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As per the Communications Policy of the Government of Canada, you can request alternate formats on the "Contact Us" page. file:///C|/Documents%20and%20Settings/ASLOBODY/Desktop/Working%20folder/archive-eng.html2013-06-20 12:59:43 PM Best Practices Early Intervention, Outreach and Community Linkages for Youth with Substance Use Problems Health Canada is the federal department responsible for helping the people of Canada maintain and improve their health. We assess the safety of drugs and many consumer products, help improve the safety of food, and provide information to Canadians to help them make healthy decisions. We provide health services to First Nations people and to Inuit communities. We work with the provinces to ensure our health care system serves the needs of Canadians. Published by authority of the Minister of Health. Également disponible en français sous le titre : Meilleures pratiques - Intervention précoce, services d'approche et liens communautaires pour les jeunes ayant des problèmes attribuables à la consommation d'alcool et d'autres drogues This publication can be made available on request on diskette, large print, audio-cassette and braille. For further information or to obtain additional copies, please contact: Publications Health Canada Ottawa, Ontario K1A 0K9 Tel.: 613-954-5995 Fax: 613-941-5366 E-Mail: [email protected] © Her Majesty the Queen in Right of Canada, represented by the Minister of Health Canada, 2008 This publication may be reproduced without permission provided the source is fully acknowledged. HC Pub.: 4980 Cat.: H128-1/08-531E ISBN: 978-0-662-48417-2 Acknowledgements This report involved the collaborative efforts of Health Canada, the ADTR Working Group and W. Morrison & Associates, Inc. We would like to express our appreciation to the ADTR Working Group and other experts who reviewed drafts of the document, the key informants who participated in interviews, and the focus group participants who gave their time to advance the research on best practices in early intervention, outreach and community linkages for youth with substance use problems. Project Team Members of W. Morrison & Associates, Inc. Dr. William Morrison, Project Director Dr. Cynthia Doucet, Research Coordinator Maurice LeBlanc, Content Area Expert and Research Consultant Acknowledgements | i Table of Contents Executive Summary . .1 1. Introduction . .9 1.1 Methodology . .10 1.2 Scope and Limitations . .11 2. Literature Review . .13 2.1 Patterns of Youth Substance Use . .13 2.1.1 General Prevalence . .13 2.1.2 Gender-Specific Considerations . .16 2.1.3 Age of Initiation . .16 2.1.4 Alcohol . .17 2.1.5 Cannabis . .18 2.1.6 Volatile Substances/Inhalants . .18 2.1.7 Non-Medical Use of Prescription and Over-the-Counter Drugs . .19 2.1.8 Ecstasy and Other Amphetamines . .19 2.1.9 Opiate, Cocaine and Injection Drug Use . .20 2.1.10 Alcohol Abuse and Dependence . .21 2.2 Client-Related Characteristics . .22 2.2.1 Pregnant or Parenting Youth . .22 2.2.2 Youth and Sexual/Gender Orientation . .23 2.2.3 Poly-Substance Using Youth . .23 2.2.4 Youth Living with or at Risk for Blood-Borne Pathogens . .24 2.2.5 Homeless and Transient Youth . .25 2.2.6 Youth with Concurrent Mental Health Disorders . .26 2.2.7 Aboriginal Youth . .27 Table of Contents | iii 2.2.8 Youth Who Use Volatile Substances/Inhalants . .28 2.2.9 Youth in Conflict with the Law . .28 2.2.10 Diverse Ethnicity and Culture . .30 2.2.11 Rural Youth . .30 2.3 Early Intervention . .31 2.3.1 Introduction to Early Intervention . .31 2.3.2 Screening for Substance Use . .32 2.3.3 Screening Formats . .33 2.3.4 Screening for Stages of Use and Readiness to Change . .34 2.3.5 Brief Interventions . .35 2.3.6 Aspects of Brief Intervention . .36 2.3.7 Motivational Interviewing . .37 2.3.8 Evidence for Brief Interventions and Motivational Interviewing . .38 2.3.9 Group Interventions . .41 2.3.10 Parent/Guardian and Family-Focused Intervention Efforts . .43 2.3.11 Student Assistance Programs . .44 2.3.12 Internet-Based Interventions . .44 2.4 Outreach . .45 2.4.1 Introduction to Outreach . .45 2.4.2 Assessing the Need and Targeting Outreach Services . .46 2.4.3 Outreach Staff and Activities . .47 2.4.4 Peer Helpers in Outreach Activities . .49 2.4.5 Evaluation of Outreach Programs . .50 2.5 Community Linkages . .51 2.5.1 Introduction to Community Linkages . .51 2.5.2 Essential Community Linkages . .52 2.5.3 Barriers to Community Linkages . .53 2.5.4 Case Management . .53 2.5.5 Step Care Methods . .54 iv | Best Practices – Early Intervention, Outreach and Community Linkages for Youth with Substance Use Problems 2.5.6 Coordinating Mental Health and Problem Substance Use Services . .54 2.5.7 Creating Linkages Among Service Providers . .55 2.5.8 Implementing Community-Wide Approaches . .56 3. Key Informant Interviews . .59 3.1 Selection of Key Experts . .59 3.2 Key Expert Interview Process . .61 3.3 Key Client Considerations . .62 3.3.1 Circumstances Faced by Youth with Substance Use Problems . .62 3.3.2 Key Actions for Working with Youth Who Have Substance Use Problems . .63 3.3.3 Important Considerations for Specific Youth Populations . .65 3.4 Early Intervention and Outreach Approaches . .67 3.4.1 Theoretical or Applied Orientations for Early Intervention and Outreach . .67 3.4.2 Structuring Early Intervention Approaches . .68 3.4.3 Implementing Early Intervention Screening Approaches . .69 3.4.4 Internet-Based Intervention Support Materials . .70 3.4.5 Outreach Approaches . ..
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