Over the years, I’ve seen and heard of so many bad practices in treatment services, commissioning, and policy making within the addiction treatment system. You would think the system would learn, but bad practices continue and people’s lives are negatively impacted upon.
On the other hand, I’ve heard about, and seen, some wonderful services and met some truly special people who have developed, or worked in, excellent services or recovery-based initiatives. One of those people is Rhoda Emlyn-Jones OBE from Cardiff, who I first met over 20 years ago when she was running Option 2, an outstanding family-oriented services she set up.
I was due to meet Rhoda—as well as Wynford Ellis Owen (formerly of The Living Room, Cardiff) and his wife Meira, and Kerry Manley (a former volunteer for my Wired In initiative)—when I was in the UK in April/May. However, I completely ran out of steam a few days earlier and, to my deep regret, had to rest up and cancel this part of my South Wales trip. My apologies again to those four special people.
Here is a film I have previously edited from Rhoda’s conversation with my Recovery Voices colleague Wulf Livingston which illustrates Rhoda’s special nature, approach, and contribution to the field. I hope it won’t be too long before I see her again. It’s been far too long.
Rhoda worked, at a management level in Social Services, with adults affected by drug and alcohol problems. She was also given a free rein to build new services and raise money. In effect, she was working like a voluntary organisation. Wulf points out this situation is so different to today’s commissioning world. Rhoda emphasises that when the commissioning process first began years ago, it scuppered a lot of growth from the ground up through its arrogant nature. Today, there is usually little listening, collaboration, or shared learning.
Rhoda set up an In Reach service for people with alcohol problems who were going back and forth to prison. This was long before the highly-funded Drug Interventions Programme (DIP) which started in 2003.
Rhoda and her team engaged with people while they were in prison, and met them on the day they were released, when they had very little money and plenty of fears and hopes. Her team advocated for the person and helped them find ways forward. In many cases, they had already discussed with the person’s family what it felt like having the family member come home—there was a mixture of anxiety and hope for the family.
As a result of this work, the ex-prisoner was a much less vulnerable target for those wanting to take them down a path that would lead them back into trouble. Like every service that Rhoda ever developed, In Reach developed impact measures. Rhoda did this herself, as Social Services did not use such impact measures. Her data showed that after two years there was an 80% reduction in recidivism! After five years, Rhoda’s In Reach service was abolished and a new criminal justice programme was launched.
Later, Rhoda ran a multi-agency DIP which included a health component providing scripts. It used the true connection strategy of her earlier alcohol initiative. Every other DIP with whom she talked waited until people knocked on their door after coming out of prison before engaging. In response to people not turning up for appointments, DIPs got stricter and more demanding of the person, increasing pressures on the individual.
Rhoda’s view on personal responsibility is that you start with the most meaningful things for people—help them understand and articulate their own hopes for the future. Together, unpick the things that are going to help get them to a positive outcome. The personal responsibility of attending appointments is then much greater.
Wulf talks about how people at that time used to get labelled as ‘unmotivated’, when they weren’t that at all. Rhoda points out that if you recognise that the person is not unmotivated, the power for change is much increased. You must truly engage with the person and help them think through their journey towards their desired outcome.
Along the way, there may be all kinds of slips, difficulties and troubles because ‘the connection they have with drinking is so huge. But it’s understanding that, not judging that. We’re not being cross with someone because they are not changing, despite everything that we are giving them.’ We must understand that some people really struggle, ‘some find the right thing at the right moment, and it’s never one thing.’
Rhoda points out that we are facilitators of these processes. People may then gain a sense of belonging—often to their families, which they have previously ‘lost’—as they are regrowing, along with feelings of self-worth, and being someone who contributes in the world and is not seen as a charitable case. ‘All of that psychology is part of that journey…That’s where we all need to work together.’