Audit of Substance Abuse Treatment Facilities in ... - SA HealthInfo

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3.8 ADDRESSING BARRIERS TO ENGAGEMENT AND RETENTION INTREATMENT FOR VULNERABLE GROUPSThis section describes the extent to which treatment facilities target barriers toengagement and retention in treatment for clients from historically underserved groups;particularly Black South Africans, women and young people. Retention activities aregrouped into activities relating to (i) the cultural-sensitivity and appropriateness oftreatment, (ii) the gender-sensitivity and appropriateness of treatment, and (iii) the agesensitivityand appropriateness of treatment.Core findings:• All facilities offer treatment services in multiple languages• Half of the facilities use culturally appropriate assessment tools• Only 43.8% of facilities provide child care services/facilities• Half of the facilities provide staff with special training in gender-related issues• Three quarter of facilities employ staff trained to work with young people• A small proportion of facilities (37.5%) provide adolescent-focused/adolescent-onlytreatment services3.8.1. Cultural and linguistic sensitivity and appropriateness of treatmentOverall, all facilities report providing treatment programmes and materials in multiplelanguages, 87.5% provide counselling that is culturally appropriate, and only half reportusing culturally appropriate assessment tools (Figure 20). Just over half of facilities(56.3%) have assessment instruments and programme materials translated into multiplelanguages.54
Figure 20.Proportion of substance abuse treatment facilities offering culturally andlinguistically appropriate services (%).120100808810060505640200Culturally appropriateassessment toolsTranslated instrumentsCulturally appropriatetherapyProgrammes in multiplelanguagesOverallNone of the facilities in Northern Cape report attempting to improve the culturalsensitivity and appropriateness of their programmes or provide culturally appropriatetherapy (Table 13). Facilities in Limpopo do not provide translated materials.Table 13. Proportion of facilities that address cultural and linguistic appropriatenessof services by province.Activities to improve cultural andlinguistic appropriateness ofFree State(N = 7)Limpopo(N = 2)Mpumalanga(N = 3)NorthWestNorthernCapeOverall(N = 16)treatment(N = 2) (N = 2)N % N % N % N % N % N %Culturally appropriate3 42.9 2 100.0 1 33.3 2 100.0 0 0 8 50.0assessment toolsTranslated materials 4 57.1 0 0 2 66.7 2 100.0 1 50.0 9 56.3Culturally appropriate therapy 7 100.0 2 100.0 3 100.0 2 100.0 0 0 14 87.5Programmes: multiple languages 7 100.0 2 100.0 3 100.0 2 100.0 2 100.0 16 100.03.8.2. Gender sensitivity and appropriateness of treatmentThree quarter of facilities provide gender-appropriate therapy and sensitive counsellingservices (Figure 21), with 68.8% of facilities providing services that address women’sissues, such as power, trauma and violence. In addition, 68.8% of facilities use genderappropriate assessment instruments and procedures for administration. Only 1 facility55
Page 1 and 2:
Alcohol & Drug Abuse Research UnitM
Page 3 and 4: 3.1.2 Treatment facility profile by
Page 5 and 6: 4.3 Targeting barriers to treatment
Page 7 and 8: EXECUTIVE SUMMARYA cross-sectional
Page 9 and 10: services to historically underserve
Page 11 and 12: use, reductions in criminal activit
Page 13 and 14: Despite high levels of substance ab
Page 15 and 16: Despite the apparent availability o
Page 17 and 18: treatment services provided. At pre
Page 19 and 20: use disorders whose physical and em
Page 21 and 22: delivery, treatment retention, and
Page 23 and 24: audit substance abuse treatment fac
Page 25 and 26: 2.8.3. Further data considerations
Page 27 and 28: Figure 1. Inpatient intensity of ca
Page 29 and 30: Since there is a large overlap betw
Page 31 and 32: the total client population (χ = 4
Page 33 and 34: Figure 7.Comparison of race profile
Page 35 and 36: services per month ranges from 13 t
Page 37 and 38: 3.4.1. Characteristics of staff at
Page 39 and 40: supervision. In contrast, a much sm
Page 41 and 42: In terms of client record-keeping,
Page 43 and 44: Core findings:• Compared to the p
Page 45 and 46: using 12-step approaches, 75.0% rep
Page 47 and 48: Figure 16. Proportion of treatment
Page 49 and 50: 3.7. ADDRESSING BARRIERS TO TREATME
Page 51 and 52: Table 11. Proportion of facilities
Page 53: Table 12. Proportion of facilities
Page 61 and 62: 3.9.2. Monitoring of clients’ pro
Page 65 and 66: PART 4: DISCUSSION OF KEY FINDINGSW
Page 67 and 68: previous audits of specialist subst
Page 69 and 70: small proportion of South African d
Page 71 and 72: high levels of substance use among
Page 73 and 74: these barriers appears to significa
Page 75 and 76: appropriate services for Black/Afri
Page 77 and 78: clients progress post-treatment, an
Page 79 and 80: • The number of state facilities
Page 81 and 82: • Another way of ensuring (indire
Page 83 and 84: • The age appropriateness of serv
Page 85 and 86: REFERENCESAllard, S.W., Tolman, R.M
Page 87 and 88: Myers, B., & Fakier, N. (2007). Rep
Page 89: Zule, W.A., Lam, W.K., & Wechsberg,
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