During June we have had four peer group meetings. Together with the clients we have eaten self-made fish soup, fixed bikes and played a typical Finnish outdoor summer game called Mölkky.
The number of participants in the peer group meetings has varied from zero to six. It seems that few men have committed to the group. The others come and go, appear in the meetings and then disappear. Some of them respond to messages that we send to them to inform them about coming peer group meetings. Some of them even call us. We might have long telephone conversations with them, but when it is time to come to the meetings the men are not there – even though on the phone they have promised to be there. Also, some of the men have lost their phone connections in a couple of weeks’ time and we have lost the contact with them.
We discussed these problems with our colleagues from our local partners, Sininauha Oy and A-kilta, which are organizations that work with substance abusing clients or former alcoholics. The colleagues agreed with us: it is a very typical phenomenon among the clients of this target group. The clients have difficulties with committing to the group meetings or other activities. The summer time highlights these problems. During winter many clients take part in this kind of activities more actively but in the summer time they find something else to do – or don’t do anything special, which is more common.
Sometimes even getting out of one’s own home can be a huge psychological effort for our clients. It’s typical that they have decided and promised beforehand to attend some activity – and they have truly believed that they are really going to do that. But when they should leave their homes they just can’t do it, for one reason or another. There are also more practical explanations why our clients don’t always show up even though they have said that they will. They have told us that they don’t have money to buy bus tickets or they don’t want – or they don’t know how – to use public transport.
If it’s rainy or the sun is shining too warmly they don’t want to come by bike. Also that the biking route through the city centre is full of temptations that they feel they can’t resist. It’s not yet easy for them to bypass all those pubs and beer gardens. On the contrary, one of the men told us that he had biked to a beer garden straight after our peer group meeting. He explained that the weather was so nice that all his old bad habits came back to his mind and his addiction took the control. As we know it’s a long and bumpy road to overcome alcoholism.
Our clients, middle-aged men with past – or not so past – drinking problems – are mostly people who have had no “normal “hobbies (beside drinking) in their adulthood. They are not familiar with the idea of committing themselves to some activity regularly. Some of them are also shy and they suffer from a lack of social skills. For them it is not easy to come to a group where they don’t know other participants beforehand and it takes time to make them feel comfortable enough to join the meetings.
Attending these Much More peer group meetings are not tied to any financial benefits of the clients. So their livelihood doesn’t depend on taking part in these meetings. That means that our clients have to want to come to the meetings totally voluntarily – so they must feel our group so meaningful that they will come again and again. For us it means that we have to manage to form a group that the clients feel important for them themselves.
How can we make that happen? That’s the question and a major challenge for us professionals. After all, we have decided to find out how we can do that with the Much More project. Together with our clients we have made some plans for the next peer group meetings: we are going fishing, bowling and playing billiards together. That’s what our clients suggested.
In May the Blue Ribbon Association had their meeting outside and made it a barbecue. The weather was nice and the sun was shining.
During the meeting the men started to talk about why they didn’t find watching sports fun anymore. They told that watching sports reminds them about drinking beer because in their past watching sports was always connected to drinking. Nowadays, when they are trying to live without alcohol they don’t want to watch sports anymore because they are afraid that it could be a trigger that makes them drink again. The men said that it is quite easy to become sober but it is so hard to stay and live sober if drinking has been the number one activity of the everyday life.
Later the discussion turned to the life stories of the men and their family and relationship problems. Due to their drinking some of the men had totally lost contact with their children. They felt deeply sad, sorry and guilty because of that but some of them had accepted to live without their children.
Some of the men, for their part, meet their kids regularly. For them building good relationships with their children has been the main reason why they wanted to quit drinking.
After all this eating and talking we planned our next group meeting. The men decided that they would like to fix their bikes next time. They had enjoyed this meeting very much and expressed an interest to continue attending the group.
We started our project here in Turku by a meeting with our local partners from three different organizations that work with substance-abusing clients. Those organizations were: Sininauha Oy, A-kilta and Tietu ry.
Sininauha Oy is a company that works with clients who have had drinking, drug or mental health problems and who have lost their homes. It provides supported rented accommodation for their clients. The work is based on the housing first principle, which means that housing is the primary need. According to this framework housing is the first step of the social rehabilitation for substance abusers. In the meeting we agreed with the Sininauha Oy that their social instructors will encourage some of their male clients to attend our Much More -peer group. The social instructors pick the clients that would benefit our Much More -group and take them to our first meetings.
