The longer term view: Working with Arnie

Gavin Wilkinson
Friday, 12 October 2018

 Whilst working in a community drug project I remember walking into work one Monday morning and seeing Arnie’s (not his real name) referral paperwork on my desk.

I had not worked long at the project, and the psychological treatment programme for people experiencing drug and alcohol problems had only recently been constructed. This meant that Arnie would be in the first ever cohort of ten people to enter the  26 week programme. The main focus of the programme was to assist people experiencing drug and alcohol problems to get them to a position of abstinence. The programme would seek to do this by helping people build up their own portfolio of more adaptive coping strategies and life skills. The idea was that they could go on to use newly acquired coping strategies as an alternative to drugs and alcohol.

Arnie was now in his early forties. He was referred to the treatment centre by his probation officer. He had history of alcohol problems, and committing violent offences. The violent offences were common assaults committed in  pubs whilst intoxicated when he perceived that someone had insulted him. He was now under probation supervision on a Suspended Sentence Order and an Alcohol Treatment Requirement. 

Initially the probation officer was concerned that Arnie’s alcohol problem was starting to re-surface after a long period of abstinence. He had started to appear at the probation office intoxicated and incapable of engaging in conversation. Luckily for Arnie, his probation officer had taken a considered and thoughtful view of the incidents. Instead of responding in a punitive reactionary manner (by breaching him) the probation officer saw it as an opportunity to catch Arnie when he was not intoxicated and address the recent behaviour. The aim was to forge a constructive way forward for Arnie.

The probation officer knew Arnie was accessible enough to have an important conversation with him about his future. Luckily Arnie was receptive to being spoken to about his two possible future choices. Should he carry on drinking and turning up intoxicated it would result in him returning to prison. The alternative choice presented to him was that he consider engaging with a new community-based substance misuse programme. The idea was for Arnie to try and re-assert control over his alcohol use and maybe even his life. After a lengthy discussion, Arnie agreed to engage in alcohol treatment. 

In treatment 

When I met Arnie to conduct his assessment, the first thing I noticed about him was his sheer physical size. It was easy to see how members of the public could feel intimidated by him. However, what I saw in Arnie was a vulnerable man with a troubled past. Neglectful parents, a violent peer group, attendance at a violent school, and time in the armed forces had all taken their toll on him. 

Despite these negative life events I could also see other more positive characteristics in Arnie. Whilst engaging with him through treatment I could see that he was intelligent and insightful. He had some talents and interests that could be developed which could allow him to even make a living from in the future (i.e. computer programming, writing). 

Post treatment 

Within the treatment centre’s aftercare service (post treatment), Arnie became a volunteer at the treatment centre. Eventually, Arnie got a significant breakthrough of his own. He acquired a job as an admin assistant -  his first job in nine years. With some financial assistance from the treatment centre, he completed a one year course in basic computer programming.  He then went on to  be promoted, within his organisation, to work as a computer programmer. 

Still a bumpy, but a more positive road ahead for Arnie 

Arnie had made some incredible progress over four years. He had been abstinent from alcohol for three years. Despite all of the progress Arnie did lapse and gradually relapse back in into more serious alcohol misuse. Looking at the bigger picture, Arnie had come a long way. Despite relapsing into alcohol misuse, he did not re-offend violently or in any other way. He also entered into a short-term residential rehabilitation programme with the support of his employer and social contacts. On this occasion Arnie had a stable home to return to and as well as a job. 

This was progress for Arnie when you think about where he was when he first entered into the criminal justice system. He had no job, no stable accommodation, no welfare benefits and no social network.  Arnie is never going to be ‘cured’ as his love of alcohol and pre-disposition to seeking it out  numb his emotional distress. However, he did demonstrate with the appropriate forms of support he was able to build a better life for himself, sustain a better life for longer, and re-enter into those improved life circumstances after ‘falling down’ again. Of equal importance, was his increased personal resilience, declining risk to public safety due to the more solid protective factors to re-offending he had built up himself over the years.

 Gavin Wilkinson is a Forensic Mental Health Practitioner at Together for Mental Well-being’s Forensic Mental Health Service