Mr. Mick Williams:

I have never seen a referral about a person who has a substance use disorder even though the person is being referred to a substance use recovery service. That is strange. We will see referrals for people diagnosed as bipolar or as having personality disorders. When we start treating them, though, the bipolar or personality disorders are no longer visible or there. I do not know what happens to them - maybe they disappear when the substances are taken away - but they are no longer there. That is what we find. I am not sure whether it is due to wrong diagnoses.

Clinical trials and programmes have been mentioned. Sankalpa runs psychosocial models similar to those run by other substance use services and mental health organisations. Clinical trials with addiction models - for example, cognitive behavioural therapies, CBTs - are the most researched models among professions like psychotherapy and counselling. Empirical research has been done on people who have been treated using these models, so they are backed up strongly. I know I am not pointing to a specific trial, but that is because this is not about specifics. Rather, it is about having an evidence-based model as well as the competence and capability to deliver it. That is why we use evidence-based models. There are various models, such as CBTs, motivational interviews and a community reinforcement approach.

We can talk about all of these approaches but, as Ms McGillivary says, it is how we deliver and how we treat the person who comes through the door. It is compassionate care that is trauma informed. It is about using all our smarts and creating the right conditions for people whose trust has been eroded for whatever reason, whether it be abuse, trauma or institutional. When it comes through our service we recognise it. It is about creating conditions in which people can trust us to speak about the issues and tell us they have done certain things.

People speak about unconditional positive regard. I have worked with various professions and people always ask me why I have been working in addiction for 22 years. Why not? People ask how I can have unconditional positive regard for people who are addicts. I do not get that. I do not understand the question. What do they mean "how"? I just do it because I have been trained and that is who I am. I know what they are trying to say. Some of the people we work with are perpetrators of certain things. They have done certain things in their lives such as criminal activities. They may have sold substances. Unconditional positive regard is easy when dealing with victims. Dealing with perpetrators of certain things is the essence of unconditional positive regard. This is what we have in essence. As a manager I try to pass this down to our staff and service users. It comes back to what I said originally, which is that recovery is contagious. It starts at the top down. That is how we do it. It is unconditional positive regard, whether people are victims, which is not a word I like but I use it in this context so that committee members understand what I am saying, or perpetrators. This is unconditional positive regard. This is what we have in abundance in addiction services. This is our expertise.