Between prevention and therapy

First attempts
The correction program for youth experimenting with psychoactive substances (cigarettes, alcohol, drugs), which we currently implement at the PROM Preventive and Development Center for Youth and Children in London, was created for many years. The first attempts to help parents who come with children who experimented mainly with alcohol at that time – these are basically the beginnings of the Center, i.e. 1992 – 93. Over the past ten years, the program has changed, housing conditions have changed, as well as people implementing individual stages of the program. The inspiration for introducing changes to the program, which was initially implemented in accordance with the assumptions taken from the Study of Addiction Therapy (STU), was the book Ruthless Grace1 (Scott Peck, 1994). Today’s perception of the potential client of the program as a person with a tendency to a compulsive way of functioning, regardless of the type of psychoactive agent, whose reception is the reason for his application (coming) to the Center is due to the influence of the book. Undoubtedly, Dr. M. Scott Peck also owes us spiritual elements in the implemented program, including classes based on Steps I, II, III and IV of the Alcoholics Anonymous Community2.

Further changes in the program fall in the years 1996–99. It was then that as a result of my personal fascination with salutogenetic orientation3 and documented research on the impact of a sense of coherence on drinking alcohol among young people (Pohorecka, Jelonkiewicz, 1995), we began to introduce timely important changes today. In those years I even tried to write about my ideas, but probably then the time to promote different approaches to addiction treatment was not very good. Our experience in implementing these ideas was also too small to defend a different ideology than the generally accepted one. Today’s version of the program has been complemented and made more attractive by elements of the American program of environmental prevention “Snowball” 4 as well as ideas and procedures that we saw during internships in addiction treatment centers in the USA, including the Rosecrance on Alpine youth center in Rockford5.

The mine of ideas turned out to be a book of the McWhirter clan at-risk youth published by the State Agency for Solving Alcohol Problems in 2001. In my opinion, this reading can successfully be regarded as a textbook for learning preventive interventions in the broad sense, from early prevention to tertiary prevention, not rightly so , in my opinion, called resocialization in Poland.

Of course, in addition to the theoretical foundations mentioned above, the final shape of the program was influenced by a large number of experiences, failures, minor successes and the involvement of a dozen or so people – psychologists, educators and young people who after the procedure stayed in the Center and wanted to serve their peers with experience, strength and hope , according to the assumptions of the AA Community program.

To describe the correction program in more detail and what is most important in it, I would like to use the four stages of psychological and spiritual development which Dr. M. Scott Peck (1994) distinguishes in his book Ruthless Grace. I think that this way will allow the reader to better understand the program itself and its impact.

Phase one – Anarchy

“It’s chaotic, antisocial, agnostic, lacking spirituality.”
I think that in this phase there are young people coming to the center as potential candidates for the correction program. They are characterized by several common features:
1. They are in adolescence – adolescence itself carries specific characteristics of this period of life: criticism towards the adult world, emotional and motivational lability, negative identity, idealism, moral conformism and disturbed relationships with important adults (parents, guardians, teachers). It is the period of adolescence that is characterized by receiving a large amount of contradictory information, which causes a great sense of chaos and constant attempts to organize, often ending in failure.
2. At least one young person’s environment (home, school, peers) does not agree to his experimentation with psychoactive substances, and therefore his behavior is perceived as a violation of applicable laws and principles, i.e. as anti-social behavior.
3. Tendency to agnostic attitudes, especially in the area of ​​incurring consequences resulting from specific behaviors (e.g. non-recognition of the relationship between experimenting with psychoactive substances and worse grades at school).

In connection with the above, it is easy to notice that the world of our client is above all a world of conflicts, chaos in which the rapid pace of transformations, as well as their radical nature cause difficulties in adapting to new situations and tasks. (requirements from parents, school, their own expectations, etc.). Hence the large amount of anti-social behavior, rebellion, subjective ideas for functioning and problem solving, including experimenting with psychoactive substances, which the child’s environment sometimes perceives as anarchist behavior.

Phase two – Letters of law
“Formalized, hierarchical, institutionalized.”
In this case, it is a center, a psychological and pedagogical team responsible for implementing the correction program, and the program itself, for participation in which the child must be agreed with his parents or legal guardians (at least one). They must also agree to contact and cooperate with the educator or educator at the school attended by the young man. The program includes strictly formalized interaction procedures: diagnostic and consultation meetings, participation in initial and program groups, implementation of an individual correction program, all within the rights, principles and norms in force at the Center. Most of these recommendations are contained in a written contract, including consent to tests for the presence of psychoactive substances in the body. The above-mentioned activities take place within strictly fixed dates, the time of individual procedures is specified, those interested are informed about the expected duration of all impacts that the Center can offer them. They also receive information that it is they, through their commitment and compliance with applicable standards and principles, will have a decisive impact on the timely completion of all planned activities: addiction recovery guides

Precisely agreeing ways of contact, information flow, scope of cooperation and division of tasks (e.g. parents undertake to carry out control tests for the presence of drugs). A very important element of the first stage of work is to show the child the Center, his own family – and sometimes also the school as friendly environments for him, but with a clear nature of the institution, with a specific hierarchy of importance of people functioning in them. Acceptance by the interested parties of the places, forms and methods provided for in the correction program and persons associated with its implementation is one of the most important elements affecting the effectiveness of the program.

Phase Three – Challenging our own doubt

“She is characterized by skepticism, individualism, scientism, agnosticism and atheism.”
This is the most difficult and longest period of implementation of the program for virtually all persons declaring help to a child. It is particularly difficult for a consultant leading a child, therapists conducting group classes, and of course for the child himself, still often not very interested in these activities.

The first signs of doubt, both on the part of the child and his parents, appear at the time of diagnosis and formulation of an individual correction program. This usually happens after a month’s stay in the Center, after a thorough understanding of the rules and standards in force during the implementation of the program, sometimes after experience of the consequences of non-compliance with these standards (own experience or other program participants). Often, skepticism concerns the intensity of the actions proposed in the corrective program or methods and forms, and in some cases, not only the child, but also parents try to convince the person who conducts that this first month and what they have done so far, it is enough that the child already it is different that the whole month exemplarily goes to school, is obedient and certainly exaggerated a little, turning to the Center for help. A lot of skill and understanding must be demonstrated by the consultant at this stage of work to motivate the whole family to continue their activities, accept the proposed correction program in full and sign the contract. online rehab services Motivating is carried out in parallel with the relief of stress associated with the child’s entry into the basic program with all the agreed consequences. If this stage is successful, further actions are much easier. Problems resulting from skepticism and manifesting the individuality of people participating in the program are divided into a psychological and pedagogical team running group classes for several people. This creates the opportunity to consult, exchange insights regarding the functioning of the child and the family in various circumstances (in individual and group contact) – which undoubtedly helps in making the right decisions, flexibility, including verification of the individual correction program. It can be said that a principle similar to that of the Alcoholics Anonymous Community still applies – “bring your body (follow the instructions) and the program will do its part”.

The basic program is participation in class workshops and carrying out the tasks of an individual correction program. A significant part of these tasks is presented to the child in a workshop group, the others are settled with their leading consultant. The workshop group is psycho-educational, it takes place twice a week – on Mondays and Fridays. The location of classes on these days is a deliberate, motivating and helping to maintain abstinence from psychoactive substances during the program (abstinence for the duration of the program is a requirement in the written contract).