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The Evaluation and Interventions of Victim of Substance Abuse

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Substance abuse scenarios differs upon individuals and their lifestyles requiring assessment and intervention plans to suit the individual. According to the YouthAOD Toolbox “Most young people will experiment with alcohol and potentially other drugs at some stage”. Angela aged 16, grew up living with her mother and 9 brothers and sisters, although was unable to ‘handle the situation at home’ due to her mother’s drinking and violent issues. At the age of 14 she contacted the Department of Health and Human Services, which resulted in residential care. Angela became involved in drinking, marijuana use and adopted violent tendencies due to various components in her life such as trauma and housing situations ultimately leading to substance abuse.

Evaluation

Trauma

More than two-thirds of young people will have experienced a traumatic event by the age of 16 (Copeland et al, 2007), with higher rates amongst young people who use substances (e.g., Funk, Mcdermeit, Godley, & Adams, 2003; Ozer & Weinstein, 2004). Trauma can be defined as a psychological, emotional response to an event or an experience that is deeply distressing or disturbing. There are different forms of trauma as different people process traumatic events differently due to the experiences they have suffered, these include complex trauma, post-traumatic stress disorder (PTSD), and developmental trauma disorder. As per ‘The Center for Treatment of Anxiety and Mood Disorders’ complex trauma happens repetitively, Post-Traumatic Stress Disorder (PTSD) can develop after a person has been exposed to a terrifying event or has been through an ordeal in which intense physical harm occurred or was threatened and developmental trauma which forms during a child’s first three years of life as of the result of abuse, neglect, and/or abandonment which interferes with the infant or child’s neurological, cognitive, and psychological development. Angela has suffered trauma due to her upbringing and the violence in which she witnessed in her mother’s home. Angela’s mother was an alcoholic with violent tendencies and when Angela had turned the age of 14 she had contacted the Department of Health and Human Services as ‘she could not handle the situation at home’ and wanted to be removed from this setting.

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Housing

Angela has been living in the care of the Department of Health and Human Services in a residential care setting from the age of 14. She lived in residential care for 2 years and when Angela turned 16 she moved into a lead tenant situation where the guidelines state that young people must be either attending school or working or actively seeking employment. ‘Residential care services in community-based houses are provided to children and young people in out-of-home care’ as part of The Department of Health and Human Services. “Children and young people who live in residential care are often those who have experienced the greatest level of trauma and who, therefore, require the most expert therapeutic care and support” (Department of Health and Human Services, State Government of Victoria, 2017). Lead tenant situations provide semi-independent accommodation options for young people aged 16 – 18 years who are child protection clients transitioning to independence from state care. Whilst in this situation volunteers, also known as ‘lead tenants’, work with other staff members to support young people and share the accommodation as part of a program which lasts for 12-18 months where young people learn independence skills in a supportive environment. “The young people living in the home must be studying, employed or actively seeking employment. They also have a responsibility to help out cooking and cleaning, and pay a portion of their wage or benefit towards rent and utilities” (Wesley Mission Victoria, 2016). Whilst in the lead tenant situation Angela would not return for a couple of days, she would be violent and aggressive towards the volunteers. This situation was unsafe for the volunteers and other young person in the house so Angela was removed and placed back into residential care until she was 18 years old.

Substance Use

Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs (World Health Organisation, 2019). Whilst living in residential care for 2 years Angela had become involved with drinking and marijuana use and when she got drunk she would become very abusive and miss school on a regular basis. Angela would often not return to her placement and when she did she would be rather violent towards staff because she was hungover or still drunk. Adolescents in the process of developing their own identity, AOD use might have several functions including: providing pleasure; alleviating boredom; satisfying curiosity; facilitating social bonding; attaining peer status; or as an escape or coping mechanism. “Alcohol use directly affects cognitive and physical function. Hazardous alcohol use can reduce self-control and the ability to process incoming information and assess risks, and can increase emotional lability and impulsivity, to make certain drinkers more likely to resort to violence” (World Health Organisation, 2019). Set and setting may also have an impact with young people and AOD use. A young person’s state of mind at the time of drug use can determine the experience they have, both positive or negative. If a young person is experiencing a crisis, anxiety, breakdown of a relationship or domestic conflict, the risk of negative experiences are increased. Setting and the environment a drug is taken in, can also influence the experience.

