PSYKOLOGISK INSTITUT BUSINESS AND SOCIAL SCIENCES AARHUS UNIVERSITET

 Presentation  Re-inventing drug treatment – Part One: Constructing drug treatment with a non-drug focus  Re-inventing drug treatment – Part Two: Constructing drug treatment with treatment in quotation marks  Concluding remarks Centre for Alcohol and Drug Research AARHUS UNIVERSITET

 20 weeks of participant ethnographic fieldwork at two Danish drug treatment centers for young people in 2011  39 semi-structured interviews with treatment providers and young people  Audio-taped sessions Centre for Alcohol and Drug Research AARHUS UNIVERSITET

 Drug treatment  Young people until approx. 25 years  Non-residential, common intensity: 1-4 days a week  Formalized sessions (e.g. individual sessions, group treatment) and unformalized sessions (e.g. sports, meals)  Treatment is voluntary (in principle, sometimes court orders) Centre for Alcohol and Drug Research AARHUS UNIVERSITET

 Variety of professional backgrounds: - Educators (social pædagoger) - Social workers (socialrådgivere) - Psychologists - Psychiatrists - Other: Teacher, artisan, psycho therapist ’Treatment provider’ (behandler) used as common designator  Variety of treatment methods, e.g. motivational interviewing, narrative, systemic and cognitive therapy, existential psychology. All claim to mix and match. Centre for Alcohol and Drug Research AARHUS UNIVERSITET

 Aged  Approx. 60% young men  Majority without current school/work affiliation  Majority receive social security income  Some still live at home, some have own appartments (sometimes supported housing/institutions), few homeless  Some come into treatment on their own initiative, others through other systems (e.g. social welfare or justice system)  Most use drugs, most frequently cannabis, also amphetamine, cocaine, ecstacy Centre for Alcohol and Drug Research AARHUS UNIVERSITET

Ditte: What topics are you discussing with them? Do you mostly talk about cannabis or – Charlotte: No! That's what we're talking the least about. We mostly talk about, well, that I should eat three times a day, get some decent food, not candy and cake. And we talk about getting healthy habits, socialize a bit, get some exercise and go outside. Maybe just a short trip out shopping. Because otherwise I often sit at home alone. And get some, some more structure. And then, well, feel better about myself. Centre for Alcohol and Drug Research AARHUS UNIVERSITET

Ditte: What is treatment to you? Christian: The issue of cannabis smoking, well, that’s just the entrance ticket. That’s not really the problem. It's everything else in life that causes one to use cannabis in order, in my case, to relax, relieve restlessness, forget bad memories and a bad everyday life. Centre for Alcohol and Drug Research AARHUS UNIVERSITET

“We don’t talk much about drugs. Actually we talk about everything else and often everything else is what causes drug use [...] When we begin handling these issues [...] it actually turns out that “Oh, I’m getting in control of my everyday life. Well, then I don’t need these drugs. “ “There’s always a reason for continued drug use” “Those who become enrolled are the ones who use drugs as a coping strategy [...]. These young people are not using for fun. It's not just a period of their life. They struggle with very serious issues, heavy psychological issues.” Centre for Alcohol and Drug Research AARHUS UNIVERSITET

”Problem is that treatment is a silly concept[…] Treatment is to have a relation with a young person in a way where we help them pick up stuff we’ve lost” Across professional backgrounds treatment providers express doubts, ambivalence or straightforward aversion towards the concept of treatment. Centre for Alcohol and Drug Research AARHUS UNIVERSITET

Ditte: I’d like to ask what you understand by the concept of treatment? John: [laughs] [...] It's very funny. I know people in this system loves to call it treatment because it gives some sort of status[...] Yeah, what is treatment? Well, it consists of an alliance that enable you to talk about different issues and deal with whatever is most urgent in their lives. That's really what I mean by treatment. [...] I have a bit of an aversion – I mean in regards to the concept of treatment [...] Treatment is like a white coat, and you entering for an examination[...] D: In you own perception do you perform treatment? J: I never think treatment. I mean, in my head, I never think treatment. Centre for Alcohol and Drug Research AARHUS UNIVERSITET

“What’s also the problem with this concept is that it [treatment] is something WE do to someone else. That means it's not something we do together - "You are treated“ - but in fact it’s the young people who make a lot of things happen. That’s why the concept is a real annoyance.” Centre for Alcohol and Drug Research AARHUS UNIVERSITET

Deconstruction of (drug)”treatment” - Drugs are not center of attention - Treatment are set in quotation marks Construction of a local understanding and formula for enactment Centre for Alcohol and Drug Research AARHUS UNIVERSITET