TM · 2015-12-07 · especially Aquarius, East Midlands Drug and Alcohol Team (DAAT) and alcohol services in the East Midlands s The London Housing Foundation and St Mungo’s for

Drug & Alcohol Star

User Guide

Developed by Sara Burns andJoy MacKeith of Triangle Consulting

Social Enterprise

TM

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drug use

alcohol usefamily &relationships

communityaccommodation

money meaningful useof time

offending physical health

emotionalhealth

T h e O u t c o m e s S t a r f o r d r u g a n d a l c o h o l r e c o v e r y

Page 2 Drug & Alcohol StarTM © Triangle Consulting Social Enterprise Ltd | www.outcomesstar.org.uk

Published by

Triangle Consulting Social Enterprise LtdThe DockWilbury VillasHoveBN3 6AH

Copyright © 2012 Triangle Consulting Social Enterprise All rights reserved

Authors

Sara Burns and Joy MacKeithTriangle Consulting Social Enterprise Ltdwww.outcomesstar.org.uk

Designed and edited by Jellymould Creativewww.jellymouldcreative.com

First edition published July 2012

The Drug and Alcohol Star is the intellectual property of Triangle Consulting Social Enterprise. In order to sup-port effective implementation of the tool, organisations wishing to use the Star are required to buy a licence and train all workers using the Star with service users. Licence holders receive:

• Access to up-to-date documentation for all relevant Stars including Star Charts, User Guides, Organisation Guides, Quizes and additional resources such as flashcards through the Star Online portal

• Online completion, benchmarking and outcomes reports through the Star Online portal. See www.staronline.org.uk to try the free demo

• Recognised user status: organisations with a licence will be Recognised Star Users and will be listed as such on the Outcomes Star website.

Please contact [email protected] to enquire about buying a licence and training.

Licences are also available for those wishing to translate the document into other languages.

The Outcomes Star™This Star is part of a family of Outcomes Star tools. Each tool includes a Star Chart, User Guide or Quiz and guidance on implementation and some have visual and other resources. For other versions of the Outcomes Star, good practice and further information see www.outcomesstar.org.uk.

Triangle was originally commissioned to work on an outcome measurement system by St Mungo’s, with finan-cial support from the London Housing Foundation, and recognises St Mungo’s vital role in the development of the Outcomes Star.

AcknowledgementsThe Outcomes Star has a long history of development and we would like to thank all the managers, workers and clients who have contributed their feedback and made it possible for Triangle to develop such an accessible and effective set of tools. Triangle would particularly like to thank:

• NORCAS for working in collaboration with Triangle on the development of the Drug and Alcohol Star • Aquarius for additional input into the Drug and Alcohol Star• Alcohol Concern and all the organisations who collaborated in the development of the original Alcohol

Outcomes Spider in 2005 and the Alcohol Star in 2010 (both of which have helped inform this version), especially Aquarius, East Midlands Drug and Alcohol Team (DAAT) and alcohol services in the East Midlands

• The London Housing Foundation and St Mungo’s for their respective roles in the creation of the original Outcomes Star for homelessness.

Page 3Drug & Alcohol StarTM © Triangle Consulting Social Enterprise Ltd | www.outcomesstar.org.uk

Introduction to the Drug & Alcohol StarTM

We are here to help you with your recovery from alcohol or drug misuse.

The Drug & Alcohol Star helps us focus on what needs to change

The Star looks at ten areas of your life:

1. Drug use

2. Alcohol use

3. Physical health

4. Meaningful use of time

5. Community

6. Emotional health

7. Accommodation

8. Money

9. Offending

10. Family and relationships

How does it work?

For each of these ten areas, there is a scale. Each scale follows the same pattern, or journey, of change, with five stages.

To complete the Star, look at each of the ten scales one by one and talk it over with your keyworker. Together, you can agree where you are in each area, mark the number on the Star Chart and connect the points to create a picture of the areas of your life that are working well and the areas that are causing difficulties.

This picture will help you and your worker to agree what areas to work on together. From there, you can start thinking about the actions you want to take and the support that would help you to take them.

Your own personal journey

You and your keyworker will come back to the Star at regular intervals. You can look at the scales again, agree where you are, and plot a new shape on the Star Chart. Over time, this will help you to build a picture of your own personal journey. You will see where you have come from and how things have changed for you. This can help you to see things in a new way – to put the ups and downs of a single week into a bigger picture.

It also helps us to get an idea of whether the service is giving the right support, where our service users make most changes and where we may need to provide more help or do things differently.


The Journey of ChangeFor most of us, recovery from problem drinking or drug misuse is a process. It means understanding the trig-gers, the effects of misuse on ourselves and others and how we can make changes. This isn’t easy but it can help to understand how change works. Everyone makes changes in their own way but the pattern is often similar.

Stuck (1–2)

At the beginning of the journey we may feel stuck – we don’t feel able to face the problem or accept help. We take a step forward to 2 when we have moments of wanting things to change but when these are not yet consistent enough to accept support.

Accepting help (3–4)

From stuck we move to accepting help. At this stage we want to get away from the problem. We probably hope that someone else can sort it out for us and we go along with some of the things they suggest. We do this some of the time at 3 and more consistently at 4.

Believing (5–6)

Then we start believing that we can make a difference ourselves in our lives. We look ahead towards how we want to be living. At 5, there is an internal shift towards believing in a positive future for ourselves and taking responsibility for making that happen. At 6, we start to take the initiative and try new things to achieve our goals. This stage is a tough place to be and it can help to have plenty of support.

