AdministratorDavid Clark

Island Day Programme in Tower Hamlets

I have a lot of time and respect for MIke Trace, not just for his work as CEO of RAPT, but also as Chair of the International Drug Policy Consortium. How he manages to do so much I’ll never know.

It was therefore with great anticipation that I read his DDN article on RAPt’s Island Day Programme. This is a structured 12-step day programme in Tower Hamlets, with a client base which is very much multi-national.

There are three phases to the programme.

The first phase looks at enhancing motivation, preparation for treatment and induction, and takes up to eight weeks.

The primary phase involves group work – apart from the individual counselling sessions – and lasts at least 12 weeks. Sixteen facilitated groups a week include group therapy, working through steps one to three, lectures, workshops, health education, and activities.

Phase three is aftercare, a part-time support group for up to 12 months. This covers relapse prevention, recovery based workshops, and housing and ETE (education, training, employment) support.

The project also facilitates meetings for clients who wish to invite and involve their family members or significant others in their recovery programme.

The project has admitted over 200 participants, 49 per cent of whom have been from ethnic minority communities. A total of 79 had graduated by the end of April 2009.

Whilst RAPt have not conducted a long-term follow-up of clients as yet, they are very pleased by progress. Knowing Mike Trace well, he would not be writing so positively unless he thought the project had started well and was making a positive difference.

Well done all in the project and Tower Hamlets DAT for commissioning the programme.

As MIke points out, there are not enough abstinence-based structured day care programmes around the country. Projects that help people find recovery in their own community.

If you are part of such a programme – as participant, staff member or volunteer – then let us know more!

2 comments - First published on: 01/07/2009

About a comment: Quitting on your own

Had a great comment on my article “The Disease Model of Addiction” recently. Thanks for your time and thoughts, Hockley.

The comment started:

‘First of all, I quit on my own. No group, or steps, or sponsor. I read books, articles, etc. And, simply, not drinking.’

and ended:

‘I doubt that there is anything odd about quitting on my own.’

You’re right Hockley, there is nothing odd about what you have done. You join millions of others who have stopped on their own.

Some people manage to do this on their own, whilst others need the support and help of others. In some cases, this is professional help (called treatment) and sometimes this is the help of the Fellowship (AA, NA, etc), and sometimes both.

The important thing is that people have lots of options that they can choose, and that they have the opportunity to understand what these options are and how they can be accessed.

[Strangely, some practitioners in the treatment field seem to think that everyone needs treatment to have a chance of overcoming a substance use problem. This is not the case, although some people most certainly do need a lot of help from the treatment system and/or the Fellowship].

Hockley also says:

‘Alcohol abuse is a real problem. I see two important variables: severity of the problem. And, the state of mind of the individual. The state of mind includes all the varieties of ‘mental illness’/problems in living.’

Some people talk about the key factors being ‘severity of problem’ and ‘recovery capital’. The second factor is a little wider than what you stated, Hockley. [It includes your factor].

Recovery capital can be defined as, “the quantity and quality of both internal and external resources that a person can bring to bear on the initiation and maintenance of recovery recovery”.

Recovery capital includes access to understanding and caring people in the community, which of course is influenced by prejudice in society (it is not something the person with the problem normally influences).

Many people with serious substance use problems entering treatment have never had much recovery capital or have dramatically depleted such capital by the time they seek help.

Hockely also says,

‘This, to me, means that the individual concerned is the driver. The ‘program’ — whatever it may be – is not the driver.’

Absolutely!! The person is the driver. Recovery comes from the person, not from the practitioner, programme or treatment agency.

People with substance use problems must be empowered, as Hockley seems to have been. Books and articles seem to have played a role. Key information helped, but Hockley did the work.

The practitioner in the treatment system can be viewed as a coach, collaborator and teacher who frees up the client’s ability to make positive changes. They can also help enhance the client’s internal and external resources (recovery capital), so they are better able to focus their efforts on the processes and events needed to find recovery.

I love this part of Hockley’s comment:

‘There are reasons why I quit drinking destructively — which no one needs to know – let us say that the drinking was ‘useful’. It stopped being useful [fair is foul; foul is fair; for foul is useful and fair is not]. Logic dictated that I draw a line under it. I made it so.

I’ve met other people who started their path to recovery with this view. Others, through a multitude of factors, cannot think as clearly and decisively as this. But they can be helped to get there, and this is one role of treatment.

You are an inspiration, Hockley. Looking forward to reading more.

