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evaluation report: The Urban Breakaway Project

Summarizing a research report by the Douglas Hospital of McGill University

Authors: Michel Perreault, Ph.D., Douglas Mental Health University Institute, Department of Psychiatry, McGill University - Catherine Laurier, Ph.D. Research Center, Douglas Institute - Noé Djawn White, B.Sc., Agency for Health and Social Services, Montreal - Bruno Ferrari, Executive Director, Dianova Canada - Manon Mousseau, B.Sc., Research Center, Douglas Institute

I. Summary

The Urban Breakaway project offers street youths an organized respite in a natural environment. This break from the streets is intended to develop life skills and to provide information about the negative consequences of drug and alcohol abuse. The present study aims at providing information about the views of counselors from various organizations who participated in the Urban Breakaway project. Their views are important because such a project implies a specific collaboration model between the organization which conducts the project and partner resources. Counselors from partner resources accompany the young people who were referred to the Urban Breakaway project, which, for them, entails working in much different conditions than those that they encounter when they work on the street: a breather, in other words, for both counselors and street youths. 

During the first year of operation of the Urban Breakaway project, 9 partner organizations established 17 groups which participated in the project. A total of 148¹ street youths participated in the Urban Breakaway project's activities, accompanied by counselors whom they knew from the street. The present study, which has been conducted on 25 of these counselors, shows that, according to the latter, the project actually did respond to the need for a "break" for these young people, and might have facilitated the attainment of information on issues that they considered important.

The organization of the program has been widely appreciated, as well as post-respite consequences, such as the reinforcement of youth/counselor bonds. The partnership model which was developed has strong potential to reach out to street youths, a population considered difficult to reach out in "traditionally" implemented services.  The project seems to gather some of the conditions necessary to establish and maintain a positive alliance between these young people and their counselors.

Program Activities
The basis of this program is a 6-day residential stay at Dianova’s country retreat center. The 6-day intensive stay gives participants an opportunity to reflect on the possibility of positive life changes. A variety of fun, recreational, educational and health-oriented activities are conducted in a safe, drug and alcohol-free, stress-free, friendly atmosphere. These may include activities such as sports, hiking and other environmental activities. Additionally, the program offers educational workshops conducted by trained facilitators, including a licensed nutritionist and certified therapeutic counselors.

A few examples of these specialized workshops and programs offered as part of the Urban Breakaway Project are “Health and Nutrition” – designed to address general nutrition, eating habits, nutrition corresponding to addiction and food/budget management. Other activities are especially designed to increase participants’ self-esteem, and teach stress management skills and violence-avoidance.

II. Outcomes

Participation
Between October 18, 2005 and October 17, 2006 34 counselors worked with 17¹ groups that participated in the Urban Breakaway project during its first year of operation. The groups comprised a total of 148¹ individuals, 79% of which were male individuals coming from Montreal and Toronto.  The majority of groups consisted of both genders (10 groups).
¹Dianova Note: By March of 2008, 255 youths had participated in 39 groups. Details upon request.
Others consisted of men only (5 groups) or women only (2 groups). Participant’s average age was 29.3; in 72 % of cases they were aged 18-29. Older participants had participated in respites especially designed for them and tailored to their needs, and some older participants had joined events designed for younger participants.

Perspectives of counselors
The Urban Breakaway project generated positive comments among counselors. They mentioned that the project was able to respond to the needs of street youths who were not necessarily ready to give up substance use, although they wanted to improve the qualities of their lives. Nine of the 12 groups of counselors interviewed, said they were satisfied with the nature of the partnership and/or the quality of communications between Dianova and the various resources. Although a positive partner relationship is considered necessary to facilitate a positive program in the Urban Breakaway project, some counselors added that the break from the streets was an occasion to develop a better partnership with the participants because it provided an incentive for a collaborative work.

The way in which the Urban Breakaway project was organized was highly appreciated by counselors, whether they were counselors of partner organizations or Dianova counselors primarily in matters concerning the organization of activities.

“I was impressed when I realized how you (Dianova) are organized.”

“We had heavy drug users – cocaine, IV drug use… I was impressed by the way you were able to handle the situation.”

In addition, the flexibility of the programming was considered a positive factor by 4 groups interviewed, because flexibility helped them deal with unexpected situations.

“Flexibility is a point. Groups are diversified in terms of character and temper. The fact that we could adapt activities was very positive”

“The framework is set, but we can make adjustments from one group to another”

Educational workshops have had to be adjusted since the first implementation of the project in order to ensure the cooperation of all participants. The workshop’s overall framework is now more informal than it was initially, which it makes it possible for the participants to discuss and express their opinions more easily

Group workshops were widely appreciated by counselors who found that they could promote discussions between participants about the various problems with which they are confronted in their daily lives in the streets, and they were able to initiate personal reflections by the participants regarding their personal needs. More specifically, the education-oriented workshops sometimes elicited lukewarm comments (5 groups), compared to more open activities – either because of overly directive intervention methods or because of the particular trainer. It appears that the adequate preparation and implementation of educational workshops designed for this specific target group had initially been a major challenge, resulting in adjustments which have now been made.

