CC Wong

Abstract

Between July and October 2003, the Hong Kong Federation of Youth Groups assisted by the Paediatrics Department of Tseung Kwan O Hospital and the Youth Carenet Adventure Resource Centre ran a program for unemployed youth with substance abuse. Twenty-one youth were enrolled to the program and they came from different natural groupings. During the 10 days residential program, the youth were help to improve their problem-solving skills, sense of responsibility, social interaction skill and to develop a goal orientated lifestyle. Drug education was included in the training program. The youth were attracted to the physically demanding and exciting activities and did not resist the police trainers. Bonding was established and responsibility and discipline were developed. Nineteen out of the 21 participants had either returned or motivated to return to school/employment or stopped or reduced using drugs.

Introduction

Between July and October 2003, the Hong Kong Federation of Youth Groups (Sai Kung and Wong Tai Sin Outreach Team) assisted by the Paediatric Department of Tseung Kwan O Hospital and the Youth Carenet Adventure Resource Centre ran a program for unemployed youth who suffered from substance abuse. A total of 21 unemployed youth were enrolled to the program. These youth came from different natural groupings and one of them consisted of eight people, of which five of them had no previous experience of substance abuse.

The program adopted a multi-systemic therapy approach¹ and attempted to introduce a non-residential treatment plan for these youth. In addition to conventional medical and social services, this program provides an adventure-based training component as the foundation to induce behavioural changes. Volunteers from the Youth Carenet Adventure Resource Centre conducted these adventure-based activities.

The Youth Carenet Adventure Resource Centre is a charitable organisation established in 1999 by a group of police officers, social workers and teachers to provide adventure-training programs for youth at risk, students with behavioural problem and youth suffered from chronic illnesses. The Centre advocates multi-disciplinary partnership among professionals in the education, social work, medical, and police fields. All members and trainers of the Centre are volunteers from the respective professions and more than 1,000 youth have enjoyed the service over the past four years.

The Concept

Risk factors for both substance abuse and delinquency include family and peer influences. Juveniles may model alcohol or drug use from parental behaviour and that poor parenting skills may contribute to substance abuse. Peer relations can profoundly influence substance abuse and delinquency in juveniles. Drug use at younger ages also results in decreased contact with prosocial peers and less involvement in desirable activities, and greater contact with delinquent peers engaged in delinquent activities. Early drug use may also be related to personality characteristics of classic psychopathic such as emotional shallowness, lack of empathy and guilty, and interpersonal manipulativeness.

Delinquent youth tend to be impulsive, hostile to police, poor concentration and restlessness.² Cohen (1955) proposed that lower-class boys found it hard to succeed according to the middle-class standards of schools, partly because lower-class parents tended not to teach their children to delay immediate gratification in favour of long-term goals. Consequently, lower-class boys joined delinquent subcultures by whose standards they could succeed.³ Cloward and Ohlin (1960) argued that lower-class children could not achieve universal goals of status and material wealth by legitimate means and consequently had to resort to illegitimate means.⁴

Multi-systemic therapy conceptualizes adolescent drug abuse and problem behaviours as a product of several related systems, including home, school, neighbourhood and the larger community. Drug abuse often arises from dysfunctions in these systems. Intervention requires engagement with family members, teachers, social service agencies and others having contact with the adolescent. The program was designed taking into consideration of these factors.

The Core Components

The program was divided into three core parts, namely:

• Medical screening and subsequent follow-up by Tseung Kwan O Hospital;
• 10 days residential adventure and leisure activities, and drug education program; and
• Conventional social services including: individual counselling, vocational training and community services.

Adventure based programs have been found to improve social skills, problem-solving abilities and relapse prevention awareness. Clients are usually given a chance to engage in physical challenging activities that previously seemed impossible or improbable for them to attain, for the purpose of gaining experience in success through the support and encouragement of others. Groups participate in problem solving activities that require minimal verbal skills for resolution, since substances abusing delinquent adolescents are frequently more skilled in non-verbal problem solving. This setting provides an opportunity for effective interpersonal interactions with peers and supervisors in a prosocial environment.⁵

During the 10-day residential program, the first three and the last three days were used for adventure activities ran by the adventure trainers (mainly police volunteers) whilst the remaining four days were used for drug education and non-adventure based developmental workshop ran by social workers. The six days adventure based program were designed to achieve the following objectives:

• Develop a sense of responsibility.
• Enhanced self-esteem and perseverance.
• Improve problem-solving skills by working within a peer network.
• Foster more effective and positive social interactions.
• Create a goal-oriented lifestyle.