A-kilta is a non-governmental grass roots support organization. It offers services and support to recovering substance abusers and to their families. A-kilta promotes a substance free lifestyle by day-time activities and peer groups. We are going to co-operate with A-kilta by visiting their unit and by persuading their male clients to attend our Much More -group. We also agreed that Much More -project will organize some small events like barbeque evenings in the A-kilta house to make their clients familiar with Much More -project.
Like A-kilta, Tietu ry is a non-governmental grass roots support organization that provides services and support to people with addictions problems. It provides low-threshold substance abuse counselling. They will try to persuade their male clients to attend our group. They will also offer some professional guidance to our Much More -project if needed.
Johan Pliakas from Stickan and Per Götberg, from the Swedish Church whom also once attended in the group activities with the target group, had a work shop with the staff of Hemstagården on June 20, 2018. Stickan made a summary of what has thus far emerged in the group treatment with the target group.
What they can summarize this far is that the target group talks about different levels of obstacles to make everyday life and weekends manageable and meaningful. Everyone states that during- and immediately after treatment, you are extremely vulnerable and fragile. One of the participants said that is like your emptiness-feelings and the addiction-feelings are at war with each other. You need to fill your everyday life with meaning. Here are some of the suggestions that the target group has come up with:
Stickan also lifted that that the purpose of today's- and future work shop is to start a thinking process with us professionally about how to develop already current treatment and/or start to think about how to develop new support, treatments, models or activities.
The other half of the workshop Per from the church gave a lecture or perhaps rather held a seminar on how the Attachment theory can be linked to our target group. There were many thought shared about what attachment-patterns we all have, but above all, what attachment-patterns our target group has and how it affects them in social relations. It can also be very helpful in getting tough but also thinking about having to respond to them and how difficult it can be with trust.
The stress management and burnout prevention are becoming more and more important. Especially, when one’s everyday work is directly linked with people who have various addiction problems. Work with this target group in order to maintain their motivation is limitless and consequently might lead to the occupational risk of stress-related illnesses.
This was the reason why more than 20 professionals responded to the invitation to the seminar arranged within the project “MUCH MORE” on June 12th in Riga. Among participants were specialists from 1 to 24 years of professional experience in the field of social work. Although burnout affects individuals at all ages and occupations, it is highly prevalent among health and social professionals due to the intense and continuous nature of contact with individuals receiving care at social rehabilitation centres and night shelters. The result is negative impact on physical and mental health which ultimately relates to work and life quality. During this seminar the professionals learnt to recognize the symptoms in order to identify them in early stages. Theoretical part was well-mixed with practical tasks. Prevention and control of professional burnout are of utmost importance, otherwise stress and burnout could lead to absenteeism from sickness, bad quality of services and need to change one’s job. At the end of the seminar the participants admitted that when you know how to manage your own stress, you can be of real help to others.
On May 25th STICKAN hosted it's second meeting. We talked about how to get the target group motivated, curious and interested to participate. Do we need to add something extra to reach them?
One thing to think about in the future EU group activities is that many people attend in treatment programs, employment services activities or work during daytime. Therefore, it’s more likely that more could participate if it was during the evening.
One suggestion that came up was to make flyers and describe something that is connected to activities that makes everyday life meaningful, joyful and inspiring. This idea is connected to all the group activity events that we have had earlier, though the target group have expressed that what's missing in the currently available addiction treatment is something that builds a meaningful, joyful and inspiring everyday life. The group client also said that this should be something you offer everybody after completion of addiction treatment, or parallel before completion.
Another idea that came up was to note on the flyers/leaflet that this EU project is offering activities and meetings with people that are aiming to explore what it is that builds a meaningful, joyful and inspiring everyday life. Example or suggestions that could make this happen is to for example watch a movie together, go to a music concert or listen to a song and analyse the lyrics.
In April the actions of MUCH MORE for middle-aged men was successfully started in all three project locations: Turku, Gävle and Riga. Throughout the year, Riga will run a program consisting of several workshops: practical healthy nutrition and cooking, art therapy and sports. At the beginning, both the participants and trainers did not hide their concerns about the success of these activities - they were doubtful whether they will be able to cope with their tasks.
Since the beginning of April nine workshops have already taken place and both the participants and trainers feel inspired by these activities which provide a lot of positive emotions and new experience for all. These practical workshops help both the “parties” recognise their strengths and weaknesses and to acquire new skills and knowledge. Art therapy has been chosen to improve persons’ mental and emotional well-being by providing the opportunity to express oneself artistically, improve self-esteem and awareness and to generate deeper understanding of oneself. During the first meeting the task was to write a letter to oneself or draw a picture “How I see myself within next 6 months”. The activities and tasks are different - the participants are encouraged to try various music instruments, improvise and discover themselves through art and music. Physical activities have been included in the programme to maintain or improve good physical health. Nutrition and cooking workshops are enjoyed most of all. The participants have expressed a wish to have them more often and to make more new and simple recipes. Conclusion after the first two months is that interests and skills of the men are different but the majority of the participants admit that they really enjoy the workshops and like that the tasks are understandable and results achievable.
