Julian Cohen on ‘All About Drugs and Young People.’ (Part 2)

In the first part of this interview, All About Drugs and Young People (Part 1), JKP author, educator and counsellor Julian Cohen shared some of the insight and experience he has gained whilst working to educate young people about drugs over the past 30 years. In this second and final part, he talks about legal highs, how the internet has affected young people and drug use and offers more advice on what parents and professionals can do to support young people who are or may be using drugs. 

Cohen_All-About-Drugs_978-1-84905-427-0_colourjpg-web6. In your experience, how significant is the advent of legal highs and the internet? How do you think they have impacted young people’s experiences of drugs and drug use?

Both are very significant. As I explain in some detail in my book there are now hundreds of different legal highs being sold in this country. They can sometimes be sourced from dealers who sell illegal drugs but the main supply is through the many and growing number of headshops in cities and larger towns, from other retail outlets including some garages and even car boots and over the internet. This means young people have much easier access to a wide range of relatively cheap drugs, often without any contact with drug dealers or putting themselves at risk of breaking the law.

Many legal highs will be unfamiliar to young people who use them and some have dangerous effects, especially if taken in large quantities and/or with other drugs. We have started to see more deaths related to legal highs, many it would seem when young people have not been clear about what they have taken, how much it is safe to take or the implications of combining use of legal highs with other drugs.

Buying drugs over the internet has increased significantly, especially, but not only, for legal highs. All it takes is a credit card order and the drugs are delivered in a package to your door by mail or courier very soon, possibly the next day. There is also a growing market for buying illegal drugs over the internet, often using encrypted websites that make it very difficult for the authorities to trace sellers or buyers. The internet is likely to become an increasing feature of drug supply and markets in the future.

Ease of availability of legal highs and of drugs through the internet raises serious questions about our existing drug laws because there are now so many ways to obtain drugs without breaking the law or by reducing the likelihood of being caught. Countries such as Portugal, Uruguay and New Zealand and also some American states are beginning to experiment with new and less draconian drug controls. Hopefully, more informed debate about new ways of controlling drugs, and finding sensible ways of reducing the harm that can follow from using drugs, will develop in the UK.

7. Is addiction or dependency on drugs a common problem for young people? Why do you think some young people develop drug dependency?

The first thing I want to stress is that the majority of young people who use drugs have a good time and do not come to serious harm. Most go on to moderate use or give up altogether as they grow older and take on adult responsibilities. It is only a small minority of young users who become dependent on drugs.

I believe that drug use, in whatever form, is always functional. That is, rather than just thinking that drugs do things to people, people choose to use drugs, as they do, to obtain certain outcomes relating to increasing pleasure and relaxation and/or reducing distress, anxiety and pain.

A lot of people think of addiction or dependency as a lifelong disease or that certain people have ‘addictive personalities’ that mean they will inevitably become dependent and cannot do much about it. Having studied these issues for many years I do not think there is much good evidence to support these views, despite the fact that a lot of people believe them.

In contrast, I see dependent drug use as a symptom of deeper, underlying problems that people face. Dependency is an attempt by users to keep negative feelings about themselves, other people and the world around them at bay and to get through a life they are having difficulty coping with. It is a way of trying to deal with emotional distress and pain that is grounded in people’s past and current life experiences and situations. In the words of the author Bruce Alexander, dependent users experience a ‘poverty of the spirit’ and have become ‘dislocated’ from themselves, their communities and wider society.

8. What are some of the main things parents and professionals can do to support young people when it comes to drugs?

I have called one of the major parts of my book ‘Be Prepared’ and suggest ways both parents and professionals can help and support young people. The first thing I emphasise is the need to inform ourselves and to learn facts, rather than myths. I also stress that both parents and professionals can be proactive in helping to make sure that young people have a good drug education. Ideally we can learn alongside young people and also from them as well. It is also important to be aware of, and to question, our own use of drugs and our feelings and attitudes about drug use.

Most of all we need to develop our ability to listen to, and openly communicate with, young people, rather than lecture them. I also suggest that both parents and organisations that work with young people will benefit by negotiating sensible drug rules and sanctions, rather than imposing them or being overly draconian.

To ‘be prepared’ it also helps if we anticipate situations where young people may be using in ways we find acceptable and/or having difficulties with their drug use. This includes being clear about whom you might want or need to inform and involve, about any legal obligations you may be faced with and, for professionals, clarity about the boundaries of confidentiality. Both parents and professionals will find it useful to know how to make a sensible assessment of what is happening, why a young person may be using as they are and what risks are involved. It is also useful to know some basic drug-related first aid and about where and how to access specialist help for young people and also for yourself.

We need to be realistic about situations when young people are involved with drugs and the changes we can expect of them. Where young people are likely to continue to use drugs, whatever we may hope or say to them, it is crucial to adopt a harm reduction approach whereby we can help to ensure their safety and keep channels of communication open. I cover all these issues and more in my book.

9. How can we help young people who develop serious problems with their drug use?

As I explained before, if young people develop serious problems with their drug use they will be experiencing significant difficulties in their lives. If we are going to help them we need to empathise with them, listen to what they have to say, understand the difficulties they are experiencing in their life, help them to explore their options and help them to make realistic changes. We might also sometimes have to hold up our hands and appreciate ways we may have contributed to the problems they are facing.

