Proudly hosted by the Aboriginal Drug & Alcohol Council (SA) Aboriginal Corporation.

Conference Program

7th, 8th and 9th of November 2018 - Adelaide Entertainment Centre, Adelaide South Australia
Day 1
07 Nov 2018
Day 2
08 Nov 2018
Day 3
09 Nov 2018

The Hon. Stephen Wade

Hon. Stephen Wade
10.40

Morning Tea

Noel Hayman Oration

Hon. Linda Burney MP
12.40

Lunch

Creating pathways for Indigenous Australians to lead the way in alcohol research

The Centre of Research Excellence in Indigenous Health and Alcohol aims to create the best opportunities for Aboriginal and Torres Strait Islander people to find solutions to alcohol problems through research. The Centre’s research agenda is based on priorities of Aboriginal and Torres Strait Islander health professionals and communities, and informed by what is already known through research. This symposium will showcase some of the work being conducted by this Centre. It will conclude with a ‘question and answer’ session. Speaker 1: Kristie Harrison – Aboriginal community controlled health services caring for alcohol problems: strengths and complexities  This presentation will provide an overview of an NHMRC-funded research project which is supporting Aboriginal Community Controlled Services (ACCHSs) in delivering alcohol care. The project is a cluster randomised control trial which has engaged 22 ACCHSs nationwide. This project takes a whole of service approach and is underpinned by the NHMRC Indigenous Health Research guidelines and ACCHS models of cultural care. ACCHSs deliver holistic services to Aboriginal and Torres Strait Islander peoples in cultural ways and as per cultural protocols, with each service being unique to itself Speaker 2: Gemma Khodri – Medicines to help a person stay dry  Clinical studies on the use of relapse preventive medications have been encouraging. This presentation will focus on prescription rates and attitudes towards medicines for relapse prevention in Indigenous Australians with alcohol use disorder. The three medicines looked at in this study are: Naltrexone, Acamprosate and Disulfiram. These medicines can provide additional support for those who wish to stay dry after detoxing. Use of the medicines either alone or in combination with support services such as counselling and support groups, has been shown to decrease the rates of relapse to harmful drinking. Access to these medicines amongst the general population is poor and anecdotally even worse for Aboriginal and Torres Strait Islander peoples. Understanding why these medicines are not adequately prescribed is essential in removing barriers to client access. Speaker 3: Teagan Weatherall – Addressing unhealthy alcohol use in the Katherine region: a health promotion framework Alcohol-related harm is a major health and social issue...
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Gemma Khodri
Elizabeth Dale
Bonita Byrne
Teagan Weatherall

The Aboriginal Medical Service Drug and Alcohol Unit in Redfern

The AMS drug and alcohol (D&A) unit, Redfern was formed in the first half of 1999 because of the major heroin problem in and around Redfern at the time. There were overdoses every day, sometimes up to 13 a day. The AMS CEO, Dr Naomi Mayers, supported by the Board said: “We’ve got to do something, we’re losing people.” The AMS asked the male D&A worker to coordinate the new unit, and hired a doctor and a nurse unit manager. The promised external funds did not come until many months later. With time, a female and male D&A worker were appointed, and started some outreach. Because of fear of a backlash, the unit was set up quietly. It was in a building across the road from the main AMS and was not labelled. News spread by word of mouth, and clients brought others in. The unit offered methadone prescribing, with dosing at local hospitals or pharmacies. Later on we started dispensing buprenorphine (‘bupe’) and then Suboxone directly. The AMS now has a total of around 180 clients on the opiate treatment program, and others for counselling, including for alcohol and other drugs. Clients are comfortable to come to the D&A unit: they know they will not be judged. Clients can have mental or physical health problems and the AMS can help with that. There are GPs and different specialists at the AMS – including a mental health unit and liver clinic, and we work in partnership with other services. Kate Conigrave will most likely be co presenting with Bradley Freeburn but is not available on the Friday 9 November.
Professor Kate Conigrave
Kate Conigrave
Bradley Freeburn
15.10

Afternoon Tea

Family Circles: an education and support program for families impacted by substance misuse

As an Aboriginal controlled, Not for Profit Company,FORWAARD Aboriginal Corporation has a focuson supporting and assisting people suffering from alcohol and drug misuse. While our 25-bed rehabilitation service is suitable for the initial treatment and care of clients, we have found through our many years of operations. More effort needs to be placed on supporting clients who have graduated from our program and transitioning back into society. The team at FORWAARD are convinced that the most efficientway to support any person suffering from substance misuse is to provide a multitude of client centred, responsive, supportive and culturally sensitive programs and services. Including intensive rehabilitation programs, throughtoolong-termaftercare and support. From our research,we believe that “Family members are often in a goodspot to help people make safer choices about drugs.”(2018 – Alcoholand Drug Foundation – Preventing harm in Australia)Accordingly, the FORWAARD team have developed a program which is aimed at reducing the strain on families by providing educative tools and one on one assistance to family members. Our aim is to arm participantswith coping mechanismsto recognisechangingbehavioursand identify when these are becoming destructive, sothey can respond positively and assertively with their loved ones. Thereby reducing the overall stress on families and empower them to support their loved ones as they recover. Family Circles, the program we have developed provides opportunities for families, to gain an understanding of how best to support their relatives, as they progress back into the community. Our program, is not only for FORWAARD clients, moreover, we offer our program to anyone in the Darwin area who is in need of our services. Consequently, we would like to present our program at the NIDAC conference and share what we have identified with the community.
Kathy Katras
Rikki Fischer

Self-Care – Supporting a Healthy Workforce

At the South Coast Medical Service Aboriginal Corporation (SCMSAC) we provide services ranging from individualised and group programs and services to address substance use, and improve social and emotional wellbeing. These services are provided through the Social Health Team which includes intake and screening, case management, counselling and psychology services for Aboriginal communities. Working in Aboriginal Communities can be very complex and often comes with a lot of expectation which mainstream organisations do not often face. We the Aboriginal organisations understand the complexities of Aboriginal Health that addresses the Spiritual, Cultural, Physical, Emotional and Social needs of Aboriginal people. Therefore requiring us to provide a holistic services, thus minimising access barriers and red tape (one stop shop). We understand that providing such services takes a toll on the workforce, however the advice we provide to our communities is can be often ignored by the workforce which can lead to high stress and potentially burnout.  Self-care needs to be at the forefront of the Aboriginal workforce to ensure the longevity of its workers and the quality of service provided. There are several strategies that can been used and are more effective than others, however it is important that the workforce have joint ownership and a clear responsibility of their own self-care but are well supported by the organisation. These strategies include, case and clinical supervision, debriefing, mindfulness activities and Cultural mentoring.
Nathanael Curtis