Learning (7–8)

The next step is learning how to make what we want a reality, building on what works for us and increasing our confidence in a future without alcohol or drug misuse. By 8, we have achieved our goals and mostly got where we need to be, but it is hard at times so we still need support.

Self-reliance (9–10)

As we learn, we gradually become more self-reliant. At 9, we need occasional support but, at 10, we get to the point where we can manage without help from a drug or alcohol service.

The Journey of Change is summarised on the next page as a ladder. It isn’t necessarily a case of moving from the first point on the ladder to the last. We all start in different places and can move forwards or backwards as things change. Wherever you are on this journey, placing yourself on the ladder can help you to see where you have come from, what your next step is and how we can best help you.


21

Leave me alone

Stuck

4

3

Accepting help

I want someone else to sort things out

65

I can make a difference. It’s up to me as well

Believing

8

7

Learning

I’m learning how to do this

10

9

Self- reliance

I can manage without help from the project

• At1and2,youarecausingorriskingharmtoyourselforothers

• At3and4,thisharmisreducingbecauseyouareacceptinghelp

• At5,thereisaninternalshifttowardstakingresponsibilityandat6youaretakingactionforyourself

• By8,youcanmanagethisareabutneedongoingsupporttomaintainit

• By10,youdon’tneedsupportfromaspecialistservice

Key points

The Journey of Change


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1 Drug useThis scale is about misusing drugs, whether prescribed or not. If this does not apply to you, simply score 10 and move on to the next scale.

BelievingSe

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I am not misusing drugs but need support from the service to maintain that

Where are you on your journey?

• Beingata3orabovemeansyouaretakingstepstostaysafe,forinstance,protectingyourselfagainstinfectionoroverdose

• Between5and7,themainshiftistowardsyoutakingresponsibilityformakingchangesandlearningtomanageawiderrangeofsituationswithoutmisusingdrugs

• Beingat8orabovemeansyouhavestoppedusingillegaldrugsandmisusingprescribeddrugs

• Beingat10meansyouarealsonotusingmethadoneorotherprescribedsubstitutes

Key points

I don’t use illegal drugs or misuse legal or prescribed drugs

I am not misusing drugs but need occasional support to maintain this

I am not misusing drugs but need support from the service to maintain that

I am learning how to manage life without drugs and have few episodes of drug use

I am going along with changes that other people suggest about drugs

Maybe I need some help with my drug use

I don’t have a problem with drugs – although others think I do

I see that drugs can be a problem but that’s just the way it is

I see that I need to make changes myself to my drug use

I am reflecting on my drug use and starting to making changes


10 I don’t use illegal drugs or misuse legal or prescribed drugs•You don’t use any illegal drugs or prescribed alternatives such as methadone•Any use of prescribed drugs is as directed by a doctor and does not damage your health, well-being or

relationships• If drugs have been an issue in the past, your family, friends, GP or self-help groups (for instance NA) provide

any ongoing support you need and you can access extra help in the future, if needed

9 I am not misusing drugs but need occasional support to maintain this•You are using strategies to avoid relapse•You don’t need much support but appreciate knowing it’s there

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8 I am not misusing drugs but need support from the service to maintain that •You mostly manage feelings and situations that have led to drug use in the past •You have few or no episodes of drug use• If you use methadone or other prescribed substitutes you are working towards abstinence from them•You need regular support from the service to maintain this

7 I am learning how to manage life without drugs and have few episodes of drug use•You are learning for yourself how to deal with triggers and high-risk situations and your confidence is growing•Any problematic drug use is infrequent or moderate and you are able to learn from lapses, with support

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6 I am reflecting on my drug use and starting to making changes •There is a sense that you are ‘up for it’ in relation to addressing drugs issues•You are reducing your use of drugs or may stop completely for periods•You are reflecting on situations or people that could trigger your use of drugs and sometimes avoid these

5 I see that I need to make changes myself to my drug use•You recognise that addressing drugs will require change on your part•You are actively exploring and considering options to help you with this

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4 I am going along with changes that other people suggest about drugs•You mostly follow harm-reduction measures by this point if not before•You may agree to a plan of support but your workers or advisors are taking the lead and without them you

could slip back •You attend appointments around drug issues fairly regularly

3 Maybe I need some help with my drug use•You are concerned about the harm caused by your drug use, and sometimes follow advice to reduce harm•You want to make changes in relation to drugs but do not believe it is possible •You often miss appointments that relate to your use of drugs

2 I see that drugs can be a problem but that’s just the way it is•As 1, but you have glimmers of awareness about the harm caused by drugs•You do not engage with support or consider change

1 I don’t have a problem with drugs – although others think I do•Your drug use is at harmful or risky levels•Your life may be orientated around drugs or your use is seriously affecting other people•You don’t think this is a problem or you are not ready to talk about it

Stu

ck1 Drug use (detail)


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I don’t have an alcohol-problem – I can manage without support from the service

My drinking is not a problem but I need occasional support to keep this up

I am not drinking problematically but need support to maintain that

I am learning to manage my alcohol use and have few episodes of problem drinking

I am willing to try things my worker or doctor say will help

Maybe I need some help with my drinking

I don’t have a problem with alcohol – although others think I do

Maybe my drinking does cause problems but that’s just the way it is

I see that I need to make changes myself to tackle my drinking

I am reflecting on my drinking and making changes

BelievingSe

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2 Alcohol useThis scale is for how you deal with any problem drinking. If this does not apply to you, simply score 10 and move on to the next scale. At 10, you might be abstinent or controlling your drinking so that it doesn’t result in problems for you or others.


