Rhoda and I have known each other for over twenty years, during which time I have come to value her font of knowledge. It is therefore a real pleasure to have some of Rhoda’s thoughts on what makes a difference in enabling families to recover.
Our journey together began during the period of Rhoda and her colleagues developing the remarkable Option 2 Service in Wales. In this film, Rhoda describes how her own early familial experiences led her into working with those experiencing homelessness, alcohol and drug use, and other difficulties. She entered the social work field and ultimately ended up guiding a national approach to practice.
What is so remarkable about this interview, and in a sense what I continue to learn from Rhoda, is how the best of practice is built on the most obvious, but often neglected, cornerstones of honesty, respect and understanding. I feel our conversation really reflects some of our shared origins and a desire to translate these formative experiences into an explicit understanding of the need to work with individuals, families and communities, rather than any sense of doing unto, or prescribing, what one thinks is right for ‘someone else’.
Rhoda provides us with a clear message about the importance of valuing hope and strengths over negative sceptical stigmatisations. And, how from this it impossible to see and support genuine recovery journeys and articulate for whole system changes in practice thinking.
Rhoda’s interview was edited into 11 films, totalling just over 79 minutes, as well as a Film Teaser, for her Recovery Voices archive section.
1. Friends Over the Years [5’10”]
Rhoda and Wulf are both social workers in Wales who first met over twenty years ago. One of the initial meetings occurred when Rhoda was running the Option 2 service in South Wales, and Wulf later did some work with her involving Option 2 in North Wales.
Rhoda says that at that time the small number of like-minded people who were innovating in the community field were like a family, being incredibly supportive of each other. Usually, they were under-funded and struggling, but they had a forum of support.
Wulf points out that he and Rhoda have dipped in and out of each other’s experiences since those early days. Most recently, Rhoda generously contributed the last chapter to the book ‘Social Work in Wales’ that Wulf and colleagues edited. Rhoda is Director of Achieving Sustainable Change (ASC Ltd.)
2. ‘It Goes Back To My Childhood’ [3’43”]
Rhoda’s involvement in the field and her approach are influenced by her childhood and the time her father Alun was drinking excessively to help him deal with the deep grief he experienced after the loss of his beloved wife Prue (when Rhoda was 14 years old).
Alun, an extremely loving man, was now looking after four girls, the youngest just four years old. The children understood that their father was just trying to function to stay with them, rather than neglect his responsibilities, which was a very different perspective to everyone else, who thought that if he loved them, he should just stop drinking. From that time, Rhoda realised that ‘we needed to see people from the challenges and problems they faced, not the challenges and problems they caused.’
Alun provided so much support for people with alcohol-related issues. There are still three rehabs existing in Wales because of him. He did all this voluntarily. He used to bring home people who had nowhere to live and were drinking on the streets. Rhoda and her sisters used to listen to them.
When she was about 18, Rhoda started to go out on a ‘soup run’ at night. She noticed with the people she engaged with that it was not the charity of the soup, but the human connection, that mattered. She learnt so much from the people with whom she engaged.
3. From Counselling to Social Work [5’11”]
When she was 21, Rhoda became an assistant warden for a hostel for street homeless drinkers. The warden was off on long-term stress, so she was the only person there for 12 people. Rhoda had to ensure it was a dry house. She was doing other jobs at the same time, and it wasn’t her intended career. One day she fell asleep at her desk. She woke up to find a coat draped over her and a sign on the door saying, ‘Ssshhhh, Rhoda’s sleeping.’
Rhoda later became the senior counsellor in a community-based counselling service called Breakaway. When she had been running the service for six years, she was kicked out because it was decided only qualified people could run such a service. Within two years the service had disappeared.
Rhoda decided to get her Social Work qualification and then worked several years in Child Protection. Very luckily, she was asked to lead on a specialist arm of Social Services, tackling drug and alcohol problems. That was very rare in Social Services.
During this time, Rhoda learnt the real attentive nature of each human being—what’s unique in them that affects their potential for challenging and changing difficult parts of their lives. She emphasises the importance of focusing on, and learning from, the therapeutic conversation. You use that therapeutic conversation within a setting to advocate, build support, and do so many other proactive things with the person.
4. Developing & Managing Services [10’42”]
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.’
5. Children, Judges & Commissioners [5’56”]
Rhoda’s colleagues in Children’s Services would often refer people with drug and alcohol difficulties to Rhoda’s service, asking them to ‘fix that bit’ so that children could live safely at home.
