Sunday, 26 October 2008

Shall we name and shame trashie newspaper reporters?

The prejudice and stigmatisation exhibited by members of the press sickens me at times. Look at this quote from the so-called intellectual newspaper, the Sunday Times.

'A pilot scheme is encouraging druggies to kick the habit by giving them money to donate to charity'
I suggest we have a name and shame campaign to tackle this sort of trash - I am of course referring to the term 'druggies'. In this case, the trashie reporter is called John Mooney.
I did send in a comment this morning criticising the newspaper, but have yet to see it up and it is evening now.
By the way, the article is worth looking at - an interesting pilot scheme taking place in drug services in Dublin.   

Maybe, we could unite on this one, rather than some people taking 'pops' at others. My blogs are there to try and induce informed debate, not to be a forum for insults. I know it's tough at times, but let's try to maintain some decorum.
And one last gripe - why do so many people in this field insist on operating on a black vs white agenda, with no middle ground? 
If someone says that there is too much of (A), we need some (B)... that does not mean they want to get rid of (A). For example, you can criticise the current system of dishing out methadone without providing additional support for people - and say we are not focused enough on helping people find recovery...
WITHOUT being against methadone!!

Friday, 24 October 2008

Anyone for a good hanging?

Saw this posted as a comment on one of the blogs:

'I should just let you and the prof keep posting and watch you hang yourselves.'
Guess, you cannot keep everyone happy! If there was no criticism, I'd be doing something wrong.
By the way, an excellent blog this week by Kathy Gyngell focusing on, 'Why the National Treatment Agency is prejudiced against rehab.'

Monday, 20 October 2008

Trying to support family support groups

As some of you know, I am very passionate about trying to support family members, families and family support groups. They just don't get a good deal from the system - in fact, they generally get a lousy deal.

There are so many family members who need help. There are so many family support groups who are trying to do something positive - but exist in isolation and need help to further their agenda.
I would like to contact as many family support groups as possible, to try to help bring them together into a coherent whole. Or at least communicate with each other.
It is time we worked together to push an agenda that helps those who are indirectly affected by substance use problems. 
If you are a family support group, or know of any such group, could you please contact me.  

Thank you

I'd just like to thank all those who have been involved in the last two 'debates' centered on my blog. I've not been involved in the last one as I've been tied up - other than putting up all comments onto blogs - but I will look and will join in as soon as I can. 

We're getting closer to the launch of the new website, at which time I will move my google blog to this new location. We're hoping that we can get a number of different people blogging who can stimulate good discussion. We hope that this discussion will lead to other 'virtual' activities.
Meanwhile, please continue putting forward your views.

Sunday, 19 October 2008

Methadone maintenance in treatment services today: a form of palliative care?

Well, my Blog on Thursday, 'The power of misinformation', certainly fired up some discussion. At the moment, we have reached 37 comments. So let's see if I can do the same with this posting.

I'm writing an article at the moment on the problems with the current treatment system and what we need to do to improve matters. I'm on the methadone section at the moment. 
As I have said many times before, I have nothing against methadone substitution therapy per se, but I feel strongly about it being used with clients being offered no, or only minimal other, support. I have written:
'Due to the approach adopted by much of the UK treatment system, this generally leads people from one addiction to another without providing a realistic opportunity to attain recovery.
Whilst methadone (and Subutex) have an important role to play in helping people take the chaos out of a heroin-using lifestyle, they should not be prescribed in isolation or with minimal other support.
The majority of heroin users actually want to get off drugs completely, not be “left” long-term on methadone or other substitute drugs. They must be provided with the choice of, and help in, finding a path to recovery, rather than just being helped to live with addiction. Much of the treatment system shows a shocking paucity of ambition for its clients. If cancer patients were only offered what amounts to a form of palliative care, it would be seen as a scandal.'
What do you think?

Thursday, 16 October 2008

The power of misinformation

Heard a depressing story this week from a friend who holds a senior position in a treatment agency. They told me of a local commissioner who was telling drugs workers that research showed that residential rehab did not work. Therefore, local commissioners were not going to send people to residential. Also, very worrying was the fact that the drugs workers believed what he was telling them!

