Welcome to Social Work Stories, a podcast exploring social work practice through stories and critical reflection.
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Hello everyone and welcome to the Social Work Stories podcast.
My name is Liz Murphy and I'm joined with my friend, Dr.
Nen Fox. Nen Fox, what was it like waking up on Sunday morning?
Liz, the hello everyone.
The relief poured out of me.
I was up the night before at 12.30 watching the changing government happen in our country.
Did it feel like a different Australia?
Oh my God. Sunday morning, it just felt like the sun had finally emerged after this dark, dark couple of years where we've watched so much hardship, right?
Like COVID, floods, the list goes on and to actually hear the wave of support for change around the country.
That was what struck me, right, that this election really just showed the people wanted something different.
I feel like I've woken up in a new paradigm because I'm pretty sure I heard that there are three green seats in Queensland.
Am I right in that? I'm not.
Off the top of my head, I'm not sure.
What I do know is the amount of representation in Parliament now is going to be incredible, right?
Women are more Indigenous people, Linda Bernie, we can just say that, unbelievable, unbelievable.
Like the social worker in Miele's, just listening to Anthony Albanese's speech where he talked about growing up in housing in Canterdown and how he hoped that people out there living in housing could see that this was possible in this country to go from Department of Housing through to Prime Minister, like that just, my heart just was burst open.
I just thought that was absolutely fantastic and so different from the successive governments we've had before him.
So with a Glint in our eye and a fuller heart, yeah, let's now get on to social work business, hey?
Serious social work business I have to say Liz, this is one of those episodes that goes into a space that I don't like a lot of social workers don't automatically go into this space.
This is the Drug and Alcohol sector where traditionally you do have teams of workers who are from different backgrounds, not necessarily or social work.
Would that be right? I think you're right.
I think, look down where I live, there are a number of social workers that do work in Drug and Alcohol, so maybe it's an emerging practice down here, but classically you'll see a mixture of professions like clinical nurses, psychologists, community welfare workers.
Yeah, I remember a hospital I worked at many years ago where I was kind of intrigued by the needle exchange and the team that worked there and was told bluntly that no social workers were employed in that team.
So maybe times have shifted, but definitely the sense I've got over the years and in the other recordings we've done with a couple of other Drug and Alcohol workers since we've been doing the podcast, it does still seem to be a bit of a mix bag.
So when you get social work in that space, it's really nice to see sort of the context right and how practice can change.
So this is at a great recording, it's actually been done by a colleague of mine, Jelaine Allen and Jelaine is now an academic with us at the University of Wollongong, but back in the day she's a seasoned mental health and drug and alcohol practitioner.
And so it was really great to have the opportunity to actually hear from her the sort of practice that she's been involved with and coming at it from this perspective, she does give her this amazing amount of context, right?
Like she sets the scene in a way that you and I probably couldn't necessarily do given drug and alcohol is actually not our backgrounds.
That's exactly right. I really appreciated the detail that she gave in terms of the common school of thought in relation to drug and alcohol treatment.
So she talks about harm minimisation model versus the abstinence model.
Yeah. But we've also got a lovely combination of social worker that brings social worker values and practice into the space, but also narrative therapy.
And what I'd suggest to people is when you listen to Jelaine tell a little bit about the way she works and also her story, listen to how she approaches the assessment process.
She brings a really interesting blend of curiosity to psycho social, to a narrative therapy in terms of some of the questions that she asks.
I found it a really lovely fit to have the narrative therapy in that AOD therapeutic space.
Yeah, I wouldn't automatically put narrative therapy into this space actually.
So it is really nice to see that lens brought to it as well.
Without further ado, let's listen to Jelaine's story and come back for a bit of discussion afterwards.
My name is Jelaine Allen and I've been a social worker for over 30 years.
I've worked in youth work with homeless young people as a family therapist, as a sexual assault counsellor in a large psychiatric hospital.
And I'm trained in narrative therapy and transactional analysis.
So most of my works been in counselling interventions, therapies, that sort of thing.
