John’s case study

John was referred to the treatment program by the magistrate at his local court in November 2004; at that time he was 20 years of age.

Charges:

Assault officer in execution of duty x 2, Common assault, Breach of community service order.


Living arrangement:

At the time of entry into the treatment program John was living with his girlfriend who recently had a miscarriage with their child. They lived in a neat and tidy townhouse on the North Coast of NSW.

Psychosocial:
John's mother is a local Koori and his father is an islander. They separated about three years ago, however they still remain in the same residence for the sake of their children. John is the eldest of 5 other brothers and sisters. The youngest sibling is 6 through to the oldest being 18 years. John is close to his mother; his father has served time in jail and has warned John not to follow this course. There appears to be no substance use problems with the mother or the other siblings, the father had a past problem with alcohol, but no longer has alcohol dependency issues.


Drug & alcohol:

Current

John's primary drug of concern was Cannabis and was smoking 15 cones per day of hydro/bush buds, he was occasionally binging on alcohol up to 8 standard drinks every couple of days. He has also experimented with ecstasy and snorted amphetamines.

Past

John began smoking cannabis at the age of 13 and alcohol at 14 years and other party drugs at 16 years.

Mental health issues:

John has no diagnosed mental health disorders.

Rehabilitation case management

  • John's initial treatment plan was supervised home detoxification from cannabis and alcohol. He was placed on a two-week reduction program for cannabis with a goal to cease after two weeks. Also a controlled drinking program for alcohol limiting his intake of alcohol to weekends only, this being a maximum of 6 Standard drinks. The goal was to quit alcohol also altogether.
  • He was to attend one on one individual counseling sessions with his case manager.
  • He was to attend weekly rehabilitation program relapse prevention groups.
  • To enter into random supervised drug urinalysis
  • Have home visits by his case manager to assess his home and relationships with significant others.
  • Enroll with an Employment Agency.
  • Attend a course on understanding aggression.
  • Attend a supervised gym.


Liaison with other referred out-client services:

  • Employment Services
  • Family Services
  • Supervised Gym

Progress on rehabilitation program:

John commenced the program enthusiastically. He was committed to his cannabis and alcohol reduction programs. After two weeks he had stopped smoking cannabis and had reduced his alcohol consumption to 6 standard drinks at the weekend. After several more weeks he had reduced further to 4 standard drinks on the weekends. He had one relapse mid program when he dropped an ecstasy tablet at a local music festival in the area.
John started keeping away from his drug using peers in order to prevent relapse. He reconnected with his cousin who has moved back to the local area. This cousin was an inspiration to John in helping him reignite his passion for Indigenous dance and music.

John ended the relationship with his 19 year old girlfriend. However they still remained friends and still reside together at the same address. John has a substantial amount of family living in the area around him. He, therefore, commenced rebuilding his support network from his immediate and extended family. During his time in the treatment program he re-established his relationship with both parents. His mother visited him nearly every day on her way to work and on the weekends he would go to their residence to help out where needed. John's father helped him fix a car up so that he could get to work. He also started taking his younger brothers and sisters surfing and crabbing.
John displayed enthusiasm and commitment to the rehabilitation program's relapse prevention groups. He attended all groups held and his participation was of a high standard. He also often pointed out the benefits of being on the program and how he was using the skills to prevent relapse back into substance use.

Difficulties experienced on the program:

  • Mid program, following Christmas, John stopped turning up for his one on one appointments.
  • He didn't go to the aggression course as often as he said he did.
  • There was a miscommunication between Employment services and the Rehabilitation program. Employment services would not disclose information to the Rehabilitation program about John to protect him. However, John was telling his case manager that he wanted employment whilst in the rehab program.
  • His urinalysis was coming back with low levels of THC still detected even though he had ceased smoking.
  • How these were overcome:
  • The non-compliance mid Program may have been due to the fact that there was a change over of John's case manager and consequently some disruption for him.
  • In regard to Employment services it was finally established that John would rather wait until he had finished the Program as he didn't want the awkwardness of explaining to prospective employers why he had Program commitments that took up possible work time. At the end of the Program he secured employment and an apprenticeship through a friend of the family without the help of Employment services.
  • Supervised urinalysis testing demonstrated that John had ceased cannabis use by completion of the program.


Court outcomes:

John received a Section 9 Good Behaviour Bond and his Community Service Order was revoked.

Personal achievements:

On conclusion of the program John had ceased cannabis use and had reduced his alcohol consumption to within low risk limits.

  • Statements from John's mother and father confirm his abstinence from cannabis and his alcohol intake being minimal. They go on to state that he is now a calm and peaceful person instead of the irritable and angry person he was when using cannabis. His mother states, "I have got my son back...he is back to his old self again." She thanked the treatment program for really helping him and that she has seen a huge change in him.
  • John's urine pathology drug screen confirms his claim for abstinence from illicit substances.
  • John attended every relapse prevention group, he was always punctual and participated in the groups fully and enthusiastically.
  • John has secured a traineeship in a trade.
  • Enquiries confirm he has detached from his drug using peers.
  • John's goals are to keep applying the strategies learned from the treatment program, to deal with his life's stressors to overcome the urges rather than lapse back into substance use. He has ensured and secured support from his indigenous community; from his immediate and extended family, his ex-partner and friends.


Treatment Program Case Worker
North Coast (NSW)
March 2005