Beyond addiction. Science and kindness for positive change.

Jeff Foote is a clinical psychologist who has been involved with addiction treatments and programme development and research for over thirty years. He now runs treatment centres and a foundation for families of people struggling with substance issues. He has also written some books aimed at families to amplify the messages about evidence based approaches that families never hear about when they are helping their loved ones with their substance issues.

Jeff’s work has not always been based around families. For the first twenty-five years of his career he felt that he, along with many other clinicians, downplayed the role and involvement of families when it comes to mental health issues and peoples psychological struggles. During the first two thirds of his career he ignored families and focused on the person struggling with the addiction. Over the last ten years through, he has been working with organisations geared towards helping families.

Jeff had a pivotal experience talking with fifteen parents who he was just about to start training to coach other parents. Their kids had had terrible substance issues and they wanted to help other parents through evidence-based ideas rather than the things they had been told for years and years. That series of interviews changed his view and helped him realise the huge pain families go through, the levels of motivation they have to help and understand and the huge resource they are in helping to produce change.

Jeff has spent the last ten years shifting his focus and trying to make the tools and information more accessible to families so that they can see that they do this, both themselves and in the community, that they don’t need professionals and that they can take this up and be effective.

The US has been a blaming society when it comes to substance abuse. This is gradually changing but it is still there. One message has always been that you have to detach. If your loved one is struggling you need to step away and take care of yourself. The tough love idea that you have to let someone hit rock bottom before they will change. This has nothing to do with evidence or effectiveness and is an approach that is heartbreaking for families who come scared, concerned and asking for help.

The 12 Step Programme is often considered to be the only solution for addiction. Jeff feels that it has helped many people and many families over the last seventy years. The problem is that it's a ‘one size fits all’ process. If it doesn’t help you then there must be something wrong with you and it’s your fault. It's a programme that has been both helpful and harmful because of its demand characteristics rather than an invitational approach.

The approach Jeff has been working on over the last ten years is called the Invitation to Change‘ which is an invitational idea rather than a command one. Its basis is in community reinforcement and family training, an approach called CRAFT which is the most powerful evidence based approach for helping families help loved ones. Before that, it was a case of letting go/detaching or confrontational interventionist approaches. What we know from CRAFT and other psychological based approaches is that you can take care of yourself and stay connected to them and that this is actually the most powerful way to help someone to change.

Jeff’s process starts by having to have an understanding of what the person you are trying to help is going through, to ‘Open the door to change by viewing your loved ones substance abuse by viewing it through another lens’. By shifting your perspective and starting to understand that you can step into their shoes. People do things because they are reinforcing. They act and behave because there is something in it for them. Substances are very reinforcing and they are reinforcing in different ways for different people.

Family members need to sit back and understand that their loved one is doing this not because they are morally reprehensible, lazy but because it makes sense to them in a powerful way. This creates an entirely different relationship and atmosphere – I still feel scared, I don't like or agree with it but I can understand it now. You’re a human being and these things mean something to you. This changes everything – what you’re doing makes me want to turn away to what you’re doing makes me want to turn towards you. The thing that changes is the understanding of their motivation.

The person struggling with the addiction is the one whose behaviour is not acceptable. The family is involved in a blame way. Studies about family support and family health show the barriers to are practical and economic but the major one is stigma. When a family member steps into the change process or treatment system they get blamed, ‘why didn't you see it earlier’ and there is shame and blame. It rips the family fabric of trust and safety apart and how you reengage is different for all families. Their values are different but most are invested in staying connected, of being loving and bringing safety, connection, respect and collaboration into a family unit that might have been damaged by the substance abuse.

Jeff feels Science and Kindness is what helps people change and that although strategies, understanding and data related research trial concepts are powerful without kindness the uptake and effectiveness is much less. Kindness is an evidence-based strategy as well.

