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Tenacity is vital when it comes to working with troubled young people, Addaction’s Sam Dixon tells DDN.

When Sam Dixon from Addaction’s YZUP young people’s service received an ‘Exceptional Individual’ award at the organisation’s south west regional conference in September, the case study delegates heard was of a 13-year-old girl she’d begun working with several years ago.

The young person was in ‘self-destruct mode’, with issues around substance misuse – alcohol and MDMA, then prescription medications – risky behaviours and self-harm, and who had been let down by a range of other agencies.

‘She’d had a very late diagnosis of ADHD, which didn’t help by then,’ says Dixon. ‘She was self-harming quite significantly – at one point we were seeing her every day, essentially making sure she was still alive. She was in supported housing for a while, which was quite challenging, and even while I was working with her other agencies would come in, get involved and then pull out.’ There had also been substantial police involve­ment around anti-social behaviour, and ‘an attitude towards her that she was a trouble maker, the leader of the pack – another bit of letting down,’ says Dixon.

‘Working with young people is about hanging on in there, even when you’re told to go away,’ says Sam Dixon, who received recognition for her work from Addaction’s chair Lord Carlile.

As those other agencies began to withdraw, what was it that made her persist? ‘Gut feeling,’ she states. ‘My professional instinct was that there was much more going on than was clear on the outside.’

The key elements to engaging successfully with young people are a sense of humour, patience and tenacity, she stresses. ‘It’s about hanging on in there even when you’re being told to go away, and listening to what’s really happening with that person rather than just making an assumption.’

So how did she finally win her trust? ‘This was a young woman who’d had a lot of professional involvement, with people saying, “She’s too hard work, she keeps pushing me away, I’m going to give up.” What she got from me was that that wasn’t going to happen.’

Were there occasions when she did feel like giving up? ‘No, there were times when it was hard, and times when I felt quite distressed myself, but I had brilliant line management support all the way. I never once thought “I can’t do this anymore”. All I saw in front of me was a young person in distress.’

At one point Dixon was making a weekly 120-mile round trip to see her – there was no point when management said, ‘You need to give up on this and focus elsewhere?’ ‘No. I can’t say it didn’t impact on the rest of my working week, but I was very clear about why I was still involved and the work that needed to be done. I was very lucky that my manager listened to that, and the support wasn’t just there – it went to a very high level at Addaction because the safeguarding concerns were so great at times. The extremity of the situation – and the fact we were seeking funding for tier 4 treatment – meant it had to be reported to our commissioner as well.’

For anyone working with similar clients, what advice would she give? ‘Remember that there’s a young person at the centre of it, and that they are not their behaviour. Also, be really, really clear on your boundaries. That young person always knew that it was a professional relationship, and that’s what held her – she knew how far she could push me, what she could expect of me, and that it would be delivered. The building of trust was about keeping those boundaries strong, because sometimes you do just want to pick them up and take them home. In a case like this there were multiple times when I would have done that, but you don’t. Being clear about her boundaries wasn’t something she’d had from a lot of other professionals, so it had a really positive impact on her. And, obviously, it’s about patience.’

Given how long she worked with her, at what point did she feel ‘I’m starting to make some progress?’ ‘The nature of her mental health meant it was very up and down,’ she says. ‘We got her into college and things were going really well, but then they started to go wrong again. But I think once she went into residential treatment, and that had the impact it did – which was amazing – you very quickly saw definite changes in the way she thought about things, the way she felt about herself, and her developing confidence.’

Not only is this ex-client now an Addaction volunteer – ‘she’s very, very keen to put back into the organisation’ – but she has a full-time job and is also studying for a degree. ‘She blows my mind,’ says Dixon. ‘And it says to me, “You were right.” You have to be able to see the potential in people even when they’re in a place where they can’t see it themselves.’

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iCAAD is the International Conferences on Addiction and Associated Disorders

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