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The Lyndon Community

The Lyndon Community is a non-government organisation providing alcohol and other drug treatment through residential and community based programs. Lyndon provides residential services in Orange and Canowindra and non-residential programs across western NSW, including the Murdi Paaki Region (from Brewarrina to Dareton), Bega and surrounding communities on the far NSW south coast. Services include withdrawal, rehabilitation, one-to-one counselling, SMART recovery groups, educational programs, women's groups, mental health and drug use groups, family support and kids' programs.

The Lyndon Community received a 12-month Practice Enhancement Program (PEP) Seeding Grant from NADA in 2011 to increase their capacity to work with clients with a cognitive impairment. The following is a snapshot of Lyndon's experience in implementing an organisational change management approach to working with clients with a cognitive impairment.

About the complex needs project

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

The organisational approach to addressing complex needs was to address the practice context of each of the five programs run by The Lyndon Community so that staff from each program would have information and skills relevant to their role. The PEP grant was used to employ a worker whose specific task was to raise the issue of cognitive impairment in drug and alcohol clients and identify ways of working effectively with these clients. Having a dedicated role for the project and an individualised approach to each program was the key to the project's success.

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

The project highlighted the need for ongoing work in the area of cognitive impairment within substance treatment. We wouldn't have done anything differently but need to find ways to maintain the gains from the PEP project. Now that the funding has ended and the PEP worker role has ceased, it's a significant challenge to continue work in the area.

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Observations and recommendations

What are the benefits and key outcomes for the organisation?

The key benefit for the organisation is a new approach to psycho-educational groups and adult learning within our programs. The PEP worker was able to review and adapt the content and structure of many of the groups run with Lyndon's residential programs, making them more suitable for people with a cognitive impairment. The project highlighted simple changes that staff could make to assist people with cognitive impairment to participate in treatment programs. Changes such as wearing nametags, reducing and simplifying signs, repeating instructions and practising/role-playing skills such as drink refusal were implemented.

What cost-effective strategies could you recommend?

The Lyndon Community has taken on an approach of universal design. This is where programs, treatment and resources are designed to be appropriate for people with cognitive impairment as well as others. With this approach there doesn't have to be a separate program or special testing or treatment for people with cognitive impairment - programs are already suitable.

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

The universal design principles are a long-term strategy for the organisation to support people with cognitive impairment.

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

A key finding for the Lyndon Community was the lack of staff knowledge about cognitive impairment, its impact and ways to address it. A staff survey found that only staff trained in the disability sector had any knowledge of cognitive impairment causes and effects. Staff skills and knowledge are critical to the way client needs are addressed. As staff change, the collective skills and knowledge change also. The way this affects practice needs to be monitored.

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Find out more

For more information on The Lyndon Community's experience of implementing organisational change, see the article 'The prevalence of cognitive impairment in a rural in-patient substance misuse treatment programme' (Allan et al) in Mental Health Substance Use, Volume 5, Number 4, November 2012.

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