WHAT IS YOUTH SUBSTANCE ABUSE PREVENTION? - Support material for fi rst-rate substance education
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What is youth substance abuse prevention? Support material for first-rate substance education Revised, second edition Editors: Sanna Pylkkänen, Reijo Viitanen and Elsi Vuohelainen Preventiimi – a Knowledge Centre for Youth Substance Abuse Prevention 2010 HUMAK University of Applied Sciences, Series C: Educational materials ISBN 978-952-456-092-4 ISSN 1458-5979
To the reader The Ministry of Education and Culture has sup- The approach of youth substance abuse work ported the development of substance abuse is humane and individually centred, not problem- prevention actively since before the 21st centu- centred. Some young people are in need of spe- ry began. The goal has been to support both the cial support. It is important to identify these indi- actual prevention work and the skills and train- viduals and offer them targeted substance abuse ing of those working with young people and to prevention in order to strengthen the protective develop and network the operations. It has also factors and diminish the effects of the risk factors. been found important to define the contents of youth substance abuse prevention as a part On the basis of the information mentioned of other preventive youth work. Preventiimi – a above, the first contentual structures describing knowledge centre for youth substance abuse youth substance abuse prevention have been prevention – has been operating since 2003. It is created. This support material is aimed at bringing a development unit supported by the Ministry of out the perspectives of youth substance abuse Education and Culture. One of the tasks of Pre- prevention and facilitating more target-oriented ventiimi has been to determine the issues that youth substance abuse prevention. A vast group make youth substance abuse prevention special. of co-operation organisations have been work- ing with Preventiimi, creating this understand- ing. These organisations have increased common understanding of the phenomena in the lives of young people and established youth substance abuse prevention in practice. In Helsinki on 1 December 2009 Immo Parviainen Senior Advisor Ministry of Education and Culture 1
Contents 1. The social importance of youth substance abuse work 3 2. Substance abuse prevention 9 3. Social strengthening and youth substance abuse prevention 14 4. Methods of substance abuse prevention 16 5. From substance awareness education toward comprehensive substance education 20 6. Knowledge base for youth substance abuse prevention 26 2
1. The soCial imporTanCe of youTh subsTanCe abuse work The general purpose of substance abuse pre- to reach each new generation as well. It is not jus- vention is to promote health and well-being by tified to put unfounded blame on young people encouraging a substance-free way of life and by or vilify them as a special problem group. Moral- reducing substance use and substance-related ising, stigmatising, and blame have been proved harm. Often prevention work is targeted at young to be poor methods of influencing substance use, age groups, but in spite of this, there is no clear regardless of the age of the target group. definition for youth substance abuse prevention. This publication aims at defining some gener- al starting points and goals of youth substance iT iS NOT NECESSARy TO CONSidER abuse prevention that the actors in the field can yOUNg pEOplE AS A SpECiAl pROBlEm use in the planning and quality assurance of their gROUp WhERE SUBSTANCE USE iS operations. The purpose is not to limit anyone’s CONCERNEd. operations or exclude any responsible actors from the field of substance abuse prevention. By con- trast, specifying the central concepts and starting points encourages interaction and co-operation Youth substance abuse prevention is respected among various actors. Naturally, the most impor- and extensively implemented in Finland today. The tant goal is to enable successful, first-rate youth field of actors can, however, be considered relative- substance abuse prevention. ly disconnected and individual operations are often carried out with scarce resources. Employees on the Substance use among young people has been ground cannot always perceive the wider social sig- on the decline since the start of the 21st century, nificance of their work or at least sufficiently empha- especially among those under 18. Regardless of sise it. Sometimes it also remains unclear who is, in this, the work among young people must be con- fact, responsible for substance abuse prevention; tinued, in order to maintain this positive trend, and who can provide it; and who monitors the quality to extend it to other age groups as well. Substance of the work. Because of these issues, there is justifica- abuse prevention must be well rooted, a perma- tion for collectively highlighting the social grounds, nent part of youth education, and it must be able regulations, and political programmes that provide 3
the foundation and support for youth substance The Alcohol Act (1143/1994) aims to prevent abuse prevention. Similarly, this publication aims at harmful societal, social, and health effects caused presenting some central issues concerning quality by alcoholic substances, by controlling alcohol con- that must be considered in work with young people. sumption. The Alcohol Act is strongly in favour of It is important to define the position of substance sobriety of minors and finds it reprehensible to of- abuse prevention as part of the guidance, commu- fer alcohol to a person under 18 (according to the nication, and education work in the youth sector, in act on amendment to the Alcohol Act, 642/2009). order to enable the professionals in the field and – Restaurants are not allowed to serve alcohol for per- most importantly – the young people themselves to sons under 18. The possession and transportation understand the meaning of various forms of work. of alcohol beverages that are not legally manufac- tured or imported is prohibited. The possession and transportation of alcohol beverages for purposes Central legislation of sale is also prohibited if selling is not permitted under the terms of the Alcohol Act or there is no The legislative base for youth substance abuse pre- valid permit. Breaking these regulations can result vention lies in the basic rights defined in the Con- in a fine or a prison sentence. The Alcohol Act is stitution (731/1999). So-called well-being rights among the most important acts where youth sub- secure the prerequisites of life worthy of a human stance abuse prevention is concerned. Alcohol is being, such as a livelihood, education, and social and the substance most generally used for intoxication health services. The basic rights include the right purposes, and it is the greatest cause of detrimental to equality and inclusion. When interpreted more health effects among all age groups. freely, substance abuse prevention can be seen as a part of the well-being rights of the citizens, and it The purpose of the Act on Measures to Re- has a part to play in bringing about the realisation duce Tobacco Smoking (693/1976) is to prevent of equality and basic rights. Risks of individual and the health risks and harm caused by smoking. life difficulties can limit the realisation of the basic Under this act, it is illegal to sell or otherwise rights of an individual, and, in extreme cases, they supply tobacco products or devices to persons can prevent equal inclusion of the citizen in normal under 18. In addition, the possession of tobac- operations in the society. The basic rights are also co products is prohibited for persons under 18 one quality metric for the implementation of sub- (according to the act on amendment to the stance abuse prevention. Up-to-date legislation and Act on Measures to Reduce Tobacco Smoking, the index of amendments to the legislation can be 698/2010). Starting to smoke at a young age is found in the Finlex database at http://www.finlex.fi. seen as related to the building of social relation- 4