No wonder residential centres are struggling to fill their beds with this disgraceful misinformation and attitude. How do such commissioners get to hold such a position? And exert such an influence. It is also very worrying that the drugs workers believed the commissioner. 
The level of knowledge and understanding of many people working in the field does really worry me. If doctors and nurses working in our hospitals had the same level of training as many of our specialist workers, generalist workers - and commissioners in particular - we'd be running scared if we got seriously ill.
I don't like having to say this - there are many good and knowledgeable people working in our field - but one cannot escape reality. It is worrying.
As for the commissioner in question - he needs to be told the truth about good residential rehabs. And tell others the true reality!     

Monday, 13 October 2008

How Clients Make Therapy Work

For those of you who did not read your Drink and Drugs News, to let you know that my latest Background Briefing focused on a very interesting book, 'How Clients Make Therapy Work: The Process of Active Self-Healing' by Arthur C. Bohart and Karen Tallman. 

You are going to hear a lot more about this book in my Briefings over the coming months - and on this blog. For now, I leave you with the text of my Briefing, if you have not clicked through to the DDN pdf document with my ugly mugshot!

In my last Background Briefing, I focused on two William White books that are classics in the field. In this Briefing, I describe another classic. Whilst this book focuses on mental health and psychotherapy, the ideas it contains are of direct relevance to recovery from addiction and the treatment process.
‘How Clients Make Therapy Work: The Process of Active Self-Healing’ by Arthur C. Bohart and Karen Tallman
The authors of this book argue that the most important factor in making psychotherapy work is the active, creative involvement of the client. Clients are viewed as possessing self-healing capacities and resources that are responsible for the resolution of problems and for change in everyday life – and in any form of psychotherapy.
Clients, like all people, have a built-in capacity for learning and creative problem solving, which can help them overcome problems in their lives. The capacity for creative problem solving can be enhanced or supported – or limited or distorted – by the person’s internal resources, and interpersonal and physical environments.
Their capacity for creative problem solving can also be limited by low self-esteem, feelings of discouragement, and a lack of hope.
Most people cope, survive and grow with challenges in their everyday lives without the help of a therapist.
Clients come for help with their ‘problems’ when their self-healing capacities or resources are inaccessible or blocked. Therapy is most effective when it makes use of these self-healing capacities and resources.
The most important thing that the therapist can do to be helpful is to find ways of supporting, stimulating, and energising client investment and involvement in the therapeutic process. The second most important thing is to stimulate client learning and creative problem solving.
The authors of this book view the therapist as a coach, collaborator and teacher who frees up the client’s innate tendency to heal.
The therapist may use one of the major theoretical frameworks (e.g. cognitive-behavioural or psychodynamic), but the way their help is used will ultimately be determined by the client.
Clients know the intimate details of their problems and the intimate ecological connections that are created by their problems, and they have a sense of the factors that create the problems.
They also have a much more intimate sense of what is possible in their life space than does the therapist.
Clients actively translate the lessons and experiences of therapy into their life contexts. Therapists cannot expect a one-to-one translation of their technique and ‘teachings’ into client behaviour. Clients use their own idiosyncratic uses and understandings of whatever they have learned in therapy to help them deal with their problems.
This model of the client as a self-healer is in contrast to the medical model, which still dominates psychotherapy. In the medical-like ‘treatment’ model, the therapist is analogous to a physician.
He or she is an expert on the nature of the client’s problems and on how to help alleviate these problems. He or she forms a diagnosis and then prescribes treatment, which consists of applying interventions appropriate to that diagnosis. These interventions cause change to the client, thereby alleviating the symptoms.
In their book, Bohart and Tallman provide a wealth of research evidence supporting the idea that the active efforts of clients are responsible for making psychotherapy work. They contrast their views with the medical model.
They emphasise the fact that differences in effectiveness between different therapeutic approaches have only infrequently been found. The self-healing tendency of the client usually overrides differences in technique or theoretical approach.
The authors describe the assumptions about clients, problems and change that underlie the self-healing model, and why clients come to therapy. They view therapy as a form of education and describe different ways therapy promotes self-healing.
They particularly examine how the provision of a basic empathic relationship can be helpful. Therapy is also viewed as a meeting of minds.
This book is essential reading for anyone working in the substance use treatment field. If you have any doubts about the relevance of this book, I remind you of a quote from the excellent book by Tom Waller and Daphne Rumball, “Treating Drinkers & Drug Users in the Community” (2004):
‘Other people, however skilled they may be, never make a drinker of drug user better. It is always the client who does the work. Helping professionals can make assessments, point the way, offer suggestions, provide interventions tailored to meet a client’s needs, give appropriate counselling, and do what they can to improve the client’s environment, but success, when it comes, always belongs to the client, never to the professional worker.’
So think about this the next time you meet one of your clients. And think about the following excellent quote from Bohart and Tallman’s seminal book:
‘The client is a creative, active being, capable of generating his or her own solutions to personal problems if given the proper learning climate… therapy is the process of trying to create a better problem-solving climate rather than one of trying to fix the person.’