13 years ago I went to work in the Drug and Alcohol sector in Australia and it was a whole new world.
I was really surprised by the way, I guess the underpinning philosophies of drug and alcohol that I came across.
So I discovered a medical model.
We talk about drug and alcohol treatment, so obviously that's an idea of being sick and then getting fixed or getting treated for that illness.
There's medications, there's nurses, there's specialist doctors, addiction medicine specialists.
And all of that sort of work is underpin by harm reduction.
So do less of what harms you to be safer.
And probably the best example of that is that cars are really dangerous, people hurt in road accidents, but we don't say to people don't drive cars, we say where you're seatbelt when you drive a car.
So in drug and alcohol, probably safe injecting centres are a good example.
Medication like opioid replacement therapy is a good example of harm reduction.
So there's all this medical stuff.
And then the other approach or the other style of work that's really common is sort of a grassroots, peer-led abstinence model that's embodied in alcoholics anonymous.
And everybody will be able to think of a time they've seen the people sitting around in the group talking about their substance use and going to a meeting and that sort of thing.
That AA revolves around talking therapy, the power of groups, sharing and support from others with lived experience.
So it's the original peer support model that has been around for decades that now is a lot more common in mental health and disability services.
But I guess something that I didn't like about that approach was that it's very abstinence focused.
It's either you're abstinent or you're using drugs and alcohol and that's a problem.
Like there's no in between.
Harm reduction approaches are not really supported and the idea is that any interventions in that model are about helping people be abstinent.
The other thing that's often find is a lot of confrontation.
You know, confrontation about people's weakness or selfishness or making bad choices and ignoring their children or spending money on drugs instead of food, those sorts of things which is true.
That happens. But the approach to dealing with it was confrontational.
Just don't do it. Pull yourself together.
Get your act together. Yeah, so the drug and alcohol sector has those two approaches and it didn't have a lot of the social work, therapy, counseling type, work that I was used to and I thought in all of the work that I'd done in 20 years before I started in drug and alcohol.
I'd never really talk to anybody about their substance use.
You know, it had come up with young people who were homeless who were using drugs.
But it wasn't a topic of doing something about it or addressing it or asking them if they wanted to cut down or stop or talking about the problems that drug use caused them.
I mean, the use of drugs for people with mental illnesses is a problem because it affects, you know, if they're on psychotropic drugs or whatever medication for their mental illness, then using methamphetamine or cannabis or even tobacco is a problem because it interferes with the way that the drugs work for the mental illness.
Yeah, so I guess it was an eye-opener to go and work in drug and alcohol and think, oh my God, I've just, you know, ignored this for all these years.
And it was an eye-opener, the medicalisation of understanding substance use and then this confrontational, moral, judgment sort of way of understanding people's use.
I will probably need data moderating statement though that most people use drugs in their life, you know, whether it's caffeine or tobacco or alcohol or whatever, but only a very small proportion of them have a problem with it.
So with alcohol, for example, only about 4% of people who drink alcohol become dependent on it.
So very small amount. And then in Australia, you know, alcohol use is so supported by society.
You know, you have Friday night drinks or drinking at birthdays or weddings or funerals every occasion actually.
And people, you know, you're more supported to drink than not drink, I guess.
But if somebody gets a problem with alcohol, then you're on your own mate, you're weak or you can't handle your drink.
What's wrong with you? You've got this problem.
You should be able to drink and handle it and not become dependent on it.
So when we think about people with drug and alcohol problems, there's a lot of drug use that happens that isn't problematic.
It's just really that the people at the end who are judged and discriminated against because they have this problem.
And I think then that by the time you get to that point, drug use is not a choice.
So people are making a free choice to not turn up at work or fight with their families or whatever because drug use at that point becomes something they need to feel normal.
You know, something that people need to get through situations or get through the day or to stop the physical withdrawal effects or whatever.
And confronting somebody about that and telling them to wake up to themselves and just stop is not, you know, a useful or helpful way to do anything.
I think we'd all know as social workers that if you say to somebody, just do this and you tell them what to do, that the likelihood of somebody doing it is very small.