Re-thinking how we ask Indigenous Australians to describe their drinking

There are many challenges to assessing alcohol consumption in any population. These can be more so for Indigenous Australians because of sharing of drinks, drinking out of non-standard containers (e.g. empty juice or soft drink bottles), episodic patterns of drinking and culturally distinct approaches to communication. This talk exames the Grog Survey App as a way to collect self-reported drinking data from Indigenous Australians. We will talk about how the App was developed with Indigenous and non-Indigenous collaborators, and present findings showing how well the App is able to collect these data. To do this, we compared how the App estimates alcohol consumption compared with a clinical interview conducted by Aboriginal health professionals (in remote/regional SA and urban Qld). The survey App is offered in plain English and in an Aboriginal language (Pitjantjatjara) and uses touch-screen technologies to help participants to describe their drinking, even if they are not comfortable with numbers or reading. The App and clinical interview had high levels of agreement on which participants were at risk of their drinking. The App tended to identify higher levels of drinking than the clinical assessment.  The ‘Grog Survey App’ is a reliable and accurate way to estimate alcohol consumption. The approach taken to develop the App and its key features are likely to be useful for a wide range of marginalised or displaced peoples, including settings where non-standard drinking containers are used. An increased understanding of drinking patterns in Indigenous Australians will better inform strategies for brief intervention ad treatment for unhealthy alcohol use. The data can help inform improvement of household survey approaches and more meaningful policy development.
Scott Wilson
Scott Wilson
Kylie Lee

Fetal Alcohol Spectrum Disorder (FASD) from complexity to understanding and interventions

Children with FASD in Out of Home Care; and the lifelong impact of FASD. This workshop will include the powerful stories of six families both foster and kinship carers caring for Aboriginal children with FASD in Nyoongar country. Fetal Alcohol Spectrum Disorder is a serious global and mainstream health problem.  Children with FASD are over represented in out of home care and remain one of the most vulnerable groups within society.   Evidence highlights that the limited awareness of FASD within the world and Australia has contributed to the lack of FASD diagnosis and misdiagnosis, particularly for children in care.  Early intervention that is FASD informed is critical to prevent the onset of lifelong secondary disabilities, such as involvement in the criminal justice system and mental health. Further, evidence is now emerging of generational FASD within some families and more than one sibling born with FASD within the family. These are key points in understanding and in addressing FASD in the development of informed and trained services. Participants will have the opportunity to ask questions or share any local experiences of supporting children/families with FASD.
Robyn Williams

Supporting alcohol and other workers as they respond to complex health and social needs

Alcohol and drug use is often associated with other complex health and social problems such as mental health, chronic diseases, criminal offences and incarceration and social and family breakdown. Aboriginal and Torres Strait Islander people experience these conditions at rates disproportionately higher than that of the non-Indigenous population. To improve the health and social outcomes for Aboriginal and Torres Strait Islander people that use alcohol and other drugs, these complex factors and social determinants of health must be addressed. As part of the Australian Indigenous HealthInfoNet’s commitment to Closing the Gap, we have redesigned and updated the Alcohol and Other Drugs Knowledge Centre. The new navigation means it is easier to find information, resources and publications which provide the evidence to address the interrelated health and social impacts of alcohol and other drug use. With a focus on supporting the workforce, the Knowledge Centre facilitates easy access to the latest information about alcohol and other drugs. This presentation will cover the key features of the new website: Harm Reduction Portal Social and Health Impact Portals (including social and emotional wellbeing) workforce information, such as job opportunities, funding sources, organisations, and events health promotion and health practice resources, including videos and multimedia, as well as descriptions of successful programs social media platforms which enable the alcohol and other drug workforce to network, support and mentor, and importantly, disseminate information (which includes a Yarning Place, Twitter, and Facebook). The Knowledge Centre is an integral part of the infrastructure that supports the alcohol and other drug workforce. For those who are unfamiliar with the website, or those who have not seen the new website, this presentation will support the workforce in their efforts to close the gap in Aboriginal and Torres Strait Islander health, and address the complex interplay between alcohol and other drug use and the social determinants of health.
Avinna Trzesinski

Shifting the problem? Local versus regional approaches to alcohol management by Indigenous communities

Designing policy for alcohol regulation in remote Indigenous communities in Australia has proved particularly difficult and contentious. Our research on Alcohol Management Plans and other strategies for alcohol regulation is aimed at better understanding how alcohol restrictions, whether developed by Aboriginal communities or imposed by governments, are implemented and managed by community mechanisms. The research was undertaken in towns and communities in western Cape York and the Northern Territory. One of the key issues that emerged was the impact of the high mobility of Aboriginal drinkers and the ease with which they could access alcohol despite the restrictions.  In asking questions about the impact of Indigenous mobility on alcohol management practices and the regional variations, several problems became evident in our inquiries.  The success of the measures is undermined by the high mobility of these remote area responsibilities, as well as illegal alcohol trafficking, and result in policy and legal dilemmas that we describe and analyse in this paper. One is that policies and interventions do little more than shift the problem of alcohol-related violence and other anti-social behaviour from one location to another. The closure of drinking camps outside town and community boundaries and prohibition of the consumption of alcohol in public places force problem drinkers into life threatening behaviour in other places, such as homes, communities, resulting in fatalities. In this paper, we discuss the social and legal dimensions to these unintended consequences of alcohol regulation policies in several locations in remote areas of northern Australia.
Kristen Smith
Marcia Langton

Addressing complexity within a Model of Care

In 2017 Gindaja Treatment and Healing Indigenous Corporation identified and developed a Model of Care that would underpin and drive the focus of service provision across a full continuum of care and within a strong Indigenous led framework.  The model had to allow flexibility, yet provide a strong foundation from which the organisation could grow and move forward, giving it an increased platform to achieve better outcomes for clients and the community.  It therefore had to be lead by community and client need, yet be readily responsive to the changing political and funding climate. It had to also inspire new and innovative services and responses that could be developed and trialed.  The model also had to honour and preserve the history and purpose of Gindaja while also aspiring to new and innovative Indigenous ways of fulfilling its mission.  A comprehensive understanding of the multiple and complex needs (and their causes) of the vast majority of Gindaja clients and their families had to sit at the centre.  While Gindaja’s work in this field over the past 35 years has achieved many of these factors within the Yarrabah community and throughout the Far North of Queensland, there was a need to bring it all together so that it formed a clear and easily understandable message.  This presentation will describe the key phases and mechanisms of how the Gindaja Model of Care includes and responds to client complexity from within an organisational development and community controlled perspective.
Kathy Desmond
Ailsa Lively

It’s not uncommon in our clinics for someone to say that they’ve had a drink

Prenatal alcohol exposure may lead to a range of lifelong physical and cognitive abnormalities. Midwives play a vital role in preventing prenatal alcohol exposure and fetal alcohol spectrum disorder (FASD) by providing education and brief interventions (BI) to their clients. The objective of this study was to capture midwives’ perceptions on their alcohol-preventive practices during routine antenatal visits in the Pilbara. Six midwives and one ED Nurse working at Hedland Health Campus (HHC), Port Headland, WA, participated in a 2.5hr training session on the use of the AUDIT-C screening tool (Alcohol Use Disorders Identification Test – Consumption). The training aimed to improve midwives’ confidence and ability in using the AUDIT-C screening tool, including BI techniques. The training was designed to be interactive with opportunities for active discussion, role playing, and knowledge exchange. Data were analysed using a thematic content analysis approach. All participants were permanent employees of HHC, who reported working in the Pilbara for an average of nine years. Despite inclusion of the AUDIT-C tool in women’s pregnancy hand-held records, only one participant reported previous AUDIT-C training. Three main themes were identified: lack of AUDIT-C training, long wait-times for referrals and support, and the role of midwives in reporting pregnant women who knowingly consume alcohol to the Department of Child Protection (DCP). The need for other hospital departments (i.e. ED) to be trained on AUDIT-C was centrally connected to all themes, and there were strong views on the need for FASD education for communities and AUDIT-C training for smaller hospitals and GP services.