Rather than castigating or demonising them we need to support them as best as we can. Ideally we will do so in the ways I have already described above and by helping them to access good, specialist services, when needed. However, we should appreciate that young people cannot be helped by such services unless they are willing to engage with them.

It can be difficult for us to be consistent in our support for young people who have developed serious drug problems. It can be very taxing, especially for parents. I have devoted a specific chapter to this and also written chapters giving advice about what we can do if young people become violent or steal money or possessions to buy drugs or supply drugs and situations where young people may be using drugs but do not see any harm in it and will not stop.

In such situations it will help if we can avoid panicking, are patient and realistic about what we can expect from young people. It is important to be clear about our own boundaries regarding what is and is not acceptable to us and what we are, and are not, prepared to do for young people. All this can be very difficult to do. There are no magic wand solutions. So I want to emphasise that neither parents nor professionals are on their own and that, where necessary, they should seek support for themselves so that they are better able to help young people.

But in a wider sense it is not just down to parents and professionals. If we are to reduce the number of young people who experience serious problems with their drug use we need to make sure that we have appropriate and well-resourced education and support services that engage well with young people. I am concerned that funding for such services has been declining. And we also need to address wider community, societal and political issues so that all young people have opportunities to develop meaningful and fulfilling lives in the future.

10. What did you learn from writing the book?

I learnt more about young people’s drug use and realistic and practical ways of responding to and supporting them. There is always more to learn. The book involved a lot of research using published sources and also talking with people. It was a challenge to organise my ideas and to reflect on, and learn from, my personal and professional experiences. Above all I had to question what I think and believe and why.

The process of writing re-enforced in me that we still too often focus on substances to the detriment of understanding and having empathy for people – young people, parents and professionals – and the reasons and ways we use drugs and also respond to other people’s use. In this sense it is important that we see drug use as more of a symptom, rather than a cause, of the issues we face in our lives.

 

You can read a free extract from Julian’s book, All About Drugs and Young People, in this blog post.

Julian Cohen is a writer, educator, counsellor and consultant who has specialised in drug and sex education work with children, young people, parents, carers and professionals for nearly 30 years. He has written extensively on drugs and young people, ranging from teaching and training packages to educational games, pamphlets and books for young people, parents and professionals. Find out more about Julian including his training courses and consultancy work on his website, here: http://www.juliancohen.org.uk/ 

Julian Cohen on ‘All About Drugs and Young People.’

In the first of a two-part interview, JKP author, educator and counsellor Julian Cohen  shares some of the insight and experience he has gained whilst working to educate young people about drugs over the past 30 years.

Cohen_All-About-Drugs_978-1-84905-427-0_colourjpg-web1. Your book emphasises that nearly all of us use drugs and have a lifetime drug career. Can you explain what this means and why it is something we need to be aware of?
If we define drugs as mood-altering substances we have to include medicines, caffeine and alcohol as well as illegal and other socially taboo drugs. This means that, in today’s world, we nearly all take drugs from a very early age. You might even say that we experience drug use before birth because many substances taken by pregnant mothers cross the placenta and can affect a foetus.

Too often we tend to think of drugs as only being illegal or other socially taboo substances. Yet medicines, caffeine and alcohol can also affect our moods, stimulate or depress our body systems and sometimes cause us problems. Medicines and caffeine play any increasing role in the lives of young children and are present throughout our lives. In fact many young children expect and sometimes demand medicines when they do not feel well or cannot easily get to sleep. Inadvertently we are teaching young children that, if you want to change the way you feel, you buy a drug and take it. You could almost say this is like an apprenticeship for future social drug use. At the other end of the age spectrum many elderly people take a plethora of mood-altering medicines.

We nearly all self-medicate on an array of mood-altering substances throughout our lives. When things are going relatively well for us our drug use tends to be more moderate. But when we experience difficulties our drug use tends to increase in an attempt to keep difficult feelings at bay. The real issue is not whether we take drugs or not, but whether we have a relatively successful, safe and pleasurable, what I call, drug career or a more damaging one.
And when it comes to understanding young people’s drug use, and their motivation for using as they do, it helps if we reflect on our own drug careers and the lessons we can learn from them.  In the introduction to my book I have written about my own drug career, and those of significant people in my life, and how reflecting on that has helped form my own attitudes and views about drug use.

 

2. One of the most commonly asked questions when speaking about drugs is; how easy is it to spot the signs of drug use? How do you know if someone is using drugs?
Following on from my answer to the previous question you can see that we nearly all use drugs and often there are unlikely to be anyway give-away signs that we do. Most people ask this question with regard to young people using illegal and other socially unacceptable drugs. The difficulty here is that unless you are with a young person when they are actually under the influence of drugs you may have no idea that they use drugs at other times. And even if they are behaving strangely or out of character they may be doing so for reasons that may have nothing to do with drug use. For example, they could be ill or have had an emotionally traumatic experience. Some publications list changes in behaviour that may indicate drug use but most of these things could be due to other things. The danger of looking for set signs and symptoms is that we will jump to the wrong conclusion and even start accusing young people in a way that prevents honest and open communication with them.

