Using the Matrix Model at the Consortium Against Substance Abuse

In 1986, the Apache Tribe of Oklahoma, the Delaware Nation of Western Oklahoma and the Fort Sill Apache Tribe of Oklahoma came together to establish a Consortium Against Substance Abuse, in Anadarko Oklahoma. Some 27 years later, the Consortium continues to serve the three Tribes, providing outpatient treatment, referral to inpatient treatment and education for the members of the consortium Tribes and the community.

To support the Consortium's efforts, funding from the Methamphetamine and Suicide Prevention Initiative (MSPI) was programmed to address two areas of need for the Tribes. First, consortium staff identified excessive wait times for clients needing admission to in-patient treatment and lack of services locally. The delay meant that while many clients were waiting to be admitted, damage to their personal lives and the lives of their families mounted. Children were being placed into foster care for an extended period of time-- sometimes up to two and a half years. In addition to the problem of treatment wait times, no treatment centers in Oklahoma could accommodate the judicial system requirement that clients attend treatment for a year or more if using methamphetamine.

Consortium staff identified community education as second area of need. Without a program providing education on methamphetamine (meth), many community members knew only what they had read in the local paper or heard by word of mouth. Oftentimes, this information was limited to news of a meth lab being "busted," leaving the impression that the problem was addressed. Consortium staff recognized a need to educate community members on the dangerous effects meth has on the user, the family and the community.

Keeping in mind these areas of need, consortium staff came up with a plan for the MSPI project.

After researching treatment programs that would satisfy the judicial system and address the concerns of the Oklahoma Department of Human Services (OKDHS), staff chose to implement the Matrix Intensive Outpatient program. For community education, the Program Director developed a two hour meth education program for adults and another for adolescents. Additionally, the consortium contacted all Tribes in the area and asked those Tribes to notify the agency if they were having health fairs, conferences or gatherings that could be used as a forum to disseminate information on meth in the community.

Matrix Intensive Outpatient Program

In September 2008, consortium employees Rick Pickens and Ralph Poolaw attended a facilitator training for the Matrix Model at the Matrix Institute on Addictions in Los Angles, California. While there, Pickens and Poolaw developed the goals of the program which were: 1) 100% clean urinalysis, 2) 98% attendance, and 3) if a client had children, the children would be in the client's custody without OKDHS or Indian Child Welfare (ICW) involvement before completing the program.

Upon his return from the training, Pickens arranged meetings with the Family Court Judge and the Caddo County Child Welfare Department of the Oklahoma Department of Human Services. Despite initial skepticism, both the Court and the Child Welfare Department agreed to support the program by referring clients to participate in treatment.

In November 2008, the first client was accepted into the program, with several others shortly to follow. The clients had experienced a range of issues including meth dependence and other substance abuse, leading, in some of the cases, to a loss of child custody or charges of driving while intoxicated.

In addition to participating in the treatment sessions, the clients also worked toward unsupervised visitation with their children. To attain this goal, OKDHS required them to find or be actively seeking employment, have a home suitable for all their children, and stay current on all utility payments for six months.

Within one and a half years, the majority of clients were living drug free, healthy lives and had their children returned to them without any involvement of OKDHS or ICW. One of the clients graduated from an LPN program and received her licensure as a Licensed Practical Nurse.

Since this first group, eight more clients have entered the program. Two have graduated and have regained custody of their children without OKDHS involvement. Six are still working towards regaining custody.

Consortium Adaptations to the Matrix Model

The Consortium modified the Matrix Intensive Outpatient program to meet the requirements of the OKDHS and the District Court. For example, staff modified the program to provide six hours of sessions a week instead of nine per week. This allowed the Consortium to run the program for fifty two weeks, rather than the sixteen weeks that make up the timeframe of the model program. Some adaptations were made to better meet the specific needs of the client group. For instance, a women's group was developed. Structuring the program to cover an extended period of time with a smaller time commitment per week has proven to be of great benefit for the clients as the schedule accommodates work obligations, and the family and parental counseling that they are also required to attend.

Community Education and Outreach

In addition to the promising work being done with the Matrix Model, the Consortium has created a successful education and outreach campaign. The Consortium has presented its meth education program throughout Oklahoma, and as far as Ft. Defiance, Arizona, reaching over twelve hundred participants in the past three years. The two hour presentation is a basic education program for those who have no or little knowledge of meth. Pre- and post-event surveys are given to the participants, and with this input, the Consortium updates the presentation on a yearly basis.

Outreach efforts have included all day community events like a Meth and Other Drug Education Day, in July 2012. This was the first ever all- day presentation by a Native American organization in the community focused on drugs. Forty-six participants attended the event and the community has requested similar events in the future.

The Consortium also held a Men's Day this year. This day allowed men to take part in healthy activities and education programs. Programming especially geared for women has come in the form of the Annual Women's Encampment. The encampment includes two nights of cultural activities and one day of substance abuse education. Over 125 women have participated in the camp over the past three years.

Building on the momentum of these successful events, Consortium staff will expand outreach efforts to include community education on parenting. In October 2012, two staff members attended the Native American Fatherhood and Motherhood training. The Consortium will begin parenting groups in early 2013 and open those groups to all Native Americans in the community. Other educational days will be scheduled in the spring and summer to continue raising community awareness on the dangers of alcohol and other drugs.