Drug and Alcohol Worker should be a regulated title

Drug and alcohol workers provide support to some of the most vulnerable people in our society, yet we still do not have a legally enforceable minimum level of competence or regulation for those working in the sector.  It is extraordinary that professional drug and alcohol workers are still not regulated and recognised like social workers, counsellors, hearing aid dispensers or art therapists are.

The 2010 Drug Strategy recognised that “developing a competent substance misuse workforce is crucial to ensuring a high standard of service delivery” and the National Treatment Agency (NTA), before its demise, stated that “it is important that commissioners and services continue to work towards a workforce which is fully competent and able to demonstrate its competence”.

But we need more than just people with the ability to do their job; we need a workforce which puts its potential into practice on the ground. We need practitioners to work to the highest ethical standards because of the potential vulnerability of our client group.

The first step to a competent workforce is for each person to have a “role profile” identifying:

  • The range of competences they require to do their job properly
  • The knowledge, understanding and skills needed to perform each of these to the standard required.

Having identified the competences and underpinning skills required in a person’s role, we need to ensure that:

  • They are regularly assessed against their role profile, to identify any shortfalls in their knowledge
  • Any such shortfalls are addressed through training, supervision and so on.

To make sure everyone has the basic skills required to work in the field, all practitioners should be able to show evidence of their competence in an agreed minimum of relevant units from the Drug and Alcohol National Occupational Standards (DANOS).

Finally, practitioners need regular supervision to ensure they are putting their abilities into practice and acting ethically.

When DANOS was published, the following target was set:

  • All workers and their managers should have, or be working towards, evidence of their basic competence to work in the field.
  • All line managers should be undertaking, or have completed, a training course in line management.

Unfortunately the NTA, then a key driving force behind this target, did not monitor progress against this and removed targets for workforce development from its requirements of local areas. This left the DANOS targets in limbo and open to unscrupulous providers employing people without the competence, knowledge or ability to deliver services on the ground.

Blenheim has stuck by the DANOS targets because we believe they remain important.  Blenheim is compliant with the training and competence requirements and all our staff are required to sign up to the FDAP Code of Conduct.

The QCF (Qualifications and Credit Framework) is the national credit transfer system for educational qualification in England, Northern Ireland and Wales. The Substance Misuse Awards and Certificates, on the QCF, are clearly the way forward for verifying practitioners’ professionalism in our field and the QCF provides the opportunity for ongoing assessment of professional development.

Professionally qualified workers (qualified to practise in the UK in a regulated health or social care profession) have already demonstrated the ability to work with people, but not the specialist knowledge required to put this into practice in the drugs and alcohol field. They should at least be undertaking a competency-based substance misuse qualification and the Substance Misuse Award (QCF) is well-placed to address this. While anyone practising as a counsellor or psychotherapist, if not already certified by an appropriate body (like BACP, UKCP, UKRC or FDAP), should also be working towards becoming so.

I welcome Substance Misuse Management Good Practice (SMMGP) picking up responsibility for FDAP. However, there is now an urgent need for leadership and regulation of qualification and competence in our field and clear pathways for progression within the wider Health and Social Care sector.

We are gifted with committed and highly skilled practitioners; let us give them the formal assessment, qualification and recognition that they deserve and also offer a clear professional career opportunity for the practitioners of the future.

Blenheim offers a wide range of sector-specific training to improve practitioners’ approach, whilst understanding the importance of being responsive to a diverse range of needs and skills. As we continue to await the new drug strategy, I worry that there may be no focus on skills and qualifications for drug and alcohol workers in the near future. It makes me proud to work for an organisation which places such a strong emphasis on training and development.

We are celebrating Volunteers’ Week, and have welcomed a fantastic new cohort of volunteers to the organisation. I know they’ll receive the very best training to bring the best possible benefits to our service users, and look forward to the day when everyone in our sector receives this training and is recognised for it.


Stigma: One of the greatest barriers to employment

If we are to help people into employment we need to remove the stigma around substance misuse treatment, make a real effort to tackle barriers, and provide empathetic education, training and employment (ETE) support to both employees and employers. Local Authorities and other public bodies must take a leading role in providing employment opportunities.

People enter substance misuse treatment with a wide range of health and social needs. These need to be addressed alongside building motivation and aspiration for sustainable change.