You might also find what you think is a drug or drug paraphernalia. Whilst this may indicate drug use it can be difficult to know exactly what you have found and whether a substance is actually the drug you suspect. Pills, powders and herbal-type mixtures are often not easily identifiable. They may not be what you first think they are and might be for purposes other than you assume or fear. And similarly what you think may be drug paraphernalia could be things that have other, non-drug uses.

My main point is that looking for signs and symptoms of drug use is no substitute for communicating with young people. And to do this effectively we need to avoid assuming the worst, keep calm and actually listen to them.

 

3. The book also talks about how the dangers of drugs are often exaggerated; what do you mean by this and why you think it is an unhelpful approach?
As I explain in some detail in my book there is a long history of us exaggerating the dangers of illegal and other socially taboo drugs whilst underplaying the risks of alcohol, medicines and other more socially acceptable substances. We also tend to ignore the dangers of non-drug activities that we often encourage young people to participate in, such as outdoor pursuits and extreme sports. Statistically such activities are often far more likely to result in injury or death, than using drugs. In this sense we can be very hypocritical about young people’s use of drugs.

We also tend to take extreme examples of cases where young people have died using drugs and try to present these as norms and as a warning not to use drugs. The problem here is that many young people find out from their own use and by hearing from others, that drug use is not as risky as we make out. In fact it may well be an exciting and fun experience for them. They then distrust adult sources of information about drugs and feel we are lying to them. The result is little open dialogue between us and young people. Drug use can be dangerous but we need to be honest with young people and keep the risks in perspective.

 

4. Similarly, you talk about how a lot of people have inaccurate ideas or information about drugs. What are some of the main or most damaging myths?
There are so many commonly believed myths about the effects and harms of particular drugs, about the people who use drugs and why they use as they do, about how drugs are obtained and how much they cost, about dependence and addiction and about what we can realistically do about drug use. In fact there are so many myths that I will not go through them here. Many of them are listed in my book where I invite readers to think about and discuss particular myths they may think are true and to be aware of the lack of evidence for them.

The difficulty for us all is that many of these myths are commonly used and re-enforced in the media and by politicians and other social commentators. In many cases we seem to be so anxious about drugs that we lose our capacity to think sensibly and rationally and instead latch on to soundbites and mythology. This creates unnecessary fear and is not a good basis on which to have meaningful discussions with young people about drugs or for parents and professionals to make decisions about how to respond to their drug use. And, of course, it is also not a good foundation on which to make decisions about drug laws and wider drug policies in our society.

 

5. You have specialised in educating young people about drugs for many years. In what ways do you think drug use by young people has changed in recent years?
The large scale surveys that are carried out on a regular basis do not give an accurate picture of overall drug use among young people but they do give us some indicators. It is clear that, more recently, fewer young people have been smoking cigarettes and slightly fewer have been drinking alcohol. The figures for those who have tried most illegal and other socially unacceptable drugs have also fallen.

However, new trends and new substances are emerging that give a different picture. Cocaine use is now more common amongst young people than 20 years ago and although ecstasy use has declined the recent trend to more use of powder, rather than just pills, may see numbers using increasing again. Use of ‘newer’ drugs such as GHB, ketamine, mephedrone, nitrous oxide and PMA has emerged and, as I emphasise in my book, there has been a very significant increase in the use of legal highs, substances that mimic the effects of illegal drugs but are not (yet) controlled under drug laws.

So whilst there may have been a decline in the number of young people using certain drugs, many young people are still using and they now have access to, and are selecting from, a broader range of drugs. We also know that young people in the UK tend to drink more alcohol and use other drugs more often and in greater quantities than many of their European counterparts.

There are also questions as to whether or not more of the young people who do use drugs are using in greater quantities and/or becoming dependent. The evidence is not clear but there are concerns that the ongoing recession, high youth unemployment and lack of opportunities for many young people may mean that more of them may become involved with heavy use of drugs.

The other point I wish to highlight is that young people’s drug use has increasingly become part of the general pattern of commercialisation and consumption that is now such a feature of life in the UK. In this sense drug use has become both more individualistic and more mainstream. Some commentators now talk of the normalisation of drug use amongst many young people.

You can read the second part of this interview, in which Julian talks more about legal highs, as well as how parents and professionals can support young people, how we can help if a young person develops a serious problem with their drug use, and what he himself learned whilst writing the book, here.
You can also read a free extract from Julian’s book,
All About Drugs and Young People, in this blog post.

Julian Cohen is a writer, educator, counsellor and consultant who has specialised in drug and sex education work with children, young people, parents, carers and professionals for nearly 30 years. He has written extensively on drugs and young people, ranging from teaching and training packages to educational games, pamphlets and books for young people, parents and professionals. Find out more about Julian including his training courses and consultancy work on his website, here: http://www.juliancohen.org.uk/ 

C’mon everybody – get writing!

