Through Foundation for Change, Bob is addressing the revolving door culture that exists in services supporting individuals who have experienced significant disadvantage and inequality. By supporting people to create more accurate understandings of their life experiences and the root causes of their behaviours, he is working to create more sustainable routes out of treatment and into society.
The New Idea
Bob co-founded Foundation for Change (FfC) in 2014 with long-term colleague Liz Naylor, having worked for a national UK treatment provider for ten years supporting individuals with histories of substance misuse. During this time, Bob co-created a highly successful and unique approach to address a significant gap in treatment services: the lack of sustainable routes out of treatment and into society.
Bridging this gap, FfC offer courses incorporating their approach that range from six weeks to six months. At the heart of Bob’s work is the belief that people need to accurately understand their pasts and the root causes of their behaviours to move forwards in their lives. Furthermore, he believes it is crucial that people understand the inter-relationship between individual experience and the broader, socio-political and economic structures that perpetuate inequality. FfC facilitates this by harnessing the transformative power of education to support individuals to make changes in their lives rather than interventions, which leave people feeling ‘done to’, perpetuate passivity and diminish personal agency. The FfC approach is an innovative and pioneering system of learning through which participants gain deep personal insight whilst simultaneously learning about the world they live in.
The methodology incorporates a combination of specifically curated theories and concepts drawn from psychology, philosophy and sociology that contextualize individual experience and increase self-understanding. This combination significantly reduces feelings of shame rooted in the individualization of social problems and helps people understand the society they struggle to be a part of. The educational content is underpinned by an aspirational ethos that respects peoples’ agency, intelligence and capacity to learn.
Bob argues that the repeated failings he sees in the substance misuse treatment sector reflect broader systemic problems across public health and social care services. Reductive understandings of complex needs in combination with austerity and budget constraints are increasingly leading to short-term, ineffective solutions that keep people trapped in over-saturated, under-funded systems. The FfC model is an evidence-based, practical solution to this problem which Bob believes has the potential to transform rehabilitation programmes across the social care sector.
Bob co-founded Foundation for Change after repeatedly witnessing that the very structures that exist to rehabilitate people with substance misuse problems frequently replicate the imbalance of power that exists in wider society and perpetuate social inequality. He saw how deficit-based, institutionalising, and infantilising treatment and recovery support systems were, keeping people stuck within social bubbles of other ‘recovering addicts’ that perpetuate feeling othered and separate.
Bob argues that misconceptions about substance misuse are still widespread - amongst individuals with histories of addiction, within rehabilitative treatment services and in wider society. When individualized, people see their problems with addiction as being personal, leading to feelings of self-blame and stigma. When medicalized, addiction is seen as a disorder or a disease to treat. Conventional responses to addressing substance misuse focus largely on managing symptoms and putting substances down which unintentionally reinforces the idea that the drugs or alcohol are the problem. More time is dedicated to addressing what is wrong with an individual, instead of exploring what happened to them to drive them towards misusing substances in the first place, leaving root causes unaddressed.
The high rates of relapse expose the inadequacies of this approach. Recent figures from Public Health England (PHE) reveal that from April 2018 to March 2019, 42% of individuals who accessed the drug and alcohol treatment system exited successfully. Figures from 2017 reveal that of those completing treatment, 92% of opiate users and 61% of non-opiate and alcohol users relapsed within six months.
This revolving door culture comes at a drastically high cost. The 2020 Dame Carole Black review of drug harms puts the cost to society of illegal drugs at around £20bn per year. A 2016 Public Health England study on the cost of alcohol-related crime, lost output and ill health cited costs as between £27bn to a staggering £52bn per year. The profound human cost is often overlooked: individuals who feel they are unable to sustain their recovery experience a personal sense of failure, defectiveness and helplessness that is reinforced with each relapse, keeping them trapped in cycles of repeated need for contact with services.
A decade of austerity has made the situation considerably worse, with in-depth, long-lasting work with those who need help being jettisoned in favour of short-term interventions. These are nearly always tied to box-ticking for sets of metrics that demonstrate cosmetic ‘success’ stories rather than long-term, holistic care that supports sustainable change.