You can find out more about Jeff at Center for Motivation and Change Foundation or The Beyond Addiction Workbook for Family and Friends: Evidence-Based Skills to Help a Loved One Make Positive Change, 

   You can listen to the podcast in full and find out further information here. Our upcoming guest list is also available along with our previous blogs.
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Living Love. Summers at Camp Jabberwocky.

Dr Steven Gardner is a Primary Care Internist at Massachusetts General Hospital where he works with adults with a range of issues. For the last twenty-five years he has also worked during the summer at Camp Jabberwocky, a special camp in Martha’s Vineyard for people with a range of abilities and disabilities. He was introduced to the camp through his son Graham who was born with Cerebral Palsy. Graham was unable to speak or to walk and needed help with everything but he was accepted as a camper at Camp Jabberwocky and Steven became a camp doctor. For thirteen years they spent summers with an eclectic group of campers and volunteers who formed a very unique family with and without disabilities who come together in the summer time in a beautiful place to live together and care about each other.

Cerebral Palsy or CP encompasses a wide range of brain and nervous issues that can range from mild to severe. Someone with a more mild form might have a limp but would be able to function perfectly well in other areas whilst a more severe form can damage the brain more profoundly would mean someone would be unable to speak, be in a wheelchair and need assisted technology and other people to help them physically although they are cognitively absolutely fine. In the past it was thought that CP was caused by birth trauma but now it’s more likely that its due to a problem such as a toxin or virus that occurs during pregnancy and is generally completely unknown to the mother.

Steven’s son Graham possessed an inherent dignity and radiance. He was never resentful and radiated kindness and love. He lived 22 years and passed away just before his 23rd birthday from an epileptic seizure when he was swimming in a pool with his father. After his death, the family received around 1500 condolence cards and they began to realise how Graham had touched a lot of people along the way – they had taken care of him but he had given them something back. His legacy was one of love and kindness, that we support one another, that we are one family and community and don't leave anybody behind.

Camp Jabberwocky was one of the first sleep over camps for people with serious disabilities. In 1953, UK actress Helen Lamb was working in Massachusetts as a speech therapist. She had to visit a number of children who were in wheelchairs and it made her angry that they had to spend summers indoors so she decided to take a few children to a place where they could spend the summer doing the things able bodies children did. She found an island 6 miles away from Cape Cod and in the summer of 1953 took 3 kids and 1 helper away for the first time. She didn’t really have a plan and had little money but did possess a belief that it was all going to work out. 68 years later it is part of the fabric of the area.

Helen created something really special. As well as the idea that love can abound and be shared, the camp works around fun and laughter. Laughter is an important part of resilience – it reduces stress the hormones and elevates the feel good hormones. Laughter also increases humanity and hierarchy quickly dissolves when you have fun with each other - Steven quickly became Dr Steve to everyone at the camp!

Most parents don’t stay at the camp but Steven was obviously an exception because of his role. As well as providing first aid for day-to-day cuts and bruises, Steven had to monitor all the serious underlying health issues that the campers but he was still able to go on adventures with his son and engross himself into the rhythms of the camp as a dad and doctor.

After Graham’s death the most difficult decision for Steven was whether to return to the camp. It would be painful without Graham but Steven knew that by going back to that special place and family, they would be loved and supported. Steven doesn’t know the reason Helen had in naming the camp but he thinks of it as a philosophy of living – to have open hearts and open minds, to embrace each other’s differences, to support each other, to laugh and create together and even to cry and argue together. This is what’s known as Jabberwocky love and every years when the campers and volunteers go back home they are always leave with the question - why cant the real world be more like Camp Jabberwocky?

You can listen to the podcast in full and find out further information about Steven here. Our previous podcast episodes, upcoming guest list and previous blogs are also available.

Graham’s life and Camp Jabberwocky are the inspiration and location that Steven celebrates in his book  Jabberwocky: Lessons of Love from a Boy Who Never Spoke 

You can find out more at Jabberwockybook.com.