• Beingata4meansyouareconsistentlytakingstepstostaysafe,forinstance,avoidingalcoholpoisoningorunsafesituationswhendrinking

• Between5and7,themainshiftistowardsyoutakingresponsibilityformakingchangesandlearningtomanageawiderrangeofsituationswithoutmisusingalcohol

• Beingat8orabovemeansyouarenotdrinkingproblematically

Key points


2 Alcohol use (detail)Se

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8 I am not drinking problematically but need support to maintain that•You have new ways of coping with the feelings and situations that led to drinking and are not drinking

problematically•This is not easy and you are not totally confident, so you need regular support from the service to maintain this

7 I am learning to manage my alcohol use and have few episodes of problem drinking•You are exploring your triggers for excessive drinking, reflecting on the causes and have come up with ways

of dealing with triggers•You have probably reduced your drinking substantially and are able to learn from lapses with support•You have ways to maintain your progress and are increasingly confident in your ability to do so

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6 I am reflecting on my drinking and making changes•You are reducing how much you drink or are stopping completely for periods •You are making other changes to avoid drinking-triggers and support your recovery

5 I see that I need to make changes myself to tackle my drinking•You have taken on board that controlling or stopping drinking means that you need to make changes •There is a sense that you are ‘up for it’ •You are able to make choices about your drinking goal and the support you need to achieve it

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4 I am willing to try things my worker or doctor say will help•You mostly follow harm-reduction measures •You may agree to a plan of support but your workers or advisors are taking the lead. Without them you

could slip back •You attend most appointments

3 Maybe I do need some help with my drinking•You are fed up with the negative consequences of your drinking•You want change but do not believe it is possible • It may seem like there are good reasons for your drinking or that others are to blame•You often miss appointments•You may have just come out of detox and doubt you can keep it up

Stu

ck10 I don’t have an alcohol-problem – I can manage without support from the service •Alcohol is not a problem for you or, if it has been a problem, you have now reached your drinking goal and

have strategies to maintain it effectively• If you drink alcohol, it is in moderation and does not damage your health, well-being or relationships •Family, friends, your GP, self-help groups (e.g. AA) provide any ongoing support that you need • If you need extra help at any time, you are aware of this and know how to access support

9 My drinking is not a problem but I need occasional support to keep this up•You are using strategies to avoid relapse, with occasional difficulties•You don’t need much support from the service but appreciate knowing it’s there

2 Maybe my drinking does cause problems but that’s just the way it is•As 1, but every now and then you are worried about your drinking•You are not ready to make changes and don’t engage with support

1 I don’t have a problem with alcohol – although others think I do•Your life is orientated around drinking but you don’t want to talk about it•Other people say your drinking is a problem, but you don’t think it is •Drinking may be seriously damaging your health


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3 Physical healthThis scale is not about how good your physical health is but about how well you look after your health and manage any health conditions you have. This includes going to the doctor as needed, following treatment advice, maintaining dental health and trying to make healthier lifestyle choices, such as eating well, addressing any issues with sleeplessness and taking exercise.

BelievingSe

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I look after my physical health well without support

I look after my health well but need occasional support to keep it up

I look after my health well but I need support to keep it up

I am learning to look after my health better

I’m going along with treatment or I don’t have health problems at the moment

I want help with health issues that are causing me problems or pain

I’ve got health problems but I’m not seeking help

I am sometimes concerned about my health but don’t do anything about it

I need to take some responsibility for looking after my health

I am starting to take responsibility and do things myself to look after my health


• At1-2,youhavesignificanthealthproblemsthatarenotbeingtreated

• At4,ifyouhaveahealthproblem,youconsistentlygettreatment

• By8,youaretakingcareofanyhealthconditionsyouhaveandyou’remakingsomehealthylifestylechoices,withsupport

• By10,youdothatwithoutsupport,thoughyoumayormaynotfeelwell

Key points

Stuck


10 I look after my physical health well without support •You have an independent and responsible approach to your physical health•Your diet is mostly OK, you take exercise, do what you need to do to sleep well enough and keep unhealthy

habits to a minimum•You may or may not actually be in good health or feel physically well but you are managing any conditions

as well as possible to maximise your health

9 I look after my health well but need occasional support to keep it up •As 10, but you need occasional support to reinforce and maintain healthy habits

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8 I look after my health well but I need support to keep it up•You consistently access healthcare and take prescribed medication by this point, if not before•You are making positive changes in your lifestyle with support, for example changing your diet, exercising

more consistently or stopping smoking

7 I am learning to look after my health better•You see the link between getting treatment, healthier choices and feeling better•As a result, your motivation to care for your health is increasing•You may be feeling physically healthier or sleeping better•Change is difficult, so you need support

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6 I am starting to take responsibility and do things myself to look after my health•You attend health appointments on your own (or with friends or family)•You may try changing diet, exercise, addressing sleep problems or other lifestyle changes•You don’t keep up changes for long but begin to sense what might work for you

5 I need to take some responsibility for looking after my health•You actively want to look after your health, though not sure how to put that into practice•You engage in discussions about health and actively explore options

Acc

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p 4 I‘m going along with treatment or I don’t have health problems at the moment•You see a doctor regularly, if needed, but only if someone else organises it•You may be feeling better as a result of the treatment you are receiving

3 I want help with health issues that are causing me problems or pain•You want to do something about any pain or discomfort you are in•You will see a doctor or nurse but only if someone else takes you – you probably wouldn’t go alone•Although you are getting help with major problems, you are not very interested in addressing less severe or

less obvious ones

2 I am sometimes concerned about my health but don’t do anything about it•You occasionally discuss health briefly or ask for help but then refuse support when offered•You don’t believe it is possible to feel better

1 I’ve got health problems but I’m not seeking help•You don’t go to the doctor or seek help even for pressing health problems, for instance ulcers or liver

disease•Because of your drinking and/or drug use you are putting yourself at risk, for instance of violence, BBVs or

unwanted pregnancy •You don’t want to discuss your health, or it feels too difficult to even think about it

Stu

ck3 Physical health (detail)


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Stuck

4 Meaningful use of timeThis scale is about how you spend your weekdays – whether you work or are a full-time parent or carer; or in training, education or voluntary work; looking for work or actively enjoying your interests – or whether your time is orientated around drinking and/or drugs.