A Coordinated Response to Volatile Substance Use in the Ngaanyatjarra Lands

Volatile substance use or ‘sniffing’ is a dangerous practice which can have devastating effects on the user, their families and communities. While the overall number of volatile substance users in any given location may not be large, it can have a disproportionate effect on a community, particularly remote communities. The ‘Ngaanyatjarra Lands’ are extremely remote, situated in the east of Western Australia near the border of South Australia and the Northern Territory. It covers approximately 200,000 sq. km (about the size of Victoria) and comprises approximately 2,000 Aboriginal people who live in eleven communities. The nearest major towns of Kalgoorlie and Alice Springs are approximately 1000km away. The Ngaanyatjarra Lands are governed by the Ngaanyatjarra Council and permits are required to enter the Lands. The Ngaanyatjarra Lands are ‘dry’ communities where alcohol is prohibited but is also one of only two places in Western Australia with by-Laws that outlaw volatile substance use. In 2006, Low Aromatic Fuel was introduced to address petrol sniffing in the Lands which has proven successful. However, broader strategies are still required to prevent the harms associated with volatile substance use. In 2017, the Ngaanyatjarra Lands Volatile Substance Use Working Group was established to develop and implement strategies to ensure a coordinated response to reduce incidents of volatile substance use on the Ngaanyatjarra Lands. The group involves a range of stakeholders including representation from community, Local, State and Commonwealth Government agencies and non-government organisations. This presentation will focus on the supply, demand and harm reduction strategies that have been implemented so far, such as improved processes for the storage and disposal of volatile substances; and the timely, coordinated response to incidents of volatile substance use. Some of the key issues relating to the complexities of implementing the strategies and responses will also be discussed.
Angela Rizk
Nicola Shaw

Liquor permits as an option for community management of alcohol

One option available to communities in the Northern Territory for managing alcohol under the NT Liquor Act is the use of liquor permits to allow approved individuals to purchase, import and/or consume alcohol under specified conditions. These provisions were introduced in 1980, and since that time have been utilized by many communities. Today, 22 communities in the NT have liquor permit systems. The NT Government recently commissioned a review of liquor permit systems with a view to identifying operational issues associated with their use and to making recommendations relevant to other communities that may wish to adopt liquor permit systems in future. This paper draws on the findings of the review. The review found that permit systems can be grouped in two categories: (1) those that allow a small number of individuals (often non-Aboriginal employees in communities) to import and consume liquor in an otherwise ‘dry’ community; (2) those that allow a larger proportion of community members to purchase and consume alcohol, and that form a core element of community-based alcohol management systems. Both kinds of liquor permit systems have generated distinctive operational issues. We describe these, and the recommendations advanced to enhance the viability of community-based liquor permit systems.
Peter d’Abbs
Ian Crundall

Aboriginal and Torres Strait Islander Mental Health and Suicide Prevention

This presentation will provide a brief overview of Aboriginal and Torres Strait Islander mental health and will describe promising initiatives such as the Centre for Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention (CBPATSISP), that came from a national consultation . At the core of this work are concepts of community ownership and valuing culture. The mental health of Aboriginal and Torres Strait Islander people has become a critical issue and the evidence suggests a worsening mental health crisis. This is seen in reported high rates of psychological distress, hospitalisation for mental health conditions and most critically, increasing suicide rates. It is widely acknowledged that traditional Western mainstream mental health approaches have failed to address Aboriginal and Torres Strait Islander people’s needs. The wellbeing of Aboriginal people cannot be fully understood without an understanding of a historical context and cultural difference. This presentation covers work undertaken by the CBPATSISP and will review Social and emotional wellbeing (SEWB). This has emerged as an important Aboriginal and Torres Strait Islander concept of mental health and wellbeing(Gee et al., 2014). Although the term is often used to refer to issues related to ‘mental health’ and ‘mental illness’, SEWB has a broader scope. It recognises the importance of connection to land, culture, spirituality, ancestry, family and community, and how these affect the individual, family and community. SEWB issues cover a broad range of problems that can result from unresolved grief and loss, trauma and abuse, domestic violence, removal from family, substance misuse, family breakdown, cultural dislocation, racism and discrimination, and social disadvantage. This concept has been developed further by the Australian Indigenous Psychologists Association. The holistic nature of wellbeing, the historical impacts resulting in social determinants that adversely influence wellbeing are discussed. In recent times, innovative approaches are emerging in Aboriginal and Torres Strait Islander well being that confirm a promising way forward. How work in the space needs to be undertaken in partnership with   Aboriginal and Torres Strait Islander communities and the importance of culture in programs and services will be addressed.
Professor Pat Dudgeon

Addressing alcohol and other drug use among people involved in the criminal justice system

Aboriginal and Torres Strait Islander people are tremendously overrepresented in Australian prisons making up 27.4% of the prison population but only 2.8% of the Australian population. Furthermore, three out of every four  Aboriginal and Torres Strait Islander people in prison, have been imprisoned before, so there is a high rate of recidivism.. As identified in the NIDAC Committee report ‘Bridges and Barriers’ the overuse of alcohol and other drugs (AoD) is a contributing factor to the over-imprisonment. So what are the current trends in AoD use of people within this population? And how can their AoD use be best addressed? This presentation will report on Aboriginal-led research, which has looked at these issues. The current trends in AoD use will be presented as well as ways in which current prison-based AoD treatment programs can be enhanced for Aboriginal people. The presentation will also explore how the cycle of Aboriginal imprisonment could be interrupted in the future so Aboriginal people may be less likely to return to prison.
Dr Michael Doyle

Alcohol and other Drugs – Preventing and Treating complex problems – What can we learn from Giving Up?

People affected by alcohol and other drug problems rarely simply have problems with a drug or drugs. They can have complex social, psychological, legal and practical challenges in their lives. What are the implications for effective prevention and treatment? This presentation will examine what we can learn from people who give up problematic alcohol and/or other drug use. There are clear indications from this work that we must focus our attention beyond the walls of a clinic otherwise our impact will also be limited.
Professor Steve J Allsop
11.20

Morning Tea

Responding to complex needs using the Alcohol and Other Drugs Knowledge Centre

The Australian Indigenous HealthInfoNet’s Alcohol and Other Drugs Knowledge Centre is a national web resource that aims to reduce harmful alcohol and other drug use in Aboriginal and Torres Strait Islander communities by providing support to the alcohol and other drug workforce – health practitioners, researchers, academics, policy-makers, and community members. The Knowledge Centre has recently had a makeover so it not only looks great, but it is now easier to navigate your way around, or search for specific resources. It has been designed to also work on phones, tablets and other mobile devices. This workshop would be of particular interest to anyone working in the alcohol and drug, tobacco, social and emotional wellbeing or research and policy sectors. Those who have known and used the original Knowledge Centre may also find it useful to learn about the new features and layout. This 90 minute interactive presentation will take participants on a tour of the new and improved Knowledge Centre website and its resources and be shown how to: navigate the redeveloped web resource to easily access information on specific drug types access new portals on harm reduction, health and social impacts use specific health workforce and community resources find what is relevant to them, their clients, their families and their communities. Some tablets will be supplied but participants are encouraged to use their phones or bring a tablet or laptop to use in the workshop. This session will demonstrate the time-saving benefits of the Knowledge Centre and how it can assist workers in their efforts to reduce harms from alcohol and other drug use and contribute to closing the gap in Aboriginal and Torres Strait Islander health outcomes. It will equip delegates with the skills and confidence to easily obtain the alcohol and other drug information needed to optimise their research and practice.
Avinna Trzesinski