You know, we don't do that with other things.
We don't tell people just get a divorce because obviously your husband's, you know, not working out for you.
So, you know, but when it comes to drug and alcohol, we tell people what to do all the time.
So yeah, after, I guess, learning this stuff about the drug and alcohol sector, I wondered about how social work had been involved in drug and alcohol treatment or what ways social workers worked with people with drug and alcohol problems.
So being a researchy sort of person, I did a literature review and I searched, you know, the terms like social work, drug and alcohol addiction, drug use, that sort of thing.
And I didn't come across anything specific about social workers working in drug and alcohol.
But I came across heaps of things about drug and alcohol use being like a confounding factor in every other field of work.
You know, it was a contributor to domestic violence.
It was something that caused people to go to jail.
It was something that affected people's mental health.
But sort of like, as it was mentioned in these articles as a problem, but not a problem that anybody really addressed or did anything about.
I think that leaves a gap for social work to do something more with drug and alcohol.
And, but I think also that there's probably a lot of social workers out there like me who don't know what to do, you know, who didn't know, don't know how to talk to somebody about their substance use and perhaps with all of those, you know, ideas that are promoted in the media about AA and, you know, that you see on movies and TV.
We think that punishment or confrontation is the way to go.
And it's definitely not.
Yeah, so, you know, because nobody smokes their first cigarette thinking, oh, gee, in five years, I'll be dependent on nicotine and I'll be spending heaps of money and smoking a pack of day.
You know, but I think that's the same for any drug.
You don't, you know, smoke your first joint or use whatever, whatever drug people choose to use the first time they do it, thinking that they're going to have a problem with it in the future.
So I think social work is a great way and social work, understandings of the environment and social context and social and emotional factors related to people's lives.
I think that's a great way to understand substance use and substance problems because we can look at the risk and protective factors in someone's life.
What's good about their drug use?
What do they enjoy about it?
What problems does it cause?
Who's involved? When are people using drugs?
Where and what are they using?
So that sort of looking into the context of people's lives, I think, is very familiar to social workers, but I think you could add, you know, what times, you know, when if there've been times when substance use isn't a problem for you, what was happening at those times?
Did you control your substance use?
How did you control it? What was something that then made it out of control again?
All of those things are important questions to understand or to ask, to understand someone's substance use because if people spend a lot of time, by the time they have this serious problem with drugs or alcohol, they spend a lot of time looking for drugs, using drugs, recovering from drug use, going back to look for drugs again.
If you're going to change that, you need something to fill that time.
So you need to fill it with healthier, safer, less harmful activities.
So by getting a really good understanding of people's circumstances around their drug use, you can think about what they're doing.
That way is that they can cut down and that time can be filled.
But there's another problem.
Because to ask all of these questions, you have to have identified substance use as a problem in the first place.
And people don't talk about it readily.
Most people who come for some sort of assistance don't talk about it readily because of the stigma and discrimination associated with it.
For example, we had the ice epidemic in Australia for a couple of years, which was the media constantly talking about methamphetamine use the problems it caused, the dangers of people who used methamphetamine, the ways they heard other people and hurt themselves.
It went on and on and on in the newspapers and radio and television.
So much so that when I was doing an assessment with a woman who'd come to the Drug and Alcohol Center, she said, that she wanted to cut down her drug use and that she used alcohol and that she smoked cannabis.
And she wanted to do less of those things.
And I asked her, are there other drugs that you've tried?
And she said, oh, ice. But only once.
And when I talked to her a bit more about that, she actually wanted help with the methamphetamine use that she was using it daily.
And it was causing her a number of health problems.
But she didn't want to bring it up to me, even though I was a drug and alcohol worker in a drug and alcohol support service.
She didn't want to talk about using methamphetamine because she thought that we wouldn't have her in the service because we would kick her out or ban her or not supporter because metham, because ice addicts were such a problem.
So even amongst people that have, you know, they're seeking help for their drug and alcohol problem, they might be quite selective about the things that they say about their drug use.
