SiG Note: This article was originally published by In With Forward on April 15, 2014 as part of their Toronto Project: St. Chris Stories, in partnership with St. Christopher House Drop-in Centre. It has been cross-posted with permission from the author.
Is too much community – too much belonging – a barrier to change?
That’s the question we’re posing. After spending time with 16 of the 200+ members of the Meeting Place Drop-in Centre. On the corner of Queen and Bathurst in downtown Toronto. Open from 11:30am to 4pm Monday to Sunday during the brutal winter months. And Monday to Friday during the milder summer months.
Anna’s been coming to the corner for over 20 years. So too has Ozze. And Dwayne.
Telia is a relative newbie. She’s only been dropping by for 7 years. Ever since her methamphetamine addiction pushed her on the streets, and pushed her kids in care. Then came the heroin. And the crack. And the abusive boyfriend. And the death of her good friend, Greg. From an overdose. She found him. The stench was so bad. That’s when Telia decided she was going to stop putting all those street chemicals into her veins. Just the pure stuff – prescribed by her doctor – and used with supervision in the harm reduction clinic bathroom.
“That’s the place where my friends are, where you’re not judged. But then again you are just surrounded by substance abuse and brought back in. If I stay at home, though, I’m totally bored. I start to think. And that’s no good either.”
Telia’s home is filled with remnants of her past life. Photos of her older daughter. Pictures before she was heavily using. A laundry basket full of markers and paints. Telia’s always had an artistic side. She used to be a school photographer. You know the ones who snapped cute kids with missing front teeth? Now her teeth are missing and not coming back. She’s got removable dentures.
Dentures are easy enough to remove. But removing yourself from the community that understands you isn’t easy. And once you leave the corner, and are out of sight, you’re also out of mind. Few of the 16 folks we spent time with could name anybody doing well. Even though many of the staff of the Drop-in Centre were former users, ostensibly doing well.
“I don’t know nobody doing well.” Mike
No change narrative
Indeed, after 12 days and more than a dozen Tim Horton’s double-doubles, we heard no shared ‘success’ narratives. No discourse about life after the Drop-in Centre. Instead, most conversations centered on survival. On where to find a bed, a meal, a cigarette, a decent spot for pan-handling.
A survival discourse
Staff were also caught in the same survival cycle. Filling out forms for emergency housing; calling around to find treatments for bedbugs; breaking-up fights; enforcing rules; calming down irate individuals; cleaning-up urine. Less than 10% of staff’s time was spent in longer or deeper conversations. What might be called therapeutic or developmental conversations. Where the focus was on prompting or supporting change.
And some Drop-in Centre members were on the precipice of change. Including many of the members who unexpectedly passed away. Greg had been recently housed. Junior was signed-up for treatment and about to re-enter school. And yet the members preparing for something different seemed to be the most vulnerable. Caught between wanting a different identity and a social network that embraced their current identity. That implicitly advocated continuity.
“You could say I am addicted to the place. Just like I’m addicted to beer. I’m sorry, but to be crude, it gives me a big hard-on being here. It’s really hilarious. It’s a big soap opera. Like Coronation Street or Jerry Springer. It’s the same shit, just a different day. I don’t need to watch TV, I can just come here.” Dwayne
What if the Drop-in Centre (and wider service system) distributed support based on members’ readiness to change? So that somebody like Telia – very much in the preparation stages of change – was supported to build a new social network, received validation & recognition for each step forward (and back), and had real opportunities to explore other parts of her identity (her painting, her photography, her mothering).
Using the Transtheoretical Model of Change, we began to re-sort the members of the Drop-in Centre. Those in the pre-contemplation stage. Content with their current situation. Those in the contemplation stage. Ambivalent about change. Those in the preparation stage. Getting ready to do something different. Those in the acting stage. Doing something different. And those in the maintenance stage.
Here’s what our segmentation looked like:
Like identifying members cycling in and out of contemplation – and in the moments where they are interested in change, pulling them out of the same-old, same-old context. So they feel change might be feasible and desirable. When members come into the Centre for the day, they might choose a different coloured coffee mug based on how they are feeling. Enabling staff to have a different conversation and set them up with experiences happening outside of the Drop-in Centre building. Perhaps working as a chef for a few hours, or fixing bicycles down the street, or meeting a former user for a coffee. Staff might also be matched by stage of change - enabling the collection and application of specific know-how and strategies.
The most poignant moment of our time in Toronto came on the last day. As we were sharing our reflections back with the members themselves. We drew a line on the floor with green tape. And asked members to sort themselves based on the 5 stages of change. Bruce, one of the long-term members of the Centre, stumbled over. And told us we were missing a category. Removing 2 Listerine bottles from his shirt, he said, “What about the people who want to change but just can’t? Who have tried, but it’s not possible?”
It’s true. We were missing that category.
We tried a number of different categories. Re-grouping members according to the stories they told themselves (their narratives) and according to their social networks (bridging, bonding, estranged, etc.). Based on the theory of story editing, along with research on the dangers of too much bonding social capital. Each grouping offered a few new ideas for re-thinking supports and services. Give us a shout if you’re interested in the full range of segmentations and ideas.
Of course, all of the ideas are untested. No doubt, many won’t work. That’s why they need to be prototyped and revised so we can learn what works, for whom, in which contexts. We’re currently sharing stories with funders and champions – and together with St. Chris House – preparing for change.
You can prepare too…