Interview with professionals from the Zandueta centre dedicated to helping minors with behavioural disorders associated with drug use
In order to examine the different dimensions of the intervention and to highlight the good practices developed in the Dianova Zandueta therapeutic educational centre (Navarra region, Spain), we have interviewed some of the centre’s professionals, including Jana Senosiain Esparza, director of the centre, Isabel Ecay, educator, Diego Eguiluz, psychologist, Begoña Sarobe, social worker and Koldo Alberdi, teacher.
Hi, can you please present the centre?
JANA – In 2001, based on different partnerships with the administrations, we began a new experience with the therapeutic and educational programme for minors with drug use problems, other addictive behaviour and behavioural issues. The centre is located in a small rural town in the mountains of Navarre.
The main house, where our residents live, has an area of about a thousand square metre; the centre also has gardens, woodland, vegetable garden, tool workshop, sports equipment workshop and recreational area.
The therapeutic education centre, or TEC, offers a programme for young people aged between 13 and 17, both males and females. It has an interdisciplinary team that provides care 24 hours a day, all year round.
What is the aim of the TEC?
JANA – The intervention is aimed at generating changes in the person’s attitude and behaviour so that they can develop a normalised life project. The centre offers a residential programme in which educational and therapeutic activities vary in order to overcome the situation that led to the adolescent’s admission in treatment.
The programme is adapted to each person’s needs and situation in order to help them acquire healthier habits while promoting their integral development in all its dimensions, and facilitating their incorporation into adult life.
What is the profile of these adolescents?
DIEGO – Our target population is mostly made up of adolescents who’ve been socialized in deteriorated social environments and are therefore considered at-risk. They may also have had dysfunctional educational models and families (overprotection, authoritarianism, lack of limits).The programme is specifically designed to address serious behavioural disorders related to psychosocial and educational pathologies.
Actually, most of the people we attend to present behavioural disorders, drug use problems and associated risk situations. In addition, many of these adolescents are in a situation of lack of protection, with a guardianship or custody measure and/or judicial measure.
We are talking about minors whose behaviour has become highly conflictive, without necessarily being associated with psychiatric disorders. In order to respond to their needs, we utilize a series of highly structured techniques and interventions, aimed at correcting behaviours that are contrary to any coexistence model, through the learning of positive behaviours and the acquisition of basic social rules.
Do they have mental health problems?
DIEGO – Well, they generally present a characteristic symptomatology that is related to a greater or lesser extent to drug use. The most common psychological traits among these adolescents are their lack of impulse control and zero tolerance towards frustration. Likewise, they commonly present motivational deficits, related to alterations in reward behaviour.
These adolescents m ay also exhibit more significant psychopathological disorders including hallucinations and delusions, depersonalisation, derealisation and distress. In most cases, these disorders are the consequences of drug use and tend to subside through abstinence.
What other problems do they have?
ISABEL – Adolescents go through a period of profound biopsychosocial changes. In addition to these changes, those we attend to in at Zandueta present risky behaviour, including sexual behaviour, low participation in social development activities, truancy, and delinquency, among others.
Some of them also have legal proceedings open in the different Juvenile Courts or Prosecutor’s Offices. The judicial follow-up of these minors is carried out in parallel to their programme.
Does the family play a role in the therapeutic process?
BEGOÑA – It plays a fundamental role. The family forms the adolescents’ nucleus of reference and the basis of their social development. It is therefore essential that all interventions take into account the adolescent’s relationship with their family and the influence they exert on them.
“The position of the family with regard to the young person’s problems, as well as their parenting and educational skills, will influence our intervention and counselling activities.”
Whenever possible, we should therefore involve families and count on their support either as an object of intervention and/or as a therapeutic agent.
Can you explain the role of the team?
JANA – The team is made up of management, external psychiatric assistance, family worker, psychologist, teacher, social educators, health emergency technician, educational technical assistants, cook and administrative staff.
All of them have complementary profiles, which makes it possible to offer a comprehensive therapeutic and educational programme aimed at the emotional and social development of the young people.
This complementarity guarantees the management of knowledge and the ongoing training of all our professionals, who can draw upon each other’s knowledge and experiences in their own field of expertise.
Our work are divided into the three areas that respond to the bases of youth development: the educational area, with the teacher and the educational team making up the bases of direct interventions (accompaniment, training, workshops, etc.); the social area, which responds to their social needs (peer group, affective and sexual relationships, families and external relationships); and the therapeutic area, with interventions by the psychologist together with the educational team (weekly interviews and tutorials, workshops, group modules and interventions).
Do you work in relation with other centres and programmes?
KOLDO – The team works in coordination with different services and institutions. Our common objective is to work in a network dedicated to mitigating the risks for the adolescents upon their reintegration back in their communities. It is essential to accompany and monitor their therapeutic educational process in order to reinforce their learning during the treatment programme.
Among other important services, we regularly collaborate closely with mental health services, front-line services, women’s care centres, crime prevention services. In the area of training, we also work with vocational integration services. In terms of prevention, the educational programme is key to avoid relapses and other problems.
How do you work on motivation for treatment?
ISABEL – It’s an ongoing challenge! Adolescents have usually little motivation for treatment. The whole team tries to establish a close relationship with them, so as to provide a safe base to explore the world around them, and to be a safe haven from any danger or threat. From this perspective, it is essential to have trust-based, quality bonds with minors. The very quality and adequacy of our interventions depend on it.
“Our work consists of offering a safe and protected space as an alternative to the spaces they already know, where we can teach a good and peaceful cohabitation through positive bonds with the staff who become reference figures”
On an individualized level, we carry out counselling and motivational interviews to address the consequences of drug use in the person’s life. Through these talks, we endeavour to make them more aware of their situation and to build on their motivation to change.
Lastly, we work in thematic classrooms and group therapy modules to try and show them the risks to which they have been exposed, while sharing each other’s experiences.
Is it riskier to use cannabis in adolescence, and what is the role of cannabis use?
JANA – At any age, cannabis use can be risky of one’s mental and health. However, in the case of adolescence, marijuana use implies additional risks.
“Firstly, the adolescent brain is still developing until about the age of 25. Cannabis use, especially in this age group, may entail specific risks for the brain and generate cognitive and emotional problems. In addition, studies have linked cannabis to increased psychiatric disorders”
BEGOÑA – The aetiology of any drug use is generally multifactorial, making it difficult to establish a specific causality in addictive behaviour. In the case of the minors we treat, consumption usually has an anxiolytic or dissociative function, being used with the aim of relieving emotional discomfort.
However, it is important to bear in mind that these minors usually come from poorly functional social nuclei where habitual consumption takes place, and the social learning of the consumption behaviour is an important element.
Thank you very much to all the team!