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Effective Interventions Unit - Young people with, or at risk of developing, problematic substance misuse: A guide to assessment
Chapter 2: Who are the Young People?
In this guide we use the term 'young people' to mean
primarily those aged 18 years and under, although the assessment processes discussed may apply to, and be appropriate for, young people
up to the age of 25. Feedback from practitioners suggests that this is a helpful approach as young people will mature at different rates. Also, many young people's services work with young people who are over 18. 'Working with Young people: A profile of projects funded by the Partnership Drugs Initiative' (EIU 2004) found that most of the individuals in touch with the projects were aged between 14 and 17 years, but also included young people aged 18 and above.
Throughout this guide we refer to young people with, or at risk of developing,
'problematic' substance misuse. Individuals will have different interpretations of what is 'problematic'. For instance, how a parent or carer views their child's substance use and how a young person views their substance use could be very different. There is an ongoing discussion to be had in these circumstances. "One-off and experimental use of drugs and alcohol cannot in itself be seen as indicative of having caused actual harm or being related to any personal disorder" (HAS 1996). In other words, because a young person has ever used drugs or alcohol does not automatically mean that they have a problem which requires treatment.
However, it must be recognised that all substance taking by young people carries potential harm. 'Understanding problem drug use among young people accessing drug services: a multivariate approach using statistical modelling techniques' (Beckett et al 2004) provides an 'indicator of the level of problematic drug use' (LPDU). This indicator takes account of the following factors:
A recent review by the Health Promotion Agency for Northern Ireland (
www.drugsprevention.net 2001) indicated that drug use tends to occur when certain specific factors or variables are present:
positive correlation. A
negative correlation indicates that drug misuse tends not to occur when other specified factors /variables are present.
Examples of
positive correlates include: | Examples of
negative correlates include: |
intentions to use impulsive behaviour excessive personal stress boredom anti-social tendencies scepticism about school drug education and media prevention efforts peer pro-drug attitudes and behaviour lack of parental concern.
| |
The effective assessment of young people with problematic substance misuse should not focus on their substance misuse in isolation. Young people with problematic substance misuse will often have other difficulties in their lives (problems with family relationships, offending behaviour, housing, or problems at school) for which they will require support. "It will become obvious almost always that
a young person's substance problem is not the only problem, and the assessment should be carried out within this context. It is not too far fetched to suggest that practitioners should assume that this is the case until proven otherwise" (Crome et al 2004).
There is also the risk of labelling a young person as a 'substance misuser' and losing sight of the fact that
first and foremost we are talking about a young person. This guide also describes how it is the responsibility of all those working with children and young people to be able both to relate to, and engage with, them and to identify their substance misuse needs. This may be a substance misuse worker, a worker in a health or social care team, a youth worker, a volunteer or a foster carer.
One of the key messages from those working with young people and from young people themselves is the need for
the young person to be at the centre of the assessment process. In order for assessment to be effective, the young person needs to feel that he/she is involved at every stage.
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