Ethical Considerations

“A Code of Ethical Practice is a document developed by a body of practitioners to provide an agreed framework and set of values for professional practice. It provides a frame of reference in which to develop ethical and safe practice” (YACVic Code of Ethics). The code of ethics is relevant to all qualified youth workers and to others working with young people without a youth work qualification. The principles and practice responsibilities outlined will support and guide the work that youth workers do with all young people. Ethical considerations are important when working with young people as it is about avoiding any harm to children and young people as a result of their participation in an organisation’s decision making. An example of an ethical consideration is ‘Do No Harm’, which is applied for any young person who goes into care and are guaranteed that no physical, psychological or mental harm will occur to them. Another example affecting Angela would include the protection and ‘Recognition of Indigenous People’ where ‘Youth workers recognise that we live on the traditional lands and waters of the Indigenous peoples of Australia. They will be respectful of Indigenous culture recognising that culture and connection to land is a right of Indigenous young people. Youth workers will recognise the importance of culture to Indigenous young people’s self-esteem and sense of identity’ (YACVic code of ethics).

Treatment plan

A treatment plan refers to a written document that outlines the progression of therapy/counselling. It will be used by you and your therapist to direct the steps to take in treating whatever you’re working on. “Intake and assessment is the name of the process used to work out the best treatment path for people with alcohol or drug problems in Victoria. This service, which is available right across Victoria, screens and assesses clients and, if necessary, refers them to the most suitable treatment provider to meet their needs, taking into account their preferences”(Department of Health & Human Services, Better Health Channel, 2018). Intake and assessment conducts a detailed assessment of your treatment needs and then develops an initial treatment plan. Depending on the specific treatment you need, some of the services available include counselling, therapy, therapeutic interventions and youth specific alcohol and drug services. The common elements of brief intervention include:

  • Feedback about health costs of drug use
  • Responsibility for any changes resides with the young person
  • Advice to change current patterns of behaviour
  • Menu of different options for support/strategies
  • Empathy in worker approach
  • Self-efficacy enhanced by worker optimism
  • Therapeutic Interventions

A therapeutic intervention is an effort made by individuals or groups to improve the well-being of someone else who either is in need of help but refusing it or is otherwise unable to initiate or accept help. The Therapeutic Interventions which will be implemented by Angela include Motivational Interviewing and The Transtheoretical Model of Change. Motivational Interviewing is “a collaborative person-centred form of guiding to elicit and strengthen motivation for change” (Miller & Rollnick, 2009; p137). According to the YouthAOD Toolbox “most young people who come into contact with behavioural health care services such as AOD or mental health services are ambivalent about making any changes to their behaviours such as ceasing or reducing substance use”. Motivational Interviewing does not try to change a person and is tailored to the needs and issues of an individual. The Transtheoretical Model of change according to the YouthAOD Toolbox “describes how people either modify problem behaviours or adopt new, more healthy behaviours. The model provides youth AOD practitioners with a framework for understanding the dynamics of behaviour change”. Angela would use ‘the stages of change’ as a way of changing her behavioural patterns, allowing her to adapt to new healthy behaviours.

Conclusion

Due to Angelas life events she has been regularly exposed to traumatic experiences, unstable household and substance abuse, subsequently leading to violence whilst hungover or drunk and missing school. The approaches taken within her life allows for a cut down from extensive alcohol and illicit drug use of marijuana, leading to healthier physical, mental and social life. The various interventions are important whilst forming good relationship between client and worker, therefore leading to a better lifestyle.

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