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Effective Interventions Unit - Working with young people: A profile of projects funded by the Partnership Drugs Initiative

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Working with young people: A profile of projects funded by the Partnership Drugs Initiative

Chapter 3: The Philosophy and Focus of the Projects

This chapter describes the ethos adopted by the projects in the PDI and explores the nature and implications of the ways in which they defined the scope of their work.

Project philosophy

As was apparent in the previous chapter, the projects funded under the PDI varied considerably in their aims, target populations, approaches and methods of intervention. However, while the nature of the interventions and their target populations were highly variable across the 17 projects, there was a high degree of consistency in their underlying philosophy. The great majority of the projects described their orientation as being holistic and client centred.

An holistic approach to clients and their needs was seen as being essential in most projects given the interdependent nature of the range of issues with which clients were confronted. In other words, it was believed that drug related problems could not be treated in isolation and, perforce, the project had to address the broader context of people's lives. The managers of two of the projects expressed the need for an holistic approach in the following way:

"It's no good us banging away about drugs and alcohol if their Dad is kicking the hell out of them, for instance. We need to try and address that first then look at the drug and alcohol stuff. Cos it has to encompass all these things. It has to be holistic. If it isn't, we are wasting our time. You can't just jump in and do drug or alcohol education and pull out and leave them to it, cos nothing has changed for them".

"You have to be prepared to get into areas of a young person's life, and be helpful in them, that really are nothing to do with substance issues. They're lifestyle issues. But it's all part and parcel of the problem".

An example of an holistic approach in action is the Time 4 U project for children affected by parental drug misuse. This initiative addresses home and school issues and wider family concerns alongside an attempt to minimise any immediate risk of harm to a child from a parent's substance misuse. A holistic approach was built into the practice of most of the projects which were also assisted in this endeavour by being part of a wider service or project from which appropriate specialist inputs might be sought and to which referrals might be made.

The other major element of the ethos of the 17 projects was their client-centred orientation. The essential element of this was an emphasis upon the empowerment of the client. A judgemental approach which was critical of clients or one which sought to tell them what to do were both regarded as being potentially counter-productive. All of the projects emphasised the importance of working alongside clients, of giving them a voice and of enabling them to participate in decisions about how the intervention should proceed. The emphasis was on clients defining their own needs and taking personal responsibility, but within a culture of support:

"We're pretty person-centred. We'll listen to what it is they feel they need to change, and then, if that's totally unrealistic, you're going to have to go through a process with some of them and try and get to the point where they are being more realistic about what they want to change".

"Probably the first kind of thing I'll say is that our job is to create opportunity; it's as basic as that. Create as much opportunity for the client. The client is the expert in his or her life and I'm no' an expert in his or her life. I have expertise in the area of drugs and I'm able to guide and support them and advocate. So the opportunities, whether they take that or nor is a matter for them. But trying to create that, and build relationships. So that's basically the ethos".

Some of the projects expressed a desire to extend client participation beyond the individual's involvement in their own personal programme of intervention to include their participation in the design, development and, in some instances, the running of the project. In these projects the active involvement of clients in the service was experienced by those involved as being central to their achievements. More specifically, working in partnership with clients was seen as a way of getting the services right for them. Some projects were trying to achieve this through the establishment of an Advisory Forum which included volunteers from among their client group:

"That's why we've tried to put together the young person's advisory forum - that's our aim for that, to get young people involved. We recognise in terms of social inclusion young people have huge disadvantages and just don't get involved in community life in any shape or form, so it's about trying to break down these barriers. Our aim for that is really, get young people involved, and for us to consult with them. You know, basically at the end of the day, it will help us to provide better services for young people".

In one advisory group the young people participated in the recruitment of staff and volunteers. This role was much appreciated by the young persons involved as the following comment from a young advisory group member illustrates:

"And it lets us see wha we think's gonna be good for working with us and wha's no really gonna be interested and wha's just like no really cut out to do it".

The workers who were interviewed for this study perceived the client-centred, holistic ethos of their projects as being essential to their success. They believed that these principles provided the only sensible and realistic basis for intervention with their particular client groups. They further claimed that the approach was popular with young people and encouraged their engagement with the project.

Project focus

A recurrent theme in the interviews was the importance which project workers and managers attributed to the need for models of care and support which were realistic, which clearly defined the aims and scope of the project and to which everyone subscribed. Clarity of purpose was regarded as being essential to ensure that a project's mission was pursued adequately and appropriately. Project staff had to have a clear idea of what they were supposed to do and why. Several of the project workers referred to the necessity of having a period of induction at the beginning of a project which allowed sufficient time for them to become familiar with their project's aims and methods and to become acquainted with their host agency and its staff. In some cases, project workers claimed that insufficient attention had been paid to this process.