Anomie and working within a community based cultural healing model

This presentation will explore the importance of working within a model of cultural inclusiveness and community based healing for the three communities of Walgett, Bourke and Parkes. Staff need to have cultural competence and community credibility, and the ability to talk to the target group on their turf. The Weigelli and Orana Haven hub project is unique and seeks to work with these communities to provide a service that has cultural competence embedded across all aspects of client service delivery. To do this work there cannot be tight time limits or an absolute focus on normal outcomes including KPIs, rather it needs to be based on engagement by workers with the client, their family and often extended family to determine what best suits their needs. This will be discussed in detail and examples of these ways of working with groups will be given. The Weigelli Orana Haven Hub Project has sought to maximise the way in which workers are embedded within their respective communities. This approach we believe has maximised the way in which individuals and their families are able to receive a service that best meets their needs that has no occurred previously. The Hub project team spent considerable time recruiting the right community based workers and placed a greater emphasis on them being an integral part of their community rather than recruit from outside the community.  Aboriginal people who previously would not have engaged with mainstream service or Aboriginal Medical Service now have a platform from which they are getting their health needs met. Taking the time to recruit the right person based on their community connections and credibility has allowed people who previously had little contact with service to now feel more at ease to do so.
Kim Sullivan
Jacqueline Read
Norm Henderson
Doug James

Clinical audit of an alcohol screening tool in Western Australia

Assessment of alcohol consumption during pregnancy coupled with education and support can prevent adverse consequences to the child, such as Fetal Alcohol Spectrum Disorder (FASD). The AUDIT-C (Alcohol Use Disorder Identification Tool- Consumption) screening tool provides a quick assessment of risky alcohol consumption for pregnant women. The resultant score provides an indication of level of risk of harm to the woman’s health and the appropriate action, including brief intervention counselling and referral pathways. The objective of this study was to identify how often and how accurately the AUDIT-C screening tool was used to capture the level of alcohol related risks to the mother and foetus, as well as the proportion of women drinking during pregnancy. This is a cross-sectional baseline audit of maternity health records for a quality improvement intervention. Maternity records of 1,154 women that delivered in a tertiary healthcare setting in Western Australia between 2010 and 2015 were analysed. The main outcome measures were: adherence to usage of AUDIT-C three times during pregnancy, and consequent brief intervention/advice, proportion of women drinking during pregnancy. Preliminary results showed AUDIT-C score was recorded in <15% of maternity health records. Documentation of brief intervention/advice regarding health behaviours risks (smoking, alcohol and substance abuse) was low. Results indicate that there is an urgent need for quality improvement which might be addressed through education, training or structural changes to maternal health recording.

Responding to complex client needs, a Hospital Avoidance Outreach Approach

Responding to complex clients in the community is core business for the CALHN (Central Adelaide Local Health Network) Hospital Avoidance Teams. Specifically the Hospital Avoidance Outreach Team (HAOT) specialises in developing plans of care and approaches to complex and vulnerable clients in the community. The team’s assertive outreach capacity allows for flexible engagement wherever the client might be located: CALHN Hospital, rough sleeping, in an overcrowded home, sleeping at a crisis centre or housed.  Referral to HAOT is open to people who do not fit into other service models and require health interventions to reduce the impact of chronic conditions, manage acute health issues, mitigate the risk of hospital presentations and ultimately reduce the burden of disease. HAOT is a specialist group of Health and Allied professionals that provide a holistic multidisciplinary team approach to client care. The team includes Aboriginal Health Practitioners/Workers, Nurses, and Occupational Therapist, General Medical Practitioners and an Addiction Specialist with varied experiences in inpatient, community and remote health, mental health and drug and alcohol settings. The distinct advantage of the HAOT is that the response is flexible, individual and adaptive to each client referral. Risk management is undertaken to increase the safety and wellbeing of the client and the team respectfully. The HAOT receives referrals from CALHN hospitals, health units and non-government organisations (NGO). Where possible the team provides in-reach to develop rapport and commence care planning with the client and the treating team. The presentation will discuss a compilation of complex client scenarios that highlight our approach and the successes and learnings from our multidisciplinary team perspective.
Christian Wilson
Kirstine Restell
Fred Taylor
Chris Wurm

Connecting Community with Residential Programs: an approach that’s worked

This presentation will summarise the successful combination of support strategies involving a local community program and interstate residential services. RIVMED (Riverina Medical and Dental Aboriginal Organisation) in Wagga Wagga NSW have developed a program to help prepare men and women for subsequent residential programs. On completion, men and women are supported in admission to Galiamble and Yitjawaduk, Men’s Recovery Services in Melbourne and the Goulburn Valley, and Winja Ulupna Women’s Recovery Service in St. Kilda Victoria. The combination of these programs has resulted in extraordinary achievements beyond what can be expected independently for community and residential services. This presentation will summarise the components of these programs, and suggest reasons for the changes that it has supported in the lives of many men and women.
Kurt Simpson
Damien Kennedy
Bea Edwards
Mark Hammersley
Brook Perry

Outcomes of a community-based participatory research project with Aboriginal communities reducing alcohol-related harms

Solutions designed and led by Aboriginal Australians are most effective and sustainable in improving the health of Aboriginal Australians. The challenge is to bring together the leadership, skills and knowledge of Aboriginal communities with the highly specialised, real-world evaluation skills of senior researchers. This presentation will showcase how researchers worked in partnership with Aboriginal communities to develop, implement and evaluate a community-based program aiming to reduce alcohol-related harms among Aboriginal people.  Using a community-based participatory research approach, researchers developed partnerships with three Aboriginal communities and collaborated closely to develop a multi-component community-based program. The program was designed to be standardised across communities but also tailored to communities’ priorities and resources. Routinely collected police and emergency department data, supplemented by community surveys were used to evaluate the effectiveness of the program in reducing alcohol-related harms and improving empowerment and safety. Qualitative interviews with community-based partners were conducted about the extent of community participation, community impact and sustainability of the program.  Each community implemented a suite of 10 to 15 activities, reaching approximately 1,000-2,000 people in each community. Following the program implementation, there was a 19% increase in community members’ empowerment, a 21% reduction in alcohol-related verbal abuse and 9% reduction in alcohol-related injuries observed by community members. There was a 20%-31% increase in how safe people felt at night. Findings related to crime and ED presentations are not yet available, but will be available at the time of the conference. Interviews with community-based partners indicated participation was moderate to high and elements for sustainability of the program were identified. This study provides guidance for researchers, policy makers and program developers to work with Aboriginal communities to develop effective intervention strategies and frameworks to evaluate these strategies.
Mieke Snijder
Bonita Byrne