Stigma is one of the greatest barriers to employment for those who have completed treatment or who are in treatment for drug and alcohol use. The double whammy of belonging to a group of people that is stigmatised is that those affected begin to believe the messages that they encounter everyday. While two thirds of employers would not employ someone who had a history of heroin or crack use*, many of those with a history of substance misuse believe they would not be employed either. There is an urgent need to develop employment ‘in-reach’** and other initiatives to provide employers with the confidence to employ people with a history of drug and alcohol misuse.

The journey for many people towards good health, recovery and being ready for employment is often slow. New skills need to be learnt and old habits left behind. At the point of accessing treatment for drug and alcohol misuse, people often have a wide range of physical and mental health issues which are often compounded by a myriad of social problems. It may take an extended period of time for people learn or re-learn softer but essential skills such as communication alongside building self-confidence/esteem. This is alongside getting treatment for physical and mental health conditions including their drug and alcohol use.

Some people have either no housing or insecure housing. This alone is a barrier to employment since employers require an address. Conversely housing is difficult to secure without a job therefore a vicious circle operates which continually pushes people further away from mainstream society.

Many people using a Blenheim ETE service were left feeling ashamed and stigmatised when accessing Job Centre Plus. They also reported that “work programmes are too intense” and as a result those who are either “not in treatment and/or subject to easements” struggle to keep up with the rigors of the programme and are therefore at risk of losing benefits. This can result in a return to the old pattern of offending and re-offending. There was a general consensus amongst the groups that the Job Centre wasn’t very helpful and the atmosphere was often poor.

In contrast people using specialist ETE services, felt they were good, offering the opportunity to get onto courses, gave an incentive to change and helped people think about and prepare for employment as they resolved or came to terms with other issues.

We are looking for employers in London to provide volunteer, employment and training opportunities for our service users. If you or know anyone that can help please contact us.

Blenheim has ETE services in Redbridge, Lewisham, and Kensington and Chelsea.

*Getting Serious about Stigma: The problem with stigmatising drug users UKDPC 2010

**In-Reach means where employees starting work with a history of drug or alcohol use are provided with additional support in the work place, as are their employers, to overcome any anxiety they have about employing those with a history of drug and alcohol problems.

Guest blog: ITEP goes to India by Kim Maouhoub

Anyone that knows me or has been in my airspace for more than five minutes knows of my love for India.

There was a time when Delhi was a place I zipped through on the way to either south India or the Himalayas, scooping up the odd friend for a whirlwind coffee/dinner/shopping spree/enfield admiration party and leaving them in my wake.

This year I have been lucky to spend more time in Delhi and have increasingly grown to love this beautiful, chaotic, breath taking (literally, and at times not in a good way) city.

It was an idea I had entertained for awhile but a last minute breath of inspiration pushed me to google drug treatment facilities in Delhi and send out a template email offering my services for a two day ITEP training a couple of days before I left London.

I got few responses but with a blur of emails and whatsapps I eventually arrived at Shafa in Rohini, Delhi and was asked to take a seat in the cool lobby, which offered sanctuary from the searing heat outside. There were a number of people there watching an information film about the facility so I watched whilst I collected my thoughts.

The CEO of the organisation soon came to collect me and ushered me into his office. I had the sense that he was really trying to get the measure of me and we proceeded to take it in turns to offer snippets of our CVs in the work that we did and as general human beings. We built on our many shared values and quickly established a rapport with lots of laughter and easy conversation.

My test was not over yet I suspect, even though I was there to talk to him about training his staff team he wanted me to meet ‘the guys’ as he called the residents. We went upstairs and my heart came out of my chest as we entered a huge hall with men sitting cross legged in rows…it was at that point I started to get an idea of the size of the programme they were running. So with the aid of a translator and a grand introduction from Ranjan I spoke to the residents of the programme.

12004145_523265787836998_5883855277377995444_nI am used to standing up and talking in front of groups of people but to do it with the aid of a translator to an audience some of whom are in withdrawal is quite an experience. It is hard to keep your nerve and maintain eye contact and the normal means with which I communicate were put to the test. And oh did I mention the fact I was being filmed, photographed and monitored from the side-lines by the entire staff team? It was extremely gratifying to see expressions start to soften and nods of the head as they started to get why I was there. When I had finished speaking there was a chance for them to ask questions which they did by first raising their hand and being invited to stand and speak.

Many took the opportunity to do so and when they had finished a member of the group seemingly overwhelmed by the whole occasion jumped up and said thankyou ma’am which made the whole room laugh. Even as I write this now I feel the tightness in my throat his beautifully spontaneous action provoked.

