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Life Skill Training - An effort taken by CHILDLINE India Foundation

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Life Skill Training - An effort taken by CHILDLINE India Foundation

CHILDLINE India Foundation » CIF Events » “Life Skill Training” - An effort taken by CHILDLINE India Foundation

The incidence of drug abuse among children and adolescents is higher than the general population. This is notably because youth is a time for experimentation and identity forming.

In India a survey revealed that 63.6 % of patients coming in for treatment were introduced to drugs at a young age - below 15 years. According to another report 13.1% of the people involved in drug and substance abuse in India, are below 20 years. Heroin, Opium, Alcohol, Cannabis and Propoxyphene are the five most common drugs being abused by children in India. An emerging trend about child drug abusers is the use of a cocktail of drugs through injection, and often sharing the same needle, which increases their risk of HIV infection.

The problem in India is that there are no sensitization programmes about drug abuse in schools or for children out of school. India does not have a substance abuse policy. There is also a high incidence of charging children under the Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985. It has been observed that when children don‟t have access to high quality drugs, they often go for volatile substances easily found in corner stores such as cough syrups, pain relief ointments, glue, paint, gasoline and cleaning fluids. There are very few to no health centres that deal with child substance abuse problems, especially in the rural areas. The use of tobacco is another major concern amongst children. In India 20 million children a year and nearly 55,000 children a day are drawn into a tobacco addiction. The number is shocking when compared to the 3000 a day new child smokers in the US.

In 2008, CHILDLINE India Foundation published a study on substance abuse amongst children in Manipur. The study found a wide spread prevalence and acceptance of drug use from heroin to the most common Spasmo Proxyvon. Children affected by substance abuse are considered as children in need of care and protection under the Juvenile Justice Act, 2000.

Substance Abuse is a complex problem having medical and social ramifications which impacts not only the user and their families but all sections of the society. Substance Use Disorder (SUD) affects individuals across various strata of society. Though there are de-addiction centers with qualified personals, being the last point of contact, these centers are of little help. And on the top of that, though various surveys have shown that people get involved in drugs at the early stage of life, in the age of 14-16 years, there are no such special care centers for this group of population. The parents are also not aware or sometimes not willing to take their children to the available de-addiction centers which they don‟t think to be a proper place for their children. To cure the addiction as well as to regain the health, it is very important that patients come to the de-addiction centers for treatment, much earlier. And also for a better result and more effectiveness, it should be started with the children and the adolescents with addiction. Studies have shown there is a huge need of care, protection and proper de-addiction facilities for the children and adolescents with addiction. To fulfill this need of the society, CHILDLINE India Foundation with the support of HSBC Bank and All India Institute of Medical Science (AIIMS), organized a five-day training to sensitize the field workers and to introduce them to this social evil. To make the effort more efficient, NIMHANS has developed a series of Intervention sessions, specially designed for the children and the adolescents.

Life Skill Training - An effort taken by CHILDLINE India Foundation
Professor Seshadari introducing the participants to Life Skills

Professor Shekhar Seshadari from NIMHANS, Bangalore provided training on the structure and content of each session of intervention. He explained the structure of each session which should ideally have a general introduction (with a recapitulation in later sessions); warming up activities (with imagination, creativity, ideas) followed by introducing the theme of the session, the core activity with the process and finally a summarisation and closure of the session.

The structure of the training was such that two days were devoted to theoretical issues which covered the types of Drugs and the concept of drug abuse. This was followed by two days focusing on Intervention delivery - general principles of counselling, motivation enhancement and relapse prevention. The last day was devoted to role plays and practice sessions among the participants. Some of the approaches that were used:

  • Life Skills Assessment
  • Community Reinforcement Approach
  • Brief intervention

Taking cues from the past studies a new intervention approach was developed. This approach was based upon a cognitive behavioral model, with a focus on development of self-management skills in general and relapse prevention skills in particular in order to support a drug free lifestyle. Some elements of Adolescent Community Reinforcement Approach (ACRA) were also used. These include:

  • A situational analysis of the drug use and prosaically behavior
  • Motivation enhancement
  • Relapse prevention

The concept of happiness scale was borrowed from ACRA. Certain themes of the sessions were based on the Situation Assessment exercise as they emerged as important findings in an earlier completed project on out of school children.

Study design: This was a cross-sectional study that involved collection of data from several sites in India. Following training, CHILDLINE representatives conducted a baseline pre-assessment followed by imparting of intervention and a post assessment at three months after intervention to determine its effectiveness.

Geographical area/ Setting - The cities were purposefully selected as they have local CHILDLINE Partners rated high on performance indicators and who agreed to participate in the study. From west zone- Mumbai, Nashik and Bhopal; East zone- Guwahati; North zone-Noida, Gorakhpur and Shimla; South zone- Vizag, Bangalore and Hyderabad.

