Aloha House proposes to develop an interactive, dynamic, self-paced, internet based substance abuse treatment curriculum based on a written program developed by staff over the last five years. This innovative delivery system will address the treatment gap challenges that are integral to open-group setting treatment. Funds are needed to license content, convert curriculum to digital format, and to add client-utilized terminals to the existing agency wide, multi-program computer network.

Please describe your innovation?

Aloha House proposes to create and beta-test an interactive digital substance abuse treatment curriculum. This dynamic self-paced computer-based option will allow individuals entering substance abuse treatment to receive services adapted to specific drug or alcohol treatment needs, substance abuse history and drugs of choice, stage of treatment, and personal educational and cultural considerations. The design will be similar to other adaptive interactive user-friendly online learning tools such as the Khan Academy education model. The multi-modal on-line curriculum consists of 3 evidence-based treatment areas: the abuse/dependence disease model, cognitive behavioral therapy, and relapse prevention. Because recovery is essentially learning, the curriculum includes journaling, instant access to streaming links from salient domain sites in the group treatment setting, ongoing assessment, and testing. Recurring client evaluations provide a built-in evaluation for the program itself.

What is the problem or situation that your innovation seeks to address?

Substance abuse treatment is generally provided in an open-ended group setting. Because of the variance among consumers regarding educational and cultural background, and substance use and stage of treatment, this treatment model results in gaps in treatment delivery for some, and unnecessarily prolonged treatment for others. Furthermore, written treatment materials are often expensive, and by their nature are unable to address variances related to different levels of prior treatment exposure and home care knowledge; varying levels of relapse risk; varying degrees of co-occurring mental health disorders; and varying degrees of criminogenic risk and need. At the same time, group sessions tend to lack cohesion around a standardized, evidence-based consumer curriculum skill set system. Furthermore, nonprofit agencies rely on government and philanthropy. By developing intellectual property that can become a growing source of income, Aloha House can work towards self-sufficiency.

What effort have you made to test out your new idea?

Aloha House staff members have developed much of the curriculum in written format. Substance Abuse Counselor/Cognitive Skills Facilitator Gerald Palmer, under CSAC supervision has developed multiple treatment instruments, including client journaling, testing, and exercises for approximately 925 consumers in treatment in the Maui prison system, Aloha House Maui Drug Court, and Intensive Outpatient Clinic. Based on real-time experience treating consumers with criminogenic and substance abuse challenges, Palmer has developed a treatment program that integrates guidelines based on purchased criteria developed by experts in the substance abuse and criminology fields, cognitive change curricula, 12-Step programs, federal open source materials from the National Institute of Drug Abuse and the Substance Abuse and Mental Health Services Administration, as well as materials in the public domain. The curriculum has been presented to a variety of groups, on an inter-agency and intra-agency level.

What is particularly noteworthy or novel about your innovation?

While a great deal of substance abuse curricula and materials are available in workbook form and online, Aloha House is not aware of any interactive digital treatment modules available to the substance abuse community-at-large. Not only will curriculum be the first provided in interactive, digital, self-paced format, it will: • Include proprietary streaming video clips, expository, pedagogy and test components. • Include public domain citations, material and permission granted excerpts. • Focus on expanded treatment components addressing different drugs of choice. • Include end of module completable and scorable test components, checking for consumer competence and understanding. • Include universal treatment pieces for all substance dependent patients. • Include updatable printouts of sober support meeting schedules, bus schedules, social services resources and intra-agency/ex-agency resource data. • Culturally sensitive to Hawaii’s diverse community. • Run on standard desktop PCs.

What impact do you expect your innovation will have on the problem or situation described in the previous question?

By providing adjunct self-paced customized treatment modules to consumers, Aloha House will eliminate the previously described barriers associated with open-entry treatment, and will provide its clients with built-in recurrent assessments to enhance successful treatment completion via rapid identification and responsiveness to cognitive and linguistic barriers to treatment, and opportunities to screen for possible co-morbid conditions requiring referral. Digital treatment allows for standardization of therapy regimes and reduces paper records. It also allows for peer to peer treatment interactivity and for the provider to continually and rapidly update and integrate novel and best practice across the agency to each consumer. Aloha House is part of a tri-partnership including Maui Youth and Family Services and Malama Family Recovery Center. Because all three agencies are integrated in one digital network, 500-600 clients annually will be able to access these treatment modules.

What other community partners will you need if your innovation is to scale beyond your organization?

If this innovation scales beyond Aloha House, Malama Family Recovery Center, and Maui Youth and Family Services, the tri-agency partnership will work with the Maui County and other community agencies to provide the curricula in a variety of settings. Further, Aloha House will modify curriculum as need to serve a broader clientele. Substance abuse and its associated diminished wellness is a nationwide problem of enormous scope, cost and tragedy. By creating an expandable open access resource program, the Aloha House School-based program would be able to place these materials in every intermediate and high school in the State of Hawaii, for example. According to the National Center for Addiction and Substance Abuse, children reaching the age of twenty-one without drinking alcohol, smoking cigarettes or trying marijuana are certain to avoid developing a substance abuse disorder as an adult. Other potential venues include UH-MCC, Maui Meth Project, and the State Department of Health.

Why are your organization, partners, and key personnel suited to take on this project?

Aloha House has the knowledge, experience, and skills to develop the curriculum and convert it to an online treatment program. Gerald Palmer, who will head up the curriculum development committee, has worked for 12 years at Maui County Correctional Center and in the criminal supervision parole/probation substance abuse environment. Aloha House has been providing substance abuse treatment on Maui for over 30 years.The Tri-Partnership can provide the numbers and range of substance abuse needs to thoroughly beta-test the program. Between the three agencies, substance abuse issues are addressed for men, women, youth, parenting women, and drug court clients in residential, outpatient, intensive outpatient, and school based settings. Terisol, the cyber consultancy that engineers and maintains the agency’s 100 terminal network mini main frame system across Maui has the technical know how to convert the curriculum to the online format, including complete hardware and software implementation.