A participatory evaluation of a First Nations substance abuse treatment centre

Research on alcohol and substance use for First Nations populations frequently describes the problem (nature and severity, risk factors), but does not often address intervention and what works well for clients who engage in treatment. This thesis provides a comprehensive participatory evaluation of the six-week residential ‘Namgis Treatment Centre (NTC) program in Alert Bay, British Columbia. Client intake files (n = 218) were reviewed for clients who participated in 17 different six-week sessions over a two and a half years along with reviewing evaluation forms completed by clients (n = 131) at the end of treatment. Assessing program theory involved developing a program logic model. Assessing program impact included administering a telephone follow-up survey, developed in conjunction with all of the NTC staff, with clients who had been out of treatment for 3 to 37 months (n = 91, 52.7% male and 47.3% female participants). In total, 24 clients were abstinent at the time of the interview, and 67 clients (73.6%) had a relapse on average 155.29 (SD = 167.77) days after completing treatment. Cox regression univariate and bivariate analysis revealed that pre-treatment variables (age, gender, education, history of abuse, presence of medical or psychological issue and involvement in culture) were not associated with time to relapse or what happened after relapse (abstinence again, harm reduction or resuming pre-treatment consumption levels). Post-treatment variables (aftercare plan, support from friends, family, a drug and alcohol counsellor, AA/NA meetings, AA/NA sponsor) were not associated with time to relapse except using the after care plan. However, the aggregate of support items influenced what happened after relapse. The greater number of supports the client had, the more likely they were to be completely abstinent, and the less supports the client had, the more likely they were to completely relapse. NTC staff and community members were consulted with for their input into the interpretation and implication of the findings, and recommendations were shared with key NTC policy makers. Based on the findings in this project, it is apparent that follow-up and aftercare are critical for effective treatment and lasting behaviour change