Expanding knowledge among Aboriginal service providers on treatment options for excessive alcohol use

Abstract

Approaches to the prevention of alcohol problems among Aboriginal people in Australia have tended to emphasize primary and tertiary prevention, while neglecting secondary prevention or early intervention. In contrast, members of the wider Australian community can now access a variety of early interventions through general practice, in hospital settings and through drug and alcohol treatment agencies. As part of a survey of the use of brief interventions, 178 agencies throughout Australia were interviewed, and findings are presented from the 29 agencies in this sample which provided services primarily for Aboriginal people. Approximately half offered a variety of approaches including brief interventions, with goals of moderation; the other half were entirely abstinence-orientated. These findings are discussed in the context of expanding the options that might be offered by Aboriginal-run agencies.

Delivering culturally appropriate residential rehabilitation for urban Indigenous Australians: a review of the challenges and opportunities

“…Reviews have found problems with a lack of skilled staff, management issues, chronic resource shortages and poor record keeping intertwined with destabilising political complexities 7,19,22–24 . An absence of organised alcohol counselling and operating in a recuperative rather then treatment‐based context has also been a feature of Indigenous programs 19,25 . Government financial administration processes have often caused Indigenous services to operate in isolation, 2 while shifts to funding less resource‐intensive approaches, such as harm reduction and early intervention, 3 have caused many Indigenous services that advocate abstinence to be financially affected 26…”

“…The similarities between Indigenous Australians and other Indigenous communities in terms of colonisation and substance abuse has resulted in many Australian services looking to international models for inspiration in delivering culturally appropriate substance treatment 26,13 . The Canadian ‘Nechi’ residential model, based on abstinence and 12 steps with a cultural flavour, has become the most widely adopted approach 15,25 . This program has been applauded by Indigenous researchers for its indigenisation of the Alcoholics Anonymous (AA) model 32 and training of ex‐alcoholics 26 .…”

“…This program has been applauded by Indigenous researchers for its indigenisation of the Alcoholics Anonymous (AA) model 32 and training of ex‐alcoholics 26 . It is the spiritual undercurrent of the AA model that Brady suggests has been particularly attractive to the Indigenous Australian community 25,15 for its connection between health and mind‐body‐spirit healing.…”

Full Issue

“…These perceptions may echo similar traumas experienced within Aboriginal communities and are likely to pose an additional barrier to treatment access. A lack of understanding of the broad range of alcohol treatment options has been described in other contexts (Brady, Dawe, & Richmond, 1998). There is a need for community education on the full range of available alcohol treatments as well as on the role of outpatient detox specifically.…”

The Dissemination of Alcohol Interventions for Indigenous Australians: A Mixed Studies Review Using Narrative Synthesis

“…Robust investigation into the acceptability of culturally targeted interventions for 'high-risk' groups would fill a gap in current knowledge. Given the complexity of implementing alcohol interventions, particularly among Indigenous populations, it is crucial that future research addresses the context and cultural setting in which programs are operating, so that multipart needs can be effectively met [3,8,24,26,27,57].…”