delivery of Turas Counselling Services Ltd. and the development of their three year strategic plan within the context of the National Drugs Strategy’s 2009-2016 key priorities for the development of service provision and the current research available on Drugs Use in the North East Region. Turas while located in Dundalk provides support to those who are resident in the North East Region (Louth, Meath, Monaghan, Cavan) and the services are funded by the North East Regional Drugs Alcohol Task Force and the HSE.
Overall Strategic Objective
The overall strategic objective for the National Drugs Strategy 2009-2016 is:
· to continue to tackle the harm caused to individuals and society by the misuse of drugs through a concerted focus on the five pillars of supply reduction, prevention, treatment, rehabilitation and research
Within the Treatment and Rehabilitation pillar the two objectives are:
· to develop a national integration treatment and rehabilitation service that provides drug free and harm reduction approaches for problem substance users
· to encourage and support problem substance users to engage with, and avail of, such services
From its inception in 2005 Turas has developed and provided a range of support services for problem substance users and recovering problem substance users, delivered within a community setting and in keeping with current recognised best practice standards. However, this provision of service is not static and looks for ways in which to adapt to meet the evolving needs of service users. These support interventions have been evidenced as achieving successful outcomes for our service users.
In developing the three year Strategic Plan Turas Counselling Services Ltd has considered:
· where Turas Strategic Plan will sit with the National and Regional Plan
· the need to review existing and potential future service provision in line with both the Regional and National Plans
· sustainability and continuity
· identifying overall goals and then the specific targets and time frames that will indicate we are meeting our overall goals – these can be generally be broken into one year / operations work plan which have a greater level of detail of specific tasks.
Policy Context
1.1 The National Drug Strategy (interim) 2009-2016 under action 4.29 states that the development of residential and aftercare services is a crucial element of providing alternative drug free approaches to problem drug users. It also acknowledges that this approach is resource intensive and there can be heightened risks in the event of a relapse and therefore it is critical that individuals involved have access to follow on structured supports in the community and a continuum of care model to maximise their potential for success.
1.2 The NHSD National Treatment Agency for Substance Misuse Residential Drug Treatment Services: Good Practice in the Field (May 2009) cite as one of the key points of good practice as being established routes into and out of treatment, with clear arrangements for preparing people for treatment and for aftercare and re-integration.
1.3 Doyle and Ivanovic (2010) in the National Drugs Treatment Framework Document state that the four tier model of care will act as an overarching framework for the provision of rehabilitation pathways. Tier 3 interventions are detailed as specialised structured community addiction services that typically consist of specialised drug assessment and co-ordinated, care-planned treatment which includes psychotherapeutic interventions. In the integrated model of rehabilitation provision within the Framework Document it acknowledges the range of supports required to meet the complex needs of service users including Aftercare.
1.4 The NTA in Commissioning for recovery, drug treatment, re-integration and recovery in community and prisons: guide for drug partnerships state in choosing interventions Commissioners should ensure a full range of treatment, wraparound care and aftercare support options are available to aid recovery. They also state the importance of engaging with clinicians to inform strategy and drive quality, service design and resource utilisation. In Building Recovery in Communities: a summary of responses to the consultation the NTA highlight a number of key messages from the treatment field including:
· to focus on the individuals recovery from addiction as opposed to recovery from a substance allowing systems to focus on the needs of the individual
· recovery is an individual, person centred journey and will mean different things to different people
· people must have a choice of pathways into recovery, but the goals for recovery must be in the direction of becoming drug free
· the provision of high quality treatment that prepares service users for recovery while protecting communities
· links to support networks to sustain long-term recovery and re-integrate people back into society
· there is good evidence that the skills of the worker and their ability to build a therapeutic alliance are vital and that the most important task for the service provider is to identify and maintain the attitude and beliefs required to inspire sustained change in clients. Without the appropriate attitude and beliefs, competence and knowledge are not enough.
Mission Statement
Turas Counselling Services Ltd. is a community based addiction service that aims to offer a range of confidential supports along a continuum of care that are respectful of both the uniqueness of the individual’s recovery journey and their capacity to change. Through the provision of psychological, emotional and practical supports Turas hopes to provide a bridge to reconnect service users to a substance free lifestyle.
