Kosmicare Project - Crisis Intervention Related to the Use of Psychoactive Substances in recreational environments - Boom Festival

Contact name: 
Maria Carmo Carvalho
Position: 
Project Manager
Organization: 
Partnership between: Good Mood productions/BOOM Festival producer; Catolic University of Portugal - Porto; SICAD - General-Directorate for Intervention on Addictive Behaviors and Dependencies, Portugal
Telephone: 
00351 93 341 78 67
Address: 
Centre for Studies in Human Development, Faculty of Education and Psychology, Catholic University of Portugal - Porto, Rua Arquiteto Lobao Vital, Apartado 2511, 4202-401 Porto, Portugal
Summary

Kosmicare project implements crisis intervention in situations related to the use of psychoactive substances at Boom Festival (Portugal). We present evaluation research that aims to contribute to the transformation of the project into an evidence-based intervention model. It relies on harm reduction and risk minimization principles, crisis intervention models, and Grof's psychedelic psychotherapy approach for crisis intervention in situations related to unsupervised use of psychedelics. Intervention was expected to produce knowledge about the relation between substance use and mental health impact in reducing potential risk related to the use of psychoactive substances and mental illness, as well as an impact upon target population's views of themselves, their relationship to substance use, and to life events in general. Research includes data on process and outcome indicators through a mixed methods approach, collected next to a sample of n=176 participants. Sample size varied considerably, however, among different research measures. 52% of Kosmicare visitors reported LSD use. Over 40% also presented multiple drug use. Pre-post mental state evaluation showed statistically significant difference (p<.05) confirming crisis resolution. Crisis episodes that presented no resolution were more often related with mental health outburst episodes, with psychoactive substance use or not. Visitors showed high satisfaction with intervention (n=58) and according to follow-up (n=18) this perception was stable over time. Crisis intervention was experienced as very significant. We discuss limitations and implications of evaluating natural setting based interventions, and the relation between psychoactive substance use and psychopathology. Other data on visitor's profile and vulnerability to crisis showed inconclusive.

Intervention details

Type of intervention
Selective prevention, Indicated prevention, Harm reduction, Crisis intervention
Target population

Psychoactive Substance users - All Ages, including poly-substance users and NPS users.

Strategic target group (social agents acting as intermediaries between intervention and target group)

Recreational environments security staff; professionals of health, social and emergency services; Police officers; Peers

Intervention activities
Providing information
First aid
Actions
Staff training, guidelines for cooperation with medical and security staff, crisis intervention strategies in situations of unsupervised use of psychedelics, nursing, hydration, safe place to rest and chill, sitting, process and outcome evaluation, psychiatric assessment, homeopathy, etc.
Theory/evidence behind the intervention

The project relies on intervention principles drawn from Harm Reduction practice, crisis intervention models (Roberts, 1990) and Stanislav Grof's Psychedelic Psychotherapy approach, particularly his conceptualization of crisis intervention in situations related to unsupervised use of psychedelics (Grof, 2008). KC evaluation research has been designed and implemented aiming to contribute to the transformation of the project into an evidence-based intervention model. Intervention was expected to produce knowledge about the relation between substance use and mental health impact in reducing potential risk related to the use of psychoactive substances and mental illness, as well as an impact upon target population's views of themselves, their relationship to substance use, and to life events in general. Research includes data on process and outcome indicators through a mixed methods approach. A pretest posttest design, with a twelve-month to two-year follow-up, without a control group, was used in this study, was inspired by program evaluation methodology, including procedures for evaluating process and outcome indicators, gathered through the collection of quantitative or qualitative indicators through an assessment protocol consisting of several form measures, implemented in a naturalistic unconventional intervention and research setting - a recreational environment - in 2010 and 2012. A mixed methods approach that enabled the collection or analysis of both quantitative and qualitative data was used next to sample of n=176 participants gathered among a total group of N=324 Visitors in both years, for follow-up purposes. Quantitative data where analyzed with PASW 18 software. QSR NVIVO 9 software was used for qualitative data analysis.

Number of people needed
International Multilingual Team of approximately 70 people.
Specific training required?
A number of criteria are considered. Since 5 teams operate 24/24h during all festival days, all teams must integrate: reasonable number of different languages spoken, men and women, highly experienced vs novice sitters, credited psychologists and psychoth
Time required to run
24/24 hours during 8/9 days.
Other resource requirements

Nursing equipment and instruments; prescription pharmaceuticals; specially designed safe space to accommodate up to 35/40 people at a time.

Evaluation details

Activities evaluated

Staff training, crisis intervention strategies, team satisfaction, visitor satisfaction, visitor follow-up

Type of evaluator (e.g. external consultant, internal evaluator)
Internal evaluator
Evaluation references

Consult avaiable in this paper: CARVALHO, M. Carmo... [et al.] - Crisis intervention related to the use of psychoactive substances in recreational settings - Evaluating the Kosmicare Project at Boom Festival. Current Drug Abuse Reviews. ISSN 1874-4745. Vol. 7 (2) (2014), p. 81-200

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