Partnerships, Prevention & Pathways – using the triple PPP program to address alcohol and drugs in a city

How do you get people engaged in programs when they are socially isolated from the mainstream community because of their alcohol and drug use? How can one person facilitate diversionary programs across a whole city? This presentation discusses the keys to establishing and organizing a highly successful community driven initiative aimed at promoting health, wellbeing and alcohol and drug diversion in various parts of Adelaide. In response to community needs, ADAC saw that many people with alcohol, drug and associated health problems are often socially isolated and not involved in diversionary or healthy activities – even when they are available. This presentation explores: Why (Aboriginal) people do not become involved in activities Innovative ways for them to be involved. The value of partnerships with other organisations Community and client demands for the expansion the program The outstanding success and people’s stories
12.40

Lunch

How to use electronic cigarettes to reduce Indigenous smoking

Tobacco smoking is by far the biggest preventable cause of death, disease and inequality in Indigenous people. Electronic cigarettes have the potential to substantially reduce this harm. E-cigarettes are a far less harmful alternative for smokers who are unable or unwilling to quit combustible tobacco (tobacco harm reduction). They can satisfy the smoker’s need for nicotine and provide ‘a smoking experience’. Colin Mendelsohn will describe how they work, the evidence for their effectiveness and safety and the health benefits of switching from smoking to vaping. Marewa Glover will discuss why and how Indigenous peoples are using vaping. In Aotearoa (New Zealand), Maori led the call for a harm reduction approach to tobacco smoking. Marewa will describe the strategies used such as the by-Maori-for-Maori Vape2Save program which helps families who smoke together switch to vaping together. Scott Wilson will describe his experience in helping Indigenous smokers in Adelaide switch to vaping. He will outline how he helps smokers make the switch, what factors are especially relevant for Indigenous smokers and practical issues for smokers starting vaping, such as where and how to buy devices and nicotine liquid. Byron, an Indigenous smoker who switched to vaping after 52 years smoking will tell how vaping has changed his life. E-cigarettes are a legitimate tobacco harm reduction tool for Indigenous smokers who are unable or unwilling to quit with conventional strategies and could contribute significantly to closing the health and financial gap. Learning objectives To understand tobacco harm reduction To learn the evidence and rationale for using e-cigarettes for smokers who are otherwise unable to quit To learn how to advise and counsel Indigenous smokers on the appropriate use of vaping products
Marewa Glover
Colin Mendelsohn
Scott Wilson
Scott Wilson

Design and delivery of therapeutic alcohol and drug programs in remote Australia

Life Without Barriers (LWB) is a social purpose organisation working in more than 440 communities across Australia. Since January 2016, LWB Drug and Alcohol Counselling Service has operated in the Ceduna, Yalata and Koonibba communities in South Australia providing assertive case management and therapeutic counselling interventions to a 96% Aboriginal demographic. Following the program’s initiation, a rapport was built between Community Elders and the worker. This has resulted in the worker being invited into community to provide support directly related to community business during key events, such as men’s or sorry business. Clients presenting to our service typically have complex and comorbid needs with high rates of poor physical health common for this population group. Diabetes, heart conditions, liver disease, scabies, and Sexually Transmitted Diseases the more common conditions observed. Our response was for the worker to develop relationships with local medical services such as; Koonibba Aboriginal Health Service, Tullawon Health Service, and Ceduna Hospital. The worker supports clients to access these services, checking with the client on their preference for service, rather than basing it on geographical location. Drug and alcohol counselling sessions can also be facilitated from Koonibba Aboriginal Health Service, ensuring that clients feel comfortable accessing this service. The worker has developed an informal relationship with the community paramedic, which enables daily communication in line with client consent, about physical health concerns. Drug and alcohol counselling sessions are often provided informally with shorter and more frequent sessions. The presentation of complex needs by no means is limited to poor physical health and also often includes issues such as; homelessness, criminal justice involvement, domestic violence, parenting and Department for Child Protection involvement, and Mental Health. The development of relationships with other services and organisations is then key to ensure a holistic and comprehensive approach to treatment delivery.
Shelly Purvis
Michelle Fairweather

Bunjilwarra – practice knowledge from a state-wide Aboriginal youth drug and alcohol healing centre

Bunjilwarra is a 12 bed state-wide Aboriginal youth drug and alcohol rehabilitation service situated on 6 acres 75km from of Melbourne. Bunjilwarra has been operating as a partnership model between Aboriginal and mainstream youth and health services since 2014 and has seen over 150 Aboriginal youth enter the program with stays averaging 49 days. Since doors opened Bunjilwarra has built practice knowledge related to addressing the cultural and clinical complexity of male and female Aboriginal youth through the use of trauma informed and resilience based frameworks. The development of a model of care that draws heavily from the Aboriginal designed Social and Emotional Wellbeing framework has allowed Bunjilwarra to deliver holistic care aimed at addressing the complex individual presentations that are reflective of the significant challenges Aboriginal youth from urban and regional settings face in today’s society. In practical terms, treatment for alcohol and drug abuse in the context of family violence, racism and trans-generational trauma has required Bunjilwarra to adapt and blend adolescent developmental and youth drug and alcohol approaches with cultural elements such as identity, connection to kinship, land and community. The recently embedded Aboriginal Resilience and Recovery Questionnaire (designed by Dr Graham Gee, Clinical Psychologist) as an outcome measure for residents of the Bunjilwarra program will produce reliable outcome evidence of the program and counterpoints deficit focused approaches to research into the lives of Aboriginal youth. None of this of course can be achieved without strong partnerships with Aboriginal families, Aboriginal community controlled organisations, youth services, health services and youth justice related agencies. With equal importance, we listen to the voice of Aboriginal youth. Bunjilwarra will openly share their experiences and learning with conference delegates, highlighting the enablers and blockers relating to their journey as a unique service for Aboriginal youth.
Pete Dawson
Pat Farrant

The Children’s Court of Victoria – Two innovative approaches to old complex problems

The Broadmeadows Children’s Court was opened in October 2015 as a designated ‘Court of Innovation’ as a feature of the Children’s Court of Victoria’s commitment to pursue innovative new approaches to the increasing complexity of Child Protection applications coming before the Court.  Key to this commitment has been the piloting of new unique programs – the Family Drug Treatment Court and Marram-Ngala Ganbu.  The Family Drug Treatment Court, the only court of its kind in Australia, is a judicially-led court based intensive case management service supporting parents who have lost the care of their children due to concerns relating to substance use to overcome these issues so that reunification can be achieved.  Marram-Ngala Ganbu, meaning ‘We Are One’ in Woiwurrung language, revolutionises the Court’s management of child protection applications with respect to Aboriginal families and seeks to engage parents, families and community members in culturally inclusive non-adversarial problem solving. Both the Family Drug Treatment Court and Marram-Ngala Ganbu represent exciting new approaches to the way in which children’s courts can pursue solutions to complex problems that traditional adversarial court processes have failed to significantly impact on.  This presentation will detail the development of both programs, and highlight some of the wonderful outcomes that can and have been achieved for Aboriginal and Torres Strait Islander families through the innovative approaches both programs represent.
Matt Wilson
Ashley Morris
Kay Macpherson

