I spent an interesting day with Addaction yesterday in the Tower of London.
Rather than looking for ravens or Beefeaters with the tourists, we were listening to the findings from their latest project, Young Addaction Plus, which they’ve written up in a report, Closing the Gaps.
Following their involvement in the Young Addaction Plus (YAP) project, 91% of the young people made positive changes to their lives, 96% tried to keep out of crime, and 82% either reduced or stabilised their substance misuse.
The findings were particularly striking given the severity of the problems the young people suffered when they first entered the project. The ages of the young people ranged between 10 and 19; they had complex drug and alcohol problems and their needs could not be met within mainstream services.
Listening to the parent and young people who had been through the process it was clear they felt they owed a great deal to the staff that worked with them, but it had not been an easy process.
The young people spoke about relapses, with one young person saying that her drug use was “always there, always going round and round.” However they also said that when they had relapsed they had changed their patterns of use to make sure they were doing less harm to themselves. They also spoke very movingly about being able to rely on the workers from Addaction to be there for them, often seeing them 3 or 4 times a week for hours on end.
One of the young people told us about the difference that sort of interaction had made by admitting that when he’d been to traditional treatment sessions he’d told the workers what he’d thought they wanted to hear with little intention of doing what he’d agreed. With Addaction the worker had accompanied him to the various actitivities they’d agreed to, whether that was to college to choose courses for him to do, or to the gym where Addaction were able to pay for his membership. He said this positive pressure from his worker had shown him that the activities were worthwhile in themselves, and now he didn’t need the worker to motivate him to do these things he could do that himself.
The parent who spoke told us about how difficult she had found the behaviour of her drug taking son, but how she’d tried to keep his behaviour from her husband and the toll that had taken on their marriage. She said that traditional services had been unco-ordinated, and that schools in particular hadn’t been as involved their son’s well-being as they’d have wanted.
She described fleeing from a city to living in a rural town in order to change the circumstances of her family life, but found that this wasn’t the magical solution to the problems.
Addaction had given her strategies to cope, to be able to see that her husband was an integral part of the family and needed to be included in the process of changing their son’s life, and a safe and reliable place to share their problems. She told us that she suffered epileptic fits 3 or 4 times a week which made traditional services (where the client travels to the worker) unaccessible as she couldn’t drive. Addaction’s model meant that the family worker was able to visit their home.
As you’ll see if you read the report Addaction were piloting a way of working which reached 386 young people over 5 geographical areas over the 3 years of the project.
They said the approach was to provide the young people and the wider family with separate workers, which allowed for a level of confidentiality which they said was critical to keep the young people engaged. Each worker would have a case load of 5 to 10 cases, which enabled flexibility and an ability to focus on individuals in a way that isn’t open to traditional services.
The project recognised that young people may need several attempts a treatment before reaching a successful conclusion.
The workers who spoke all told us that being able to access a small diversionary fund had been critical. They told us that this had been used for things like gym membership, equipment for colleges, family day’s out, emergency food or clothes packages, and on at least one occasion a replacement birth certificate.
The latter had allowed the young person to be able to get stable accommodation, which they said was crucial to being able to work on their drug problems.
The workers also said they focused on practical issues – getting young people back into education, into accommodation, benefits etc. – rather than providing counseling services, for which they used colleagues from mainstream services.
The outcomes that Addaction reported seem to me to be immensely heartening, but as I’m sure readers will be aware very resource intensive. So it was very interesting to hear that in 4 of the 5 pilot areas the commissioners had been able to mainstream the project.
The point that I made to various people over the course of the day was that if we are thinking about reducing risks then it would make sense to ensure that prevention work is being done with other siblings in the family. Of course, some will be by default – the parenting skills that are being picked up for example – but perhaps something specific which looks at what can be done to protect other children in the family would be useful.
Filed under: treatment