ships between young people. Giving up smoking authorities, labour authorities, educational au- is especially difficult when the smoking started thorities, youth workers, and the police. at an early age. The addiction caused by long- term smoking is strong; therefore, the dangers The Temperance Work Act (828/1982) aims of tobacco products in comparison to other sub- at accustoming the citizens to healthy ways of stances must not be underestimated. life by guiding them to avoid intoxicating sub- stances and smoking. The general management, According to the Narcotics Act (41/1972), the monitoring, and control of the temperance work production, manufacture, import or export from are a responsibility of the Ministry of Social Affairs Finland, transport (including through transport), and Health and the Regional State Administra- distribution, selling, handling, possession, and tive Agencies. Each municipality must have its use of narcotics are prohibited. Narcotics offenc- own body responsible for the implementation of es are defined in the Criminal Code (39/1889), temperance work and the monitoring of alcohol Section 50. Some further substances classified as issues. The Temperance Work Act authorises and narcotics have been added to the Narcotics Act obliges municipalities and organisations to work (by the act on amendment to the Narcotics Act, to prevent substance abuse also among young 595/2010, §3). The National Institute for Health age groups. Municipalities answer for co-ordinat- and Welfare is responsible for monitoring and ing substance abuse work in their municipality as compiling statistics on narcotics. a whole and ensuring its quality. According to the Act on Welfare for Substance The Child Protection Act (417/2007) aims at safe- Abusers (41/1986), the purpose of welfare for guarding children’s right to a safe growth environ- substance abusers is to prevent and decrease ment, balanced and versatile development, and substance abuse and the related detrimental special protection. The Child Protection Act’s §25 social and health effects and to promote the defines the announcement requirement by which functional capacity and safety of the substance everyone is obliged to inform the social welfare au- abuser and his or her family. There must be co- thorities of the municipality about a child whose operation between the authorities and commu- need for care, circumstances endangering his or nities working on welfare for substance abusers. her development, or own behaviour requires as- Special attention must be paid to the co-opera- sessment of the need for child protection. This sec- tion between those attending to welfare for sub- tion lists numerous groups of professionals working stance abusers and social and health-care work- with children and young people from the fields of ers, temperance education personnel, housing social and health services and education. 5
The prevention-oriented child protection aims and to help them to access services and support at promoting and ensuring the growth, develop- that promote their growth and independence and ment, and well-being of children. The act obliges their participation in education or work. Outreach- those working in education and youth services to based youth work is primarily based on the infor- provide a child or young person with special sup- mation provided by young people themselves port when he or she or the family is not a child and their estimates of the need for support. protection client. The common fields of opera- Youth outreach work requires handling of con- tion of social and youth work meet in the field fidential personal and contact information. Ac- of preventive child protection. A child is defined cording to the Personal Data Act (523/1999), infor- in the Child Protection Act as a person below 18 mation concerning the living conditions, state of years of age and a young person as a person be- health, official benefits and support, and financial tween ages 18 and 20. status of an individual is confidential. Submitting such information to another authority requires The Youth Act (72/2006) provides strong back- permission from the relevant individual or his or ground support for youth substance abuse pre- her guardian. The information must, however, be vention. The act aims at supporting the growth delivered to the home municipality of the young and independence of young people, promoting person for the purposes of outreach work if the the active citizenship and social strengthening of young person has not received any formal edu- young people, and improving their growth and cation beyond basic education, if a young per- living conditions. The Youth Act emphasises the son below 25 discontinues his or her studies in significance of preventive work, and it provides vocational or upper secondary education, or if a the education platform for substance abuse pre- young person is released from military service or vention. From the standpoint of the Youth Act, civil service because of lack of competence. substance abuse prevention has a strong edu- cational goal and it therefore is justified to ap- ply the concept of substance education among National programme work young people. The growth and living conditions of young people must be organised in such a At the national level, there are statutory pro- way that young people can grow into independ- grammes operating under ministries. In addi- ent and functional citizens. These legal acts con- tion, the government has various political pro- cern all citizens below 29 years of age. grammes in place. The programme work aims The aim of youth outreach work (addressed in at developing the structures and services of the the act on amending the Youth Act, 693/2010) is community in accordance with programme-spe- to reach those young people in need of support cific schemes. A few of the programmes are de- 6