Makin’ Tracks aligned: Good practice in Aboriginal community drug and alcohol education

Makin’ Tracks is a mobile drug and alcohol education service designed from a grassroots perspective, and refined over time to meet the complex needs of Aboriginal communities in South Australia (SA).   Developed by the SA Aboriginal Drug and Alcohol Council (ADAC) in 2000, the Makin’ Tracks program has been evaluated several times, showing success in the areas of working collaboratively with communities and in building networks to address problematic drug and alcohol use. Makin’ Tracks has been praised for its unique, adaptable and mobile approach to drug and alcohol education, with two Project Officers travelling to Aboriginal communities when invited by community leaders.  However, its distinctiveness has previously made evaluations against Good Practice Models (GPMs) challenging, as no directly relevant model was available that also acknowledged the complexity of service delivery in Aboriginal communities.  Therefore, a GPM for Aboriginal Community Drug and Alcohol Education Services was developed for the current evaluation, based on key literature.  This model keeps in mind the specific requirements of a service like Makin’ Tracks, including a consideration of the unique cultural elements of communities, and the complex needs of people living in different locations. This latest evaluation uses evidence from interviews, observations, and previous evaluations to determine whether Makin’ Tracks aligns with the GPM.  As the model could be used more widely than Makin’ Tracks, it includes broader, aspirational elements of service delivery.  This meant that some elements of good practice weren’t fully achievable within the resources of the program, although for others, Makin’ Tracks demonstrated leadership in the field.  Overall, the resulting GPM is potentially useful to other similar services in Australia. This presentation will provide a description of key elements of the model, using photos, stories and videos from Makin’ Tracks to illustrate the rewards and challenges in successfully putting them into practice.
Monica Cass
Jimmy Perry
Jimmy Perry

The Oolong Aboriginal Corporation Drug and Alcohol residential rehabilitation for Indigenous men

The presentation of Oolong House addresses information relating to programs we offer to Indigenous men with alcohol and other drug addictions and how they are being realised. The discussion topics provide the observer an opportunity to contemplate and examine how complimentary therapies, along with Cognitive-behavioural therapies (the most widely used evidence-based practice for improving mental health) are co-existing and offering clients a broader chance of healing, independent of main stream therapies. Current trends show that society is leaning towards a holistic experience of healing. Our discussion invites you to consider how this holistic based, culturally and future focused approach helps assist our clients with drug and alcohol addictions, dual diagnosis and long term ecological, social and mental health issues, maintain healthy and remedial lifestyles during recovery and beyond.  
Tanya Bloxsome

Complex Families: Incarcerated youth with Fetal Alcohol Spectrum Disorder and Neurodevelopmental Disability

Between 2015 and 2017, the Telethon Kids Institute conducted a research project which examined the prevalence of Fetal Alcohol Spectrum Disorder and neurodevelopmental disabilities at Banksia Hill Detention Centre – Western Australia’s only youth detention facility where 75% of detained youth are Aboriginal. 36% of assessed youth were diagnosed with Fetal Alcohol Spectrum Disorder and 89% had at least one severe neurodevelopmental impairment. This has a profound effect on affected youth at almost every stage of the justice process. A qualitative study was undertaken to examine youth and family members experiences of the project. Many participants came from families where the impact and trauma of past removal and criminal justice policies have deeply scarred their lives. As a result, high levels of alcohol use and other harmful effects were evident in the qualitative study, both in the youth and more broadly in families and communities. The presentation will provide an overview of the data from the perspectives of youth and their families through a ‘wicked problem’ lens. ‘Wicked problems’ are complex, intractable and not easily solved and stakeholders have a variety of worldviews and opinions. One of the proposed key solutions to a ‘wicked problem’ is inclusion and collaboration between multiple stakeholders. Young people, their families and communities must be viewed as key stakeholders in finding solutions. The presentation will explore ideas they identified in the project and will provide a unique and important contribution to more broadly understanding the needs of youth and their families diagnosed with neurodevelopmental disorders involved with the youth justice system. The benefits of placing youth and their families at the centre of decision making are multiple, from mitigating alcohol-related harm to potentially reducing the over-representation of Aboriginal children in Australian prisons.
Sharynne Hamilton

Strong Steps: A joint initiative providing AOD counselling for complex cases in Darwin’s rural area

Council for Aboriginal Alcohol Program Services (CAAPS) 35 years and Amity Community Services 40 years strong, acknowledge the devastating effects that alcohol and drug use can have for Aboriginal families, and the broader community. Evidence shows ongoing methamphetamine use heightens the risk for negative health, psychological, and social outcomes. These outcomes include illness, stress and financial burden, on individuals, families and friends. Criminal activity including assault, family violence, child neglect and abuse, family breakdown, employment issues, disengagement from community supports are common themes. The substance use issues Aboriginal families and community are facing are growing in complexity. Our practice evidence shows us people are experiencing a diverse range of problems relating to alcohol and drugs and we know from research that every dollar spent on drug treatment has a more positive outcome on community in comparison to strong policing and criminal sanctions. It is therefore imperative that treatment is a significant part of the solution. Strong Steps service model builds local capacity to address substance use with two experienced community based organisations working in partnership. The service delivery model is underpinned by support for cultural diversity, self-determination and self-identification while integrating the three pillars of harm minimisation – demand, harm and supply reduction. Each is equally important and prevention is an integral component of our practice. This presentation will explore how the model works to provide opportunities for Aboriginal people, families and the wider community to engage in education and treatment along a continuum by adopting a ‘no wrong door’ approach to practice.
Amber–Rose Martin
Johanne Goncalves

Working within a context of long-term engagement and trust

Amity Community Services  Inc. has been working with people for more than 40 years. Some of the work has engaged nominated Indigenous Town Communities in the greater Darwin area over the last eight years, supported by a combination of Federal, Territory and other funding. Amity implements a unique service model informed by empirical and practice evidence.  We tailor service delivery to work with and support people and families experiencing complex needs, environments and unique circumstances. Amity relies on relationships we have established with community members   through a combination of mentoring, individual development and retention of Indigenous staff. These relationships provide a platform for long-term engagement and trust. Amity will often be seen by other services as a key relationship for introducing and facilitating their relationships with these communities. The complex needs of individuals and families are met through detailed understanding of their context and tailored connection with services and external agencies. In addition, Amity ‘fills gaps’ though specific expertise in volatile substances, working on and off community with young people with risky behaviours, working with families via bush camps, jointly mentoring young people with employers and offering organisation funded scholarships to assist with school, sporting, cultural and artistic engagement. This presentation will explore the model, practice evidence and case examples.
Sharon Greenoff

Facilitation of a multimedia Peace Education Programme in correctional facilities