And you know, they fully understand the stigma and discrimination that's associated with revealing problems with drugs, I think.
Okay, so I think that child protection is a particularly difficult area to work in relation to drug and alcohol use.
And there's two sides to that.
One is that I, that drug and alcohol services don't take a great deal of interest in the interests of the child when they're working with people like with this most drug and alcohol interventions are very focused on the individual and their thoughts and feelings and behaviors and actions and less focused on families and relationships.
So I was in a meeting at my workplace with a bunch of the staff and they were talking about a guy who had come to the withdrawal unit and that's where people go to withdraw from, you know, to physically withdraw from the substances that they're using, otherwise known as detox.
And it turned up with a two-year-old child and they just said to him, you've got to go away, you know, we don't have facilities for children here.
You need to go away and come back when you've, you know, taken the kid home.
So he did go away and he came back a couple of hours later and he didn't have the child with him anymore and he'd, he'd driven from a place that was five hours away to, to come to this detox unit.
But he'd only been gone for a couple of hours and he didn't have the child with him anymore.
And what he'd done was gone into town and found some people who would look after the child for him for a week while he was in detox and he'd left this two-year-old kid with these people that he'd only met five minutes before.
And he told the staff at the Drug and Alcohol Centre that that's what had happened when he came back and they were like, okay, all right, well, you know, you'll be right, you can, you'll do your five to seven days here and you can pick your child up on your way home.
And when they're talking about this after this guy had left, they were like, oh yeah, you know, he did well and he finished his detox in five days and and he's left and gone back to his home town.
But they didn't think at all that there was anything, they had no concerns about that two-year-old child being left with people, strangers, who knows what sort of arrangements were made for that child to live with these people who this guy had never met before.
So that's one challenge of the drug, that the Drug and Alcohol sector needs to come to grips with in relation to understanding people's social and family and environmental context and maybe considering the needs of children when they work with those adults with Drug and Alcohol problems.
But the other side of that is that parents with substance use problems do cause problems for their kids.
They do not feed them, they do neglect them and very often child protection workers are the ones that have to step in and address the substance problems and say things like if you don't stop using whatever drug it is, we're going to take your child away from you.
So once again, that's back to that confrontational idea of that's the drug use, that's the problem, stop the drug use, you won't have any more problems and you're making a choice about using drugs over caring for your child.
I think a good example of a different way to do it was with this guy Danny who I worked with, he was a single parent, he had a three year old daughter when I met him and he was 24, 7 parenting, he wasn't doing anything much else, he had some contact with his parents and he had a few friends that he spent some social time with but he didn't have a lot of other things happening in his life, like things for himself.
And one day he was involved with the child protection agency because they were concerned about a single man looking after a three year old and I think it happened, they'd gone to hospital because she'd fallen off a trampoline or something like that.
Anyway, the child protection worker turned up at the house one afternoon and Danny's daughter was outside playing with a dog unsupervised and the child protection worker was banging on the door, trying to, you know, thinking is this child here alone.
But what had happened was Danny was asleep and it took him a while to be woken up because he had been drinking and he'd been to the doctor to talk about being depressed, you know, with the circumstances of his life and the demands of being a single parent and the doctor had given him some value and so he'd taken the value and drank some alcohol and basically passed out and his daughter had eaten a jar of Nutella and got out the back door and found a dog from the neighbors or somewhere and was happily playing but completely unsupervised and he was asleep in bed.
So the child protection worker was horrified, you know, Danny's got to stop this drinking and drug use or we're taking his child away from him and sent him off you go to the drug and alcohol service, which was where I was working.
And what we decided to do when I talked to Danny about his drinking and his drug use, it was like he used to drink on payday, which was once a fortnighted by a carton of something, some sort of alcohol and go to a friend's place and they'd drink the alcohol.
Sometimes that would happen every week because the friends would, you know, buy their share of the alcohol and they'd get together on the week that, you know, the off week that Danny didn't get paid.
I'd take the kids and their kids would play together.