Sunday, 12 October 2008

Holidays, blogs and film

Both Lucie and Kevin have taken time off for holidays, and Jim has flown over to Norway for one of his son's weddings. So that has left me holding the Wired In fort. 

I've been too busy to notice their disappearance, as I've been deep in content management for the online recovery community. I left a lot of my admin to this coming week, as I really needed to make a push on the content and checking the functionality of the site.
I recently checked through and edited over 100 of my postings and over 70 of Kevin's from our Google blogs. Quite a time consuming process, I can tell you. 
Actually, I found it absolutely fascinating reading all of Kevin's blogs again, this time one after another. It made real interesting reading, the thoughts of someone who has 'been there' and is passionately concerned about helping other people find recovery from addiction.
I also looked over some of his film material. I had loaned Kevin a Mac and encouraged him to take it around and film (with the internal vidcam) discussions with some of our volunteers, edit the material, and put it up on YouTube and Vimeo.
Just a standard sort of thing to do in everyday life! And Kevin has not had an everyday life!!
He has been fantastic and learnt what he needed to do really quickly. One thing that struck me when working on his blogs, was the film he put together with Brian White, one of our volunteers in Cardiff.
I ask you to take a look, to see Brian's reflections on his journey into recovery.
Given the quality of what Kevin and Lucie have been doing, it is ironic that I run out of money for them at the end of next month. So I'm trying to raise funding to keep this train on the tracks - and also feed myself.

Thursday, 9 October 2008

Reflecting on heroin addiction

Research shows that 78% of smokers attempt to stop smoking each year, many making several attempts. Nearly 50% do not expect to be smoking in a year’s time.

However, only 2-3% stop permanently each year.

Smoking does not generally result in the smoker losing their job and their home, the support of their family, the lowering of self-esteem, and thoughts of suicide.

Addiction to heroin can lead to these things. And yet people do overcome heroin addiction, despite the adversities they face. The recovered/recovering heroin addict  may not be able to stop smoking.

Sadly, we do not know what percentage of people overcome a heroin addiction in the UK.

Tuesday, 7 October 2008

A productive day on the computer

I'm pooped! Bloody pooped!! 

Lucie, Kevin and I have been sitting in my sitting room all day, loading up material on the new website, testing the functionality of the content management system, talking to the website-developer and some community members, and trying to work on a funding application. Talk about multi-tasking.
It's fun writing and loading up new material (written and video), but the process can also get boring at times, particularly when one is looking through and checking and formatting old material. There is a lot of material we are moving over from the google blogs to our new site, not just Kevin's and my own, but also some of our community members. It's so easy to make mistakes and also miss typos, so it can become very frustrating.
And poor Lucie, the only one using a PC (and Vista), has been tearing her hair out because the website has been creating multiple windows on her screen. A programming bug that needs finding, but until it's caught poor Lucie will continue to be frustrated. Developing and launching a new website can take some time - one task that has to be done is to check the full functionality in all sorts of different web browsers. 
Ultimately, the real test of the system is when lots of people are accessing the website, which should happen early next month when we launch.
For now, I feel burnt out so this rambling will have to replace my originally planned more focused  blog. But I feel very happy that I have had a very productive day.