scribed below. These can be considered central programmes consist of measures, projects, and for substance abuse prevention. grants from the fields of several ministries. The current policy programmes are: The National Alcohol Programme 2008–2011, • Policy programme for employment, en- implemented by the state, municipalities, and trepreneurship, and working life organisations, aims at reducing the adverse ef- • Policy programme for health promotion fects experienced from alcohol. The previous pro- • Policy programme for the well-being of gramme period was 2004–2007. children, youth, and families The Kaste Programme 2008–2011 is a nation- The child and youth policy development al development plan for social and health-care programme (LANUKE) is approved at intervals services. Its goals are to increase involvement; of four years by the Finnish government, with decrease social exclusion; increase health and the current term being 2007–2011. It includes well-being; and improve the quality, effective- the goals for the national child and youth policy ness, and availability of services, as well as reduce and guidelines for the child and youth political inequalities between regions. programme work of provinces and municipali- ties. The programme is prepared by the Ministry The goal of a key public health programme – of Education and Culture in co-operation with Health 2015 – is to support and promote health other ministries. in all sectors of the community. The primary em- phasis is on promoting health rather than on de- Overall, there are two social approaches for veloping the system of health services. examining youth substance abuse prevention. The first of these is the planning guidance of the With Mieli – a national plan for mental health Ministry of Social Affairs and Health, which on and substance abuse work that extends to 2015 the basis of the Child Protection Act (417/2007) – the development of mental health and of sub- extends to the job descriptions for those han- stance abuse work are being examined for the dling municipal social and health care. In addi- first time as a single entity at the national level. tion, the Temperance Act (via the act on amend- ment to the Temperance Act’s §3, 1730/2009) Policy programmes (2007–2011) are exten- assigns the management, guidance, and con- sive, multi-agency task entities that aim to meet trol of substance abuse work to the Ministry of the central goals of the government. They are Social Affairs and to the regional state adminis- defined in the government programme. Policy trative agencies. The second approach is the re- 7
sults control under the Ministry of Education and and directions guiding the relevant operations Culture, in the municipal education and culture are setting significant challenges to implementa- departments in accordance with the Youth Act tion of youth substance abuse prevention at the (the act on amending the Youth Act, 693/2010). municipal level. The legislation concerning the Since the elimination of the state provincial of- development programme for child and youth fices, the local co-ordination lies within the remit policy and the municipal welfare plan for chil- of the Centre for Economic Development, Trans- dren and young people has been found espe- port and the Environment. There are, in addition, cially challenging, and it imposes mutually con- a vast group of actors from municipalities, par- tradictory obligations for municipalities. ishes, and the third sector working in youth sub- stance abuse prevention. yOUTh SUBSTANCE ABUSE pREvENTiON The complexity of the planning guidance CAN BE EXAmiNEd By USiNg TWO used in substance abuse prevention has become diffERENT AppROAChES: yOUTh WORK an evident challenge in the field. The separate ANd SOCiAl WORK. preparation of the key laws, programme work, 8
2. Substance abuse prevention Substance abuse work is an important part of structions for youth substance abuse prevention broad-based welfare work, which requires com- provided in these criteria. mitment from several administrative sectors and actors along with general common efforts. Sub- In the quality criteria, substance abuse pre- stance abuse work is not just municipal social and vention work is defined as action aimed at pro- health-care service. Substance abuse work is car- moting health, safety, and well-being. According ried out in schools, youth work, culture and leisure to the quality criteria, substance abuse preven- activities, community planning, and business life. tion has an influence on substance-related Organisations and other third-sector actors have knowledge, attitudes and rights, and factors for their own tasks in substance abuse work. protection against, as well as risk factors expos- ing the individual to, substance-related harm and The concept of substance abuse prevention substance use along with specific patterns of use. was created in the field of social and health-care The entity of the influence targets is vast, and the services, but it is used more and more in other actor must plan carefully with regard to which fields as well. It is a far-reaching concept that de- aspects he or she can affect and how large an scribes the approach of social and health care to effect is desired. The extensiveness of the effect one aspect of substance abuse work. The basic can be evaluated at anywhere from the individ- concepts and general quality criteria of different ual level to the social or even international level. work forms have been defined in the ‘Reaching for the Quality Star’ publication of Stakes (now The basic concepts of substance abuse work the National Institute for Health and Welfare – are presented in Chart 1. In the quality criteria, THL), from 2006. substance abuse work is seen as a broader con- cept that is divided into preventive and corrective The quality criteria are meant as tools for sub- work. At the level of actual operations, it can be di- stance abuse prevention workers, and they aim vided into three further forms of substance abuse at proper directing of resources and support. The work: general prevention, risk prevention, and sub- quality criteria are also designed to give decision- stance abuse care. Each work form uses its own makers and the community a general idea of the work methods. The selection of work forms de- current methods of decreasing the adverse ef- pends on the needs of the target group in ques- fects of substances. There are no separate in- tion and the objectives. In practice, the bounda- 9