Vanessa Rogers is the author of Working with Young Women, Working with Young Men, Let’s Talk Relationships, 101 Things to Do on the Street amongst others. In this article she gives her writing tips for aspiring authors. And, if you’re feeling inspired feel free to send in your proposals to post@jkp.com


They say that there is a book in all of us, and judging from the number of emails and Tweets I get from people in the youth work and social education field inspired to write their own, it would certainly seem to be true. So this is a collective response to those of you who have asked me for ideas of how to start writing, and to share my personal experiences of writing a book. I hope it is useful – but please remember this is only my way, which I made up as I stumbled along the way.

When I start a new resource book it is because the subject holds a compelling fascination for me. For example, Working with Young Women (Jessica Kingsley Publishers ISBN 9781849050951) came out of lots of girls’ groups that I was facilitating at the time. The young women came to the group because they had been identified as at risk of offending and aggressive behaviour, but the more I got to know them the more I thought that a lot of their behaviour was actually a response to the bad relationships they had with their peers, parents and boy/girlfriends. It seemed to me that their anger and aggression was a coping mechanism that until now had worked for them. So, this made me question how young women can build a sense of self, gain confidence and assertiveness, look at the role models they have and their aspirations for life – in a way that is interesting, non-judgemental and fun. After all, through the group work I was basically asking them to change their existing coping behaviour, (which whilst not necessarily socially acceptable to all, gave them the kudos and ‘respect’ they sought), to take a chance of being vulnerable and exploring things that hurt to find a better way with me. But it seemed that this was the foundation for everything else – e.g. if you value yourself and your body you are more likely to respect it and look after it.

So from here, as for every other book I have written, I devised a series of questions that I wanted to answer. These help me keep focused and distill the essence of what I am trying to do.

After that, I spend about 3 months researching the topic. I do this by reading around the subject and trawling the Internet for ethical and correct data and statistics, but also by speaking with other practitioners and as many young people, or in the example above as many young women, as I can, to ask my questions and test out some of my theories. By now I usually have at least one box file filled with clippings and stuff, as well as my trusty notebook (I always have at least one hardback notebook on the go) filled with points to remember and ideas for games, quizzes or activities.

One thing; all of my session plans have to be tried out with young people before I will include them. For me, this part is one of the rules of my work to keep it ethical and grounded – it has to have been tried and tested and I have to know that young people will learn from it and more importantly enjoy doing so.

As I write constantly this means that I often have ideas stashed on my computer that are developed later when the opportunity presents itself. I try my best to include lots of learning styles in the activities and this might mean that I write the same learning outcomes three times, with three different ideas for delivering them. So, as I try them out with young people I use the one that goes best and dump the rest. I also ask young people to give me feedback as the book comes together, which I value as they don’t hold back if they think it won’t work!

Once this is done, I stick my main points on bits of paper around my desk and tell everyone that I am going to be ‘writing’. To my family this means that I am likely to be distracted, a bit bad tempered and the dinners will be rubbish for a while – but the good news is that I will be in the house for days on end and easily tempted to buy take-aways!! To my friends it means that if I do see them I am probably going to bore them witless by obsessing over my blossoming (or not) book. All training and other work is put on hold. And then – I write it.

I tend to write ‘all over’ my books – meaning that I might write part of the intro, then get a bit stuck so move on to one of the later chapters.  It may look chaotic but it isn’t – more like putting a jigsaw together, because by this stage I know exactly what I want to write and how it will look at the end. I tend to really get into this bit so write day and night, with no adherence to office hours – I actually prefer working through the night so it is pretty usual for me to be writing between 2 and 5 a.m.

Once it is done – which usually takes about 7 days end to end – I put it away for at least 3 days before getting it out and editing / doing the final writing.

Then it is off to Jessica Kingsley Publishers …… and I miss it like mad …… get a bit sad, like at the end of any relationship …… do any edits or re-writes asked of me by the editors and proof readers ….. and leave the printers to get on with it. In my head it is over.

I try and build a break in at this point so that I can have fun with friends and family and shake off the topic that has been all consuming for what might have been up to a year. And then, just when I think that I have had enough of writing, something sparks my interest – and the whole cycle begins again.

I hope this helps – but as I say all writers are different and I am sure you will find your own way of working. My only advice would be, write for you and choose a subject you feel passionate about – if you aren’t at the start, you definitely won’t be at the end! My very best wishes and good luck with it – let me know how you get on.

 

Celebrating the launch of ‘Forensic Music Therapy’

Forensic Music TherapyJKP were delighted to attend the launch of Forensic Music Therapy: A Treatment for Men and Women in Secure Hospital Settings on Friday 25th January at the stunning Burgh House in Hampstead, London.

Hosted by the three editors of the book, Stella Compton Dickinson, Helen Odell-Miller and John Adlam, and attended by many of those who had authored individual chapters, the evening brought together not only music therapists, but many professional musicians, psychiatrists, psychotherapists and other mental health professionals. We were treated to an evening of beautiful music by the Henry Lowther Quartet followed by two solo oboe recitals. The editors, and Dr. Gill McGauley, Consultant Psychiatrist at Broadmoor Hospital, spoke about the ground-breaking work that the book sheds light on, and the proven effectiveness of music therapy with those in secure settings, especially in encouraging feelings of empathy. They also spoke about the rarity of being able to obtain informed consent for case studies involving high security offenders, another factor which makes this book unique.

