First four weeks of drug and alcohol treatment are crucial — how can we make the experience less daunting?

How do we reassure people who are looking for help?

Rosalyn Hewitt
Apr 17, 2019 · 3 min read
One of our discovery workshops around the first four weeks (thanks to Julie Dodd at Parkinson’s UK for great workshop space!)

For the last couple of months the team has carried out a discovery on people’s experience during their first four weeks after accessing one of our services for the first time.

Going to a drug and alcohol service for the first time can be daunting and the 4 weeks that follow are a crucial time period for recovery. Our data shows that people are most likely to drop-out from our services without completing their treatment during their first 4 weeks. After this time period the chances of people staying in treatment increases.

Chart shows numbers of people dropping out of Addaction services by week before treatment. Based on analysis by Datakind UK volunteers

It starts with an assessment

For most people coming to Addaction for the first time there will be some sort of assessment to help us understand how best we can help people.

The assessment cover lots of information, some of it really personal and sensitive, such as any children and their ages, relationship difficulties and any criminal activities. In an assessment, people will be asked about their drug and alcohol use, their family and home circumstances, their mental and physical health and about their goals and what they want to achieve. Assessments also help us to determine whether someone is at risk and to identify what might need to be put in place to keep someone safe.

This means that people are being asked to share a lot of information about themselves on their first visit.

Talking to our frontline staff

As part of our discovery, we spent time visiting services and speaking to frontline staff, including observing assessments. We also carried out some interviews with staff who carry out assessments.

Our frontline staff work really hard to make sure the assessment is as good an experience as possible. They recognise that it’s really important to quickly build trust and rapport if you’re going to be asking someone lots of personal questions. Rather than follow a tick-box list of questions, staff try and make it flow like a conversation.

However, neither the paper forms nor our case management systems are designed in such a way that they can be completed in full during an assessment without creating a barrier to an open conversation. This means staff can spend between 1–2 hours after each assessment updating the case management system.

Speaking to our users

We also carried out some interviews with people who had recently had an Addaction assessment. We asked them how it was for them when they first came to us, their experience of the assessment and what could improve things for people coming to us in the future.

Our starting assumption was that people would be put off by the number of questions being asked but this wasn’t the case. Instead, the people we spoke to found the questions reassuring — telling their story meant that they were going to get the right help and support for them.

As one of our service users put it, “I felt like I was understood, like I could breathe, like I could do it”

What people did tell us was how “unnerving” it was not knowing what would happen. People told us that they had no idea what type of support was available or what Addaction did. They didn’t know what would happen when they walked through our doors for the first time and that first step could be put off for months until they couldn’t cope any more.

Next steps

We’re now testing some content which aims to reassure people who are looking for help but who might need some reassurance about what will happen. This will let people know what will happen on their first visit, and what sorts of questions they might get asked.

We all recognise how daunting those first steps to getting help might be so our next round of research and testing will help us learn about how we might start offering reassurance to people before they walk through our doors and make it easier for people to take that important first step.

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