Wulf points out that at that time the system assumed that if the person stopped taking the drugs and alcohol then everything would be alright. More enlightened people realised that this was not the case. If that was all we did with people, we would actually make them worse by taking their coping mechanism away and not changing anything else. ‘Exactly,’ says Rhoda, ‘Leaving nothing in its place.’
Rhoda describes training an excellent group of judges in London who were developing the family courts—drug and alcohol, family, child protection courts. The judges were so humble and open. The court processes in the family situation became therapeutic in themselves—there was real listening and understanding—and the courts had great results. However, there was a long gap before knowing from the data how valuable these courts were for the long-term gains of the families and children compared to the existing system.
Now, courts often respond by saying, ‘Have they been given enough services? Have they gone to their perpetrator groups, have they gone to their drug and alcohol services, have they gone to their family parenting classes?’ And many families have been to six or seven different services. And they think, ‘What is it that you want from me?’
Rhoda points out that the whole focus is about process and services, rather than what is so important in this work: ‘Services are a means to an end. Not an end in themselves. And the meaning in the “means to an end” comes from the person’s sense of their value for them.’
Wulf emphasises that what Rhoda is saying is so important. He has had many discussions recently with people around services being polarised and one being more important than the other, rather than what he calls ‘the sequential means to an end’.
We need harm reduction that keeps people alive, and then we need the crisis interventions that give them the chance to change. But that isn’t the end. Successful completion of treatment is the opportunity to do the third and final part, which is to really make the change that is going to sustain and endure the person. Too many people think that as long as one bit has gone, it’s somehow valid in itself. But it’s just contributing to what the individual or families are doing, it’s not inherent to itself.
When Rhoda started Option 2 she commenced longitudinal studies, focusing on impact over time, generational change. Wulf points out that there have been few pieces of work that have completed such a longitudinal study.
6. Option 2 [8’45”]
Prior to the development of Option 2, Rhoda’s team was out-of-step with colleagues. What Children’s Services wanted from them was an immediate response, because it was a crisis for the child, whilst what Rhoda’s team needed from them was to understand the nature of the change for the parent. What needed to happen was a better beginning and understanding of the importance of people managing their own risk towards their desired outcome. ‘So it’s not an event that change, it’s a process. But you keep things safe along the way, from the family’s point of view.’
One day, a member of Rhoda’s team approached her about a referral from Children’s Services. She had met the mum and said to Rhoda that if she was going to make a difference—and reach the stage where the mum’s children were not removed—she was going to have to work every day with her for the next few weeks. Rhoda told her that this type of service was needed.
They developed their approach, looking at Home Builders—a home- and community-based, intensive family preservation services treatment programme in America—and various psychological therapies that worked. The service name Option 2 was decided upon, since it said to colleagues ‘at the point that you are about to remove children, there is another option. And come to us and then we’ll do some intensive work.’
Rhoda had an excellent team of staff and a very clear intervention over four weeks. They would work one family at a time, 24/7. Option 2 was IT for the duration of the four weeks. All families had the phone number of the Option 2 worker.
There was a huge amount of safety planning right from the beginning. Focus was then ‘on them, as a family—how they function, their values, their strengths, where the priority risks are for them, how they are going to overcome them themselves with us alongside.’ The family then began to put their alternative behaviours in place, which they had never had the opportunity to do, whilst holding a safety net of their safety plan. If things got difficult, the children knew what to do.
Outcomes were reached four weeks in—family functioning, children thriving, key issues resolved. The deep intervention was stopped, and the team member then came back one, three, six and 12 months later to check how things were going. ‘What is it about you that is keeping this change going? What are you facing in terms of challenges? What plans have you got to deal with those?’ At six months, there was sometimes a bit of a wobble, in which case a worker might go back in for a few days. At 12 months, year-on-year for ten years, 75% of families were holding their outcome behaviours and functioning.
Wulf worked with people who were given labels by others like ‘most complex’ or ‘lots of needs’. When he first met them, he realised that one of the things that stopped them achieving anything was the fact that they would have anywhere between 6-12 appointments in a week with 6-12 different people, resulting in multiple 45-minute conversations. How detrimental would that be, particularly when compared to having many hours of one conversation with one person that could turn into something meaningful.
Rhoda describes people being tied up in a ‘scattergun-referral process’ and their ability to be a better parents being judged on whether they turned up to interviews. One woman she knew, who was self-medicating for mental health problems, had two children, one who had special needs. It was demanded of her that she turn up at a clinic at 10.00 and 16.00 each day to pick up the drug that would prevent her self-medicating. She had no money, and children in schools in different parts of Cardiff. People she was supposed to meet said she had missed her appointment again.
