Cross-sector collaboration case studies

A clear rationale for collaborative work needs to include how it will benefit clients, workers and organisations as well as identifying what challenges are likely to arise.

• Research shows as many as 33 per cent of prisoners may experience problems with gambling. To address such high rates of problem gambling, this initiative involved placinga Gambler's Help practitioner from EACH in the Ringwood Magistrates' Court to promote and create a client pathway to gambling and financial counselling services.
• A detailed plan outlining the benefits for both parties was presented to the Chief Magistrate. This included interventions to prevent repeated court appearances by problem gamblers attending the court and to work alongside other practitioners to address the multiple issues that can affect a client's involvement with the justice system.
• The partnership made clear how all parties stood to benefit from the collaboration rather than being seen as an impost or complication in an already busy and demanding environment.
• The Gambler's Help practitioner was able to engage and network with court staff to establish collaborative relationships, a consistency in the professional services provided, initiate referrals and brief interventions, and provide consultation and feedback to other practitioners.
• A log was kept to record interactions with court staff which provided a means to account for the practitioner's time at the court, build on the knowledge and information being accrued, track the levels of contact with other practitioners, and how relationships translated into secondary consultations, co-working arrangements and referrals.
• Prior to the commencement of this strategy, there were no regular referrals from the court. In the first seven months of operation, there were 12 single session counselling appointments, 30 secondary consults, and 8 referrals for ongoing problem gambling and financial counselling, co-work and case planning discussions.
• The success of this initiative suggests the broader needs of the client in relation to problem gambling issues are now being considered.

More information

• Eastern Allied Community Health (EACH)

A collaborative model of care includes both inter-agency and intra-agency approaches to working together.

• Beth, 45, made contact with Banyule Community Health Service (BCH) to help her deal with issues associated with her gambling behaviour including binge drinking, depression and anxiety. During her assessment, Beth disclosed a history of severe childhood neglect and emotional abuse, and explained that both of her parents were problem gamblers.
• She felt she had learnt from her parents to use gambling as a coping mechanism to escape her feelings of grief and loss, abandonment and sense of worthlessness. Over her 20 year history of gambling, she had found that electronic gaming machines (EGMs) could provide her with feelings of excitement as well as deflecting negative feeling states.
• Through the recommendation and support of her Gambler's Help counsellor, Beth was referred to Neami mental health service for assessment and on-going case management services. Her Gambler's Help counsellor accompanied her to the appointment and collaborated with the Neami practitioner to extend Beth's support options to maintain positive behaviour post-counselling with Gambler's Help. A supported referral was also made to the Psychiatric Registrar (Austin Health) who specialised in dual diagnosis and was located at BCH one day per week.
• Beth was provided with education on the connection between depression, anxiety, binge drinking and gambling together with information on the contra-indication of drinking alcohol (depressant) and taking anti-depressants.
• Relapse prevention and harm minimisation strategies for her drinking and gambling patterns were also offered. The problem gambling counsellor also worked with Beth to regulate her emotions and to recognise her catastrophic thinking and negative belief systems.
• After six weeks, Beth had stopped gambling and was successfully managing her impulses to gamble through utilising the self-management techniques she had developed.
• In Beth's care plan, it was identified that a primary motivation for her to stop gambling was so that she could save money and be able to afford to move out of the bungalow in her parent's backyard. However, she also had a fear of living on her own without a partner, which she addressed by gambling. Once these ambivalent feelings were explored, Beth's motivation to change increased and she began to look at alternative housing options and employment.
• After a lapse surrounding Beth's gambling behaviour, the Neami caseworker negotiated with Beth to attend an appointment with the Gambler's Help counsellor as a relapse prevention strategy. Further support was also facilitated through Beth's attendance at the eight week Getting Even Group and the Peer Connection Program which provided weekly telephone contact and peer support.
• The Gambler's Help counsellor facilitated a total of five referrals including North East Housing, Neami, the Austin Health Psychiatric Registrar, the Peer Connection Program and the eight week Getting Even Group. The coordination of these referrals and the collaborative work across services enabled Beth to address a range of inter-related issues associated with her gambling.

More information

• Banyule Community Health Service
• Neami

Flexible service delivery to meet the needs of different population groups with acceptance and respect for cultural diversity

Acceptance and respect for cultural diversity is demonstrated through flexible service delivery that is reviewed and adjusted to meet the needs of different population groups.

• In 2010, a new partnership was formed between the Centre for Culture Ethnicity and Health, Gambler's Help Western at IPC Health, Health West Partnership and New Hope Foundation to the risk of gambling-related harm in the Karen community, Wyndham municipality.
• With funding from the Victorian Responsible Gambling Foundation, the three year project provided a community specific response to raise awareness about problem gambling to more than 1,000 community members.
• To identify and address issues such as stigma and to build rapport and trust with the Karen community, a number of meetings took place before substantive project planning began. A service mapping exercise was also undertaken to identify the relevant agencies and key organisations who had direct relationships with the Karen community.
• A community advisory group was established, and a skilled bilingual worker was employed to support the project and help facilitate the group. A skills assessment of the advisory group members was conducted to identify the levels of support needed for them to participate fully. Some advisory group members did not have an understanding of what was expected of them so the lead agency developed plain language documents and the role of the advisory group was clarified regularly.
• As the awareness and capacity of the community grew, so too did the project. The first year focused on community education and raising awareness. The second year of the project focused on developing and disseminating a Karen problem gambling DVD, and reaching disengaged men.