SUBSTANCE ABUSE WORK preventive work corrective work general prevention risk prevention substance abuse care Chart 1: Structure of substance abuse work ries between various work forms are not always Substance abuse care and rehabilitation do as strict as the chart might suggest. It is, however, not belong to the traditional work field of youth essential that the professionals are able to detect work. However, some youth work is carried out in the primary work form meant for their current youth work facilities, at rehabilitation centres for work and how extensively other work forms can young people, and in workshops. Risk prevention be used in relation to their professional skills. is the boundary between, and at the same time the common work field of, preventive and cor- Corrective substance abuse work can be rective work. It is also worth remembering that, carried out in collaboration with other men- especially, advanced corrective work is preven- tal health services, since substance-related and tive work as well, since it aims at preventing re- mental health problems are closely connected turn to a lifestyle favouring substance use. There- among young people as well. Corrective work fore, strict division between these two work fields is performed within the framework of general is neither self-evident nor even possible. services of a municipality, such as in social and health-care services and child protection. Those The distribution of work content between working in successful multidisciplinary tasks rec- preventive and corrective substance abuse work ognise the perspective (preventive or corrective) is not adequately discussed in substance abuse from which they are approaching this boundary. work. Preventive work has been partially overshad- This publication wishes to emphasise substance owed by corrective work, which is given much abuse prevention; therefore, the text concen- more resourcing. Because of the fractured posi- trates on the work forms of general prevention tion of substance abuse prevention, its role is fairly and risk prevention while the issues related to unclear on all levels of society instead of it having substance abuse care are not discussed. an established position in service production. 10
Targeting substance abuse act discusses the issue from its own perspective. This is the reason for the inconsistencies in the prevention at young people definitions in legislation. In Finland, 18-year-olds We all have our own idea of who is considered are considered adults and from the viewpoint of young, so it might come as no surprise that, child protection they become young people at when evaluated more closely, youth is a fairly this exact age. In the Youth Act, the age limit is difficult concept to define. Generally in modern higher and people below 29 years are consid- society, youth can be seen as a fairly long phase ered young. There is no lower limit for youth in of life, during which a child gradually disconnects this act. him- or herself from the parents and grows in- dependent, obtains an education, and prepares From the standpoint of legislation, youth is for independent life and takes responsibility for not a gradual transition to adulthood, but cer- his or her future. Sometimes youth as a phase of tain rights are gained at the same time and the life is positioned between certain ages, but the limit of 18 years is decisive with respect to the age limits are difficult to set when one considers availability of alcohol and tobacco. For stronger the various development and life situations on alcoholic beverages, the limit is 20 years. an individual level. When these different views are all taken into There are several sections in the legislation consideration, youth can be seen as a long phase that define youth and the rights and responsi- of development in modern society. There are, bilities assigned to young people. The acts list- however, certain fixed age limits. For youth sub- ed in the first section of this document speci- stance abuse prevention, the age of 18 years is fy some age limits or stages of youth, but each a very important watershed. Work must be car- Youth Childhood Adulthood 18 v. Chart 2: From childhood through youth to adulthood 11
ried out both before and after one reaches this not, however, be considered a problem or to be age, but with different approaches. In the work a problematic phase of life, and the work in the with young people below 18 years, the age lim- field cannot be simply problem-based. Young its must often be emphasised, but in work with people must be provided with support and as- those who have crossed this threshold, the main sistance in the process of natural socialisation emphasis is often on the responsible use of sub- and personal growth. This is a time of many kinds stances and on acknowledging the risks of sub- of questions, needs, and thoughts. stance use. However, it must be remembered that work in accordance with the Youth Act con- The mainly preventive nature of youth work cerns young adults aged 18 to 29 as well. stems from the idea that young people can get guidance, help, and support as needed in their Chart 2 shows the initial state from which growth and socialisation process where issues a child begins to turn into a young person. As that they are not able to solve themselves are certain developmental tasks of childhood are concerned. It is extremely important that young completed, the child starts slowly to turn into people always feel part of the solutions concern- a young person. The highest point of youth is ing their own life. This is the only way they can in the centre of the chart. This is the top point learn to understand the reasons behind the so- of youth, when turning into an adult begins. As lutions and to follow set instructions and rules the stages of development in youth gradually are consciously. Forced and external doctrines often completed, the challenges of adulthood begin provoke resistance or at least are easily forgotten. to increase. Youth ends on the right side of the The inclusion approach must be extended to the chart and adulthood begins. This chart facilitates services directed at young people as widely as examination of the relationships between child- possible, and it concerns substance abuse pre- hood, youth, and adulthood, but it does not take vention as a central principle as well. the differences between individual life situations into account. In youth work, youth is considered a special phase of life, during which the growth and de- yOUTh SUBSTANCE ABUSE pREvENTiON velopment of the young person requires holistic REQUiRES iTS OWN mEThOdS ANd AlSO support and in which professional youth work EXpERTiSE iN TARgETiNg ThEm. has its own place alongside families, others close to the youth, and other professionals. Youth must 12
Youth substance abuse prevention differs the overall life management of young people. from substance abuse work in both its educa- In work among young people, the goal is to af- tional targets and the emphasis. In substance fect attitudes toward substances in a more com- abuse prevention targeting adults, the health prehensive manner and at an earlier stage than hazards and risk factors are emphasised, while in is possible with adults. Furthermore, it must be substance abuse prevention targeted at young remembered that, because of its special nature, people, substance abuse work can be per- youth substance abuse prevention requires its formed without substances even being men- own methods and expertise in targeting of the tioned and by concentrating on supporting methods. 13