BelievingSe

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I use my days well and don’t need any extra help

I use my days well but I occasionally need support with this

I am using my days well but need support to maintain this

I am doing some meaningful things with my time and getting some sense of satisfaction

I am doing things that others suggest I do to use my days better

I don’t want to spend my days like this anymore

I am doing nothing with my time

There is no structure in my day but occasionally I wish there was

I know I need to take the initiative to change things

I am getting clear about what I want to do and taking steps towards that


• At1–4,youeitherhavenoresponsibilitiesintermsofcaringforothersorworkoryoudohaveresponsibilitiesbutyouareneglectingthem.However,asyouprogressfrom1to4,youareincreasinglyacceptinghelptoaddressthis

• By7,youaredoingsomethingmeaningfulwithyourtime(orifyouarealreadyinwork,youarenotatriskoflosingyourjob)butyouneedsupport

Key points


10 I use my time well and don’t need any extra help•You are engaged in a regular activity which works for you, for instance paid employment, full-time

parenting, voluntary work or training•You are able to change jobs, advance and progress, organise training or activities, or address changes

affecting your days, such as your children getting older, without the support of the service – friends, family and colleagues give you any support you need

9 I use my days well but I occasionally need support with this•As 10, above, but you need help occasionally, for instance if circumstances change or a course comes to an

end and you need to make new arrangements

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8 I am using my days well but need support to maintain this•You are engaged in a regular activity that works for you, for instance paid employment, full-time parenting,

voluntary work or training•You may encounter difficulties but with support you can learn from these

7 I am doing some meaningful things with my time and getting some sense of satisfaction•You are learning what sorts of activities you enjoy and getting closer to doing the things you want to do•You run into problems at times and you need help to get through them• If you are working, you are not at significant risk of losing your job due to alcohol or drugs and are learning

how to manage work stress and other triggers

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6 I am getting clear about what I want to do and taking steps towards that•You are exploring possible training courses, work, volunteering or ways of managing your existing job with

support •You are setting and meeting short-term goals •You have some sense of the direction you might want to go in but it’s hard to put that into practice so you

need support

5 I know I need to take the initiative to change things•You are actively considering the future and your options for work, training, education or other activities• If you are in work and problems with work are contributing to your problem drinking or drug misuse, you

are aware of that and talking about how to make changes

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p 4 I am doing things that others suggest I do to use my days better• If you are working, you are at high risk of losing your job due to drinking or drugs • If you have other responsibilities, such as parenting, you are at high risk of neglecting those responsibilities•You follow through on actions agreed with your worker but need lots of encouragement to do this

3 I don’t want to spend my days like this anymore•You are doing very little or nothing with your time but are fed up with living like this and want to change •You want help but don’t have a sense of what else is possible •You agree with your worker to do things but after the meeting you lose motivation and don’t follow through

2 There is no structure in my day but occasionally I wish there was •As 1, but you are occasionally fed up with doing nothing and may talk about this, though not for long and

you refuse any offers of help with how to use your time

1 I am doing nothing with my time•Your life is too chaotic to manage work, training or education or to fulfil the responsibilities you have. Your

time may be taken up with drinking or finding ways to maintain a drug habit•You are not able – or don’t want – to think or talk about how you are using your time in the day

Stu

ck4 Meaningful use of time (detail)


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5 CommunityThis scale is is about feeling connected and having people in your life. These may be friends, people you know locally, being part of a cultural or religious community, or people with whom you share interests or participate in activities. It includes how you feel and cope in social situations without alcohol or drugs.


• At1–4,youareeitherisolatedorsurroundedbypeoplewhodon’tsupportyourrecovery.Asyouprogressfrom1to4,youareincreasinglyacceptinghelpwiththis

• A10canlookdifferentfordifferentpeoplebutasaminimumyouwillhavesomeconnectionswithothersandtherearepeoplewhowouldnoticeifsomethinghappenedtoyouandyoudidn’tcontinueyourdailyorweeklyroutine

Key pointsI feel connected and supported and I don’t need help in this area

I have a good sense of community/support network but need help to maintain it

I spend time with people who support me but need help to maintain that

I am learning what is right for me in relation to community and social networks

I am doing things that others suggest to build a supportive social network

I am isolated or the people around me aren’t good for me and I want some help

My life is focused on drinking and/or drugs but I don’t want to talk about it

Sometimes I wish I had people around but there’s no way this will happen

I believe I can build positive connections with other people

I am trying to reconnect or spend more time with people who support a positive lifestyle

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Believing


10 I feel connected and supported and I don’t need help in this area•You have the level of contact with other people that you need and want. This may be with friends,

neighbours, through activities and/or within your local, religious or cultural community•You feel confident enough in social situations without drinking problematically or using drugs•You don’t need any help from the service in this area