So I don't think he had a dependence on alcohol, he wasn't using other drugs, but his substance use and his drinking was a problem for the child protection agency.
So instead of talking about not drinking, we talked about how he could get better supervision for his daughter.
So that on Thursdays, payday Thursdays, he'd talk to his mother and arrange with her that his daughter could have a sleep over at her place, he'd pick her up at Friday lunch time and then he could do whatever he wanted on Thursday night with his friends.
And that worked really well and his mother had agreed to do that and, you know, he said to my daughter love spending time with you and, yeah, that worked well to focus the problem as being the supervision of the child rather than the problem being the substance use.
And I don't think that happens very often in child protection cases that other ways of looking at a problem are thought about when drug use is mentioned.
I think that, you know, there's a lot of work to be done to address that idea of, you know, demonizing and stigmatizing people who come to the attention of authorities because drug use might be a part of the things that they're doing.
Yeah, so I think the other thing that is really important for social workers to do or to think about doing when they work with people with drug problems.
Like, first of all, you've got to get that opportunity to talk about drug use and that takes a lot of work and establishing rapport and trust and all of those things that social workers do.
But I think the other thing is the use of language and not calling people addicts or drug abusers or are that person's clean from drugs because, of course, the alternative is that they're dirty because they use drugs.
So we think about language all the time when we talk about people have disabilities or people who have mental health concerns or whatever.
And I think that it's a really important part of working towards the stigmatizing people that have drug and alcohol problems as well.
Liz, I want to talk for a second about the word stigma and the discrimination that Jolaine speaks to quite a bit that exists for people in the AOD space, in the drug and alcohol space.
It was a repeated theme in what she was saying that the stigma and discrimination was coming up again and again and again.
And the fact that it was not only existing within individuals themselves, therefore preventing them from disclosing or preventing them for really engaging fully with services, but it was existing within professionals as well.
And so, and that then Jolaine gave a number of examples about how that would play out in the language that people used in the way that they approached or worked with individuals.
And it just really sat with me, Liz, the amount of power that we have as social workers with people.
And I know that shouldn't feel like such a big revelation.
I mean, come on. That's social everyone, right?
But listening to Jolaine, that was the big takeaway from me, was the amount of power there is in the language that we use every day in how we write our case notes, what phrases we choose to include or don't include, and how that can play out actually on the lived experience of people.
Well, you've got me thinking now because I had taken, I was focusing on something quite different, but you're right.
And I think your point about stigma is an interesting one, because even down to the language you use, like you said, and like Jolaine mentions, just being focused on, you know, someone's either clean, dirty.
I thought that was a really useful example of the weight that can be carried in a label.
Yeah. There's so much weight, isn't there?
You know, and we teach that to students and we speak about it all the time in the profession.
But I do think until you see it play out negatively for someone, it doesn't become real.
Nim, I also liked the way that Jolaine looked at the other areas of Danny's life.
So if we can just focus on Danny for a minute, you know, like sometimes I guess, you know, you can drug an alcohol, that could become the all-encompassing focus.
But I liked the way that she asked things like, when is it an issue for you?
When is it? And I liked the way in which she shone the light on areas of Danny's life that were working.
You know, his relationship with his kid, the fact that he was a single parent, I think that gave me a sense that she was really looking at all facets of his life, not just the fact that he drinks, you know, one day a week.
And I was thinking about it in terms of gender too.
I kind of know the work that I've done with women who often talk about the importance of having to have time for self.
Yeah. And I thought about how different it was.
Look at this. And then a single parent, he has a day of drinking with these mates.
Some of those elements, I think, were seen through a particular lens.
Yeah. I just, I think the way that she looked at it in terms of the harm minimisation model again, the importance of him having some time socialising with these mates.
Like I just thought it was a different angle that she took it.
Yeah. And that's what you were talking about in terms of the power stuff.
Yes, absolutely, absolutely.
Because had she chosen any particular perspective or orientation, it could have changed that conversation, right?
I totally agree with you on the gender point I had not thought about that.