3. Social strengthening and youth substance abuse prevention Social strengthening refers to, for example, build- it. In substance abuse work, general prevention ing and supporting communities for young peo- is primarily geared for strengthening the protec- ple themselves, listening to young people, pro- tive factors, although it can include discussing moting inclusion, encouraging, being present, the risks related to substance use as well. and being part of young people’s everyday life as an adult. Youth substance abuse prevention There are several protective factors. The follow- can be seen as part of a larger whole, or along a ing list includes some of the most general ones: continuum at one end of which is work aimed • Confidential social relations in the imme- at social strengthening of the young person and diate community on the other end of which is work aimed at cor- • The possibility of influencing one’s own recting the young person’s life situation, health, position and future or position. Substance abuse prevention con- • Good self-respect and self-knowledge centrates on improving young people’s under- • Awareness of the risks of substance use standing of the risks related to substance abuse • Responsible attitudes of the immediate and on strengthening the protective elements. community to substance use While substance abuse prevention is generally • Critical substance use cultures divided into general and risk prevention, in the • Restricted availability of substances, and related youth work there is one more level: social practical control of them strengthening (see Chart 3). It is worth noting, • Responsible attitude to substance use though, that not all social strengthening is aimed at influencing attitudes toward substances. The Risk factors are the characteristics related to the role of social strengthening is built into almost all individual or the environment that in a certain work performed among young people. group increase the probability of a disturbance or a problem. In substance abuse work, ‘risk preven- The evaluation of young people’s attitudes, tion’ means decreasing these risks or their effects life situation, and behaviour from the angle of and strengthening the protective factors. Risk the factors protecting from substance use and factors for substance use might be, for example: the risk factors exposing one to them is essen- • Social mistrust and weak self-respect tial. Protective factors are generally connected to • Uncontrollable changes in the life situa- the living environment and the social relations in tion 14
• Pressure favouring substances in the so- tors predispose young people to problems, but cial environment individual events or factors can also influence the • Loneliness and exclusion from one’s age choices they make. group • An unfavourable social circle, such as one The significance of protective factors and risk with a common factor of dropping out of factors from the perspectives of target-setting and school or from work the sphere of prevention is illustrated in Chart 3. • Ready availability of substances and lack There are probably both protective factors and of control risk factors in the life of all young people, at work • Use of substances for the purpose of in- simultaneously, and they are not mutually exclu- toxication sive. In targeting work and selecting the sphere of • Use of substances when alone prevention, one must, however, be aware of what • Risky behaviour and risk of getting into kinds of issues should be emphasised at the par- accidents while intoxicated ticular moment in question. If the young person’s substance use and behaviour are associated with The presence of numerous protective factors accident-proneness or violence, the work forms does not mean that a young person is com- should be selected from the standpoint of risk pre- pletely safe from problems. Similarly, there being vention. If the work is carried out through provision several risk factors does not mean that a young of general information concerning the risks related person automatically has a lot of problems. Pro- to substance use, it must be approached from the tective factors strengthen young people and en- perspective of general prevention and emphasis on courage them to choose the right path. Risk fac- extensive horror scenarios should be avoided. risk factors protective factors social general prevention risk prevention strengthening Chart 3: Protective factors and risk factors in relation to the sphere of prevention 15
4. Methods of substance abuse prevention There are several methods used in substance are in the same developmental phase. For exam- abuse prevention. These methods can be called ple, some 13-year-olds may already have used tools, instruments, operating processes, or inter- substances while others have not even consid- ventions. The professionals working in the field ered it yet. Therefore, evaluation of the relation- and with various targets generate new names for ship between protective factors and risk factors these methods. For the target-setting, selection is very important if suitable methods are to be of the correct method is one of the most central selected. Most importantly, the correct sphere of indicators of first-rate substance abuse preven- prevention should be chosen and the methods tion. The methods must be suited to the goals, must be chosen according to the needs of the target group, and resources. When one is select- target group. ing the method, the age of the target group must be taken into consideration, since not all Chart 4 presents some examples of the goals methods are suitable for young people under 18. that can be set on various levels of prevention The limit is based on the legislation that aims to in work with groups or individuals. The basic protect children from the detrimental effects of levels of youth substance abuse prevention are substances, since no substances are meant to be presented on the first line. There are, naturally, used by children under 18. other factors to be considered in the selection of methods, but the chart aims to provide a gen- In youth work, the target group of substance eral basis for the selection and to examine the abuse prevention can consist of a group of matter as a multi-dimensional issue. In addition young people or consist of just one young per- to the issues listed in the chart, at least the age son. This will determine the various methods of the target group, the available resources, and used and the nature of the target-setting. The the professional skills of the actors must be con- group size must be taken into consideration in sidered. It is crucial that the methods be selected selection of a suitable method. In a large group, with awareness and that those using them know there can be young people with very different their purpose of use, groundings, and limitations. backgrounds and experiences. Also, when work- ing with an individual young person, one should When the issue is examined from the social remember that the state of development varies strengthening angle, it must be remembered and not all young people in the same age group that the majority of young people are typical rep- 16