9 I have a strong community or support network but occasionally need support •As 10 above, but you occasionally need support when particular difficulties arise Se

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8 I have a good sense of community/support network but need help to maintain it•You have relationships with colleagues and friends and other people around you that are not based on

drinking or drugs•You may sometimes feel uncertain in social situations or encounter difficulties but you manage them well

with support

7 I am learning what is right for me in relation to community and social networks•You have regular contact with people outside a drinking or drug-using circle•You are learning what kind of contact is right for you and addressing any issues you may have with

community and social networks, for example learning how to survive or even enjoy social situations without drinking problematically or using drugs

•You are still learning what is right for you so this area is challenging and you need lots of support

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6 I am trying to reconnect or spend more time with people who support a positive lifestyle•You have some contact with people outside a drinking or drug-using network•You may be getting to know other people through the service or trying to rebuild past friendships•At times you actively avoid people and situations that revolve around alcohol or drugs but this is hard and

sometimes you go back to those networks

5 I believe I can build positive connections with other people •You know that the people you spend time with make a difference in either holding you back or supporting

you to change•You want to make positive choices about who you spend time with but it might seem frightening to let go

of some people or you don’t know how to find new people who will help you make the changes you want to make

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p 4 I am doing things that others suggest to build a supportive social network•You follow through on actions agreed in case work, with lots of encouragement

3 I am isolated or the people around me aren’t good for me and I want some help•You would like things to be different and are open to talking about the lack of positive connections in your

life but don’t have a sense of what else is possible•You agree to do things with your worker but lose motivation and don’t follow through

2 Sometimes I wish I had people around but there’s no way this will happen•You are fed up with being alone or with the people you know but feel powerless to change this

1 My life is focused on drinking and/or drugs but I don’t want to talk about it•Either you are isolated or any connections you have are focused on alcohol and/or drugs•You may not feel confident with other people unless you have been drinking and/or using drugs•You don’t see a problem with how things are or don’t want to talk about it with workers

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ck5 Community (detail)


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6 Emotional healthThis scale is about how you deal with anxiety, stress or feeling low or unable to cope. It is about the extent to which life’s ups and downs (particularly downs) affect you and might contribute to you drinking or taking drugs. People with an underlying mental health issue can use this scale to talk about how they manage those issues.

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I feel fine – I manage my emotional and mental health well

I mostly feel fine. I just need support now and then

I am managing my emotional and mental health well with support

I’m learning what keeps me stable. I have ways to help myself when things feel tough

I am going along with help in relation to emotional or mental health

I want to get out of this hole and to feel better

I often feel pretty bad but I don’t want to talk about it

I don’t like feeling like this but there is nothing anyone can do about it

I know stress and emotions contribute to my drinking or drug misuse. Maybe I need to work on this

I am trying ways to improve my emotional well-being


• From5–7,themainshiftistowardsincreasinglymanagingyouremotionalhealthforyourself

• By8,youaremanagingstressanddifficultiesforyourselfwithoutgettingillorresortingtoalcoholordrugsbutyouneedsupporttomaintainthis

• At10,youcandothiswithoutthesupportofaspecialistservice.Ifyouhaveamentalhealthcondition,thismaystillbethecasebutyouaremanagingitwell

Key points


10 I feel fine – I manage my emotional and mental health well •You feel reasonably resilient and positive emotionally, within the inevitable ups and downs and stresses that

are part of life•Strong emotions do not cause you to drink or misuse drugs•Your family and/or friends provide you with enough emotional support when things feel hard so you don’t

need help from a substance misuse service• If you have a diagnosed mental health problem, you may have symptoms but you are managing them well

9 I mostly feel fine. I just need support now and then•As 10, but you may find the idea of letting go of support frightening •You are comfortable with your ways of coping

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8 I am managing my emotional and mental health well with support•You are using strategies to feel OK and deal with stress but it can be difficult so it helps to have ongoing

support•Strong emotions or any underlying mental health issues are unlikely to trigger your drinking and/or drug

misuse

7 I’m learning what keeps me stable. I have ways to help myself when things feel tough•You understand how stress and emotions can trigger drinking and perhaps using drugs•You are starting to make better choices and can see the effect of this on how you feel • If you have a mental health problem, you understand the symptoms, what triggers relapse and what helps

you feel better

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6 I am trying ways to improve my emotional well-being•You may be doing things to lift your mood, work with stress or stabilise your emotions and avoiding things

that have a negative effect• If you are on medication, you are taking it as prescribed•You are likely to need good support

5 I know stress and emotions contribute to my drinking or drug misuse. Maybe I need to work on this •You can see there is a connection between your drinking and/or drug misuse and how you feel emotionally •You believe you can find ways to feel better emotionally to reduce the effect of any mental health problem but

you are not sure how

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p 4 I am going along with help in relation to emotional or mental health•You feel very anxious, stressed, depressed or up and down and it is hard to believe you could feel different•You don’t recognise any connection between how you feel and alcohol or drugs but you accept help most

of the time and go along with suggestions to feel better

3 I want to get out of this hole and to feel better•Your symptoms of anxiety, stress or depression are severe •You will discuss this and/or make appointments but often do not attend or follow through• If you are on medication for a mental health issue, you may take it but erratically

2 I don’t like feeling like this but there is nothing anyone can do about it•As 1 but you will occasionally talk about symptoms •You don’t see the link between how you feel and your drinking or drug misuse • If help is offered, you do not engage meaningfully

1 I often feel pretty bad but I don’t want to talk about it•Symptoms such as high anxiety, stress, depression, insomnia, panic attacks, low self-worth or suicidal

thoughts are causing you distress and have a severe effect on your daily life but you don’t want to talk about it

•There may be an underlying mental health problem that is not being addressed

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ck6 Emotional health (detail)


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7 Accommodation This scale covers you and your accommodation including any risks to your home, for instance being behind on rent or mortgage payments, having nowhere secure to live, “sofa surfing”, sleeping rough, hostels and supported accommodation or any other accommodation issues that affect your life. If you have no issues in relation to accommodation, simply mark yourself at 10.