Having met ‘the guys’ I went downstairs to meet with the staff team and some of the senior peers to discuss the mapping training I proposed to run. They were extremely enthusiastic and it was agreed that the first of two days training would take place the next day.12036849_523266397836937_4921126196957729621_n

I cannot tell you how much fun it was to go home, amend my material to suit the purpose and then go to work in rush hour on the Delhi metro. I think my metro experiences alone could be a blog in themselves but suffice to say as with every human interaction it gave me lots of opportunity for growth and enough anecdotes to dine on for the foreseeable future!

It was my first experience of delivering this training to a mix of staff and senior peers and I had to give careful consideration to my amendments to maintain safe boundaries without compromising the work. In all honesty I saw it as more of a challenge so I was taken aback with delight when I saw the value of staff experiencing not only their own journey with maps but their amazement witnessing the changes in those they had worked with for almost a year. As with every training the mapping sells itself but with the hundreds of times I have facilitated this process I have never seen anything quite as beautiful as this.

Due to the confidentiality agreed which is crucial to support the integrity of this training I cannot say more but I can say that everybody engaged with a passion and joy that was infectious and it soon became apparent that some members of the group were thinking of their own sessions and planning their own bespoke maps.

At the end of our session mindful that I would be returning to the UK I wanted to formulate an action plan with the team to ensure that this would be carried forward.

12009785_523265867836990_5857122002329707386_nTogether we agreed phases of implementation including cascading the training to absent staff, showcasing the maps to clients, adapting maps to client need in terms of language and a Skype call with me to review actions achieved and actions to complete.

Shafa published their own experience of the training. Tushar said “I take the whole concept of mapping as one of the most important tools that someone has given to me to play with. Session continued for two days and still I felt that it was not enough. The whole technique enables you to find out the solutions of your problems by using out own inputs to any situation. More over I would like to add to it that it also helps to identify our true self like our strengths, our weaknesses, our challenges, the people who matters in our life the most etc. It allows a counsellor to record all the necessary information about the counselee in a more systematic order” Sachin said “Attended this session on Mapping which would be so informative i had never expected. It was like peeling an onion layer by layer, same was the case with this session on mapping it had different layers of valuable information within it. A very thoughtful innovation to get information related to any body and any sort. By attending this session I feel more powerful and confident, because for the first time I saw things from a different perspective and tried to find out solutions for my problems with the resources available with me. This was really motivating and skilful technique for life.”

It is not uncommon at the end of the two day training that there are emotional goodbyes, tears and hugs from 12032923_523271207836456_1180870037899864262_ndelegates. Over the years I have been privileged to witness huge events unfold, decisions made and action plans put into place through mapping over the two days. ITEP node-link mapping is one of my favourite trainings to run, the privilege of facilitating such powerful change is not lost on me and is always an honour. I have forged powerful connections with delegates I may never meet again but the link will never be broken.

I found it so hard to go after such an emotional three days but I know that I will meet the Shafa family again. I want to thank them for allowing me to work with them and am grateful for all the learning I underwent whilst with them. I know because of them I left a better trainer.

By Kim Maouhoub, Training Manager at Blenheim

To find out more information or to book training please contact our training team using this enquiry form.

Offer support not stigma

With the Black review looking at alcohol, drugs, obesity and welfare (including the possibility of sanctioning the benefits) it is hard not to see this as an outrageous attempt to stigmatise people whose lives are often difficult enough. Many have recognised physical and mental health conditions underlying their drug, alcohol and obesity. This is often compounded by deprivation and a lack of social capital. Many are too ill, too old, or lack the skills necessary to enter the workforce. I do not believe that it is right to sanction people’s benefits where they do not access treatment.

I do believe that Government and the drug and alcohol sector need to seriously consider whether and how more people addicted to drugs and/or alcohol, and those in recovery can be supported into sustainable employment something many are desperate to achieve.

A chaotic lifestyle is common for many in treatment for problem drug and alcohol use and most are far from ready for employment.  Many are unlikely to have experience of recent employment and so are detached from the labour market. They often face a series of additional issues at the beginning of the process of recovery, such as managing their addiction and the associated health problems, and a lack of stable accommodation, all of which may hinder the gaining of employment.