A majority of counselors interviewed consider that the reflection initiated by the participants during their stay in the Urban Breakaway project, permitted them to “make a break”, with their usual lifestyle. In addition, according to them, this break brings about a number of interesting benefits for the health of the participants. They would end the program rested, “sober”, because “they have the opportunity to live intimately with themselves”. This 6 day sobriety, made possible by the stay at the Urban Breakaway project, is perceived positively by counselors; counselors of half of the groups (6/12) mention this factor specifically as a primary success indicator for the project, because the youth have the opportunity to become aware of the extent of their drug consumption.

“Everyone is there… they come to realize “Oh boy, yeah, I use a lot of drugs”

“During the stay, they are alone with themselves… the notebook, it’s funny to see a drug user with his small notebook, his intimate notebook - maybe… It’s a big change.”

At a psychological level, participants frequently express intentions to change as a result of new information they have received that can help them to do so.

“It’s like a rebirth… their personalities dramatically change … because, all of a sudden, they don’t have to be tough anymore; they can be themselves.”

“They were able to talk about something else other than just drugs… one of them came back saying ‘I was able to ride a horse’. They have something else to say; they have nice experiences to share. Usually we hear them talk about drug use or prostitution; every things is related to drugs… Now they have something else to say"

Establishing sustainable relationships
The Urban Breakaway counselors also believe that one of the major positive elements of project is the opportunity to establish a trusting bond between counselors and participants.

Developing skills
In one of the groups interviewed, counselors raised an interesting point relative to the development of their own professional skills. They said they were able to reevaluate their own intervention skills as a result of the specific intervention experiences they encountered during the project.  

“I lost my temper. I had never been like that before with the youths. It has helped me a lot, it showed me where my limits are - up to where I can go with the youths in relation with my own emotions.”

“It helped me put my own limits to the test, about how I can work with him outside of the project to test what I can or can’t do with him.”

Return from the project   
While multiple stays seem to facilitate integration into the community, several counselors from  post-stay, partner organizations contributed a variety of comments concerning return procedures (in 5 among 12 groups). These comments remain relevant according to these counselors in spite of the fact that, following the recommendations of our partner organizations, the participants’ returns from the project now always occurs on Sundays, a day that is usually calmer than Fridays or Saturdays. Many counselors commented that the return from the project was not sufficiently structured and required greater attention. Some suggested that the return may be too abrupt after the tranquil stay in nature. They report that several participants were worried about the end of their stay and would have liked for it to have lasted longer. Some counselors suggest implementing a structure designed to facilitate the transition between the stay and the return to town. More precisely, some counselors suggested having a apartment available for returning participants.

“Here, it is perfect, it is for them an opportunity to cope better with various problems. But reintegration back into the city is very difficult. It’s a major issue. They get back to town and they should have a resource available.”

Multiple stays
Originally the Urban Breakaway project was designed to provide single stays for the participants. For some counselors, even though the program provides the same activities at each stay, it may be profitable to have the youths participate in several stays. This perception of the project had not been anticipated, but comments seem to show that multiple stays increase and/or reinforce the positive results.

“He’s doing very well now, After he came back from project, he went back to school; he’s doing well now. I think a minority of them really start to move on when they come back, but most of them make small moves.”

“It’s a minority, but it spreads the idea to all of them.”

“He went through 3 or 4 programs; he wanted to go to the next one, but he said to me: ‘I did what I had to do’, Now he’s got an apartment; he went back to school; even his mood has changed.”

“At every program he participates in he adds a little something.”

“I think It’s interesting to have them go to more than one Breakaway. The more they go, the more they are friendly and patient.”

“You can see their attitudes change; you can notice an evolution. One of them went once; he was confident that he could stop using drugs, but when he got back he relapsed and he was disappointed afterwards. After his second Breakaway, he was more down but more realistic at the same time. It permits them to have more introspection capacity; he was thinking less that results would happen miraculously”

III. Discussion

During first year of operation, the Urban Breakaway project organized 17 breakaway stays for homeless individuals, which were organized in cooperation with nine partner organizations. The demand to participate in the project has been of particular importance, as indicated both by the increasing number of partner organizations and individual participants and by the fact that several of the partner organizations have chosen to participate in the project more than one time. This fact tends to prove that this project can provide responses to actual needs. Young individuals targeted seem to have enjoyed this time off from their regular lifestyles, as attested to by the 25 counselors who participated in the present study.

