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Tackling volatile substance abuse in Scotland
a training course for the social care workforce

Course content: Prevention

Case study (part three)

INTERVENTION

What does Stacie want? For placement to continue and independence plan to begin.

What do Foster Carers want? For Stacie to totally cease solvent misuse, and for her to improve her behaviour and keep to house rules.

What does Social Worker want? Placement to continue until Stacie is 16, no more significant incidents, to access relevant agencies for support.

What happened?

Stacie:

  • Agreed to attend 4 sessions with Alcohol & Drug Worker.
  • Encouraged her to set her own goals regarding petrol. Goal = to stop using altogether.
  • Added contingency plan of how to limit misuse if did end up sniffing petrol. She had made a decision to stop sniffing petrol, so wasn't prepared to consider 'relapse prevention' work or explore the function of her solvent misuse, as she didn't anticipate using again. Initial focus of sessions was on strategies to promote sleep (sleep disturbed since ceased sniffing).
  • Other work over these sessions:
    • Accessing education/ employment — aim for constructive use of time
    • Identify goals for the future — considering college courses & hopes to be accepted into the Army
    • Focussed on positives since ceased sniffing — better attitude, more energy
    • General drug information to fill some gaps in knowledge, and a discussion of 'harm reduction' strategies regarding alcohol & drug misuse

Foster Carers:

  • With Stacie's consent gave general updates to carers after each meeting with her. Discussed six strategies for avoiding substance misuse (drew parallels with giving up smoking), gave details of support for parents/carers of drug users, referred them to sources of alcohol and drug information, both written info and training courses they could access. They also chose to:
    • Remove solvents from the house and lock the garage. Lock their car fuel caps. Contact the youth service regarding activities for Stacie (but no activities she would do)
    • Clarify house rules, set (and keep to) clear boundaries of acceptable behaviour in the home
    • Also, feeling unsupported by Social Services at this time, they took Stacie to see a Duty Social Worker and refused to leave until more support was promised for Stacie

Social Worker:

  • Received regular updates from Alcohol and Drug Worker. Placement appeared stable, waited until could begin 'independence plan' before engaging with Stacie regularly.

Outcome

Attended four sessions as agreed, then didn't meet again. Clearly many unresolved issues, as Stacie hadn't wanted to consider the underlying reasons for her use (past experiences of abuse, family background, experiences whilst looked after etc.) Remained at this placement until moved into supported accommodation shortly after 16th birthday. Evicted for drug use on premises. Further information not known.

Factors affecting communication with young person:

  • Stacie maintained a passive role, not accepting responsibility for her thoughts, feelings or behaviour, so intervention largely at an information/ education level
  • Stacie clear that she 'doesn't like being told what to do', interventions carefully pitched to ensure plenty of opportunities for her to be an 'expert', and she wasn't made to feel that the Alcohol & Drug Worker was being too directive
  • Drug effects/ after effects impacted on clarity of her thoughts, her mood etc
  • We met at her home, in her room, and the fact that I was on her territory (without her foster carers present) may have made it easier to talk. Find a safe space to talk
  • Being clear about confidentiality, negotiating boundaries with young person and sticking to them is an important part of developing trust
  • The Foster Carers were supported in managing the situation but with a clear young person focus, and were directed to other agencies to meet the needs outside of the Alcohol & Drug Workers remit

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