More information

• Centre for Culture Ethnicity and Health
• IPC Health
• Health West Partnership
• Working with the Karen Community: A Resource for Service Providers

Regular communication, project team-building events, project team meetings as well as whole cross-sector team visits promote relationships between individuals and services.

• With a service area spanning a 500km in Gippsland and low referral rates from the Gambler's Help phone line, Latrobe Community Health Service Gambler's Help decided to explore referral pathways to see how they could improve the number of clients.
  
• By tracking the pathway of clients to the Gambler's Help services in the region, it was found that clients could speak to as many as five separate people before accessing a Gambler's Help counsellor. This most likely meant that clients may `fall though the cracks' and not receive the service they needed in a timely way.
  
• The intake and counselling team manager was contacted by Service Access at Turning Point to discuss how the services could work together to improve referral pathways for clients. Given they were using two different databases, working together would enable a better understanding of each service's processes and help determine funding requirements.
• Practitioners from Latrobe Community Health travelled to meet with Turning Point staff and took time to review the information on the database used for referring clients.
• In order to improve his knowledge of the region, the Turning Point manager also visited Latrobe Community Health Service and gained a better sense of the geography and location of the available Gambler's Help services.
• Together, they identified that a more accurate method of gauging service delivery points and client location could be achieved by sharing information through online communications. Email pathways were established and information sharing information was streamlined.
• By visiting each other's services, staff developed a greater understanding of culture, processes and the types of services that could be provided. To further build relationships and build confidence in the referral process, staff profiles were shared across the services so that the interests, skills and expertise.
• As a result, information sharing across services improved and structures were instituted to review service information quarterly which translated into a more efficient and responsive intake system.
• The two agencies also identified the need for a faster turnaround in providing referrals and care to clients in the region. This involved providing an immediate telephone response from a Gamblers Help counsellor, and offering a `walk-in' service. The Gambling Information and Support Team was introduced to respond to all Gamblers Help referrals and queries, from basic information through to single session work.

More information

• Latrobe Community Health Service
• Service Access
• Turning Point

Both formal and informal contacts promoted through co-location can generate mutual understanding, sharing of information and a sense of trust on an inter-personal and cross-sectoral level.

• The Neighbourhood Justice Centre in Collingwood is the only community justice centre in Victoria where a court, support services and a community facility are all co-located.
• A number of people attending the centre have come into contact with the justice system due to gambling related issues. Although many of these clients are compelled to participate in formal counselling, they don't necessarily perceive the need to receive help with their gambling behaviour.
• Gambler's Help City at Melbourne Counselling Service therefore sought to work with staff at the Neighbourhood Justice Centre to engage clients with court orders in problem gambling treatment, and to provide support for people with gambling issues prior to their hearing.
• Despite counsellors spending considerable time following-up clients, there was a high rate of 'no-shows' at individual counselling appointments. This led to a complex relationship with Corrective Services staff who were primarily concerned with a client's compliance to their court orders, while Gambler's Help counsellors were more attentive to the therapeutic process and client privacy. The clash between legal and therapeutic cultures made it difficult for either service to achieve good client outcomes.
• To overcome these issues, the Problem Gambling Counselling Group was established to provide psycho-education for mandated clients who were not ready or willing to take part in counselling, while also meeting the needs Community Corrections Services and the courts.
• The two-hour group sessions run for six consecutive weeks. Intake into the group begins with a referral from Community Corrections staff. Clients are then contacted by the group facilitators to discuss expectations and to assess their suitability for the program.
• In the group sessions, participants are encouraged to explore their own gambling behaviour through a series of educative activities, including sessions on identifying triggers and de-bunking gambling myths. At the end of the six-week period, participants receive a certificate of participation that can be used to satisfy their court orders. All participants are also able to access individual counselling throughout the group program or after its completion.
• Although new programs can take time to gain momentum, the outcomes of this group have been encouraging from the outset. In a notable contrast to the poor attendance at individual sessions, all clients who attended have completed the program. Participation within the group sessions has been strong with initially ambivalent attendees becoming active group members over time.
• After witnessing the effectiveness of the group, Community Corrections liaised with Gambler's Help practitioners to expand the group to include other clients with gambling issues as well as those mandated to attend. The group is now also able to cater for people who wish to revoke their self-exclusion from Crown Casino.
• The benefits of locating the group program at the centre, has resulted in increasing the profile of Gambler's Help, raising awareness about problem gambling, and the strengthening the relationship between Gambler's Help practitioners and other co-located services.

More information

• Neighbourhood Justice Centre