resentatives of their age group. They need confi- of their trust and sense of responsibility are es- dential relationships with adults, and they should sential. be given opportunities to ponder the issues and phenomena that are important in their life. So- The central goal of general prevention is to cial strengthening takes place in all growth envi- provide young people with topical information ronments on both an individual and group level. on various substances and the general risks they These environments could be, for example, clubs, pose. All young people must have the right to youth centres, open cafes, organisation-arranged receive correct and valid information on sub- events, and self-organised groups of young peo- stances in order to facilitate them making their ple. Adults must facilitate versatile examination own choices. A significant amount of the exist- of these issues and phenomena in order to ing body of methods and materials is meant to strengthen young people’s responsible views be used in the sphere of general prevention. In on substance use. From the social strengthen- addition to health risks, the work can include dis- ing angle, substance-related phenomena can be cussion of the difficulties substances can cause approached from a wider perspective and the between friends and in school work and family issues discussed can include, for example, the life. The methods, viewpoints, and examples that social, economic, and societal consequences of are employed should be as close as possible to substance use. The inclusion of young people in the young people’s own experiences. Describ- the discussion or actual operation and building ing horror scenarios or risks that are not part of social general prevention prevention strengthening strengthening group of young targeted work, general social the group, people as the small-group skills tolerating group target group operations pressure one young strengthening individualised emphasising person as target self-respect and support, individual choices group set of values rehabilitation Chart 4: Selection of methods in relation to the sphere of prevention and target 17
young people’s reality often just causes unnec- essary worry and anxiety. Methods of substance iT iS EXTREmEly impORTANT TO EvAlUATE education that use intimidation can arouse cu- ThE ATTiTUdES, lifE SiTUATiONS, ANd riosity, if anything, and that has very little to do BEhAviOR Of yOUNg pEOplE fROm ThE with the goals of substance abuse prevention. STANdpOiNT Of pROTECTivE fACTORS ANd RiSK fACTORS. The challenge often faced in general preven- tion is lack of interest in substance abuse infor- mation on the part of those in the risk groups. The message does not seem to reach those who seen as a certain kind of targeted work. Not all need it most. For example, in comprehensive young people of a certain age or group neces- school, substance awareness education reaches sary need it, and the basic information given the majority of young people but not necessar- in the general prevention is sufficient. In the ily those at risk. Sometimes substance awareness risk prevention sphere, the methods of social education can attract young people’s interest to strengthening and general prevention are not substance use. This is a sign of a poorly selected necessarily enough. In this case, the worker must target group and methods. However, all young consider the young person’s own experiences re- people must have the right to receive informa- lated to substance use. A lifestyle favouring sub- tion on substances, and target-setting in gener- stances must be discussed critically, and its actual al prevention should not be done on the basis dangers to all areas of life must be presented in a of the needs of risk groups alone. Prevention is concrete manner. The work can include various also unsuccessful if the message does not reach small-group tasks and individual support. These everybody. In real life, an actor can check wheth- methods are used, for example, in operations in er the information reaches young people as in- social work, targeted and youth outreach work, tended, by discussing the issues with them. This special youth work, workshops, and work within enables the actor to identify those risk groups in various organisations. Risk prevention must al- need of different methods. ways be implemented by forming close networks among the actors near the young person and his Risk prevention refers to the actions target- or her family. ed at a certain group or an individual. The risk behaviour of the target group has already been Youth substance abuse prevention can pro- identified, or it can be clearly predicted. Risk pre- vide the principles for distinguishing the spheres vention in youth substance abuse work can be of general prevention and risk prevention more
clearly from each other. Especially in risk preven- also very close to the everyday life of young peo- tion, the contentual emphasis could be recon- ple, or at least closer than are the health prob- sidered. Emphasising the common health risks lems that may result from substance use after caused by substance use is seldom concrete several decades. when examined from the standpoint of every- day life. Long-term health risks are of no interest The significance of the information behind the to young people, because they want to live here methods applied in substance abuse prevention and now. Therefore, prevention work could em- should be emphasised in their selection and use. phasise the risky behaviour caused by substances Competent methods are always based on infor- and provide examples concerning the daily life mation including groundings for the pedagogical of young people. Substances are part of many starting points the methods lean on. No method accidents involving young people. In drink-driv- automatically offers the desired results. Profession- ing, for example, young people aged 18–19 years als using various methods must know the basics present the most significant risk group. The social of the methods and know how to use the meth- and financial problems caused by substances are ods correctly in the appropriate situations. 19
5. From substance awareness education toward comprehensive substance education Although there are various methods used in sub- but to the limitations of the viewpoints taken stance abuse prevention, it is often understood in substance abuse prevention. Providing in- as substance awareness education. Substance formation is not always enough. It should be awareness education is a traditional form of sub- checked how the young people have interpret- stance abuse prevention that offers up-to-date ed the information given and how the result- information on substances to everyone or to a ing understanding corresponds with their own certain target group. It is typically used both in experiences. general prevention and in risk prevention. Sub- stance awareness education has, historically, Substance abuse prevention should be inter- been the most frequently used approach for con- active and consider the views and experiences veying information on the adverse effects of sub- of the target group concerning substances. Very stances. It is based on the Finnish temperance young children sometimes have had experiences work. The challenge of substance awareness ed- involving substances. Personal experience does ucation is partly due to the difficult targeting of not refer solely to the young people’s own ex- the work and sometimes due to the vagueness periments with substances; these might come mentioned