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Karralika Programs Inc

Karralika Programs Inc. has undergone organisational change to increase its capacity to work with clients with complex needs. Karralika has been focused on becoming a more complex needs capable service as a part of the 12-month Practice Enhancement Program (PEP) Seeding Grant it received from NADA in 2011. There's an increasing expectation on staff at Karralika to work with people with a range of complex issues beyond drug and alcohol and mental health issues.

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About the complex needs project

Karralika Programs Inc. is a non-government organisation providing drug and alcohol treatment to people in the ACT and the surrounding NSW region and is accredited by the Quality Improvement Council. Karralika supports people to address their alcohol and drug dependence, lead productive lives and positively contribute to their communities through the provision of residential and community-based programs. These include the Karralika Therapeutic Community Adult Program, the Child and Family Services Karralika Family program, the Karuna Short-stay and Nexus programs, the Solaris Therapeutic Community program at the Alexander Maconochie Centre, outreach programs, and the Sober Driving program.

Karralika received a 12-month PEP Grant from NADA in 2011 to increase its capacity to work with clients with complex needs/cognitive impairment. The following is a snapshot of Karralika's experience in implementing an organisational change management approach to working with clients with a cognitive impairment.

What key areas did you cover in your organisational approach to complex needs?

Key areas covered as part of the Karralika Programs Inc. PEP project included:

  • Development of complex needs policy and procedures
  • ABI-targeted staff training
  • Review and modification of assessment tools
  • Review and modification of program delivery and support mechanisms
  • Modification of treatment environment to incorporate quiet time/time out spaces
  • Updated service information, including: website, pamphlets and program information.
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Observations and recommendations

What were the challenges, and what would you have done differently?

During the initial phases staff were somewhat daunted by the project proposal. There were particular reservations with regard to our capacity to work with clients, specifically those with ABI conditions. There was not a clear understanding that (as there had not been clear identification of risk of ABI previously) this work was not significantly separate or different to that which was already occurring.

The training component of the project had a significant impact in reducing anxiety and improving confidence in working with clients with complex needs, specifically ABI conditions. In this regard the training, while delivered in the first six months of the project, may have been better delivered earlier in this period, given the positive outcome that this achieved in terms of attitude change and confidence building for workers.

What are the benefits/key outcomes for the organisation?

The enhanced capacity of staff, at each program point (including through our assessment processes), to work with clients with specified complex needs is the most significant outcome of the project. This has occurred through:

  • Modification of our assessment form, which is now a comprehensive tool which identifies risk of ABI for all clients accessing our residential services
  • Upskilling of clinical staff through the provision of targeted training relating to ABI; training packages delivered during the project period included Working with ABI, Fetal Alcohol Spectrum Disorder and the Triple Comorbidities (AOD, mental health and acquired brain injury)
  • Whole-of-organisation support for the project as well as access to and/or provision of supporting information and resources for clients and workers.

What are your strategies for the long-term implementation of the gains made?

In order to build on the gains already achieved as a result of this project, KPI will:

  • Ensure access to ongoing training for workers
  • Complete an ongoing review of policy and practice, maintaining currency in terms of developments in the field through the NADA Complex Needs Capable resource and those achieved by other grant recipients which will support and inform good practice
  • Develop partnerships with other community agencies and specialist providers to assist clients and support program delivery within the therapeutic community and our other residential programs further enhancing our capacity.

What cost-effective strategies could you recommend?

One cost-effective strategy is to develop effective working relationships with other community agencies and/or specialist service providers that can support and assist service delivery. This is also an area of ongoing work for KPI.

What recommendations do you have for services considering becoming complex capable?

Recommendations would be for services to determine their capacity to become complex capable and what their specific requirements might be for that to occur in terms of policy development, training requirements, program modifications, etc. It is also important to ensure that there is whole-of-organisation support for the initiative through the inclusion of management and staff in planning and development activities, and that a staged approach is undertaken with regard to project implementation.

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