Ingo Ilja Michels
Heino Stöver
Nurgul Musaeva
Dinara Yessimova
Jiang Du
Azizbek Boltaev
Subkhon Ashuro
Umeda Munavvarova
Social work and strengthening of NGOs in development cooperation to treat drug addiction

Social work is one of the youngest scientific disciplines, it has developed itself as a discipline to address individuals, families and communities in social crisis (poverty, low level of education, unemployment, diseases, social isolation). In the last decade also problems with alcohol and drug dependencies increasingly became the subject of social work support(systems). Due to coming globalisation, where living space has become wider than the community itself, social work was forced to operate within wider horizons and to go beyond communities boundaries. 

Social work nowadays has been becoming a more global scientific discipline seeking answers to global questions. Social work is therefore linked to all seventeen global goals of sustainable development (SDGs). As the prevention and treatment of drug addiction in Germany and Central Asia has reached a common urgency, a training and research project in the field of social work in addiction support was developed in Germany, Central Asian countries (Kazakhstan, Kyrgyzstan, Uzbekistan, Tajikistan) and China. The development of social work in these countries increasingly led to the development of common principles in the technology and ethics of social work, comparing standards and working out the socio-cultural peculiarities in the definition and practice of social work. These developments are examined and presented and their common solution ideas discussed in the context of achieving the UN Sustainable Development Goals.

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UN Commission Policy Paper

The Sustainable Development Goals (SDGs) were established in 2015. With the 17 goals, the main areas for progress were identified to achieve transformational change in our world. As with the Millennium Development Goals (MDGs), the SDGs have proven difficult to implement and gain traction. Poverty, and all the other interrelated SDGs have made little progress. The situation has worsened and some member states have struggled even more during the current COVID 19 pandemic.

The concern from the Social Work profession is that the agenda of the SDGs may get overridden in the aftermath of the pandemic, and the predicted global economic turmoil, that will significantly impact global governance in the next 5-10 years. Unfortunately, we have to expect a devastating negative impact on people and communities with whom we work together, and the gap between the very rich and the majority already living in poverty will widen and deepen the existing inequality gap in societies, locally as well as globally. Additionally, the unfair paradox is that those who often suffer the most from global failures, mal-development and negative effects are the ones who usually contribute the least to these societal and ecological ills, and this is known as environmental injustice. This is de-stabilising for individuals and their communities. Such global challenges underline the need for global transformation.

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Journal of Adolescent Health
Drug use Prevention Computerized interventions Central Asia Post-Soviet
Building Competencies to Prevent Youth Substance Use in Kazakhstan: Mixed Methods Findings from a Pilot Family-Focused Multimedia Trial

Purpose: The knowledge-based approach to substance use and HIV prevention, commonly used in Central Asia, does not equip at-risk adolescents with risk reduction skills. This pilot study aims to adapt and test the feasibility and estimate the effect size parameters of a skill-based and family-focused intervention for at-risk adolescents from communities affected by heroin trade and use in Kazakhstan, located on the major drug trafficking route from Afghanistan.

Methods: This National Institute on Drug Abuse-funded pilot trial used a mixed-methods approach and included 181 adolescents (ages 14¡17) that reported at least one risk factor (e.g., substance-using family members or friends and parental criminal history). In addition to the school-based health education program, intervention-arm adolescent-caregiver dyads received three computerized pilot sessions focusing on risk reduction self-efficacy, resistance to peer pressure, and strengthening of family relationships. Adolescents completed baseline, 3- and 6-month Audio Computer-Assisted Self-Interview surveys in Russian and treatment group adolescents (n = 12) also participated in postintervention focus groups.

Results: Small size effects were observed for youth-level theoretical mediators associated with lower substance use. Compared to the control group, intervention-arm adolescents showed improvement in personal and social competencies such as assertiveness (Cohen’s d = .21) and self-esteem (d = .22) at 3 months and increased engagement in prosocial activities at 6 months (d = .41). Adolescents from the intervention group also reported improved self-control skills helping alleviate emotional distress (an increase in anger and tension management d = .30 at 3 months and a reduction in temper d = ¡.27 at 6 months) along with a lower likelihood of binge drinking at 6 months (odds ratio = .18, p = .023).

Conclusions: In middle-income countries like Kazakhstan, an intervention that utilizes interactive technologies and combines an empirically tested skills-based approach with family involvement may be an engaging, acceptable, and culturally appropriate tool for preventing substance use among at-risk youth.

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Deutsche Gesellschaft für Soziale Arbeit in der Suchthilfe
Competency profile of Social Work in Addiction Support and Addiction Prevention (2015, Münster, Germany)

The entire addiction support system is complex and designed through various statutory orders and cost unit/ sponsor structures. So, the qualified withdrawal treatment (Qualified Detoxification) at the expense of health insurance usually as seamless transition to outpatient or inpatient addiction rehabilitation at the expense of the German Pension insurance is well regulated, following the principle: outpatient before inpatient and rehab before pension. The service providers have created a Comprehensive Quality Assurance Program to ensure structural quality.

A different picture is shown in the outpatient addiction help, which is anchored in the regional municipalities. According to the political relationship of state or district policies at the local level, depending on the budgetary and regional demand situation, different drug service systems have been established as well as networking structures and cooperation. Due to primary funding from local authorities and the dependency on their financing scope, the maintaining, expanding but also limiting of this technically meaningful offer structure for the care of addicts is often subject to change.

As a result, at the regional level there has been a lot of heterogeneous systems of outpatient addiction help differentiated and professionalized. It ranges from the low-threshold survival aid, crisis intervention, prevention offers, addiction aid in companies to outpatient rehabilitation. Nevertheless, in order to have a certain comparability in the structures for access, we have created work areas such as those are found in addiction help organizations, and a descriptive, structured form of presentation. On the one hand, this represents the peculiarity of the respective field of work, but enables on the other hand, a basic comparability with the others areas. A total of eight fields of work are described:

  1. prevention;
  2. early intervention;
  3.  so-called low-threshold offers
  4. outpatient advice services (including psychosocial support during opiate substitution treatment);
  5. outpatient assisted living;
  6. the so-called acute addiction care;
  7. outpatient rehabilitation and
  8. aftercare as well as inpatient rehabilitation.

Based on the analysis of the forms of interventions in the entire area of addiction support not all of them, but most work areas are covered. 

The following structure is followed by the descriptions of the respective field of work:

  • Brief description of the field of work
  • Objectives of the offer
  • Range of services / interventions
  • Specific skills
  • Legal basis / cost unit
  • Cooperation partners
  • Documentation / evaluation / quality management
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