I have no problems with my accommodation and don’t need support in this area

I manage my accommodation fine, with occasional support

I manage my accommodation OK but sometimes need ongoing support

I have secure accommodation and I’m learning to manage it for myself

I am accepting help with accommodationconsistently

I can see I need help with accommodation and I accept help sometimes

I have nowhere to live or my accommodation is at risk. I’m not doing anything about it

I’m in a mess with accommodation. Sometimes I get anxious but mostly I ignore it

I can see that I need to take control of getting my accommodation sorted out

I am taking action myself to get my accommodation in order. It’s difficult


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• Therearetwodifferentpossiblestartingpoints–eitherhavingnohomeorbeingatsevereriskoflosingyourhome

• Beingat7orabovemeansthatyouhavesecureaccommodationand,by8,youcanmanageitwithsupport

• From7to10youbecomemoreandmoreindependentandneedlessandlesssupporttomanageyouraccommodation

Key points


10 I have no problems with my accommodation and don’t need support in this area •You have secure accommodation and there is no significant risk of you losing it•You can deal with changes, such as moving house, without support from the service

9 I manage my accommodation fine, with occasional support•As 10, but you need occasional support when things get difficult or when you are dealing with big

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8 I manage my accommodation OK but need ongoing support •You have somewhere secure to live and there is no evidence of risk to your home • It helps to have ongoing support in this area as you are likely to experience setbacks

7 I have secure accommodation and I’m learning to manage it for myself•You are not at immediate risk of losing your accommodation •You are learning how to manage your accommodation more independently but it’s not easy

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6 I am taking action myself to get my accommodation in order. It’s difficult •You are making efforts to regularly pay your rent, mortgage and other household expenses• If you have nowhere secure to live, you are taking action yourself to find somewhere•You may need a lot of support at this stage

5 I can see that I need to take control of getting my accommodation sorted out•Your accommodation may be a source of great stress on you•You want to feel secure where you live•You attend housing-related appointments and engage with services as necessary but don’t have a sense of

what is possible or how to achieve it

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4 I am accepting help with accommodation consistently •You are going along with actions suggested by workers, with support • If you are in a hostel you are mostly sticking to the rules and regulations but are not looking ahead and

making plans to move on

3 I am in trouble and see that I need help with accommodation•You do not have secure accommodation or if you are in your own home, it is at severe risk through non-

payment of mortgage or rent•You do not accept responsibility for accommodation problems and may feel others are to blame•You engage with support around accommodation but erratically and only around major problems

2 I’m in a mess with accommodation. Sometimes I get anxious but mostly I ignore it•As 1, but you sometimes feel anxious about your problems with accommodation•You find it impossible to think about it for long so you won’t accept help to start sorting it out

1 I have nowhere to live or my accommodation is at risk. I’m not doing anything about it• If you are in your own home, it is at severe risk through non-payment of mortgage or rent•Or, you do not have anywhere secure to live and may be moving between friends houses or even

sleeping rough•Despite severe problems, you are not doing anything to change this situation and do not talk about it

with workers

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ck7 Accommodation (detail)


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8 MoneyThis scale covers issues in relation to you and money. It can include debt, not paying bills or maintenance and the effect of any money issues on you and your life. If you have no issues in relation to money, simply mark yourself at 10 and move on to the next area.

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I have no problems in relation to money and don’t need support in this area

I manage my money fine, with occasional support

I manage my money OK but need help with a few things

I am learning to manage money for myself

I am going along with help to get my finances sorted

I am in trouble with my finances and need help

My finances are in chaos or crisis but I am ignoring the situation

I am in a mess financially. Sometimes I get anxious but mostly I ignore it

I can see that I need to take control of my money

I am taking action myself to get my finances in order. It’s difficult


• By4,youareconsistentlygoingalongwithmeasurestosortoutyourproblemssothingsarenotgettingworse

• From6,youaretakingsomepreventativemeasurestoavoidfutureproblems

• At8,youaremanagingyourmoneywellbutneedsupporttomaintainthat

Key points


10 I have no problems in relation to money and don’t need support in this area•You have enough money and manage it OK •You pay bills and can meet your needs and those of any dependants• If you are on benefits, you can maintain your claim without support• If you have debts, you are keeping up payments

9 I manage my money fine, with occasional support•As 10 but you need occasional support to get back on track when things get difficult Se

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8 I manage my money OK but need help with a few things •You can plan ahead and manage your money OK • It helps to have ongoing support in this area as you are likely to experience setbacks

7 I am learning to manage money for myself•You are learning how to get in control of your money but it’s not easy •You may be paying off past debts but there are no court orders or other risks outstanding

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6 I am taking action myself to get my finances in order. It’s difficult•You open bills and letters, manage benefits for yourself and take steps to avoid future money problems•You are aware of your budget, though you often can’t stick to it•You may need a lot of support at this stage to face a difficult situation and make the right choices

5 I can see that I need to take control of my money•Money worries may be a source of great stress for you•You want to understand your financial situation and address it•You attend appointments and engage with debtors