Click below to see a video of Stella Compton Dickinson’s speech at the celebratory evening:

[youtube]http://www.youtube.com/watch?v=XGh8PXIxRkY&feature=youtu.be[/youtube]

 

© 2013 JKP blog. All Rights Reserved.

A case study extract from ‘Forensic Music Therapy’ – Working with Conflict

Stella Compton Dickinson, editor

This is an edited extract from Forensic Music Therapy: A Treatment for Men and Women in Secure Hospital Settings edited by Stella Compton Dickinson, Helen Odell-Miller and John Adlam. This case study comes from Chapter 7, ‘Working with Conflict: A Summary of Developments in the Long-term Treatment of a Man Suffering with Paranoid Schizophrenia Who Committed Manslaughter’, by Stella Compton Dickinson and Manjit Gahir.

Introduction

This chapter describes the process of long-term music therapy over seven years with a man who we shall call “Ewan.” Ewan has given informed consent for case material to be used in telling the story of his rehabilitation; his real name has not been used. Ewan suffered with paranoid schizophrenia and whilst actively psychotic with hallucinations and delusions, he killed a man.

Overview

Committed to hospital for an indefinite period after being convicted of the offence, Ewan spent ten years in high secure detention without undertaking therapy until he requested a referral to music therapy, “to learn to play the violin” as his grandfather had done. He engaged in music therapy as his main psychological treatment. The intervention and its impact were new to the clinical team who had to adjust to the fact that internal changes were starting to happen for a patient who they had known to be static for many years. Thus their own past experiences, their judgments of Ewan in the face of fear when he had erupted with violent outbursts, and their perceptions for his future were all challenged.

Music therapy

Ewan’s fundamentally chaotic presentation was marked by fixed perseveration, which is typical of schizophrenia. Notable in his early musical improvisations were repeated, stuck, desperate, and stabbing sounding attacks on the piano keys. This represented exactly his situation and offence: angry, locked in, stuck, as if he had nowhere to turn. The therapeutic work required orientation to the here and now, rather than unlocking too much past material at once. Nevertheless, Ewan recognized how he could receive rather than reject my non verbal musical support. This elicited a maternal transference. Towards the end of the second assessment session, Ewan rushed from the room, having exclaimed his recognition within our musical improvisation that “you are supporting me! I have not felt like that since I was with my mother.”

The significance of this was central to the therapy as Ewan had been unable to mourn the death of his biological mother. He returned explaining that this experience had “brought a tear to my eye.”

Starting the treatment process

Ewan had never experienced any previous psychological therapy at all, so the same weekly place and time was an entirely new experience for him, which he almost religiously observed. As the therapy progressed, he became more proactive in ensuring that regular physical health appointments were not timetabled to coincide, as nothing had to come between him and his music-making. Over time, as he became more trusting in the continuity of his life and less fearful of sudden abandonment, he gradually extended his range and felt safe to play the piano on his own rather than with me. Ewan began to take responsibility for his own actions rather than remaining over-identified with his own victim self-state.

The mother–child dyad and symbolic musical representations

In session 12, Ewan elucidated on his feelings of stupidity and how he played on these as a childhood strategy. He said he had taken to “acting stupid” whenever he felt threatened by his father. The mother–son relationship was enacted symbolically as a maternal transference developed. The merged relationship that developed between Ewan and his biological mother during childhood was cemented when both mother and son cowered from the violence and physical abuse of the father. This relationship was represented musically in session 2 in which initially Ewan played mournfully on the recorder, copying my choice of instrument, then merging with it and introducing a sensual, rocking rhythmic pulsation which indicated an as yet unconscious underlying erotic transference. The music then became violent and angry as Ewan repeatedly hit a small glockenspiel as if he was a frustrated child waiting for dinner. This had a direct correlation to verbal material in which Ewan described the intimacy and frustrations that he felt with his mother. After this the music became mournful and sad although it finished in a resolved, harmonious fashion.

The index offence: developing victim empathy

In reference to the man who he had killed, Ewan attempted to make an offering in musical terms by sitting at the piano to play a piece which he entitled “Requiem.” At the time this felt sincere but also very sad, as I perceived that Ewan felt very clumsy and inadequate in trying to address such a huge and tragic event. From this state, the first expressions of remorse at the magnitude of his violent act began to emerge. Perhaps the fluctuations between reflecting on his offence and reflecting on his childhood suggested how Ewan was trying to make links in understanding why he had committed his offence.

Conclusion

The individual music therapy was characterized largely by a positive transference. Ewan completed his mourning process in the following two years of group therapy where he discovered how to be part of a “family,” as well as how to feel included and valued by others. He remains in custodial care at a lower level of security. At his care program review as the therapy closed, he described his recovery process in music therapy as “akin to the raising of Lazarus.” This biblical reference to Christ’s greatest miracle probably says at least as much about Ewan’s internal morbid state of loss, including loss of hope prior to engagement in music therapy, as it does about his creativity and ability to express himself and to develop through music therapy in a way which, after ten years of stagnation, he may have felt was miraculous.

