In April 2016 a number of drugs and alcohol taskforce coordinators and other staff along with representatives of various drugs projects participated in a workshop on shared measurement of personal outcomes in recovery. The purpose of the workshop was to help services identify common outcomes and work towards a shared system of measurement for interventions in rehabilitation and social reintegration.

The workshop was hosted by the HRB National Drugs Library, which seeks to encourage the use of research-based evidence in decision-making and to contribute to learning in drugs and alcohol taskforces and addiction services.

The workshop facilitators have compiled a report based on the discussions at the workshop, the findings from a survey of taskforces and interviews with a number of taskforce coordinators. The report comprises three sections:

• a guide for understanding a person’s recovery, identifying groups of factors that contribute to successful recovery;
• a series of measures of each aspect of recovery, drawn from published resources which are freely available; and
• guidance on how to implement the shared measurement framework, including practicalities such as gathering input from service users, training and the use of technology in enabling data collection and analysis. 

To use the shared measurement framework, services need to identify three to five outcomes, match these outcomes to the shared outcomes in the framework and identify the recommended measurement that accompanies that shared outcome. This is the first step in deciding on and using common outcomes. The framework recommends established questionnaires and psychometric scales to measure these outcomes. Services will need training in using these questionnaires to gather data and a technical infrastructure to facilitate data management and analysis. Understanding how shared outcomes data are aggregated and compared will help to determine the relative effectiveness of interventions. Results must be presented in a way that allows services to learn about what is and is not working in recovery services and to make the necessary changes and improvements.

Responding to the needs of those recovering from addiction is multi-faceted and demanding work, requiring knowledge, personal skills and determination. Good service is built by selecting interventions which are known to be effective, monitoring the implementation of these services and responding to information gained through rigorous evaluation and sharing of knowledge. In this way good practice is identified and spread, resources are used effectively and services developed in a shared learning environment.  

Housing, education and employment have been identified as key elements in reintegrating those overcoming addiction into their communities. Recovering drug users need social and emotional support beyond the initial treatment period to develop their capacity to participate in the housing, education and employment spheres. Recovery is multi-faceted but this project is particularly concerned with the measurement of personal outcomes in this process, the types of change in outlook and self-perception that enable progress along the recovery path.

The HRB’s evidence review on social capital in recovery1 looked at the role played by friends and families in helping the service user to develop a secure social network, to find examples of success and to develop the confidence to plan their own lives. The review found good evidence that social and human capital contribute to recovery.   It identified a number of areas for future work so that service providers can understand how needs change over the course of the recovery process and how needs differ from person to person.

There is an evidence gap in this area and a lack of consistency when it comes to evaluating recovery interventions. Shared measurement of the impact services have on recovering drug users would help to lessen this gap, improve services and make achievements in this work more apparent. It would lead to better outcomes for the people using services and provide evidence that taskforces play an integral and valuable part in responding to problem drug use in Ireland. Deciding on appropriate personal outcomes in recovery, which services can recognise as milestones in the achievement of their goals, and agreeing on indicators to measure these outcomes are important first steps in building knowledge, sharing it and using it to spread good practice.

Over the coming weeks a number of taskforces will work on the next phase in the development of the outcomes framework and seek to ensure that it is relevant and meaningful to services users, making it more likely to be implemented and used effectively. Service user consultation will encourage a sense of ownership of the measurement system, ensure the measurements used are proportionate and the service user experience is clearly and accurately articulated.

1 Munton T, Wedlock E and Gomersall A (2014) The role of social and human capital in recovery from drug and alcohol addiction.  HRB Drug and Alcohol Evidence Review 1.  Dublin: Health Research Board. https://www.drugsandalcohol.ie/23078/