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4 I am going along with help to get my finances sorted•You go along with actions to avoid the situation getting worse, for instance, to avoid legal action •You accept help getting agreements in place, for instance payment plans• If you are on benefits, workers take the lead in ensuring these are correct and you go along with their help

and suggestions and sign forms

3 I am in trouble with my finances and need help•You accept help with pressing money problems, such as those arising from non-payment of debts or

problems that put you at risk of losing your home•You may feel others are to blame for your money problems•You engage with support erratically and only around major money issues

2 I am in a mess financially. Sometimes I get anxious but mostly I ignore it•As 1, but you sometimes feel anxiety about your problems with money •You find it impossible to think about for long so you won’t accept help to start sorting it out

1 My finances are in chaos or crisis but I am ignoring the situation•You have extensive unpaid bills, debts and/or problems with the courts•Your money problems may be caused by drinking or drugs•You may have no experience of managing money and/or might be financially exploited by others•Despite severe problems with money, you are not looking at your financial situation

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ck8 Money (detail)


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9 Offending This scale is about changing your lifestyle to stop any offending behaviour and to relate to people in ways that avoids conflict. This includes theft, fights, domestic violence, drug dealing, drink-driving and other behaviour which is against the law. It covers both current offending and how you deal with any consequences of past offending and orders of the court.

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I am not offending

I am not offending but need occasional support to maintain this

I am not offending & deal with any consequences of past offending with support

I am learning how to avoid getting into trouble

I am going along with help to sort out problems caused by my offending

I wish I didn’t have these problems

I am offending and do not deal with the consequences

I am offending and occasionally acknowledge this is causing problems

I want to stop offending permanently

I am making changes to stop offending and/or deal with the consequences of past offending


• By6,offendingisreducing

• By8,youhavestoppedoffendingbutneedsupporttomaintainthat

• Ifyouhaveneveroffended,youareat10

• Ifyouhaveahistoryofoffending,10meansyouareabletoavoidoffendingandconflictandchoosetodoso.Younolongerneedsupporttomaintainthat

Key points


10 I am not offending •You’ve never had any issues with offending and workers have no reason to suspect offending, anti-social or

nuisance behaviour•Or, you are no longer offending and can maintain this without support and you have no outstanding issues

with the police or courts, or you are complying with these effectively without support from the service

9 I am not offending but need occasional support to maintain this•As 10 but you use occasional help to avoid offending or anti-social behaviourSe

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8 I am not offending and am dealing with any consequences of past offending with support•You are not offending and are actively engaged with any court orders or dealing with other consequences

of past offending with support•You are changing your lifestyle, have strategies for avoiding high-risk situations and conflict and mostly use

these

7 I am learning how to avoid getting into trouble •You are aware of triggers, learning what works for you and accessing any extra help needed to manage

your behaviour, for instance anger management •You are recognising the impact of your offending on others and the consequences for you, or those close to

you, of involvement with the Criminal Justice System •You may occasionally commit minor offences but you learn from this

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6 I am making changes to stop offending and/or deal with the consequences of past offending •You are reducing or stopping offending•You understand how and why you get into trouble and how to avoid high-risk situations•You are taking responsibility to comply with the terms of any legal orders

5 I want to stop offending permanently•You are facing up to offending, to the consequences and risks for yourself and others and to how alcohol or

drugs have contributed•You may have realised that you have been offending without knowing, for instance driving the morning after

drinking while still over the limit•You are actively considering changes to your lifestyle to help you stop any criminal activity, such as avoiding

certain people

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p 4 I am going along with help to sort out problems caused by my offending•You mostly comply with the courts or any legal orders as a means to an end •You go along with some actions suggested by workers to reduce your offending but do not take the

initiative or make any long-term changes to your behaviour

3 I wish I didn’t have these problems •You are unhappy with the negative consequences of your offending or anti-social behaviour•You do not accept responsibility or address the causes of the offences and are likely to blame others or

circumstances for your offending

2 I am offending and occasionally acknowledge this is causing problems •As 1, but you occasionally recognise that your offending is causing problems and want to get rid of them

1 I am offending and do not deal with the consequences •Workers know or strongly suspect you are offending but you do not talk about this aspect of your life•You do not acknowledge there is a problem, may deny responsibility or view offences as ‘one-offs’ and

don’t see the patterns •You are not dealing with any outstanding consequences of past offending•You may be attending the service to comply with a court order•You do not accept support from the service with these problems

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ck9 Offending (detail)


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10 Family and

This scale is about your relationships with your family and other significant people in your life. If there are child protection issues or there is a risk of domestic violence then you should look at these here. This scale may also be about coming to terms with past family problems. The scales mostly refer to ‘your family’ but this can include close relationships with others.

relationships

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I have healthy enough family relationships and don’t need support in this area

I have healthy enough family relationships but I need occasional support with this

Things are mostly fine in relation to my family but I do need support in this area

I am learning what works in relation to my family

I go along with some workers’ suggestions to try and improve things with my family

I need help with difficulties in relation to my family

There are serious problems in relation to my family and I am not doing anything to help

My family situation is difficult but there is no way it can get better

I hope that things can be better and know I have a part to play in making that happen

I am doing things to make a difference to my family situation but it’s difficult


• By4,thingsarenotgettingworse

• By8,thereisnoneglectorabuseandnoriskofyoubeingthrownoutofthefamilyhome

• 10meansyoudon’tneedsupportwithfamilyandrelationshipsfromtheservice.Itdoesn’tmeaneverythingisperfectandyoumaystillhavesomedifficultiesinthisareafromtimetotimebutyoumanagethem