Though the incubation period for the FfC approach was within a substance misuse setting, the understanding that fed the development of the approach was that Bob and his team were in fact working with multiple and complex disadvantage. Individuals weren’t presenting with the singular issue of addiction but with a combination of problems that particularly included homelessness, mental ill health, and criminal behavior. Bob has worked with over 2,500 people since he started working in the sector in 2004 and sees these presenting issues as surface symptoms of deeper, unaddressed trauma. Furthermore, though there is an increasing awareness of the inextricable link between systemic marginalization and trauma, there appear to be few practical solutions that adequately address it. This is the focus of Foundation for Change.
Having worked successfully within the substance misuse sector for a significant period, FfC are broadening their reach beyond addiction to establish proof that the FfC approach is effective and replicable for working with multiple disadvantage. By replicating their methodology, they aim for support services to recognize the interplay between personal experience and systemic inequality and develop a more sophisticated understanding of trauma so that individuals are seen as people and not problems. Through this, they aim for greater numbers of individuals to permanently exit support services and be a part of society where they can live with dignity and fulfil their potential.
At the heart of FfC’s work are its courses. Participants enroll in one of four courses: Psychology for Change, Feminism for Change, Knowledge for Change, or the more vocationally focused Clothing for Change. Each course requires attendance for between one to two full days per week. They involve a level of structured interaction that contrasts strongly with the one hour of support offered weekly to those in more conventional post-treatment programs.
The terminology used at FfC is deliberate and supports crucial shifts in identity away from problematic labels towards simply being a person. Participants are called ‘trainees’ and not ‘service users’, they come for ‘tutorials’ not ‘keywork sessions’, they attend ‘courses’, not ‘groupwork programmes’. Critical thinking, attachment theory, Transactional Analysis and existential philosophy form the backbone of the approach. Information is taught in an engaging and stimulating way that ignites the trainees’ desire to learn and creates another key identity shift in their ability to learn. They are gently encouraged to apply what they learn to themselves, a process in which they begin to ‘re-author’ how they understand their lives.
A clear ethos underpins FfC’s work. ‘Problem behaviour’ is reframed as a manifestation of trauma and behaviour such as substance misuse is seen as a rational response to trauma, a survival strategy to cope with adversity. This alone is incredibly liberating for people starting on their courses. FfC sees trainees as adults with the capability to determine their own sense of purpose and direction and not clients with symptoms to manage.
Courses are experiential, supporting people to develop healthy relationships to themselves and thereby others, helping them learn to trust and grow in confidence. FfC’s work focuses on developing emotional resilience and providing information and tools that help navigate the challenges of 21st Century living. It focuses on building self-esteem and self-awareness and is predicated on the idea that with those as the foundation of one’s life, recovery, employment and a sense of purpose fall into place organically.
FfC’s work has resonance with the work of Paolo Freire, founder of Critical Pedagogy. Deep learning about marginalization and structural inequalities deepens the trainees’ understanding of their lives through broader, systemic perspectives. They become more able to ‘read the world’, understand their life experiences in relation to wider, systematic oppression and disadvantage and develop a vocabulary with which to deconstruct social systems. This significantly reduces the shame, self-blame and stigma that persists when people believe their problems are of their own making.
FfC’s graduates are empowered to take this learning out into the world, initially through volunteer placements arranged within the local community. Alongside developing valuable workplace skills and experience, graduates interact and integrate with others who may not be from disadvantaged backgrounds, where a process of ‘humanizing of the other’ occurs. The high percentage of post-course volunteer placements and later employment translates into stability and purpose for graduates as they move forwards in their lives.
They are invited to receive the qualifications gained on their courses at their annual birthday celebration, a formal recognition attended by the Board, donors and former FfC graduates. Qualifications are awarded from the Open College Network and provide something tangible for course graduates to take pride in and celebrate, creating another shift in their ability to learn and their ability to meet their potential.
FfC are running pilot courses in Spring 2020 for new cohorts of individuals from the homelessness and mental health sectors, and individuals released from prison soon after. Believing in integration and not segregation, and working with the deeper issue of trauma as opposed to surface symptoms, FfC aims to work laterally across sectors, challenging siloed ways of working by running courses for people from a range of backgrounds, the commonality being the experience of social inequality.
A key aspect of this stage is in building the evidence base and a clear economic case for implementing the FfC methodology on a larger scale. Bob has sought out sector leaders in impact measurement and work is already underway to ensure that efficient systems are in place to support FfC’s ability to influence how social inequality is addressed. An academic study released in Spring 2020 by a City University senior health psychologist on what it is about FfC’s approach that catalyses such profound change will further support this.