The Content of the Adventure Program

Pre-camp Briefing

The adventure based program started with a pre-camp briefing. The briefing was conducted by one of the trainers who would engage the trainees. The most important part of this briefing was the contracting of ground rules. There were five ground rules and the trainer would get all the trainees to agree to each and every one of them. Two of the ground rules were of significant importance and were part of the training. They were 'be on time' and 'no drug and alcohol'.

During the training, the trainers started all the activities on time. Latecomer was confronted with the fact that they had broken their promise to be on time. By not keeping their word, they were destroying relationship with the other contracting party. At an appropriate time, they were told of the importance of the term 'time is of essence'.^a All the trainees were reminded that they were responsible for the natural and probable consequences of their behaviour.^b The ground rule of 'be on time' was a very important tool during the training to induce a sense of responsibility.

Adventure Activities - Part I

On the first day of the adventure training camp, small groups with 6-8 trainees of their choice were formed. They were introduced to 11 adventure facilitators, 7 of them being serving police officers; either currently attached to special units (Special Duty Unit, Airport Security Unit, etc.) or with previous experience in these posts. The youth were invited to choose their group facilitators.

During the first three days, they had gone through a physical fitness test, rope course, orienteering, canoeing, rafting at night, jump from a pier when blind-fold, night walk and some team tasks. At the end of this phase, all of them were requested to paint their own vision on a T-shirt. This was a question of 'what do you want'. The improvement of some of the youth was significant but the dynamic within the group had prevented them to go further.

The youth were attracted to the physically demanding and exciting adventure activities. Surprisingly, they did not resist the police trainers and quickly established bonding with them. The discipline was good and they gradually became more responsible. They then left the camp and the social workers ran developmental workshops, drug education activities, leisure activities and community services activities for them.

Adventure Activities - Part II

When they returned to the camp four days later, the youth were less responsive to discipline. It was reported that their performance was not good for non-interactive and drug education program. To avoid adverse influence by the less responsive youth, smaller groups were formed. Naturally, those more ready to do well went into the same small group.

After they were re-engaged and re-contracted, the youth were taken for hiking and a canoe trip. The trips were tough in order to enhance their capability on endurance, persistence and tenacity.

After the trips, trainees would speak for two minutes in the small group on the topic of 'self introduction'. It was amazing to see the difference of how they see themselves after ten days. Their introduction of self now consisted of energy and hope.

Before they left the camp, each of them was asked to set a goal and write it down on a paper to be sealed inside a bottle, which would be opened at the end of the program.

Results

The results of the program were encouraging. Eighteen out of the 21 participants had either returned to school/employed or motivated to return to school/employment. Again 18 of them stopped or reduced the frequency of using drug/substance.

Although the program was not supported by scientific research or evaluation, it tends to indicate that multi-discipline partnership adopting multi-systemic therapy approach is a viable option for substance abuse treatment program.

Notes

1. Failure to complete on time was a repudiatory breach of contract rendering performances by the purchaser impossible and entitling the vendor to reject the late tender of the purchase price and to rescind the contract; only slightly late (10 minutes) in completing did not justify departure from that general principle even though the result of the rescission was that the purchaser had forfeited the equitable interest in the land arising under the contract. Union Eagle Ltd v Golden Achievement Ltd (P.C.) [1997] 2 WLR 341.

2. It has long been the policy of the law that those who use violence on other people must take their victims as they find them. A man who did a wrongful act was deemed responsible for the natural and probable consequences of the act. R v Blaue [1975] 3 All ER 446.

References

1. Lexcen F, Redding RE. Substance abuse and dependence in juvenile offenders. Juvenile Justice Fact Sheet. Charlottesville, VA: Institute of Law, Psychiatry, & Public Policy, University of Virginia, 2000.

2. Farrington DP. Human Development and Criminal Careers. Oxford: Oxford University Press, 1994.

3. Cohen AK. Delinquent Boys. Glencoe III, Free Press, 1955.

4. Cloward RA, Ohlin LE. Delinquent and Opportunity. New York: Free Press, 1960.

5. Gillis HL, Simpson CA, Thomsen DD, Martin BA. Final evaluation of project adventure's co-op program for court referred, drug involved youth [on line], 1995 (Available at http//:www.aee.org).