successfully in previous courses around the world such as mindfulness , psychoeducation , solution-focused brief therapy , theory of marginal gains , theory of hope , CBT and biological and motivational theories in psychology – all underpinned by a compassion-focused approach . Each element provides the framework to explore topics such as barriers and benefits to risk taking , self-esteem ,
We already know that recovery is a long and unstable road . The journey begins by understanding the difference between thoughts and stories , developing self-compassion and working with the past so we can live in the here and now .
identity , guilt and shame , the driving force , here and now , cognitive distortions , perspective taking , emotional regulation , communication , trauma and moving forward . The core element threaded throughout the course is to ensure that we work towards de-shaming and increasing self-esteem , and therefore allow clients to become more open to learning , new ideas and hope .
ROOT CAUSES We feel the gap between this course and others is the identification of the root cause of ACEs and trauma , rather than primarily focusing on the triggers of the substance use itself . Instead of adopting the stance of being the experts , we ’ ve taken a more inclusive approach , developing a compassionate , experiential , non-shaming and relationshipbased model which allows the clients within a safe and contained environment to develop responsibility and control of their journey .
We have so far delivered 12 courses , nine at Nottingham Prison and three at Ranby – 72 clients have started the ABC in total . In each group we capped the attendance to six clients due to the depth of the work that was being carried out , which ensures a therapeutic environment conducive to working with trauma . It has embraced a structure that limits grooming and manipulation of facilitators , and ensures a collaborative approach .
CHALLENGES The challenges included a certain number of clients who were transferred , the environment ( such as difficulties in finding rooms ), a lack of understanding of trauma informed care , and the fact that it was written and piloted through COVID .
The psychometrics used for the first eight cohorts at Nottingham Prison were the Brief situational confidence questionnaire ( BSCQ ), the Cognitive and effective mindfulness scale – revised ( CAMS-R ) and the Emotional problems scale : self-report inventory ( EPS : SRI ).
The BSCQ indicated an average increase of between 14 per cent and 38 per cent in confidence dependent on situation , while the CAMS-R indicated an average increase in mindfulness of 5.1 on a scale with a maximum score of 40 ( a 12.75 per cent increase ). The EPS : SRI showed on average a general reduction in thought disorder , impulse control , anxiety , depression and low self-esteem with an increase in positive impression .
We are continuously developing the ABC and receiving feedback from clients , staff and the national panel in the psychometrics . To this
FEEDBACK
FROM STAFF / PAROLE BOARD :
‘ I just wanted to say that ……. is the third person on my caseload to complete the ABC course , it has literally changed his life ! He has found this life changing and healing , the change in his outlook on his life is really inspiring . I ’ ve had a session with him this morning and he couldn ’ t speak highly enough of this course . He is applying all he ’ s learned to his everyday life , moved to house block 8 and is focused on Cat D . He ’ s keen to be an SMS mentor , I have referred him for MAPS worker in the interim as I think he has a lot to offer , and he is really keen to help others . Great job !’
‘ I just wanted to raise how fantastic these ABC courses are . My two men that have done it are so much more aware of their issues , triggers and risks around relapse . The reports from the SMS teams are also a great resource due to the level of detail . The two I have received will make a great impact of their parole hearings .’
FROM CLIENTS :
‘ I didn ’ t really understand myself and how to cope with past trauma . I was feeling anxious , nervous and unsure before the course . Once the course had finished I felt sad , but I ’ m in the best place I ’ ve ever been in .’
‘ This has been the best thing I ’ ve done in my life to date , life changing !’
‘ I take it a day at a time . I now feel more confident that I do not need drugs to make me feel better or to forget , and just try to be happy and make happy memories for future . Also , I am the way I am and I have nothing to apologise for . Things can only get better .’
end the BSCQ has now been replaced with the drug-related locus of control scale ( DR-LOC ), and we ’ ve also developed a training package to train staff to deliver and understand the models used .
We are now working towards validation at HMP Ranby and , in the future , accreditation .
‘ I take it a day at a time . I now feel more confident ... I am the way I am and I have nothing to apologise for . Things can only get better .’
Alana Diamond is substance misuse training facilitator at HMP Nottingham
Deborah Franks is senior counselling psychologist in the NHS Danny Pearson is substance misuse training facilitator at HMP Nottingham
Steve Hartland is assistant psychologist in the NHS
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