First Contact - Introduction

Drugs & Youth and Mental Health: First Contact

In this manual, the original First Contact: A Brief Treatment for Young Substance Users has been adapted to help you integrate the treatment of drug use with co-existing mental health problems. Since so many youth present with concurrent mental health and substance use problems, we have provided you with a brief, first step intervention that focuses on drug use in the context of other mental health problems. It incorporates motivational interviewing, cognitive behavioural and harm reduction approaches discussed in the earlier chapters of the resource. It can be implemented in the various settings where youth present - addiction services, mental health services, social services and education programs - as a first step to more extensive treatment or as a stand-alone intervention with youth who do not need or want more treatment. It can also be offered concurrently with treatment for mental health or family issues. First Contact is suitable for youth aged 14 to 25 and is mostly used with groups of youth, but may be used in sessions with individuals.

The materials cover Feedback at Assessment and four subsequent treatment sessions: Decision to Change; Triggers, Consequences and Alternatives; Things that Are Important to Me; and Stages of Change.

The adaptations were developed with the help of mental health agency staff and clients who field-tested the original First Contact and gave feedback about how to integrate mental health issues into the exercises that focus on drug use. They also made suggestions about how the exercises could be more user-friendly for younger clients and youth who struggle with mental health issues. The original written exercises require literacy skills and conceptual and communication abilities that are not always present among youth who seek treatment. It was suggested that the four sessions be presented in three different modalities: written exercises, activity-based exercises, and art therapy exercises to allow therapists to choose the modality most suited to their clients. The manual suggests activities for only two of the sessions, and we encourage counsellors to make up their own activities that correspond to the goals of a particular session. In our field tests, clients who were younger, less schooled and/or had ADHD or other behaviour problems were better suited for the activity-based exercises, while youth with social skill or conceptual deficits or psychotic disorders, such as first episode, did well with the art therapy modality.

The materials in this manual are still in draft form. CAMH is evaluating the efficacy of the written modality and will update and disseminate the new material when the research has been completed. In the meantime, we invite you to use the materials and provide us with feedback, if you have suggestions for improvements, or wish to share with us how First Contact is being used in your setting.

Elsbeth Tupker, MSW
Clinical Services Consultant
Education and Publishing Department
Centre for Addiction and Mental Health

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