Copyright © Jessica Kingsley Publishers 2012

 

In Search of Youth Work by JKP author Vanessa Rogers

An interesting and thought provoking article from JKP author, Vanessa Rogers on what it is to be a youth worker today. Vanessa is the author of a number of titles on working with young people including, Working with Young Women, Working with Young Men, Let’s Talk Relationships, 101 Things to Do on the Street, and new from JKP the Little Books on Alcohol, Drugs and Tobacco Set.


What is Youth Work?

Today I realised that I have been a youth worker for over 15 years, yet I still struggle to explain exactly what that means, especially to someone outside of the profession. It is not a simple answer and I have even been known to say, ‘social worker’ in certain social settings just because it is easier.

The irony is not lost on me; that I am prepared to betray my profession, even though I feel so passionately about it, because I can’t be bothered to explain what I do and that it involves more than playing pool and sorting out squabbles about which track to play next on the iPod in the youth club. Explaining detached youth work is even harder, and has even been met with snorts of laughter at the thought of being paid to wander the streets talking to unknown young people. ‘But what is the point?’ is a constant refrain.

It has not always been so. There was a time not that long ago when it would be hard for me not to weigh in with my views. In fact, many of my ex-students could stand testament to the fact that, ‘what is youth work?’ is one of my favourite assignment titles, and the 500 words produced in response are a constant source of interest and heated debate.

Then it dawned on me that perhaps the sinking heart I get whenever someone asks me what I do for a living is not merely personal apathy, but because I have had the conversation one too many times. The sense of justifying what youth work is, why it matters and the unique place it has in supporting young people – not only amongst friends, family and strangers but also with youth workers and other professionals – has become habitual. I realised that I am a bit tired of the struggle and don’t want to spend time any more time analysing the process at a cost of actually doing it less.

It hasn’t always been so difficult, although I am in no way harping back to some mythical golden age of youth work. I am simply pointing out that if you had asked me 15 years ago what I did my answer would have been pretty easy – an area youth worker for the Youth & Community Service responsible for developing girls work, work with young parents and managing a large and busy youth wing on the site of a school in an area described as ‘deprived’. So far, so clear.

The role of a Youth Worker

Fast forward and my role, but not my professional title, has changed so many times that writing a CV can be a daunting thing. Terminology for the young people, or ‘client group’, has changed from young people ‘at risk’ through ‘vulnerable’ to ‘targeted’; youth services have dropped the ‘ & community’ tag and been variously part of the education, leisure, Connexions and social care departments.

Responsibilities have changed to include meeting parents, undertaking social care assessments, creating community profiles and measuring work by the number of accredited outcomes achieved.
What constitutes ‘youth work’ has changed so many times that it can now be tagged on to virtually any service that works with young people.

But is this a good or bad thing? Is the increase in those using traditional youth work skills to engage with young people something to be celebrated or lamented? All I know is that ‘youth work’ is a notoriously difficult term to describe, and it isn’t getting any easier. The task of trying to find a pithy one-liner to sum up the collective aims of so many different clubs, societies and detached projects is almost impossible.

Perhaps it is that so many people now describe themselves as ‘youth workers’, whilst working in areas more traditionally associated with social workers or youth justice? I have even spoken with police officers that say they do ‘youth work’. Really? Are the professional boundaries so completely enmeshed? Please note this isn’t about professional qualifications, or even the lack of them, more a questioning of how the ethos of voluntary participation and the gradual process of building positive relationships and engaging and empowering young people fits within a law and order or social care framework.

The ethos at the heart of Youth Work

Historically, youth work did not develop just to ‘keep people off the streets’ or to provide aimless amusement, it has always offered social and political education in an informal environment. Good youth work may look as if it just ‘happens’ but the success of it actually depends on good planning, clear aims and measurable outcomes. This ethos should be at the heart of all youth work – especially detached projects. Surely an exciting detached project that motivates young people to get involved should result in more, not less, youths on the street? And that should constitute success?

Put simply, providing young people with a ‘good time’ is not enough. Effective youth work should offer young people the opportunity to meet, socialise, develop new skills, explore the world around them and learn to question and challenge what they see effectively. Detached projects should not be about forcing young people off the streets and away from adult eyes, but more about building trust and developing interesting projects that are relevant to their needs, reflecting the things of importance to them. Which is unlikely to be the same as the media focus on demonizing young people as part of a lawless counter-culture.

As I see it the need to build two-way respect between young people and other members of their community is paramount – after all it is hard to encourage young people to take up their responsibilities and become active citizens if they are treated like social outcasts. Why would you want to be part of something that clearly doesn’t want you?

Perhaps the answer is purely financial. In the struggle to chase funding and secure projects we have been forced to chase the pound, rather than offer what young people truly want. Or maybe as numbers dwindle in traditional old-style youth clubs what’s on offer is simply outdated and no longer meets the needs of teenagers. In that case let’s stop hanging on to the solutions of the past and try new ideas.

Listening to Young People

Young people can be innovative and visionary, with energy and enthusiasm to shape and change the world. To do this they need to find ways to get their voices heard and be able to see that their participation in things like youth councils, forums and consultations actually makes a difference. To be honest, as an adult I am happy to give my opinion on things that matter to me but I get disheartened and then disinterested if nothing ever comes of it and I don’t receive any feedback. Too often I think young people are let down because although they are told that their opinions count, when it comes to money and budgets, they don’t. Participation has to be more than a paper exercise or a way to ‘tick boxes’.