Wulf points out that someone in the system probably labelled her as ‘unmotivated, not wanting to change’. Rhoda says the woman loved her children. Option 2 was able to change the situation very quickly and the family moved to a very strong place.
‘You have to start where people are, and not assume that services define motivation…. The trust that builds between one [Option 2] worker and one family is unprecedented. And that trust provides total disclosure. So, within a week you know everything. And when that deep disclosure comes, there was masses of supervision back in our team, shared reflective practice where we talked that through, and the question for all of us was: “Does that disclosure indicate a new issue that we have to rethink, or can that be wrapped up in the intervention? Let’s not knee-jerk here.” But then we had to consult with all the other professionals around the family to help them understand that.’
Rhoda continued: ’There was a lot of the evidence that the system was the problem. Not the workers within the system, and not the families within the system, but the system itself.’
7. Integrated Family Support Services (IFSS) [10’50”]
Wulf describes how Rhoda migrated into Integrated Family Support Services (IFSS), which was something that the Welsh government had embraced and encouraged her to do as part of a much wider piece of work with social workers across the whole of Wales.
Rhoda says that the money for Option 2 came from the Drug & Alcohol funding stream. However, she has always emphasised that the Option 2 approach isn’t just important for issues relating to drug and alcohol problems. It is relevant to any issues that are impacting negatively on a family’s functioning. Her team, working with the most extreme situations, have shown that the Option 2 approach leads to true generational change.
When the team conducted their longitudinal studies they could find their control group families very easily. They had initially been referred into Option 2, but as no space was available they moved on to other services. The researchers found all these control group families still in the system years later. In contrast, the researchers struggled to find Option 2 families in the system, presumably because they were now not experiencing problems.
Rhoda describes one family who participated in the programme, where the husband was attacked by someone with a machete, and then went and attacked someone else with a machete, a week prior to starting Option 2. At the time, he and his wife were injecting drugs into their groin and feet. The family completed the Option 2 programme and later became leaders in the family community.
When the Welsh government set about trying to integrate all professional groups concerned with health and social problems, with an emphasis on families and reducing the number of children in care (which were extremely high in the country), they found Rhoda’s Option 2 research and asked her if this could be the basis of their proposed Integration Model. Rhoda agreed and set about thinking what the structure should look like, who would be involved, and how they would relate to the pathways into their own professions, and how they would function.
The idea was that Community Psychiatric Nurses (CPNs), drug and alcohol specialists, social workers, occupational therapists and health visitors would form one team. The team would look at new referrals and only one person would visit the family, since they were all doing the same thing. They would then bring their specialist knowledge together in their team’s reflective groups. In this approach, the family would only see one person and would not get muddled up by multiple visitors from different siloed professions often with very different philosophies.
Rhoda emphasises that their model had always been about consultation. When any professional rang into the team, they had a truly skilled consultation around what’s going on for the family, the strengths in the family, the family’s priority risk, and what they (the family) hoped for in terms of an outcome. They wouldn’t start the work until they were sure that the worker referring wasn’t just working on family deficits.
‘We engaged with that worker as a human being, empathised with them, their stress, their worries, their fears, and not treat them as someone who doesn’t understand.’ If the team was going to have collaborative approaches, they really needed to respect and empathise with each other right from the beginning. Once this referral came in and was discussed amongst the team, one worker would go out to the family. The team also had a philosophy that all IFSS members would be trained, and then learn to be trainers of others, so they could deliver training themselves—learning would therefore always be rippling out.
Rhoda recently had the joy of attending an IFSS workshop in North Wales with Wulf. The team had been running for ten years and she was thrilled to see that the model and approach had not drifted at all from the original philosophy. She saw the same results as she had previously seen, and met family members who said they wouldn’t have their children, or their lives, if it wasn’t for the IFSS team. ’True fidelity,’ says Rhoda with a huge smile.
Two IFFSS workers approached her after the workshop and said, “I am so thrilled to be in the IFSS because I had a placement there, it took me five years to get in because there were no vacancies.” Rhoda says, ‘The reason there’s no vacancies, people are doing their best work.’
She points out that it was so special to hear that, because in the social care industry in Wales a massive number of workers are losing their mojo. Wulf points out that a lot of people want to do drug and alcohol work or be involved in similar occupations—‘I just want to help people’—but they then find themselves in a job where they are just processing paperwork, rather than doing the things they thought they would be doing.