Enabling good choices, building resilience, rebuilding self-esteem and creating personal strength and clarity are ways to respond to the many complex issues, paths and stories in the lives of addicts. The Peace Education Programme (PEP) allows participants to reflect upon their own innate value as people and feel the self-esteem which is inherent in everyone. Dr Ramsay has observed increased motivation and engagement by PEP participants with drug and alcohol addiction problems. The non-sectarian, non-clinical and non-religious content has proven to be acceptable and effective with indigenous participants at Wolston Correctional Centre in Queensland.   The reduction in violent incidents (from records kept by custodial officers) in the PEP cohort at the Wolston Correctional Centre (a men’s maximum security facility) has been noticeable – indeed remarkable.  Dr Ramsay will expand on these statistics in his presentation and will show video footage of the programme’s use and success in reducing violence at Wolston. In stressful environments mental health and alcohol and drug issues often drive the agenda of rehabilitation.  Education programmes that encourage participants to rediscover and use their inner resources and develop inherent skills are fundamental to change and rehabilitation. The purpose of this innovative educational programme is to help participants discover their own inner resources—innate tools for living such as inner strength, choice, and hope and the possibility of personal peace. The content is based on excerpts from Prem Rawat’s international talks on personal peace. Since 2013, the Peace Education Programme has been offered in Drug and Alcohol Units, mental health rehabilitation facilities, Correctional Centres and community groups in Australia and New Zealand.  The programme has been facilitated world-wide since 2009, has been translated in to 35 languages and facilitated in 74 countries.  
Andrew Ramsay
15.10

Afternoon Tea

Building Resilience Capacity in Vicarious Traumatisation in the Aboriginal Social and Emotional Wellbeing Workforce

This workshop focuses on the Aboriginal Social and Emotional Wellbeing (SEWB) workforce, to assist in building resilience capacity in the area of compassion fatigue (also known as vicarious traumatisation). The workshop will provide knowledge and skills in the areas of: Social and Emotional Wellbeing Workforce Statistics Understanding Trauma – Primary and Secondary Trauma Compassion Fatigue: Presentations, Signs, Symptoms, and Impacts SEWB Workforce Impacts – Burnout versus Compassion Fatigue Common Self-Tests to Measure Individual Risk Individual Prevention and Resilience Capacity Building around Compassion Fatigue Organisational Risk Mitigation and Capacity Building Strategies around Compassion Fatigue The workshop will be made up of 1) underpinning theoretical knowledge, 2) evidence-based self-tests to gain approximate baseline measures of participants in the areas of empathy, stress, trauma, and quality of life scales, 3) qualitative group discussions, and 4) skill development to prevent or minimise the harms of secondary trauma exposure, and building general resilience capacity. The workshop is designed to provide robust theoretical knowledge around the impacts of secondary traumatic exposure to Aboriginal SEWB workforce whilst undertaking their occupational roles, and is aimed at minimising the risks of harms, embed protective knowledge and behaviours at both the individual and organisational level, and improve resilience capacity in the SEWB workforce to enable a more empowered service provision to the communities that they serve. Research shows that a large percentage of SEWB workforce are Aboriginal themselves and experience the same social determinants of the communities/clients they service, therefore it is critical that the SEWB workforce are provided the key knowledge and skills to both protect them from the harms of their work roles, and, empower them to build resilience capacity for optimal functioning so they may continue to service their communities and improve the social determinants of Indigenous peoples.
Peta Phelan

Promoting Positive Choices for Aboriginal and Torres Strait Islander youth

Prevalence of substance-use related harms are higher in Aboriginal and Torres Strait Islander people compared to non-Indigenous people. The culturally diverse and complex context in which these harms occur accentuates the need for culturally appropriate prevention approaches, education and resources for Indigenous young people. This project aims to develop culturally-appropriate and effective drug prevention resources through the development of an online alcohol and other drugs portal that provides an accessible range of informative and evidence-based resources for Indigenous students, parents and teachers. The Positive Choices – Aboriginal and Torres Strait Islander portal was developed through in-depth consultations and focus testing with teachers, parents, students, and service providers. A scoping review of existing substance-use prevention resources was conducted to identify existing evidence-based programs using NHMRC guidelines. Fact sheets were written by researchers based on literature reviews and consultations. User testing was conducted by interviewing 12 Aboriginal and Torres Strait Islander media and communications workers around the country. Consultations indicated a preference for culturally appropriate substance-use prevention materials that had a strengths-based approach, enhanced cultural knowledge, were empowering, and had a harm reduction focus. The scoping review searches identified 107 resources, of which 11 were relevant and met NHMRC evidence-base criteria. User testing feedback indicates Positive Choices is appropriate for Indigenous audiences, is easy to navigate and contains relevant and informative resources for use by school communities. Details of the focus testing with parent, teachers and students will be discussed. The findings of user feedback and testing indicate that the Positive Choices – Aboriginal and Torres Strait Islander portal is appropriate for Indigenous people around the country. The portal provides a much needed opportunity for teachers and parents to access evidence-based drug prevention information.
Danielle Bradd

Addressing Intergenerational Trauma with Quality Healing Responses

The process of colonisation – including the forced removal of children from their families, the suppression of language and culture, dispossession from country, disruption of kin networks and destruction of an independent economic base for living – has had profoundly negative health and wellbeing effects on Australia’s First Nations. The evidence for intergenerational transmission of the trauma stemming from colonisation processes is well known and supported by The Healing Foundation’s own evidence, including the voices and experiences of Aboriginal[1].  Whatever their origin, these traumatic experiences:  ‘can be transferred from the first generation of survivors that have experienced (or witnessed) it directly in the past to the second and further generations of descendants of the survivors … [this] intergenerational trauma … is defined as the subjective experiencing and remembering of events in the mind of an individual or the life of a community, passed from adults to children in cyclic processes as ‘cumulative emotional and psychological wounding’[2]. For many Aboriginal people, trauma is an ongoing experience, either because the discriminatory practices continue or because they live in families and communities where others have been subject to such practices and then pass the trauma on. It has also become clear how unaddressed intergenerational trauma is a significant, if often unrecognised, driver of some of the most serious social and emotional wellbeing issues faced by many Aboriginal communities today, including leaving school early, drug and alcohol addiction, criminal behaviour, violence, and suicide. There is also clear evidence that if not healed, trauma negatively affects neurological development which passes to future generations. Given that communities live collectively and experience distress collectively, this is critical to creating real change. The failure to tailor healing efforts at a community level means families continue to live in vulnerability without the strength of a community to assist them.  

The Glen

The Glen is a residential drug and alcohol rehabilitation centre for men. Since 1994, The Glen has been an example of the triumph of the Koori Spirit and how working together can make dreams come true. The founding motivation for The Glen was witnessing the suffering of Aboriginal people at the hands of drugs and alcohol. The Glen was especially interested in trying to get men (Indigenous and Non-Indigenous) out of the criminal justice system and into treatment for their drug or alcohol addiction (which causes the offending behaviours). This presentation will discuss the different issues that men coming to the centre face, including the types of drugs they use, family and cultural disconnection, and experiences of trauma and incarceration.  In addition, this presentation focus on the many and varied solutions being offered at The Glen that are helping men turn things around as they begin to embrace their culture and a new start in life. The Glen programs treat clients in a holistic manner (spiritually, mentally and physically). This involves treating the underlying issues that may be causing the addictive behaviours, in addition to the addiction itself. The programs are about trying to empower people to take control of their lives, to live a good fun life, and to become active members back in their families and the community as a whole.  The different program elements are based on Indigenous values and spirituality with a heavy emphasis on the individual and the consequences of the individual’s choices. The presentation will also talk to the need for a culturally appropriate Women’s only service in NSW and what The Glen is doing in this space.