earlier with respect to the boundaries from seeing someone in their immediate com- of general prevention and risk prevention (sees munity using substances. Extensive generalisa- Chart 2). This can also be seen as a larger issue tions and overemphasising or exaggerating the concerning youth substance abuse prevention. risks of substance use in substance awareness Consequently, it must be discussed in detail. education can result in young people connect- ing these risks to the people close to them. For Another challenge facing substance aware- example, use of alcohol by parents can cause ness education is the field’s domination by anxiety in the young person’s mind even if the methods based on one-way communication. use was moderate and far from problematic. In The pedagogical methods and information- this case, the approach of substance awareness based methods do not reach the risk groups or education has not been correct and the young their effect on the risk groups is insignificant. person has interpreted the information different- This is due not to lack of skills of the educators ly than the educator had expected. These situa- 20
tions can be avoided through interaction and by education for young people. Substance educa- providing enough time for substance education. tion has the same core – based on information on substances – that substance awareness edu- In the modern information society, there are cation does, but substance education must have vast amounts of information available, and the a more extensive target than simple provision of substance abuse educator must accept the fact information. It must include guidance concern- that young people are these days’ also active pro- ing life skills and values and offer such activities ducers of information. In spite of numerous ef- for young people that do not include intoxicat- forts and methods, substance awareness educa- ing substances. The educational target is to con- tion of the 21st century does not take sufficient vey the responsible attitude toward substances account of the theoretical starting points, such as that enables the users to control their use them- the interactive nature of communication and the selves and to understand the related risks suffi- inclusion of the target group. Young people are ciently. seen rather more as targets of substance aware- ness education than as active actors building their own understanding, and they are expected dealing wiTh a group to be ready to accept the information provided directly. The planning of substance abuse pre- in subsTanCe eduCaTion vention should consider the interactive nature One of the strengths of providing substance ed- of communication and the effect of community. ucation for groups is reaching a large number of people at one time. This enables simultaneous In addition to substance awareness education, use of several methods. For example, in schools, modern society needs comprehensive substance health education creates a good foundation for substance use prevention. The problem aris- ing in substance education in groups is that the education is limited to general prevention. This iN ThE mOdERN iNfORmATiON SOCiETy, means that the risk groups are not reached well ThE SUBSTANCE ABUSE EdUCATOR mUST enough. The importance of interaction must be ACCEpT yOUNg pEOplE AS ACTivE remembered for large groups as well. Although pROdUCERS Of iNfORmATiON. personal discussion with everyone is not possi- ble, co-operation can be created by organising tasks in small groups, by utilising the young peo- 21
ple’s own descriptions or writings, or by utilising not enough time for forming confidential and in- the possibilities provided by the new technology teractive relationships. in a network environment, for example. Substance education should be linked to the Group-based substance education includes the basic operations in municipalities, parishes, and following targets and features: youth organisations, which include targeted co- operation with professionals of substance abuse 1. Offering information on substances and prevention. Planning should aim at long-term their effects and multi-level substance education. Youth sub- 2. Discussing life skills and values stance abuse prevention and related long-term 3. Learning refusal and tolerating social plans should be codified in the substance strat- pressure egy of any relevant organisation. This helps to 4. Highlighting substance-free ways of act- avoid only short-term and occasional substance ing awareness education events, which cannot of- 5. Utilising peer education and support fer a consistent, extensive picture to support the growth process of young people. Various group-based approaches are widely used in youth substance abuse prevention. Typically, they are used in schools, organisations, youth Dealing with a individual in clubs, and similar environments. Often the re- sponsibility for the actual implementation in sub- substance education stance education is given to an external party. For Sometimes it is forgotten in substance abuse example, in comprehensive school the teachers prevention that many people do not see sub- may not see it as their task, there is not enough stances as problematic. Young people may have time for it, or they do not feel that they have suf- had many positive experiences of substance use ficient skills for it. Thus it is that substance abuse that have shaped their overall attitudes toward education often can be arranged only once or substances into something more positive. Adults, on very rare occasions, and organised separate- however, have more extensive life experience so ly. Providing comprehensive or long-term edu- may be able to evaluate the positive and nega- cation is therefore only rarely possible. External tive sides of substance use better than can young educators often do not have enough time to get people who are just on the threshold of their first acquainted with the target group, and there is experiences. In this phase of life, they need edu- 22
cational advice in order to approach issues from person’s viewpoint. Traps provoking resistance can a broader perspective. exist both in talk and in actions. Examples of typi- cal expressions causing resistance: Changes in attitudes are challenging for both adults and young people. Ambiguities in one’s • Trap of accusing: ‘You were acting incor- own values and targets can prevent changes in rectly and irresponsibly!’ attitudes. Sometimes young people want to take • Trap of confrontation – i.e., denial: ‘Sub- the easy way out and use the same solutions as stance use is wrong/forbidden/illegal.’ earlier. New alternatives can also be seen as trou- • Trap of expertise: ‘I know what is best for blesome or unpleasant. A young person’s resist- you.’ ance to change can be caused by psychosocial or • Trap of stigmatising: ‘You are socially ex- behavioural problems that manifest themselves as cluded – you have failed.’ active resistance or denial. Sometimes the actions • Trap of answering questions for someone of a substance abuse educator can cause resist- else: ‘Don’t you feel that...?’ ance in a young person, if the approaches used • Trap of hasty conclusions: ‘So we agree by the educator are unsuitable from the young that...’ 10. Maintaining the changed behaviour 9. Strengthening the changed behaviour 8. Making a change in behaviour 7. Recalling the learning about the issues 6. Remembering the learning about the issues 5. Adopting and understanding the new attitude 4. Learning skills and receiving information 3. Becoming interested in the subject Chart 5: Transformation of 2. Discerning and identifying the subject substance education into a new behavioural model 1. Participating in substance-related education (after the McGuire model). 23