8. Being Holistic, Inclusive, and Empathic [8’24”]
Wulf asks Rhoda what she thinks is important in helping families create sustained change. What is most important for families, most important for workers, and what must happen for a system to change?
Rhoda believes that one thing that makes a big difference is having an approach that is inclusive; it includes the person, the family, and their network. She asks and provides an answer to a key question: When we think of wellbeing outcomes, which are now beautifully written into Welsh government legislation and give us such an opportunity, where is our wellbeing tied up? It’s tied up in: (1) our own sense of self and our own contribution; (2) our sense of belonging and who is around us; and (3) loving and being loved. If we work just with individuals, we can’t understand what is at the heart of things for people.
Rhoda points out that she and her team have developed a number of services to support families as a whole, and they must help build confidence in family members and workers to work in this different way. The latter groups have been used to being in one-to-one relationships. We’ve gone through decades of the individual being the focus, and not being to share information within distressed families. Instead, we give another family member another service, ‘and never shall the two meet.’ These other family members may be at the heart of the motivation for the one we’re working with to actually help them make a change.
‘So, holistic, inclusive, really skilled staff who understand the psychology of all of that. And that doesn’t mean being trained in anything in particular, it just means being open to those concepts. And feeling comfortable with their conversational skills that allow them to empathise with everybody in the situation. And as they are empathising with everyone in this situation, it builds empathy in those relationships. And that empathy, understanding that John’s doing his best or understanding everybody’s perspectives, builds the capacity to change.’
Rhoda points out that if we just work on individuals and then try to fit the bits together, we’re more likely to face difficulties. Individual work does have a place, but it is not the whole answer. Wulf points out that of course you don’t send the whole family for a detox because one person needs it. As Rhoda says: you hope that the nurses in the detox unit understand the importance of family, networks and friendships. The things that make the person feel better in any individual day. The importance of a continuum of support.
‘Holistic, thoughtful, insightful… the uniqueness of people. Our services are uniform. People are not.’ Healthy public services and organisations should be learning and changing all the time. ‘Holistic, skilled, respectful, engaging.’
Making choices is also key. People have stabilised their lives and given themselves new possibilities through community. The recovery community provides fantastic support, but it has to be something the person is invited into. It’s not, “You will go there and learn from them.”
Rhoda says that it’s got to be a different kind of conversation that helps people see that being part of a community will ease them through that really tricky journey towards something they’ve identified and articulated as an outcome. And that outcome might be… “I will be contributing to the world, maybe doing some voluntary work myself. I’ll be building bridges back to my family. I will be seeing my grandson again.” If that’s the person’s outcome, then the journey makes sense in that they need to work on building bridges with their daughter so they can see their grandchild. This creates a sense of hope, so that’s what should define our work.
Wulf points out that these are different outcomes to anyone’s relationship with drugs and alcohol. The relationship to drugs and alcohol will change in order to facilitate that journey, but that’s not the outcome. He hears people strip down their desired outcome in very basic terms: ‘I just want to be able to sit around the table and have dinner with my mum again’, and stuff like that. When they describe it in these concrete terms, drugs and alcohol are not in the description of that future. That doesn’t mean that they are not going to have to change their relationship with alcohol and drugs—it’s something that happens as part of the journey, but it isn’t the end goal.
Rhoda points out that a person’s journey may be enormously challenging, but ‘once you’ve heard someone’s articulated outcome you’re alongside them deeply, and respectful of how tough it is.’
9. What Can We Discover? [6’28”]
‘Once you have heard someone’s articulated outcome you are alongside them, deeply respectful of how tough it is. And then you notice their strengths and you notice the ways in which they continue to struggle…’
Rhoda emphasises that you mustn’t build some sort of stereotyped picture of: ‘Oh yeah, well they would say that wouldn’t they. They’re not telling the truth. They are bound to relapse.’ These kinds of negative descriptions are a different perspective on the same issue. We must encourage people to not see it from that point of view.
Wulf points out that Rhoda has always said to him over twenty years that we must always recognise all the strengths and capacities for people to change. Rhoda says that we have fallen into the trap of releasing resources only when people can be defined as a big problem.
‘So if that’s the way to get a service and release resources to people, then the conversations between professionals, and between professionals and the citizens, are all about how bad is this, and where can you go and get something to fix it. So the conversation is all about the deficits and the problems, and sometimes they’re even escalated in order to push someone to crash through into the referral criteria of the service the worker wants.’ To get a service for my service user I must tell everyone how bad it is. Imagine every conversation in every new service starting with, “How big you are as a problem.”
