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Eoin Coughlan Trinity College Dublin/ Coolmine TC

Introducing & Implementing the Community Reinforcement Approach (CRA) to Coolmine Therapeutic Community (TC) . Eoin Coughlan Trinity College Dublin/ Coolmine TC. Presentation Structure . 20 mins External policy environment Recent history and development of Coolmine

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Eoin Coughlan Trinity College Dublin/ Coolmine TC

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  1. Introducing & Implementing the Community Reinforcement Approach (CRA) to Coolmine Therapeutic Community (TC) EoinCoughlan Trinity College Dublin/Coolmine TC

  2. Presentation Structure • 20 mins • External policy environment • Recent history and development of Coolmine • Rationale for CRA implementation • Practical implementation & Action Research • Compatibility & current status • 10 min Q & A

  3. Context • Inherently and unusually contentious aspect of health and social care systems • Contraversies: • relative roles • what works best/research paradigms • Genesis • Question the rationality of these contests

  4. “Present-day substance abuse treatment is characterized by a compelling demand for applying evidence-based interventions. Vehement discussions between policymakers, practitioners and researchers illustrate this clash of differing paradigms” (Broekaert et al 2010.)

  5. Addiction treatment as technology • How we embrace or resist change? • TCs as a pioneering movement • “Decades of TC research have been extremely productive but not necessarily persuasive in furthering the acceptance of the TC among some scientific critics and policy makers” (De Leon 2010).

  6. “characterised by large-scale social and economic deprivation and marginalisation. The physical/environmental conditions in these neighbourhoods are poor, as are the social and recreational infrastructures. Abuse and addiction are associated with crime” (Rabbitte 1996 p. 5).

  7. Background • External Policy Environment: • Rabbitte Report • Local Drugs Task Force • National Drug Strategy • Paul Conlon • Aggiornamento!

  8. Strategic Challenges • Improve reputation; attract and retain new clients • Avoid demoralizing committed and experienced staff • Identify and preserve core values while changing practices and traditions out of keeping with the new policy environment • Persuade the policy-making community and service funders that the TC model still had a valuable contribution to make

  9. The Community Reinforcement Approach • Based on the belief that environmental contingencies can play a powerful role in encouraging or discouraging drinking or drug use. Consequently, it utilizes social, recreational, familial, and vocational reinforcers to assist consumers in the recovery process. Its goal is to make a sober lifestyle more rewarding than the use of substances.

  10. CRA PROPOSAL • Personal development opportunity for staff to become CRA accredited counsellor • Increase retention rate across the range of Coolmine services • Decrease in client complaints • Create positive community environments/treatment programmes • Update content and culture of group programme’s/ 1:2:1 interventions • Organisation will shift from being good to being great- centre of excellence whilst preserving core values

  11. Purvis & MacInnis & TTM • BlanchardstownLocal Drugs Task Force (BLDTF) • 1st 6 months achievements • End of year achievements • Practical supports for strategic change management

  12. Mr. Rogers • Relative advantage • Compatibility • Trialability • Observability • Less complexity

  13. Current Status • CRA is accepted as part of the TC programme • Coolmine TC is now seen as a pioneering organisation in the field • Participatory implementation, reflective practice and strategic planning, re-invention

  14. Lord Paddy Rossmore: “Coolmine seems to be able to reinvent itself a little bit”

  15. EoinCoughlan Trinity College Dublin/Coolmine TC eoincoughlan@yahoo.com MíleBuíochas

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