Finally, Bob wants to reach more people with the FfC approach by scaling nationally through a social franchise model relevant to sectors working with individuals who experience a combination of traumatic experience and multiple disadvantage. He envisages a two-tier model: 1) initial, experiential, training for practitioners mirroring FfC’s flagship course, Psychology for Change, that supports both personal and professional development and leads to a more sophisticated understanding of inequality; and 2) a comprehensive package consisting of FfC’s educational courses that can be embedded into services with full support from FfC staff.
Bob was born in the UK to parents who had migrated from East Africa. His mum, a victim of a forced and violent marriage, defied cultural obligations by fleeing with her two sons and just £10 in her pocket. Despite the risk of being disowned by her family, facing the stigma attached to divorced and single parent households, coupled with the challenges of poverty, she raised her children alone. Her strength and resilience were to have a profound influence on Bob’s life.
Bob remembers feeling different to those around him from an early age. He had lived on four continents before he was five, went to an unconventional junior school where Bob Marley songs were sung in assembly, and knew he was gay at the age of 7. Rather than being on the outside looking in, Bob remembers thriving as an outsider that only wanted to look further outwards. He spent hours poring over reference books and encyclopedias, always seeking greater understanding of the world around him.
Being on the outside provided a useful vantage point from which to question the status quo. He began questioning the Hinduism he was born into. The prayers he would hear at the temple were in ancient Sanskrit and Bob became increasingly frustrated at the inaccessibility of the deep wisdom they were said to contain. He questioned his cultural programming, the unfair gender roles and expectations placed on women and the misogyny inherent within his culture. His search to understand himself and the world around him intensified.
Bob studied psychology at university. What he understood as being theory relevant to everyone was at odds with how it was taught: that it only applied to broken people with disorders. This othering of ‘patients’ left Bob feeling progressively more uncomfortable. He completed his studies but chose to distance himself from psychology. Upon graduation, he started practicing yoga, not knowing it would become such a significant part of his life. Being 21 and seeking adventure, he moved to Japan where he taught English.
It was in Japan he first encountered Buddhist philosophy, finding great solace in discovering a school of thought that acknowledged the universality of human suffering. This led to another year abroad, living with Buddhist monks and nuns in the high-altitude desert of Ladakh, a Buddhist enclave on the Tibetan Plateau. He taught English in return for shelter and lessons in Buddhist philosophy. Bob lived in a cave, and spent several months working with the Ladakh Nuns Association (LNA), an organization breaking the tradition of nuns forced to live their lives in servitude to the monks.
This was to be a formative time within a formative time. The mission of the LNA resonated greatly with Bob’s past. It tackled gender inequality, improved literacy and provided scholarships to facilitate direct access to Buddhist teachings. Fueled by his passion for their cause, he helped them attract international attention and funding by building a website for them and streamlining their administrative infrastructure.
Returning to London in Spring 2004, Bob founded Beautiful World, a charity dedicated to supporting and teaching English to the community of monks and nuns in Ladakh. He sourced, interviewed and arranged for volunteers to teach English at various monasteries and nunneries throughout the region. As a result of Bob’s dedication, the monks and nuns had access to English instruction for nearly three years.
In the Summer of 2004, Bob started work in the substance misuse field, joining the national charity Addaction. The following year, he co-created the NEXT Project - a unique, educational program for individuals wondering what to do next, having completed their substance misuse treatment. Over the following decade, The NEXT Project became the testing ground for ideas that later developed into the Foundation for Change approach.
This period coincided with Bob undergoing an intense developmental leap. He returned to psychology, studying contemporary forms of therapy and completed training in counselling. He devoured books on positive psychology - its emphasis on the promotion of psychological wellbeing, in stark contrast to the pathological focus of the classical psychology he had trained in, astounded him. He became aware of the privilege of having access to such knowledge and felt passionate about making it available to the socially and educationally disenfranchised people he worked with. He increasingly fed this learning into the NEXT Project and continues this at Foundation for Change.
Bob’s passion for self-empowerment through knowledge, and the ability to make it accessible to those who need it most, is embodied through his work at Foundation for Change. This, and his yoga practice of 20 years, provide endless inspiration and learning about the deep process of change.