Alcohol Treatment Matrix cell D5: Organisational functioning; Safeguarding the community

2020/21 update funded by

Alcohol Change UK web site. Opens new Window

Alcohol Change UK

Previously also funded by

Society for the Study of Addiction web site Society for the Study of Addiction

Developed with

Skills Consortium web site. Opens new window

Alcohol Treatment Matrix

Effectiveness Bank Alcohol Treatment Matrix

Includes brief interventions

Drug Treatment Matrix

Effectiveness Bank Drug Treatment Matrix

Includes harm reduction

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Organisational functioning; Safeguarding the community

Key studies on organisational influences on alcohol treatment where the main aim or a major outcome is to reduce crime or otherwise safeguard the community. In the context of a market which drives treatment organisations to expand, asks, “Is small beautiful?”, explores the implications of focusing treatment on the family rather than the patient, and finds signs that control responsibilities can undermine therapeutic quality.

S Seminal studiesK Key studiesR ReviewsG Guidancemore Search for more studies

Links to other documents. Hover over for notes. Click to highlight passage referred to. Unfold extra text Unfold supplementary text

K Inter-service networking by smaller agencies associated with evidence-based treatment (2008; free source at time of writing). Rather than large, well resourced corporations, among treatment agencies working with US criminal justice services, smaller organisations which networked with other organisations were more closely associated with the adoption of evidence-based substance use treatment practices. For discussion click and scroll down to highlighted heading.

K Organisational stress and non-interventionist philosophy undermine drinkers’ hostel (1999). Criticised by other services, a London project housing rough sleepers unwilling to stop drinking retreated into a ‘siege mentality’, while a non-interventionist stance on drinking spilled over into a dangerously laissez-faire attitude. Discussion in cell C5’s bite.

K It takes a special sort of organisation to manage a ‘wet’ day centre. (2003). Based on a detailed analysis of British centres, suggestions for the kinds of organisations, premises and locations which can best handle the daunting task of offering street drinkers a place where they can start to reverse years of deterioration. Discussion in cell C5’s bite.

K Motivational interviewing style clashes with criminal justice context (2001). Actual performance of US probation staff after motivational interviewing training contradicted more promising written responses, and the officers were rated as less ‘genuine’ than before – a probable example of organisational context limiting how far a practitioner could genuinely stay true to motivational principles. Same study described in an Effectiveness Bank essay. For discussion click and scroll down to highlighted heading.

R Integrating substance use treatment and criminal justice supervision (2003; free source at time of writing). Analyses research to find the common organisational features of effective programmes. Drug-focused but with crossovers to alcohol.

R Do criminal justice settings undermine motivational interviewing? (2006). Asks whether the contradictions of at the same time helping and punishing, controlling and being client-centred (“motivational arm-twisting”), undermine motivational interviewing’s ethos and effectiveness. For discussion click and scroll down to highlighted heading.

R Supervising offenders is about the quality of the relationship (2002). Download is the whole issue of the journal; the featured article starts on page 16, numbered 14. Question addressed (page numbered 23) is how criminal justice agencies responsible for supervising offenders can overcome the “social worker vs. law enforcement” conflict to transform themselves into agents not just for monitoring offenders, but bringing about positive changes in their behaviour. Associated supervision manual below. For discussion click and scroll down to highlighted heading.

R Female offenders particularly need holistic treatment (2008). Argues that treatment for female offenders should take into account the high prevalence of post-traumatic stress and other mental and physical health problems, and the importance of relationships and of their roles as mothers. Concludes that women respond best to holistic, integrated programmes which incorporate empowerment and peer mentoring and adopt a collaborative rather than an authoritarian approach.

R G How treatment services can become ‘family sensitive’ ([Australian] National Centre for Education and Training on Addiction, 2010). Reviews generic and substance use-specific research as a basis for guidance on organisational cultures and workforce development practices to help ensure drug treatment services safeguard children. Quotes review (2008) which says “the importance of having an organisational commitment to the development of family-focused interventions cannot be understated”. See also associated report (Australian National Council on Drugs, 2014) on policy and child protection systems in Australia related to implementing child and family sensitive practice in substance use services. For discussion click and scroll down to highlighted heading.

G Manual for research-based offender supervision (2005). What research-based ‘tools of the trade’ (in the words of the title) does a criminal justice supervision agency need to transform it into a force for positive/therapeutic change in substance using and other offenders. Associated review above from the same author. For related discussion click and scroll down to highlighted heading.

G Incorporating child protection in UK substance use services ([UK] Advisory Council on the Misuse of Drugs, 2003). Results of an inquiry into children in the UK seriously affected by parental drug use. Says that though “Our main focus is … on problem drug use … many of the recommendations … will also be applicable to the children of problem drinkers”. Includes (starting p. 82) guidance on incorporating child protection measures in the work of drug and alcohol services. Update published in 2006. For related discussion click and scroll down to highlighted heading.

G Scottish guidance on protecting families and children advocates “whole family” recovery (Scottish Government, 2013). Guidance specific to substance use intended for all child and adult services, including drug and alcohol services. Sees treatment of the parent’s substance use as one element of a “whole family” strategy responding to the wider family’s needs, such as supporting children and enhancing parenting and resilience. Challenges substance use services to play their part (Getting our Priorities Right is the title) in prioritising child welfare. For related discussion click and scroll down to highlighted heading.

G Addressing family and domestic violence problems in alcohol and other drug treatment ([Australian] National Centre for Education and Training on Addiction, 2012). Includes (“Part C: What can alcohol & other drug services do?”) principles to follow and actions to take to respond to the high levels of domestic violence associated with problem substance use, with recommendations for organisations from generic front-line services to those specialising in substance use treatment. Written for the Australian context but will be more widely applicable. For related discussion click and scroll down to highlighted heading.

G US consensus on treatment in the criminal justice system ([US] Substance Abuse and Mental Health Services Administration, 2005). Guidance endorsed by US experts includes the kinds of services feasible and desirable in the criminal justice/prison context.

more Retrieve all relevant Effectiveness Bank analyses or search more specifically at the subject search page. Also see hot topics on why some treatment services are more effective than others and protecting children.

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