In the last two years, Rhoda’s work has been moving on from the implementation of IFSS (Integrated Family Support Services) to supporting whole organisations shift their approach into being outcome-focused, not service-focused. ‘And focused on strengths, but not just a list of positives, but the strengths that could be utilised to address the risks.’ Strengths in that person, identified by that person, that are going to offset their risks to reach that outcome. ‘Services don’t come into that. We are alongside people and along the way they’ll invite in that extra help that keeps them going, but not as an end.’
And when we have a whole public service in Wales doing that, we understand right from the beginning more of what is needed, rather than leading with “What have I got in my bag that I can give them?’, such as appointments. There must be a shift in workers’ consciousness to the idea that they are there to use their skill to discover and build the relationship.
Along the way, you unpick those really unhelpful systems that have stopped people seeing each other as human beings. So, if you’ve got an expectation that you do assessment in this time, and you do an intervention in this time, you’re feeding a machine that leads to far less time being available to truly understand the uniqueness of this person in this world. In the local authority work and the collaborative communication programme work that Rhoda is doing, it’s all about transforming away from process-driven work, unpicking all those unhelpful systems, letting people truly see what is needed, and moving away from labelling and stereotypes.
One of the pillars of Rhoda’s work is to leave a local authority with a strong infrastructure of reflective practice. If you sit in a good reflective practice group talking about your work, you have no doubt about the quality of the work that’s being done. If you pull a file and try and see whether someone has filled in the right forms, you have no idea of anything other than their ability to feed the machine.
Enabling organisations to unpick the problems is complicated. Government has written amazing new legislation relating to these matters, and we welcome that, but if they don’t pull out some of their safety blanket, if they don’t stop asking for the wrong data, then they will continue to constrain people. So, right through the system we have to free people up. ‘You can’t grow roses in concrete, and we have poured concrete all over our public services, so our workers can’t flourish.’
10. Communities are the Answer [5’39”]
Taking into consideration what Rhoda has been talking about, Wulf describes reasons why recovery communities work. First, they absolutely believe in peoples’ capacity to change. Second, they are always very adaptable and changing, but because they’re not usually well-funded and their resource is all the people themselves, they clearly are coming at it from a very different space. Third, they don’t have any of the ‘concrete’ that has been poured into treatment and other services constraining their ability to genuinely help people.
However, recovery communities are criticised for not having the ‘concrete’ and they have to defend themselves endlessly. Wulf says: ‘They may not have the paperwork, forms and numbers (‘concrete’), but their defence would be, “Just come to the building at 7.00 in the evening and see twenty people sober talking to each other, supporting each other”, or as I did last Friday, walked five miles on Colwyn Bay promenade with 75 people. That’s the evidence!’
Rhoda emphasises that community is the answer. We’ve got overwhelmed public services. Over the decades, we’ve had so many opportunities for people to converse with each other stripped out. People are not having the same opportunities to support one another in general. Rhoda thinks that all public bodies have a responsibility to learn from communities and keep pushing resources, where they have them, out into those communities, because that’s where the answer lies. Supporting one another, and within that philosophy, not fixing everybody. Listening to people in a group, as Wulf has described, is true respect. In that case, they’re not expecting a particular answer, they’re not telling people off, they’re really ensuring that people have a chance to express themselves freely.
The big voluntary sector organisation with whom Rhoda works is steeped in the collaborative communication approach she describes. Their collaborative communication is with the professionals, the commissioners, the citizens, and their volunteers. They used to have a job description for volunteers, but they now say when a person approaches them, “Come in if you’re interested, and let us know what you’re really interested in, and then we’ll build on your strengths.” This new approach has tripled their volunteer base in a year.
The approach takes courage, but the CEO is absolutely steeped in it and is really committed. It also takes total humility and understanding. The approach ‘is a way of really understanding what helps, and if we build more of that, more people have the opportunities to step into environments that feed them in their huge challenges to make changes around their alcohol and drugs.’
Rhoda emphasises, ‘What you focus on grows.’ If we have a world where our public services focus on the problem, define the problem, and then decide whether it’s going to release resources to meet that problem, that is a lens that just grows a sense of problems and difficulties, and fears and anxieties, and risk. And if we let people take risks, then blame culture develops. Whereas if you push it out in the other direction, you get growth and creativity.