Monday, 6 October 2008

The first service user conference in Scotland

I recently spent nine days in Scotland on holiday. After three lovely days on the beautiful island of Skye, we went to Saltcoats to visit Annemarie Ward, who has been working closely with Wired In. It was only the second time that I have met Annemarie in person, but I felt I had known her for ages. 

Annemarie had recently spoken on recovery at the first service user conference in Scotland. Amazingly, around 700 people attended, the majority being service users. What a fantastic response to the efforts of the organisers.

Annemarie was very excited by the reaction of the audience to her talk, which I use her words to describe, ‘Well, I can tell you I was totally overwhelmed by the positive response I had from the floor during the presentation. Folks were whooping and hollering, clapping and stomping, in a really scary exciting way. After my “speech” and during the workshops later in the day, I was again really shocked by the amount of people who wanted to support me.’

I also spoke to Neil McKeganey who said he was taken aback by the nature of the positive response to Annemarie. He thought that she is a natural leader.

It’s really great to hear this, because Annemarie is helping Wired In push the recovery agenda in Scotland – she is our Scottish leader. I was really impressed the first time I met Annemarie whilst we were both visiting the LEAP project in Edinburgh. She was an absolute natural with the clients, who quite obviously took to her in a very positive fashion. She is also knowledgeable and intelligent.

We consider ourselves very lucky to have Annemarie working with us. Whilst we were out for dinner, we took the opportunity to do some plotting for pushing the recovery agenda. I was also pleased that Annemarie and my partner Linda (who is Australian) got on so well, although the latter did initially struggle with Annemarie’s accent!

I was also very touched by a special gift that Annemarie gave me – a memento signifying the 11th year of her recovery (she is now 12 years in recovery). Symbolically, it was one of the nicest presents I have ever received.   

If you want to help push the recovery agenda north of the border, then let us know - or

Sunday, 5 October 2008

Carers' conference in Gloucester: 'Who Cares?'

It seems a very long time since I was last on the blog, having just had three weeks vacation. Lots to talk about over the coming weeks, I'm sure.

During my vacation, I gave a talk at a carers' conference, 'Who Cares?' in Gloucester. The day's event was organised by Andrea Wilson, with the assistance of Irene and Ian MacDonald, and the financial support of the Gloucester DAT. 
I was really pleased to participate in such a meeting, not just because the focus was on families and carers, but because I wanted to meet Ian and Irene MacDonald. Ian first contacted me over five years ago to tell me about their work, but whilst we had met periodically we had never managed to spend some good time together. And I wanted to meet his wife.
Now this was no ordinary presentation, since I was given a 90 minute slot to talk about recovery. Now, I do not usually practice talks - and therefore do not time them - so with such a long talk, it was difficult working out how many slides to use. So I set up 72 and thought I'd leave some out as I go along, which is what happened. I attach all 72 slides here! [Please note, the file takes time to load. Let me know if you have problems]
I spent a very interesting morning listening to the other speakers. All the talks were of a high quality and there were some moving moments. I was very touched by a talk given by Laura, who reflected on the harm that her alcohol misuse had caused to her mother.
I was thrilled by the response to my 70 minute talk. Yes, 70 minutes (broken up by an 8-minute film) and the audience managed to stay awake! Talk about staying power!!
I felt genuine interest (and excitement!) in the room during and after the talk. The feedback since the event has been great. I've received many positive responses, my favourite being that I (or my message) should be bottled and passed around services (treatment agencies and generic) in the area.   
Now, I know this can be viewed as blowing my own trumpet, but it is very important for people to realise that audiences get excited about the recovery agenda. I spoke about things that mattered to people in the room, things that they could understand and desire. If someone wants to 'bottle me' to get the recovery message out there and improve matters for those people affected directly or indirectly by substance use problems, then so be it! Bottled DC. Mmm!
The one disappointing aspect from the conference was whilst I received positive compliments from many sources, this did not include the NTA representative. I guess you cannot win them all.
I really enjoyed the conference and the organisers and participants should receive a big pat on the back. Andrea, you did a great job! Ian and Irene, you've done so much you should be proud of. All three of you, a real pleasure to spend time with you.
Let's keep the agenda moving forward.