3 comments - First published on: 29/06/2009

Working at grassroots and getting YOU on board

I was watching an interview with Stuart Honor by Inexcess TV last week that is well worth watching.

Stuart has carried out an amazing amount of ethnographic research over the years – he’s interviewed more people than NTORS – and he set up The Basement Recovery Project in Halifax. I have a lot of time for Stuart and always look forward to getting together.

Stuart mentioned a few things during his interview that we need to think about.

Firstly, he pointed out that he has some problems with use of the term recovery, since it assumes that people have a natural state to recover to. As he points out, that natural state does not exist in a lot of cases. Many people never had anything to recover to.

Stuart is more inclined to use the term ‘discovery’ rather than recovery.

George Williams of Inexcess TV asked Stuart what the North West – which has a thriving recovery agenda – is getting that other areas are not getting.

Stuart emphasised that a lot comes down to leadership. The North West has a very active NTA regional adviser who is really passionate and understands the issues. Mark Gilman has an abundance of charisma.

I don’t want to embarrass Mark here, but I have to say that I agree with Stuart. Mark is special. However, we need many other people like (and not like) Mark who push the recovery agenda across the country. We need more people with real passion, drive and charisma. That could be YOU.

That is one major reason why we set up this community, in order to get YOU on board.

Stuart also emphasised that people with problems need to know that recovery is an option. The vast majority of such people don’t know that recovery is an option because they have never seen it.

Stuart struggles with the idea that addiction is thought of by many as being an illness. He emphasises that there is a road into addiction, in particular opiate addiction, with many people having been in care, thrown out of school, etc.

I agree with Stuart, we really need to realise that heroin (and other drug use) is often a response to a person’s social situation. Then, once they have become a regular user and a ‘member’ of a drug ‘culture’ or ‘culture of addiction’, it is very easy to develop further problematic behaviours.

To just call this problem a disease and think only in medical terms is naïve.

Stuart refered to what someone had said to him some time ago, ‘We’re moping up the water, no one has looked at what turned the tap on.‘ He’s right there. We cannot just be looking at how to deal with the problems, we need to be working to prevent the problems. This has got to be happening at a community level.

Where to start?

Stuart believes that there is too much ‘us’ and ‘them’ in society. He points out that we must make the ‘them’, the ‘us’. We need to empower people to help them to be able to deal with their own problems . And we need to make them stakeholders in the future. This must be built at a grassroots level – at a community level, on the street.

Well-spoken, Stuart.

Look forward to seeing you and the family again. Take care.

4 comments - First published on: 28/06/2009

Leaving a legacy, and writing on recovery

Today is my youngest daughter’s birthday. Natasha, five years old, lives in Dubai so I sadly don’t see her a great deal (I’m counting down the 11 days until she and her two brothers arrive for a month’s holiday).

I probably won’t be able to help Natasha (and her brothers) through many of their life problems over the coming years because of the physical distance. This makes me feel very sad. I only hope that I can make up for this in other ways and be there for them when I can be.

On this day, I am reminded by something that Mark Gilman has talked about on several occasions. By strengthening the recovery agenda and recovery communities, we are helping create a legacy for our children and their peers.

Isn’t it a nice thought, that by helping build this community, you are helping create something that your children and their friends (and many other young people) would potentially benefit from If they were to experience a substance use problem in the future?

Wouldn’t it be nice to know that we helped create a more understanding and knowledgeable society that provided a better environment for recovery?

Changing the topic slightly, the MacDonalds picked me up on my call for articles on ‘What Recovery Means to Me’ for focusing only on those who directly experienced substance use problems.

Of course, these people are not the only ones who experience problems and travel the path to recovery. Family members and friends do so as well.

So please, why not write and submit an article on this theme. This article can be of any length up to a maximum of 1,500 words. You can write what you like as long as it is relevant to this particular theme, in one way or other.

We will edit the articles if this is required (e.g. style, grammar, etc), contacting you if there is anything that we are unclear about. We will then upload the articles onto the Family channel page.

Please participate in this call as it is an important way that YOU can inform, educate, inspire and support other people. We’ll change the theme on the 19th July.

If you want to write something very short, more blog-like, then please feel free to do so – just post a blog on ‘What Recovery Means to Me’.

And if you wish to write an article on any other topic or issue, just let us know. We are looking for other material for the website.

All submissions to .(JavaScript must be enabled to view this email address).

3 comments - First published on: 23/06/2009