Key points


10 I have healthy enough family relationships and don’t need support in this area •There are no significant problems in relation to your family •You may or may not be living with family members • If you are a parent, you have contact with your children or you have done all you can to have contact and

accept that it is not possible at this time•Where you are in contact with family, your communication is good enough •You are meeting your responsibility towards any dependents•You appreciate your own needs and meet these

9 I have healthy enough family relationships but I need occasional support with this•As 10, but you need help sometimes to maintain a positive family situation

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8 Things are mostly fine in relation to my family but I do need support in this area•You have positive enough relationships with members of your family •There is no abuse or neglect and you are not at risk of being thrown out of the family home•Sometimes you need help when difficult situations arise

7 I am learning what works in relation to my family •You are learning what works in dealing with difficulties with your family•You understand the needs of your dependants and are finding ways to meet these

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6 I am doing things to make a difference to my family situation but it’s difficult•You are trying out new ways of responding to family issues, but it’s hard•You may have to come to terms with a situation where, whatever you do, it is not possible to improve

relationships with your family at the moment• If social workers or other professionals are involved with your family, you are actively working well with them

5 I hope that things can be better and know I have a part to play in making that happen •You understand how your behaviour impacts on others in your family and/or the effect of a damaging family

context on you•You are willing to look at patterns of family life and choices open to you•You may recognise that you need practical and emotional support, too

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4 I go along with some workers’ suggestions to try and improve things with my family•You may agree to an action plan around your family but you find it hard to stick to•You mostly comply with any order, injunction or agreement in relation to children •You are not really taking responsibility so may rely on others to do something and then blame them when

things don’t work out •There is little risk of you being thrown out of the family home due to drink or drugs

3 I need help with difficulties in relation to my family •You accept help with pressing issues, including child protection issues •You may not recognise the effect of your own behaviour on the situation •You may feel trapped or fearful about what might happen when you accept help

2 My family situation is difficult but there is no way it can get better•As 1, but you are sometimes concerned about harm to your family or yourself• If support is offered, you do not take this up in a meaningful way

1 There are serious problems in relation to my family and I am not doing anything to helpYou have serious family issues but don’t want to talk about them. This may include one or more of the following:•The safeguarding team, your social worker or others have concerns about your children’s safety•You are attending this service because social services require you to do so•You are at risk of being thrown out of your family home due to your drinking, drug use or other reasons•You have rejected or been rejected by your family and have no contact•Or, you are experiencing domestic abuse or another harmful family situation, or you are still affected by a

previous harmful family situation•You do not discuss family issues or accept help in this area

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ck10 Family and relationships (detail)


Additional resources for using the Drug and Alcohol StarTM

In addition to this User Guide, there is a range of resources available to help organisations use the Drug and Alcohol Star effectively.

Drug and Alcohol StarTM Chart and Action Plan

The Star Chart and Action Plan is a four-page document that includes the Star Chart on which scores are marked, a summary of the Journey of Change for quick reference, space for notes, and a simple action plan your organisation may also choose to use. It is completed by workers and service users when using the Drug and Alcohol Star as a paper-based system.

The Drug and Alcohol StarTM online

The Drug and Alcohol Star, along with many other versions of the Star, is available online via an intuitive web application called the Star Online. This application has a feature that allows users to complete the Star Chart with service users on screen, incorporating the scales from the Drug and Alcohol Star User Guide and guidance for workers and service users. The Star Online can be used in conjunction with a paper-based system, if pre-ferred. Workers and service users can complete the Star on paper and then input the scores on the Star Online at a later date.

The Star Online is secure and provides a wide range of features that enable organisations to analyse and report on the outcomes data that staff have added to the system, and to benchmark their outcomes against averages for similar services and client groups. It is available to organisations using the Drug and Alcohol Star for an an-nual licence fee, based on the number of workers and managers using the Star.

For more information, or to sign up to the Star Online, go to www.staronline.org.uk.

The Organisation Guide

The Organisation Guide is intended to support the implementation and use of the Drug and Alcohol Star. Part one is for service managers and provides guidance and good practice examples in implementing the Drug and Alcohol Star across a service or organisation. Part two presents guidance for support workers in using the Drug and Alcohol Star with service users.

Outcomes StarTM website

The Outcomes Star website – www.outcomesstar.org.uk – contains all versions of the Stars along with sup-porting information.

Training

It is essential that workers receive training before using the Drug and Alcohol Star. For further details, see the Outcomes Star website – www.outcomesstar.org.uk/outcomes-star-training – or email [email protected].

The Drug and Alcohol StarTM is a version of the Outcomes StarTM, a family of tools developed by Triangle Consulting for supporting and measuring change when working with people.

A tried and tested tool for supporting and measuring change

www.outcomesstar.org.uk

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drug use

alcohol usefamily &relationships

communityaccommodation

money meaningful useof time

offending physical health

emotionalhealth

Support service users to make changesScore in a consistent wayTake a holistic approach to keyworkLearn from successesProvide data for analysis and reports

•••••

Email [email protected]

or visit

www.outcomesstar.org.uk

Training is vitalOur trainers can support your team to:

www.staronline.org.uk

Online

Intuitive and easy to use

Service user-friendly, online Star completion

Live reports give immediate data and analysis

Individual and service change shown on a Star

•

•

•

•

Try the demo at www.staronline.org.uk

The web application forOutcomes Star users

Documents

TM · 2015-12-07 · especially Aquarius, East Midlands Drug and Alcohol Team (DAAT) and alcohol services in the East Midlands s The London Housing Foundation and St Mungo’s for