In a small number of projects a lack of clarity in their focus, or deviations from the project's original conception, appeared to have created substantial difficulties for staff. For example, a lack of clarity and specificity in a project's focus could give rise to difficulties in defining and prioritising the work of the initiative. One worker contrasted her experience in a project with the greater clarity of working in an area social work team:

"There are times where I'm just not quite sure, and again, that is because the role has been a lot broader, it's far broader than anything I've done previously and I personally, at times, kind of, don't lose my way, but it's like in an area team your priorities are clear. You know what's at the bottom of the pile and what's to go to the top and its very easy to define why that is, why your case load is structured in that way".

However, a much more common problem than vague or changing models of support was the breadth of focus adopted by some projects and an attendant lack of clear boundaries. Some projects appeared to have been defined very broadly. For example, one young person's worker who considered her role to be inappropriately broad was, in addition to offering one-to-one support to young people who were struggling with chronic and often harrowing life circumstances, also offering family support and responding to increasing requests for drugs education from schools and various other bodies. Other projects worked with a very broad age group - in one case 12-20 year olds - or had fairly loosely defined criteria for acceptance onto their programmes. One consequence of this was to present serious challenges to workers in terms of the range and diversity of the issues with which they were expected to deal and in terms of their need to balance the various demands on their time. Sometimes the breadth of a project's focus and a lack of clear boundaries presented difficulties at the point of referral:

"The key thing about this project is that it works with the young people that are at risk of as opposed to currently having an issue with misuse. Now this got - it's really easy for someone to twist if they so choose, to make it seem like somebody's at risk. So we have to filter that out a wee bit. And initially we were probably more relaxed in taking those referrals on. So we're slowly pulling it in tighter and tighter and in the last wee while we've refused a number of referrals whereas initially we didn't really refuse any".

Part of the pull towards breadth and diversity stemmed from the holistic approach adopted by most of the projects. For example, in one of the projects designed for children affected by drug use in the family, much of the worker's role involved developing the children's self-esteem and resilience. However, the task of minimising the risks to the children within the family also dictated that the intervention go beyond the child and focus on the family as a whole. This, in turn, involved working with parents by making them aware of their responsibilities, providing 'practical home support', facilitating access to services and developing links and joint practice with other organisations. While not directly addressing their drug use, any associated behaviour of the parents that put children at risk might be challenged. Parents would also be supported in accessing statutory services such as health or social work on their own and on their children's behalf.

The level of diversity within projects could involve staff in a difficult balancing act in which they attempted to ensure that a project's focus was not lost, that its priorities were maintained and that the various demands on its resources were met. This could be difficult to achieve and, as a result, project workers and managers often struggled on with highly pressurised caseloads and a sense of being engulfed by the work.

The projects' perceived need to be flexible in dealing with the range of issues presented by their clients also served to increase the breadth and complexity of workers' roles. The need to be flexible was a product both of the holistic approach adopted by nearly all of the projects and the diversity of clients' needs and experiences. In short, a project had to be capable of accommodating and adapting to the variety of needs and circumstances of its clients.

The co-ordinator of one of the outreach projects provided a good illustration of flexibility in action in describing the way in which they deal with young people at risk of establishing problematic drug use:

"If the needs of that young person are around raising awareness in order to reduce harm then that's what we'll do. If the needs of that young person is stabilising certain situations or certain substances in order to address other situations then that's what we'll do. If they're using 4 or 5 substances and one of those substances is creating a chaotic response, is leading them into offending, self harm, and such, then we'll deal with that one first. We'll focus in there and work with that to try and stabilise the situation. In order to start to then address the other things, other issues. So it's a pragmatic approach. That's it, you know, it's on the ground, it's pragmatic in that it's what's best for the young person".

A good example of flexibility in response to clients' needs is provided by the Reiver project in the Borders. In order to deal with the problems of geographic spread and of the variety of needs among its target group of 12-16 year olds, this programme is highly flexible both in the extent of its activities and the content of its interventions. Intervention can encompass youth work methods (e.g. talking about issues over a game of pool), addressing risks through education, acting as an intermediary with schools or parents, onward referral or one-to-one counselling. The number of times a young person is seen varies between one and twelve. These contacts can take place on a weekly, fortnightly or monthly basis and the time-scale is tailored to individual needs. Appointments can take place at the young person's home if appropriate. Otherwise, clients are seen in schools, health centres, youth centres or other locations. Where possible and appropriate, parents are involved in the process of intervention.

The irony is that this flexibility could, in turn, also increase the range and diversity of a project's work and impose an even greater burden on workers and managers. Nevertheless, according to the staff who were interviewed, it was vital to the success of a project that it remain flexible and sensitive to the individual needs of its users.