Bridge PROGRAMME
About us
We offer a Service User led programme for individuals motivated to change their substance dependency issues.
We aim to empower and enable individuals within the programme to make lifestyle choices to ultimately achieve a drug/alcohol free life.
The Bridge Programme is based within Ty Gobaith and was set up in late 2005 in an attempt to address the complex needs of homeless people with substance misuse issues. Often the complexity of the issues faced by service users meant that many experienced a “revolving door” of homelessness where substance misuse was a key factor preventing resettlement within the community. The Bridge programme is a joint working initiative between the Salvation Army and the Community Addictions Unit in Cardiff which aims to end this cycle. We provide a three phase bio-psycho-social intervention which aims to support service users towards abstinence where this is appropriate and concentrates on harm reduction where it is not. As ever this decision is driven by the needs of individual service users and their treatment journeys. The programme also focuses heavily on resettlement with the ultimate aim being to resettle service users in stable accommodation.
The NTA Models of Care states that homeless people need access to a full range of drug and alcohol services. In the DrugScope / Homeoffice Good Practice Handbook “Drug Services for Homeless People” it outlines the need for special arrangements to provide community services for people without secure housing.
There is a large body of research, which has identified widespread problematic drug use amongst homeless people. The Advisory Council on the Misuse of Drugs (ACMD) identifies drug misuse as having a central role in homelessness (ACMD Drug Misuse and the environment, Home Office 1998)
The Bridge Programme was therefore an initiative to provide access to treatment within a secure therapeutic setting. We provide a psycho-social programme aimed at delivering the tools necessary to reduce harm to the individual both physiologically and psychologically. The joint working with the CAU provides the programme with sound clinical governance as well as providing access to much needed health interventions. We now offer access to BBV screening and Hepatitis B Vaccinations as well as access to specialist Hepatitis C treatment. The strength of the therapeutic programme can be seen in the increase year on year of individuals making it to detox (26% in the first year, 55% in the last), Planned discharges have more than doubled over the last 3 years (24% to 55%) and unplanned discharges have fallen by 10%.
The Programme has always, and continues to take a Service user led approach and they remain our main influence in shaping not only the content, but also the direction of the programme. Chapter 2.6 (Uk Clinical Guidelines) outlines:
“Patients should be fully involved in the development of their care or treatment plan, in setting appropriate treatment goals and reviewing progress in treatment. They should be informed about the benefits and risks of different treatment options so that they can be actively involved in choosing treatment appropriate to their needs”
It is because of this approach that we are introducing a modified Contingency Management Approach after Service User consultation and feedback. Any individual feels little motivation to change their behaviour unless a positive outcome is perceived as achievable within a reasonable period of time. Most homeless people have experienced change as a negative force, for example they may have had histories of unstable housing or work experiences and disruptions in key relationships are common. People who perceive change as a threatening and negative experience may be reluctant and uncomfortable with staff who suggest strategies for change. In addition, if the desired outcomes of these changes appear to be unlikely or possible for only the distant future, commitment will not be sustained. The CM system is intended to address this fear of change and place the locus of control back into the hands of the Service User. The system that has been introduced has done away with the punitive and medication based approaches commonly seen with CM and instead concentrates on a motivational approach to increase self-efficacy.
Another new initiative for the Programme is the community based Aftercare House which has been set up in partnership with Cadwyn. The House offers a second stage to the Aftercare stage of the programme. The Programme has always endeavoured to deliver enjoyable and meaningful activities both in the context of treatment for the Service User and now in the community in which they reside (Alverson et al 2001). This movement into the community has taken the programme toward the next obvious step for development and will provide a Bridge toward living a life free from dependency.
We were also very privileged to be nominated for The Home Office “Tackling Drugs Changing Lives” award and were awarded the UK Regional Winners award for Wales and came in the last 10 for the UK as a whole. This recognition is testament to all the hard work by the Bridge staff team. To manage such a passionate and dedicated staff team is an inspiration and an honour and we all look forward to developing the programme over the next twelve months to ensure the service reaches its full potential.
