Turning Point’s 218 project for women with drug or alcohol problems

In Glasgow, women with drug or alcohol problems are being offered relaxation and support as an alternative to custody.  Samantha Thorp reports

An interview for a part-time job may not seem the most exciting prospect in the world, but for Claire Alexander,* 29, securing such an interview is a milestone of which she is proud.

Alexander’s recent past has been difficult. A need to feed her drug and alcohol problems led her into shoplifting, prostitution and the criminal justice system. Prison beckoned. But then she was referred to 218, a rehabilitation centre in Glasgow, run by the charity Turning Point Scotland.

Alexander is one of 14 residents staying at 218; a further 50 clients use the day programme. Part-funded and supported by the Scottish executive, NHS Greater Glasgow and the council’s social work department, the centre was set up to offer an  alternative to custody. It seeks to break the revolving door syndrome that characterises many female offenders’ relationship with prison by tackling the substance misuse, trauma and poverty that drive it.

With the help and support of staff, Alexander was able to detox from alcohol and she is now reducing her methadone intake.

But equally crucially staff are helping to rebuild her self-worth, confidence and motivation. It is a treatment programme that has changed her outlook. She says: “I’ve started taking responsibility for myself. It’s just simple things like making myself  presentable and being on time for appointments. Before I came here I wasn’t looking after myself.”

To provide a multi-agency solution that addresses the root causes of these women’s offending behaviour, staff have a range of  professional backgrounds, including addiction, social work and psychiatry services. The centre provides assessment, detoxification services, advocacy, counselling, rehabilitation support and group work to help the women overcome their  problems and reintegrate into society.

The women who are referred to 218 face many disadvantages, often including a history of substance misuse, prostitution, poverty and mental health problems. “The women here have often been abusing drugs or alcohol for many years,” says Alice Keith, a service co-ordinator at the centre.

“Usually the women are self-medicating to blank out traumas from the past – they may, for example, have been abused as  children. They are extremely vulnerable.”

A care plan is drawn up for each woman when they start the 12-week treatment programme. As well as addressing their substance abuse, offending behaviour and physical and mental health needs, the care plan also explores issues such as  relationships, accommodation and welfare benefits.

Drawing up the plan is a collaborative process. “The women usually tell us what vision they have for the future and help map out their short, medium and longterm goals,” says Keith.

Staff aim to spend enough time with service users to build trust and encourage the women to open up. Service users can mistrust well-meaning professionals but, says another service co-ordinator, Anne-Marie Carlin, sincere relationships can still be built. “It doesn’t have to be done in a formal setting, it could be informal as well – we might accompany them on a shopping trip, for example,” she says.

Staff have a policy of always eating their lunch with service users – sharing tables helps to diminish the divide between  professionals and service users and encourages everyone to chat openly. As well as detoxification programmes, yoga, massage, hypnosis and acupuncture are all used to help service users relax. This is an important part of the recovery process.

Carlin says: “Some of the women have never really had the opportunity to relax – here they realise how valuable it is.”

*Not her real name

Lessons learned
● Always speak first to your client group to find out what their needs are.
● As the service is aimed at addressing the root causes of the women’s offending behaviour and addiction problems, “professionals need to explore the service user’s life experiences – a lot of the women don’t even realise the extent of the trauma they have been through,” says Carlin.
● Take the time to build trusting relationships with service users to encourage them to open up.
● Spend time with them in informal as well as formal settings.
● Let the women make choices for themselves. Each woman’s idea of recovery is different.
● Support each service user to set their own goals and to move at their pace.

This article appeared in the 30 November issue under the headline “Relax – Don’t do it”