Reclaiming Youth Work

So I think it is time for youth workers to stand up and reclaim youth work by celebrating how different it is to other work with young people. It should be seen as a whole, not as a useful pick’n’mix to compliment other services, and defined in our own terms – whether that is through a Youth Work Academy or some other collective process – before someone else does it for us.

In another 15 years time I don’t want to still be ducking the question, ‘what do you do for a living?’ – I want to be able to say (still with pride), ‘I am a youth worker’, and for that to mean something.

Professional and Therapeutic Boundaries in Forensic Mental Health Practice

By Dr. Anne Aiyegbusi and Gillian Kelly, editors of the new volume in the Forensic Focus Series, Professional and Therapeutic Boundaries in Forensic Mental Health Practice.

Photo: Dr. Anne Aiyegbusi (left) and Gillian Kelly.

The word ‘boundaries’ is used a lot in forensic mental health practice. This is not surprising given that by definition the offender populations who constitute the client groups in forensic services have breached boundaries in serious ways. It is also clear that forensic populations include a large percentage of people who have also had their personal and bodily boundaries breached in traumatic ways during their early development.

When groups of people with these backgrounds are locked up together in secure settings where they feel disempowered, restricted and themselves to be victims of the system, the task professionals have of establishing and maintaining safe boundaries is a challenging one. Although there is little research evidence available, a picture emerges from clinical practice that suggests there are complex gender issues at play with regard to boundary violations in forensic settings. Indeed, if we turn to newspaper reporting in the United Kingdom we will find that there are regular stories of female staff accused of sexual relationships with male patients in secure services.

A complicating factor that emerges in forensic services is that clients have a combination of vulnerability and risk. Clients may be vulnerable to being abused and at risk of abusing. Sometimes it is not easy to separate vulnerability from risk, especially when clients are high profile or severe offenders. Working with this combination and maintaining balance is a particularly delicate task.

This book provides detailed accounts of therapeutic practice in all forensic settings, explaining exactly how clinicians from a range of different disciplines work with complex boundary phenomena in the context of nursing, psychotherapy, arts therapies, family therapy and psychology. Importantly, the perspectives of victims and perpetrators of professional boundary violations in psychological therapies are included in this book which provides an insight into the impact of professional corruption on clients who enter into therapy to recover but end up being used by their therapists. The perspective of perpetrators is included by reference to a service in the USA specifically for boundary violating professionals.

This book is important because establishing and maintaining professional and therapeutic boundaries in forensic mental health practice is crucial and yet shockingly there is little available literature to support clinicians in the complex task they have. In particular, there is a complete absence of guidance which elucidates the reality of day to day clinical work with its difficult balancing acts, slippery concepts, confrontation with offence paralleling  behaviours and being tested, pushed and pulled out of professional role.

This book is a valuable resource for clinicians of all disciplines and grades who practice on the front line of forensic practice because it clarifies that they are not alone in facing the boundary challenges inherent in this work. The key roles played by supervision and reflective practice are emphasised throughout the book. Training in boundaries work is also referred to. These are the tools that enable effective clinical work which is important information for managers and academics organising services and providing education for front line workers in order that they ensure their products are sufficiently robust.

The Therapeutic Milieu Under Fire

By John Adlam, Anne Aiyegbusi, Pam Kleinot, Anna Motz and Christopher Scanlon, editors of the new volume, The Therapeutic Milieu Under Fire.


What therapy can be offered to people with forensic histories and how might it work? What can we learn about the minds of offenders from observing our own reactions to working with them? How do teams working with dangerous and disturbed people survive? How can organisations themselves become perverse and abusive, and how is it possible to prevent this through reflective practice and team development?

In The Therapeutic Milieu Under Fire, we explore these and other essential questions in forensic work in organisations and institutions. We work with highly complex, disturbed, dangerous and endangered people; trying to keep their thinking alive despite conscious and unconscious assaults on the therapeutic relationships and on the milieu itself.

This book is based on a series of seminars organised by practitioners that promoted psycho-social enquiry into the nature of forensic systems of care and the qualities of their relationship to the excluded outsider.

This book also reflects on this particular historical moment and it movingly describes the impact of the lethal attacks that have been carried out against organisations and institutions that were dedicated to providing care for some of our most vulnerable fellow citizens. It argues powerfully that it can be a false economy to ignore the wealth of accumulated practice-based evidence and to offer, by contrast, so-called evidence-based, technical-rational packages of treatment under the guise of improving access to psychological therapies.

This volume is in the form of a series of psycho-social and ‘groupish’ associations to the theme of the therapeutic milieu under fire. The approach is trans-disciplinary and it offers spaces for conversations between service-users, nurses, social therapists, project workers, housing support workers, probation officers, psychiatrists, social workers, group analysts, psychologists, psychotherapists, managers, civil servants, educators, researchers and the general public (among others) about the changing and complex relationship between troubled individuals and their troubling social, organisational and institutional context.