Even though the Urban Breakaway project targets primarily youths, the characteristics of the participants demonstrates that this project responds the needs of a larger population. It is worth mentioning that three of these groups consisted of individuals aged 45 years on average (45.7 years). This result shows the necessity to provide services addressing the needs of older homeless and/or street individuals, as shown in the Research Study on Homelessness Poverty, and Social Exclusion (CRI 2006).

Discussions with counselors emphasize the capacity of project’s organizer, Dianova, to take advantage of its relationships with partner organizations to recruit the targeted population. Indeed, given the high degree of difficulty most organizations have when trying to recruit street youths (Ensign, 2006; Feldmann & Middleman, 2003; Thompson & al., 2006), the fact that the individuals were recruited by counselors they knew, facilitated their participation in the project. This consequence of partnership was expected and welcomed. The partnership model seems to be greatly appreciated by counselors. It is furthermore in agreement with the “Quebec Action Plan for Drugs”, which encourages “the exchange of information and the sharing of expertise between service providers, thereby enhancing the quality, accessibility, continuity and efficiency of the interventions” (Government of Quebec, 2006).  

It would be relevant to study more precisely this collaboration model, focusing on resources utilized by the target population already utilized in order to reach out to them. These implementation modalities certainly present an interesting potential for accomplishing specific intervention objectives relative to recruitment. They are in line in the background of an integration service model, where every partner resource actively contributes to treatment with a specific expertise. Virtual integration leads to the coordination of actions so that they can offer a diversity and a continuity of services to clients (Fleury, Mercier, 2002). Several authors (Watson, Kimberly and Burns (1996)) consider that virtual integration, as an organizational structure, can adapt better to the complexity of healthcare services, while providing more flexibility to respond the client’s various needs. When the bonds between partners are well articulated, this model can put forward a richer, more diverse, service offer than that a sole resource would be able to offer.

The Urban Breakaway project represents such an organization model, because it relies on a partnership between resources which already offer services to street youths, which complement others that are also available. The modalities which are offered are appreciated by the counselors working for the many resources which have participated in the project during its first year of operation, which appreciation serves, per se, to demonstrate the specific relevance of all of the existing service options which address the targeted population.

Having counselors operate in different contexts and environments with their clients represents a certain challenge. In one of the groups consulted counselors mentioned the limits with which they were faced. The strength of this new environment is that it provides the youth with a different reality than that of the street. In nature, in a structured environment, these young individuals can experience another kind of social living, as well as leisure activities which are alternatives to drug-related activities. Furthermore, for the counselors, this new environment forced them to accompany the youths during several days, 24 hours a day.

In addition, this new environment implies that counselors are obligated to accompany the youths during several days, 24 hours a day, and the new rules that they are forced to implement become of particular importance.

After interviewing the counselors, some elements appeared to be particularly appreciated within the structure and the organization of the stay. The flexibility of the program was appreciated by counselors. In particular, this flexibility facilitated the ability to make adjustments to some workshops which were initially poorly adapted to the reality with which street youths are confronted. Counselors noted the positive effect on the youth that motivated them to begin thinking about their lifestyles and their needs.

Several counselors also appreciated another aspect of the project - that being in close contact with the youths during several days in a row might encourage the establishment of a significant, positive relationship, which would continue after the project. This bond could contribute significantly to the process of leaving street life, as suggested by Colombo (2003) – the latter which emphasized the role of significant persons in helping youths reconsider their lifestyle.

The counselors made several comments about the youths returning to street life after the completion of the program. They commented that they were worried about this situation and suggested that further measures be taken to facilitate the transition more effectively from the Breakaway Project back to the society to which they were accustomed. Colombo (2003) emphasized that the process of leaving street life requires that youths and the social service resources concerned take action simultaneously. According to the latter author, the process of leaving street living is a dramatic one which transcends the question of whether or not one lives in the streets. It requires a process in which the individual is attended to and encouraged psychologically towards leaving the street. In examining the dynamics of this process, it seems relevant to consider further collaboration between the partner organizations in the process of following up with the youths after they have completed the Urban Breakaway project.

Moreover, depending on the length of the breakaway stay and the number of stays in which an individual has participated, the activities offered during the project might be modified in order to provide the participants with more appropriate support when returning to their communities. For example, the Urban Breakaway project’s outcomes show that one of the partner organizations found a positive relationship between the number of stays in which the youths participated and their success in returning to their normal communities. The comments made by the counselors of another organization noted a significant improvement of the youths’ situation after every stay. They seem convinced of the value of this type of project; however, one should question whether the programming and the activities proposed should be the same for youth participating in successive stays in the project.  Considering a progressive prospect, it is likely appropriate that individuals who show signs of growing closer to leaving the street receive additional support, and access appropriate resources, such as temporary housing, which could help them, ultimately, to achieve a lasting success in the achievement of the objectives of this project – an outcome suggested by a number of the counselors interviewed during the present study.

 

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