Wulf points out this is what recovery communities want to do. They stand there and say, “We can change,” and then collectively grow from this position. Rather than listen to people who say they can’t change.
11. Don’t Forget the Family [8’18”]
Wulf points out that all alcohol-related services today have come out of one original community alcohol team in the Maudsley Hospital and the book by Shaw, Cartwright and colleagues, Responding to Drinking Problems, in the 1970s.
One of the things that the system collectively has forgotten since then—Rhoda obviously hasn’t—is that specialist alcohol services started off as being consultant services, not services to work with the individuals, but a bunch of skilled professionals who enabled the whole of the rest of the system to do better. Its principle was, ‘Well, if people with drug and alcohol problems are coming through this door, this is the door where they want to receive the help, not another door three doors down. But if the door is not feeling comfortable, we need to support the door.’ One of the problems today is that a range of statutory services have become high intensity referral units and have stopped giving that expertise out to everyone else.
Rhoda points out that it was not acceptable [to the system] in the end for the original consultant services just to support other professionals to integrate alcohol and drugs into their thinking and skill-set, so they had to move on to provide a service. Then they became specialists, and other professionals’ thinking around drug and alcohol was, ‘There’s an issue, we will refer to them.’ So we lost all that potential growth in that consultation.
No service that Rhoda developed ‘ever excluded the possibility of consultation and then more intensely an invitation to training. So we would train people so that they could continue to have those better conversations and really engage with people without fear, because the more specialist your issues are, the more fear exists for the professional. Then they are not going to be able to engage, and they resort to aligning themselves with some stereotypes about how people might function.’
Rhoda continues: ‘So it is really important every time we grow anything to see ourselves seeing the other professional as a potential person who might feel better after our conversation, less fearful, more open and considerate, and so we sort of treat them as the system who is our main focus in that moment.’
Wulf goes on to talk about families, saying ‘There is nothing specialist about families. We all come from families.’ Rhoda replies: ‘We have disaggregated [separated into its parts] family members in our public services consistently for decades, so that holistic thing just gets lost… But there is no doubt that everyone at some point has been in a family or a network and understands the power of that on their own self and their own hopes and aspirations, as well as sometimes in the source of their pain.’
Rhoda remembers the old statutory framework for Social Services for social workers that started with the individual. You assessed the individuals and decided if they needed a service, and then do a financial assessment. Two years later, you might realise you’ve left the family out and therefore access a separate pot of money for families. The solution for the carers might be respite care. That’s an example of disaggregating families.
Wulf has noticed in working with recovery communities, that there are lots of activities that the community members do together, but there are other broader activities that are family-inclusive, involving partners and their children. He emphasises that recovery communities are more than just a collection of the individuals. Rhoda emphasises that it is important for people to see themselves in their family role—it is so empowering. “Being the best Dad I can be,’ is an aspiration. ‘Handling my pain in a way that doesn’t hurt my children,’ becomes the journey.
Wulf describes a piece of research evaluating stuff related to a detox and all the outcomes were portrayed ‘in the examples of families, and holidays, and dog walking, and barbecues, and gardening, and partners.’ He says it all comes back to that same place.
Rhoda points out that in other studies where people were asked, “What helped most?”, they say, “Someone listened to me, truly heard me, and understood me.”
‘There are general universal things that we need to do to respond well to people. And the most unhelpful thing to do is to create stereotypes, to label people, to block people from the help at the moment they are inviting it in. Give people no more, no less than they need to take that journey through to an outcome they’ve been able to articulate with you, that they’ve never been able to articulate with anyone else because no ones listening. So we really need to create that momentum, don’t we, for all of our services.’
Rhoda’s interview has also been edited into a large number of shorter clips which will be used on our Themes section. Rhoda’s YouTube Themes PlayList (30 film clips) can be accessed the link below:
Rhoda Emlyn-Jones Themes Playlist
Biography
Rhoda Emlyn-Jones OBE has developed a wide range of services over the past 40 years that deliver proven effective interventions to thousands of people and families. Her successful Option 2 service works intensively with families where parents experience substance use difficulties and whose children are at risk of being taken into care. She supported the Welsh Government in the roll-out of Integrated Family Support Services (IFSS), which draws heavily on the learning from Option 2. Rhoda currently works in an independent capacity supporting health and social care organisations throughout the UK in strategic workforce development. She was awarded Welsh Woman of the Year in 2007, and an OBE in 2009 for services to disadvantaged families.