The target group and the group leaders met in Stickan's premises with on the 4th of April. The group leaders explained their background, competence and described that they had joined this EU-project though they were- and still are interested in the subject; "What gives a better well-being, or better health in common and for this specific group".
The group raised the following questions:
1. What conditions must be met in order to be able to work with the above questions
2. What experiences have the group members given them a better well-being?
3. What do group members think can provide them a better well-being?
4. What activities and/or people can help to explore what will improve your well-being?
The men discussed their backgrounds and different treatment programmes. They found that trust in the group is a necessary component for success.
On 30 and 31 January, the partners of MUCH MORE project met in Gävle to learn how the social services and non-governmental organizations in Sweden help men with past addiction problems find the way in life, and discuss how this experience can be used during the workshops with men and training for professionals to be organized within the project frame later this year.
The representatives of the MUCH MORE partner organizations – municipality and NGOs – had a chance to learn about the approach and treatment methods used by the social services in work with the target group and the non-institutional care. The meeting at Gävle’s Social Services – Outpatient Unit, Treatment Coordinator Roger Larsson presented the model of support for those, who look for “good and meaningful life”. The support is based on the conversation and mapping of difficulties as well as one’s strengths and developing the strategies to reach one’s goals. “The approach is motivational”, said Larsson. There are also programmes for relatives, support groups and knowledge and introduction groups for those who want more information on how does the alcohol or drug dependence affect them and their environment.
During the days, also the premises of the Swedish partner of MUCH MORE, Stickan – Centre for Men in Crisis were visited. Stickan offers support for men, who need help because of family problems, home violence, addiction, loneliness etc. The work with clients is done through individual and group therapy in a cozy environment of Stickan’s office in the centre of Gävle. “This organization is run by men for men. This helps us reach our clients”, explained Johan Plikas, Stickan’s therapist and local coordinator of MUCH MORE.
The final stop was done at the Social Services' supported housing Stallgatan – a house that provides accommodation for those, who do not have a chance for another apartment anymore because of various troubles. The private and affordable accommodation gives people another chance to live a dignified life. “We started in 2006. Before that you could see the homeless people on the streets of Gävle. Now it does not happen. They have home.”, admitted Solgerd Hedberg, accountable manager at Stallgatan.
The study visit was enriched by the lecture of Anders Hammarberg, medical doctor at the Karolinska Institute in Stockholm and a behavioral scientist and certified psychotherapist. Hammarberg has worked with treatment, research and education concerning addiction problems for almost 20 years. He has been involved in specialized addiction care, occupational health care, social services, criminal health-section and as a psychotherapist. The lecture was on controlled drinking, which has been a goal for many patients Anders has met during his career path. As the traditional therapies require from the clients the total abstinence, the controlled drinking concept presents a new perspective to the treatment. It requires self-control and self-organization and while it is no for everyone, it can help reach more people in need for help.
“The visit showed us that the problem of alcohol abuse has become an all-encompassing problem that affects one’s home life, finances, ability to work and one’s health. Alcohol abuse cannot be ignored as a problem that will go away on its own; many people need professional help. We got encouragement that our planned project activities based on motivational approach will serve the needs of the target group”, said Aija Vecenane, a local coordinator of MUCH MORE in Riga.
Seppo Nikula from the Blue Ribbon Association of the Southwest Finland commented: "It was great to get the whole picture of Swedish way of operating in this area. Also the lecture of Anders Hammarberg opened out eyes on how to motivate and set goals with our target group during the project".
"This is a great project and we are very much looking forward to our cooperation" - said the MUCH MORE partners at the kick-off meeting in Turku on 16 November 2017.
The full name of the project is "Skills for social and working life for the middle-aged men with past addiction problems". The project aims to develop the intervention model for work with the target group, which is empowering, participatory and attractive. This will be done by organizing the peer-group, do-it-yourself or nature-based workshops, where the men will receive the health and social advice that should help them reunite with the society.
All of the project partners agreed during kick-off that the project is an excellent opportunity to learn from each other and create activities not present in their organizations at the time. The concept of "empowerment" and "participation" was widely discussed and it was agreed that the men should be involved in the co-creation of the activities to the biggest possible extent.
As a site-visit, the premises of the Blue Ribbon Association of the Southwest Finland were visited and the partners from Latvia and Sweden had an opportunity to learn more about the work of the Association.