The obstacles due to the substance abuse ed- stead, it requires time and hard work. It also serves ucator relate to structures and the encounter. The as a reminder that it is not necessary to implement encounter requires the ability to listen to what a a change quickly. Instead, the right kind of idea young person wants or what he or she is ready should be given to young people, who can then for. Sometimes advancing through the process is process it into desired operational models. too rushed or the substance abuse educator has set the targets too high. In this case, one should Guidance focused on building of resources also evaluate which individual approaches and encourages young people to participate, by ask- work methods are suitable. The change can be ing them about their thoughts and by listening to hindered by lack of structure in the operations or them. Daily conversations are important, and they by too strict a structure. should be given time. This sends a message of the possibility of participating. The self-evaluation of Chart 5 describes targeted substance educa- young people is supported by tentative talk and tion translating first into attitudes toward sub- questions. Listening and feedback, as does neu- stances and then, finally, into a lasting behaviour- tral presentation of alternatives, show respect for al model. The chart indicates that attitudes and the young person’s role as an expert in his or her behaviour cannot be changed quickly or with a own life situation. Direct talk, positive feedback, single lesson of substance education. There are 10 and peer talk indicate respect to another person. phases shown in the chart, in all of which young people process the issue. As the issue has been discussed on several occasions, young people are pROvidiNg iNfORmATiON able to recognise the subject, become interested iS NOT AlWAyS ENOUgh. in it, and gradually start to shift their attitudes in the right direction. As young people have more in- formation and better understanding of substanc- es, they will make better decisions concerning their use. They become confident of their choices, The aCTors providing subsTanCe and these attitudes will be reflected in their eve- ryday behaviour. Adults and other close people eduCaTion and Co-operaTion can support this process by confirming the posi- There are a lot of professionals and volunteers tive actions, showing a negative attitude toward working with youth substance abuse prevention. substances. The chart is designed to demonstrate Not all actors participate in the prevention work that the change cannot take place overnight; in- full-time; for many, it is a part of other educa- 24
tional, guidance, counselling, support, or other Co-operation among various actors aids in un- assisting work among young people. Because of derstanding the grounds for different approach- the diversity of the actors, the approaches and es and in enhancing everybody’s work. Youth views concerning substance education can di- substance abuse prevention does not form one verge somewhat. This should be seen not as a coherent organisation; rather, it operates with problem but as a resource. Since the issue of information received from various sources. Co- substances is very complex and broad-based, operation must be built on the activity of the ac- it is good that several approaches to this issue tors. Professional peer support plays a significant are used. The deciding factor, however, is for the role in all operations aimed at development and work to be carried out with responsibility, high innovations. quality, and co-operation, and such that the ac- tors can view each other with respect. The most pREvENTiimi ENCOURAgES ThE ACTORS important thing is to have young people at the iNvOlvEd iN SUBSTANCE ABUSE pRE- centre of all operation. vENTiON TO ENgAgE iN RESpONSiBlE NETWORKiNg. 25
6. Knowledge base for youth substance abuse prevention This publication is the first to examine youth sub- velop youth work in their respective fields at the stance abuse prevention on the basis of the qual- national level. ity criteria for substance abuse prevention. There One of the actors appointed to serve in the is plenty of further information available on the service and development centre structure is Pre- topic both in Finland and abroad. Substance use ventiimi, administered by the HUMAK University and attitudes toward substances among young of Applied Sciences since 2003. Preventiimi is a people are systematically monitored. Similarly, knowledge centre that operates as a specialist various statistics, reports, evaluations, and stud- and support service in the implementation of ies provide the necessary knowledge base for the substance abuse prevention and provides guid- professional work. The main challenge is to get ance and counselling for professionals in this those working in the field to learn to utilise the field on the national level. available information sufficiently. The group aims to increase knowledge of the content of youth substance abuse prevention by promoting research, evaluation, and high-quality The decision in principle of the work. Preventiimi applies a holistic view of sub- Council of State concerning the stance abuse prevention and organises high- quality further training for professionals in this national development and service field. Preventiimi develops co-operation in sub- centres on 10 August 2010 stance abuse prevention by exercising and en- The Ministry of Education and Culture has made couraging responsible networking. The partner a decision in principle to appoint 13 actors to network of Preventiimi is a national youth work serve as national development and service cen- development community that concentrates on tres in youth work in Finland. The ministry’s de- producing new information and increasing ex- cision in principle is part of the general devel- pertise. The peer support meetings are venues opment of youth work and of creation of the for sharing expertise, preparing publications, and prerequisites for it. The decision clarifies the ac- developing methods for youth substance abuse tors in the national service structure for the youth prevention. The Preventiimi network includes work that the ministry supports regularly with more than 80 organisations, which together have annual operation grants. The actors accepted in appointed about 220 key persons as members of the national service structure for youth work de- the developer network. 26
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