Formal and informal supports
When working with clients with complex needs, it's important to make use of supports beyond your service, including families, carers, other services and referrals.
Involving families, carers and formal supports
Recently there's been a move towards incorporating family-inclusive practice into drug and alcohol service provision. Best practice recommendations are that services "more routinely: (a) assess the strengths and needs of the substance misuser's current familial and social networks; and (b) implement one or more of the range of evidence-based approaches which impact either the substance misuse in their familial/social context or the affected family members" (Copello et al 2006 in NADA 2009).
When working with people with complex needs, involving family or support workers in treatment planning can be beneficial. Support workers, advocates or family members may be able to support you to better address the client's needs (NSW CID 2011). Establishing and maintaining solid social supports can be an essential element in preventing lapse and relapse post treatment.
Family contact for people who've had contact with the criminal justice system can have a stabilising influence on release from prison. Working with the person and their family to enhance or maintain a functional family relationship can help prevent reoffending (Borzycki 2005) or relapse into other problematic behaviour patterns.
Organisation-wide systems need to be in place to allow for the involvement of families, carers and formal supports. These systems should incorporate policies and procedures, training and workforce development, and partnerships with external organisations that provide formal supports to the person or can assist in providing specialist support to families and carers.
The following questions provide a brief guide to what to consider when developing organisation-wide strategies to involve families, carers and formal supports:
- What systems are in place to cater for the organisation-wide impact of involving informal supports? (E.g. what information and organisational support is provided to staff about the involvement of family or carers in a support role for a client?)
- What systems are in place to cater for the organisation-wide impact of involving formal supports? (E.g. how will staff communicate to the broader client group about the role of an external support person's involvement in an individual's treatment?)
- What consent is needed to engage formal and informal supports?
- What support can our service offer to formal and informal supports?
- At what point in treatment should you engage these supports with the person?
Partnerships with other services
Establishing partnerships will allow your service to work with a person with more complex needs on their drug and alcohol misuse while they simultaneously receives support for other health and social issues. Partnership benefits include:
- The person receives the most appropriate care for their needs.
- The person connects with services that can continue to support them once they've completed a drug and alcohol program.
- Better support for you in your work with a person with complex needs.
It's important to have a good working knowledge of support services available in your area. Allocating resources to researching potential service partnerships and undertaking activities to establish partnerships is essential. This initial investment will pay off at a later date when your service has access to additional supports or points of referral. Services that are geographically isolated could explore opportunities for accessing additional services using teleconferencing or web-based technologies.
Providing coordinated care that involves a number of different workers and services working in partnership is generally regarded as best practice, but it's important that all parties are clear about the specific responsibilities of their service and that mechanisms are established for regular communication between services.Back to top
Aftercare, outreach and referral practices
When working with people with complex needs, a continuum of care is vital to ensure people do not fall through the cracks of service provision and to prevent relapse into alcohol or drug misuse or other risky behaviours.
Practice Tips for Workers includes a range of information on aftercare, outreach and referral that can be used to review your service's current practices, policies and procedures.
The following questions provide a brief guide to what to consider when developing an organisational approach:
- Are assertive outreach, aftercare and referral practices used in our service?
- What level of outreach, aftercare or detail of referral can we provide?
- Are agreements in place with external service providers to support provision of service outside of own resources or geographical constraints?
- Are transition plans (as part of a care or exit plan) made with the client when they're moving from our service to another provider? At what point is the transition plan implemented?
- What level of staff facilitation is involved in this transition plan? For example, do we accompany the person to the first few meetings? Is our service involved in the care plan while the person's still in treatment?
- Are aftercare and referral practices used for all clients exiting our service?
- Is there active follow-up with the person and/or the relevant service provider to check the person's level of engagement with a new service?
- Is there a system in place to address any problems with a referral?
Find out more
For further information on family-inclusive practice see:
- NADA (Network of Alcohol and Drug Agencies) (2009) Tools for Change: A New Way of Working with Families and Carers, NADA: Sydney.
- The Bouverie Centre and NADA (Network of Alcohol and Drug Agencies) (2012). From Individuals to Families: Single Session Family Consultations DVD. The Bouverie Centre, Melbourne, provides practical examples from alcohol and drug services on how you might implement and sustain family-inclusive practice. See www.nada.org.au/resources
- the NADA Policy Toolkit 2nd Edition for a range of templates
- Marsh, A., Dale, A. & Willis, L. (2007a) A Counsellor's Guide to Working with Alcohol and Drug Users, Drug and Alcohol Office Western Australia: Perth.
The NADA website partnerships webpage www.nada.org.au/nada-focus-areas/partnerships lists a range of resources and links to further information that may help you in developing effective partnerships.Back to top