Objective of the Training

The objective of the workshop was to educate and sensitize the field workers about the outreach programme. The outreach programme for the street children is primarily based on psycho-social intervention. The intervention aims

  • To enhance the capacity of CHILDLINE partner organization representatives involved in service delivery at ten sites in India
  • Develop a training framework and a pool of trained persons on delivery of psycho-social interventions for street/homeless children
  • To collect baseline information on family, peer, stress, psychological and physical health and legal drug use aspects for children in distress contacting the CHILDLINE partner organizations
  • To impart psycho- social intervention to children contacting the CHILDLINE partner organizations
  • To carry out an impact assessment and document changes among recipients of interventions

Findings from the training

  • One third of children did not want to give up drugs on the street
  • Many reported difficulty in remaining away from drugs on the street
  • Inhalant users had more drug using peers
  • Extra money available (after meeting their basic requirement of food) was not managed properly and many had poor hygiene and personal care (poor awareness of health issues)

Some of these issues had also emerged in a previous study conducted by NIMHANS on street children.

It is expected that the treatment approach would lead to at least a reduction in drug use. It is necessary that the intervention must keep the harm minimization perspective rather than an all or none approach. In short, though abstinence is the desirable goal, any reduction in drug use quantity or frequency or any positive change in lifestyle are desirable as intermediate goals and are likely to affect reduction of harm due to drug use.

The Life Skills Training was inaugurated by Ms Heenu Singh, Head of NRRC, CHILDLINE India Foundation in the auspicious presence of Ms Nidhi (Spokesperson, HSBC Bank), Dr. Anju Dhawan (AIIMS), Dr. Ramandeep Pattanayak (AIIMS), Mr. Deepak Yadav and the participants from various parts of India. Ms Heenu Singh introduced all the resource persons and the participants. Ms Nidhie Grewal, a representative from HSBC Bank, spoke a few lines about the effort and importance given by the HSBC Bank in this programme.

The topics that were covered during the programme included:

  • Basic information on Addictive Substance use in Children & Adolescent
  • Introduction to the various issues related to drug abuse with the help of different researches conducted in India
  • Importance of psychosocial intervention in the prevention and treatment of drug abuse
Life Skill Training - An effort taken by CHILDLINE India Foundation
Lighting the inaugural diya (clockwise from left to right) Mr. Deepak Yadav, Dr. Ramandeep Pattanayak (AIIMS), Dr. Anju Dhawan (AIIMS), Ms. Heenu Singh (Head, NRRC, CIF), Ms. Nidhie Grewal (HSBC Bank)

The Life Skills Intervention sessions were structured in a way so that much could be achieved and gained. Various activities and sessions were developed for participants keeping in mind the goal to help children not to fall into temptations.

A five day training programme by technical partners from AIIMS and NIMHANS was held at a central location. The participants included a CHILDLINE City in- charge, CHILDLINE Coordinator and two team members from each city. Thus a total of 30 persons underwent training which was both theoretical and practical. It included information on basic aspects of Substance Use disorder, training on issues related to drug use in children or adolescents, familiarization with the questionnaire and intervention delivery. Training involved mock interviews in the field setting; any queries put forth were addressed. A pre and post training assessment was carried out to assess the impact and skills understood and developed.

Life Skill Training - An effort taken by CHILDLINE India Foundation
Participative sessions and role play at the training

The intervention package comprised six sessions to be delivered in groups of 8-10 children over five to six half days or 3 full days. This package has been developed in consensus with experts and resource persons by NDDTC, AIIMS. It aims at

  • Facilitating development of understanding children’s own behaviour
  • Enhancing self management skills (money management, pursuit of healthy recreational pursuits, health care and treatment seeking),
  • Enhancing self esteem and motivation
  • Relapse prevention (understanding of the perceived benefits and harms, process of relapse, drug refusal skills, understanding the role of social support/family)
Life Skill Training - An effort taken by CHILDLINE India Foundation
Participants at the training

Following are some of the aspects that were aimed at during the training:

  • To give the children an opportunity to think and develop an understanding of their behavior in general and the inhalant use behavior in particular. A new concept was introduced: each behavior has some antecedents and consequences. By establishing link with the past and the future, it enables the children to understand how what we do now is going to affect us in the future and also lets them realize that the long term effects might be different from the immediate effects. It gives them the perspective that they could have a choice in indulging in or not indulging in a given activity.
  • To allow children to distinguish between happiness derived from negative things and happiness from pro social activities taking a longer term perspective.
  • To provide hope and optimism
  • To provide children with the options of ways of changing their behavior
  • To inform the participants that there can be various alternatives of dealing with a situation and specifically to enhance skills required for drug refusal.
  • To show various possible ways of spending money in a more sensible way and to seed a thought of “Saving”
  • To demonstrate the conflict that happens in the mind at the time of relapse and factors that help to overcome a relapse
Life Skill Training - An effort taken by CHILDLINE India Foundation
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