One of the central aims of the treatment system I believe needs to be to help people resolve these problems and where possible assist them to become ‘job ready’ whilst acknowledging that gaining and sustaining employment is unlikely to be successful unless the primary issues are addressed and there is evidence of stability.

The Work Programme and its Payment by Results funding has resulted in a focus on those easiest to get back into the workplace whilst those furthest from being ready to enter the job market are often parked with little support. Specific services working with drug and alcohol misusers around employment and training were an early casualty of the Works Programme as were many services commissioned by the treatment system to address employment issues.

There is in my view a clear consensus about what is required (see UK Drug Policy Commission) to assist drug and alcohol users to re-enter the workplace or in some cases enter for the first time.

  1. Treatment for physical and mental health problems
  2. Building motivation and aspirations
  3. Stabilise drug use
  4. Provide appropriate stable accommodation
  5. Develop soft skills e.g. through volunteering
  6. Formal training and skills development
  7. Work trials and job placements
  8. In-work support

Given the recovery agenda and the importance of employment in sustaining recovery I believe that employment support and ETE advisors should be part of drug and alcohol treatment provision and commissioned as such, rather than part of wider DWP initiatives such as the Works Programme. Many drug and alcohol charities run excellent such services but such initiatives remain rare. Current employment initiatives via the Works Programme fail Blenheim’s beneficiaries and where we are able to get people job ready do not seem to be able to deliver employment.

There are two clear challenges in getting more service users into employment

‘Job-readiness’ – an individual’s beliefs and feelings about their readiness for work;

‘Employability’ – employers’ perceptions of the suitability for employment of individual jobseekers

Until the Government puts pressure onto employers to ring fence placements for disadvantaged people, then our service users will continue to face an up hill battle and further disappointment.  Perhaps local authorities and public services should be expected to offer employment opportunities for those seeking re-entry into the labour market or it could be a condition on agencies taking public sector contracts.

Many will need significant help in overcoming some of the common barriers to being job ready which include:

  • low levels of education or skills;
  • poor physical or mental health;
  • evidence of multiple forms of deprivation;
  • gaps in provision of support services;
  • personal and presentation barriers;
  • and interpersonal barriers

There are significant dangers of rushing people back in to employment too soon becoming ‘job ready’ incorporates a range of factors, from primary issues of stabilising drug/alcohol use and accommodation, and related health issues, to re-engaging with the labour market, including volunteering, to build up a CV and a skills base.Helping people develop a positive and realistic attitude to work, through building confidence and motivation (e.g. undergoing training, volunteering etc.), is an important task for services. It is important to provide practical support in the search for employment along with aftercare support to help sustain employment.Currently recruitment processes are used in different ways to manage these perceived risks. This can range from ‘blanket’ recruitment policies that rule out employing those with a history of problematic substance misuse, through to a more discerning individual approach. A central concern is whether an individual is ‘fit for the job’ in terms of being reliable, capable and punctual.

Any worthwhile ETE programme needs to have an Employment Engagement worker who can job broker for those returning to work and carve out local employers to get on board and contacting employers directly for clients on an individual basis, selling it as a free recruitment service for people we know and have worked with for a long time. It will be important to negotiate work placements to give people and employers an opportunity to see if it will work out or to provide valuable experience for the CV.

The active engagement of willing local employers to offer work placements and employment opportunities is crucial. There is an on-going need to allay the fears of employers who are generally reluctant to take on potentially ‘risky’ job applicants. The development of in-work support packages would greatly assist with this.

There needs to be a process of matching the expectations between people and those helping them with ETE regarding suitable employment. This will include the need to recognise that health and drug status along with education, age and experience will play a fundamental part in the types and number of job opportunities available.

There remains a lack of access to specialist support for drug and alcohol users, services need to incorporate ‘specialist trained ETE workers’ in the field as part of the treatment system not something to refer onto

There is a need to create an ‘appropriate’ ETE environment to aid with employment search/links. Work programmes are not set up to deal with our client group, JCP does not have the time or resources and staff in most drugs and alcohol agencies are not skilled or equipped or tasked to deal with this area whilst clients are  in treatment.

DWP, Government and local authority have a responsibility to put pressure on employers to ring fence work placements and offer work based apprenticeships.  Some ex-offender charities and organisations have made huge progress in this area.

Stigmatising people who are overweight, or have drink and/or drugs problems does little to improve their employment prospects.  Instead providing targeted ETE support and finding supportive employers to offer opportunities for employment provides a positive and potentially much more effective response.