And that is a very interesting difference between the dialogue we engage with men and women, especially around parenting, really interesting.
But I think as well, what she was alluding to about a sort of a culture within drug and alcohol services, about seeing the drug or alcohol use in certain ways, imagine if we were seeing the same case, but we were sitting in a child protection team.
Or if we saw the same case, but we were sitting in a health context, right?
Or a probation and parole context.
I think how the priority or orientation we would give to that conversation would be different.
And I think there is something there that we have to acknowledge about social work practice overall.
I mean, we train social workers to be generalist social workers in this country.
But the reality is that when you go to work in any given context, you are taking on the orientation of that context.
Look, I must admit, I reflected on the work that I used to do in generalist counselling and also in domestic violence.
And I realised that I wasn't actually looking too closely at drug and alcohol issues that may or may not have been in play with my clients.
I waited for them to raise it with me.
And then, if they had raised it, what can often happen in health and what I did in my own practices that I might have got Jolaine in to have worked with that particular person.
But listening to Jolaine, what I took as well is that that can be part of the psychosocial assessment.
Oh, absolutely. And that we can do this as social workers where there were in the context of community, hospital, wherever it doesn't actually have to be just something that AOD specialists do, that it's something that can be very useful in developing a thorough assessment of a person and where they're at.
Absolutely. And I just want to go back for a second and name that what you were talking about before, where you were saying, asking those questions that were about capacity that the person already holds.
I mean, that's strength-based practice, right?
That's the theoretical frame we're coming from.
And so I just kind of want to name that as well, that what Jolaine's done in that situation, it's not just narrative therapy questions, but it's coming from a position of strength in her questions and giving that ownership back over to the person who is otherwise really vulnerable in that moment.
Because given the stigma, given the discrimination, they're actually disclosing what is often a very private lived experience.
That's associated with a fair amount of shame.
I mean, one of the things that I was also curious about was earlier in Jolaine's description of the work in AOD was that she'd taken herself off to do a lit review on social work practice in drug and alcohol and the lack of articles that she was able to find in that space.
And I'm wondering about whether that's still the case.
Well, firstly, can I just say I love a social worker who is asking questions about their practice and goes off and goes on to the lit review?
I do. I mean, come on. She did call herself a researchy social worker.
Yeah, but I love it. I love it.
Let's just put that on the table.
But second to that, I don't know.
And that's possible. And given the fact that you and I are not from a drug and alcohol perspective, highly likely, that there is a volume of research that now is sitting out there and I would hope.
So I would like to put that out to our listeners if there is something that you think that we could link to Jolaine's story to on the website.
We would be more than happy to like really important that we actually make sure this is a current discussion I think that we're having.
But also given the orientation that Jolaine came from from a drug and alcohol team, I'd really be interested is if there's social workers out there coming from a different orientation, coming from child protection, coming from mental health, coming from health, hospital context, coming from parole and probation, whether there is another perspective they would have on this case and whether they do think their practice would have shifted because of their orientation.
So I think if you're listening to this and you're coming from one of those other perspectives, send that through to us.
But that would be really fascinating to hear and to kind of expand our understanding in this space as well.
Absolutely would. I think we're going to put Jolaine's contact in the show notes and I would be surprised if in fact she hasn't written any articles in this space.
Oh, absolutely. I would really suggest that if anyone wants to engage with Jolaine about this context and yeah, go directly to the source, absolutely.
I really thank Jolaine for naming herself so that we can actually start a dialogue around this list.
I mean, yeah, let's take this podcast out of the audio realm and make it into our dialogue.
And thank you Jolaine for sharing with us.
Absolutely, absolutely.
On that note, Mim, shall we say farewell?
I think we shall. As always, listeners, hit us up.
Social media, www.socialworkstories.com.
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So if you think, oh my gosh, there's a lot of new stuff coming through on the feed, thank you to Maddie.
We are out there, Liz. We are live.
We are happening. It's so good.
And that means that we are really here to be engaging more and more with you also.
Please get in touch. Thanks so much, everyone.
We'll speak to you next time.
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