The contributors all work on the ‘frontline’ in one way or another, many working with marginalised and excluded outsiders at the edges of our exclusive society. This book explores the ways in which these outsiders are offended against and how, in turn, they offend against others, within systems designed both to care for and to contain them. What is the task of the professional caring for a mentally disordered offender? How can they offer security without custody, or care without collusion or detachment? When does ‘care’ become a perversion of ‘control’? Why is thought replaced with action and why might it be so hard for the milieu to replace action with thought? These are some of the central questions that were debated in our one-day seminars, and whose dynamics are explored in this text.

In presenting this range of papers, and the multiple complexities that these authors explore, we hope to enable the reader to come to a better understanding of the ways in which the therapeutic milieu comes under fire from without and within, so that we can think together about how to remain thoughtful and committed to the task while anticipating and responding to these inevitable attacks.

Thinking under fire is essential in this work, and so too is reconstructing our internal and external milieu. The systems-psychodynamic thinking of the International Association for Forensic Psychotherapy and the therapeutic community model combine in contemporary practice to give us a model of the conscious and unconscious processes that inform criminal acting out or the expression of personality disorder: a model that helps us to make sense both of the violence in the patients and the violence in the societal response.

Copyright © Jessica Kingsley Publishers 2012.

My Journal Journey – An Article by Kate Thompson, author of Therapeutic Journal Writing

Kate Thompson is a BACP Senior Accredited Counsellor and Supervisor in private practice, and a professional member of Lapidus UK. In 2010, she wrote Therapeutic Journal Writing as part of the JKP Writing for Personal Development Series.

In this short article, Kate shares her thoughts on process writing and includes some handy notes on writing for yourself and with a group.


My own journey from childhood diary writing in the 1960s to journal therapist in the 21st century has indeed been an almost lifelong process. This journey continues today, propelling me into the modern world of blogs and internet therapy which in some ways is a very natural development from journal writing.

I start from the premise that writing is always both a creative and a therapeutic act. I know that many people, including some of our greatest writers past and present, would agree with me, but others would not. I need to emphasise that therapeutic journal writing (almost a tautology, certainly the opposite of an oxymoron) is about process writing rather than product writing.

I have since childhood been one of those who felt ‘compelled’ to write. But I also want to stress that I am an intermittent journaller. I am full of admiration for those who do write every day but I do not – some of my clients write far more than I do.

[NOTE: Journal writing is sometimes referred to as a discipline or practice. One of the Myths of journal writing is:

“you have to do it every day”

You don’t. Often as possible is good, even five minutes counts, but there is no point in setting up unachievable goals – that way ‘failure’ lies and neither our clients nor ourselves need encourage that.]

So I have journalled on and off through childhood, adolescence and adulthood. It is the way I process experience; it is the way I make sense of the world.

Writing the book was a personal and a professional journey. It is the culmination of more than15 years of professional practice. It brings together my twin passions for therapy and literature (I was a reader before I was a writer; I was a student and teacher of literature before I was a therapist). I wrote this book because this was a book I would have liked when I was training as a counsellor. At that time I had no idea that you could (‘were allowed to’) use journal writing as a therapeutic medium with clients. But I did know that it worked for me so it seemed natural to want to try. This book would have legitimized my instincts and given me the confidence to do it openly. Finding Kathleen Adams and The Center for journal Therapy in Colorado told me I was right.

In fact I’ve had three mentors who have encouraged me and supported me in this work:

Kathleen Adams, Gillie Bolton and Emmy van Deurzen.

I thank you all.

The journal container is big. People who come to my workshops or groups often show surprise about how broad the idea of journal writing is – the range of techniques at our disposal goes far beyond the descriptions of ‘what I did yesterday’. Journals can also include art, quotation and project plans as well as personal written stories or reflection leading to healing and growth.

Feedback forms often contain comments such as:

“I had a very narrow definition of journal writing – I know better now.”

I think my favourite comment on a feedback form is:

“I came with very low expectations – they were exceeded.”

I’m sure he meant it kindly.

There is one therapeutic journal technique which completes the reflective loop and does much to promote the integration of experience. It is a way of giving yourself a little written feedback after any journal entry:

The Feedback Loop

Read through your journal entry and then write a couple of sentences:

E.g. When I read this I notice…

When I read this I feel…

This to me is the key to therapeutic journal writing – I encourage anyone who keeps a journal to employ this technique which really completes the loop and can consolidate the insights and learning – you can try this at home immediately.

I always love to hear how people use journaling for themselves and with others, for personal and professional reasons – please tell me your experiences: kate.thompson@journaltherapy.co.uk

Read Kate Thompson’s Therapeutic Journal Writing Blog »

Copyright © Jessica Kingsley Publishers 2012.

VIDEO: Writing for Therapy or Personal Development – A Conversation with Dr Gillie Bolton

Dr Gillie Bolton is a renowned therapeutic writing practitioner and author of many JKP books, including Write Yourself: Creative Writing and Personal Development.

In this video, Dr Bolton discusses the new book – the latest in the Writing for Therapy or Personal Development series, of which she is also the series Editor – and shares some of the experiences that brought her to the growing field of therapeutic writing. She also shares some of the types of writing exercises that she returns to again and again for her own personal development, and talks about the importance of hearing your own internal mentor.

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Copyright © Jessica Kingsley Publishers 2011.