Strong & Deadly Futures: computerised school-based drug prevention for Indigenous youth

Computerised substance-use prevention programs have been found to be effective for non-Indigenous secondary students. The potential for sustainability, reach and implementation fidelity of computerised programs, combined with high rates and confidence in technology use among Indigenous youth, make this a promising, innovative approach in substance-use prevention for Indigenous secondary students. This study aims to develop a computerised school-based substance-use prevention program that is culturally appropriate for Indigenous students. A systematic literature review was undertaken to identify effective elements of past Indigenous substance-use programs. Researchers partnered with four schools at which focus groups were conducted with teachers and parents, using an appreciative inquiry approach to identify current substance-use prevention approaches and what is needed. Indigenous students participated in a Photovoice project where they took and shared photographs of positive social interactions in their community and their role models. Group sharing of the photographs included a creative story telling session. Additional story input was gathered through a nation-wide story-telling competition for Indigenous youth aged 12 to 14. An Indigenous creative development agency assisted in writing storylines and characters. Workshops were held with the students to further develop the stories and characters. Students completed a brief empowerment questionnaire before and after the consultation process. Effective elements of substance-use programs included cultural knowledge integration, AOD skills and diversionary activities, highlighting the complexity behind substance-use prevention. Consultations indicated a need for culturally appropriate substance-use prevention materials that are empowering and suitable for delivery in a mixed classroom setting. Students shared positive stories about their community life that informed the program story lines. An interactive, computerised program was developed that integrated the evidence from the literature reviews and the consultations. The story and characters in this illustrated story-based program were based on students’ stories gathered through the photos.
Mieke Snijder

Culture is paramount for Aboriginal healing and recovery

The challenges for any drug and alcohol services is that no one organisation is generally able to provide all of the required services for a client torecover from alcohol and/ or substance misuse.  Given the complexity and multiple needs of people with alcohol and other drugs (AOD) issues, and the poor socio economic status of Aboriginal communities, further complicates those who have alcohol and other drugs concerns. Racism and intergenerational trauma experienced by Aboriginal people and communities is concerning as both  relate to alcohol and substance misuse. Culture is often forgotten because its not seen as the primary foci for recovery, however Weigelli has found that culture does have an active role for healingand recovery. The program itselfintegratesculturally specific practices, including Aboriginal values with a focus on spirituality and social and emotional wellbeing. Weigelli recognises the value of Elders and utilising local mainstream community resources. However, there is a need to ensure that these services are culturally aware and respect culture as a vital part of  the healing and recovery pathway. Weigelli is well integrated into the community and respects the integrity of both Aboriginal communities and mainstream but for client recovery culture connections to country, mob and community plays a significant role for healing. Aboriginal culture is recognized as the oldest traditional and living intellect in the world and has significant values to the models of care for  rehabilitation and recovery, Weigelli was developed in 1996 with a Aboriginal culture focus which remains today.
Wayne Rigby
Steven Taylor
Warren Williams

Methods of survey collection and characteristics of a sample of methamphetamine users: Findings from the NIMAC Study

 There are few data available describing how methamphetamines are being used in Aboriginal communities nor evidence based approaches to prevention and treatment suitable for Aboriginal community contexts. Working with ten Aboriginal Health Services in urban, regional and remote locations, NIMAC aims to elucidate patterns of methamphetamine use and associated factors at individual and community levels; then to translate this knowledge into culturally appropriate interventions. A cross sectional survey of recent users (last 12 months, 50% Aboriginal) is in progress (300 of 800 complete at the time of writing), alongside a series of focus groups with service providers, community members and current or past users in each site. Community coalitions, supported by researchers, will use this data to implement prevention-focused interventions in their communities, and health services are participating in the development and trial of an Aboriginal web-based therapeutic tool for methamphetamine dependence. Preliminary findings indicate that respondents most commonly smoke or inject methamphetamine in private homes and cover the spectrum of regular (daily or almost daily) to occasional (less than monthly) use. They generally feel connected to family and friends, but are disconnected from employment, education and health services, and experience high rates of psychological distress stemming from this and other sources including racism, grief and loss. This presentation will summarise NIMAC findings to date, providing insight into the unique sociocultural environment of methamphetamine use in Aboriginal communities, and outline the translational goals of the project moving forward.    

Youth Empowered Towards Independence (YETI)

Young people are unique and adolescence is a time of intense development. Whilst most young people move through their adolescence unscathed, unfortunately some require specialised services, spaces and ways of working to meet their needs. Youth Empowered Towards Independence (YETI) is a specialist youth drug and alcohol service in Cairns, Far North Queensland that works to support highly vulnerable young people aged 12-25 years old experiencing complex issues such as alcohol and drug issues, homelessness, mental health, legal and trauma and disconnection from family, culture and community. The service has been designed with and specifically for young people and staff are skilled and trained to provide intensive case management, counselling and models of coordinated care that meet the needs of the young people accessing the service. Approximately 80 per cent of young people attending YETI are Aboriginal and or Torres Strait Islander and YETI works hard to provide culturally appropriate spaces and responses including: ‘return to country’ initiatives; intensive outreach; through-care support to prisons; and partnerships with community controlled services in the region. This presentation intends to describe the model of care and key practice elements we believe are important when delivering an alcohol and drug treatment program to young people, particularly young people who might not yet want to cease their alcohol and drug use.
Tonya Fuschtei
Wendy Sammons

Drawing On Complexity to Shape a Stronger Future

Addiction emerges from the intricate and complex experiences that shape a life, and then as addiction grows it can add many additional layers of complexity and difficulties to that life.  Here at Pinangba (formerly Blue Care Indigenous Services) we work with the belief that addiction cannot be fully understood if only considered within the isolation of an individual life. This presentation will demonstrate how we employ a Systemic Family Therapy framework to assist the individual to understand the context of addiction within their own life, that of their family, both now and past generations, as well as in their own community and the broader Australian community. The genogram will be used as a tool to capture the essence of the stories, identify sometimes hidden influencers of addiction, emphasise patterns, weaknesses and strengths. The genogram will also be used to demonstrate how the individual and family can draw on the unique complexity of their unique and shared stories to then shape a stronger future of their own choosing.
Tamra Bridges
Nash Snider
Erin Cunningham

Issues of pregnant women in remote communities of the NT

As an Aboriginal Corporation where our delivery to our SHSAC populations is classed as remote – remote vice remote, we have many different issues than other funded recipients that are based out of the regions that may be closer to larger towns or cities. Katherine is 330 kms from Darwin and we have communities another 300 kms away from Katherine, only accessible by 4 x 4 in the dry season and aircraft in the wet. We do have closer communities (to Katherine) but to service all in a comprehensive and inclusive manner brings a myriad of issues not only logistically but also socially. Our focus for this presentation is pregnant women who face uniquely different concerns in our remotest populations than those closer to the town of Katherine. For many months now, our team of AOD and Tobacco workers have utilised an Holistic approach to this assembly and it has been certainly interesting to note that whilst in some communities this methodology has a positive impact, in others it is seen as the opposite. This presentation will discuss the different styles of communication, delivery approach and strategies to support these groups in both our remote communities and our remote/ remote communities.

Keynote

Mr John Singer

Closing

Scott Wilson
Scott Wilson