Social Ideology
The social ideology is based on community care – service-users remain in their own community during therapy. To that end Turas offers a continuum care service that provides a range of interventions / supports that are delivered within a community setting.
Range of Services on Offer
Structured 20 Week Day Programme
Turas have developed a Structured 20 Week Day Programme specifically designed in response to the needs of recovering problem substance users within our community who wish to look to their future with a view to change. The twenty week programme is run twice annually offering group process and individual counselling support. The principals underpinning the programme of empowerment, respect and support offer safe therapeutic encounters within the group process and individual counselling in which recovery work takes place.
Eligibility Criteria
· over 18 years of age
· two to three months drug/ alcohol free
· must be available/willing to attend three full days per week with additional one hour counselling session for the twenty week period
· if on the Methadone Programme, the service user must be stabilized for a period of two to three months
· if there are past mental health concerns, the service users current mental health must be stable
· if on prescribed medication, the service user must be medication compliant
All of the above can be explored and clarified at the assessment interview.
Referrals
Referrals are taken from Statutory and Voluntary Services, G.P’s, Community Services and Turas also accepts Self-referrals.
Community Alcohol Detox
This service supports individuals with an alcohol dependency to detoxify from alcohol using a number of methods including pharmacology and psychosocial interventions, harm reduction techniques and ensuring a range of wrap-around support is available, e.g. counselling, structured 20 week day programme, housing advice and training opportunities. In this regard effective multi-agency working is essential.
The following is offered:
· assessing a person’s needs
· developing care plans
· carrying out risk assessments
· providing harm reduction advice to clients
· recording accurate case notes
· preparing reports
· motivational interviewing
· cognitive behavioural therapy (CBT)
· co-ordinating services and liaising with other agencies
· engaging and supporting carers and families
· group work re: motivational work/ relapse prevention planning
· key working re: pre exit through to post detoxification
The clinical governance arrangements underpinning practice are consistent with national guidance and principles, and in line with the evidence base. (Drug Misuse and Dependence UK Guidelines on Clinical Management 2007 NTA p17).
This involves:
• a GP/clinical nurse specialist in place with links to HSE Alcohol and Mental Health services thereby providing appropriate clinical governance
• internal and external supervision in place within Turas
• Continuous Professional Development (CPD)
The Clinical Practice Guidelines are:
· to ensure that the community detox service can address both the physical and psychological needs of the service user during withdrawal from alcohol
· to deliver a practice specification for the community detox service that reflects current best practice in assessing, matching and the management of treatment needs of service users
· using a continuum of care approach within a multi-disciplinary and inter-agency setting working towards supporting service users identified goals is clearly working to current best practice guidelines
Criteria for Community Detox
• physical dependence on alcohol and desire to detoxify in community
• no history of severe withdrawals, seizures or D.T.s
• an identified support person and an alcohol/drug free environment
• no evidence of severe physical ill health
• no evidence of mental health disorders which may be exacerbated by detoxification process
Counselling Support
Turas provides a confidential screening, assessment, brief intervention and counselling service to service users who are experiencing problem substance use. The counselling support is delivered within a confidential and safe environment in which to explore their difficult life issues.
Counselling can be used as a stand- alone intervention for service users who want to reduce their use or gain abstinence as preparation to meet the criteria for accessing the Structured 20 Week Day Programme, or as an additional therapeutic support for those already engaged in the Structured 20 Week Day Programme.
Outreach
In the various stages of recovery a range of services are needed to support service users.
The outreach service offer support to service users across the continuum of care, delivering harm reduction advice, motivational and cognitive behavioural coping skills sessions. It also offers a range of wrap-around support including liaising with other agencies to co-ordinate services to maximise training, education and employment opportunities and advocacy support on housing and benefits issues. This service also provides two weekly outreach clinics within the community and is available to clients who wish to access the range of services on offer within Turas. The outreach clinics provide support to young people aged 14 years of age upwards.