Last week gave a new meaning to the phrase working “in the field” when my co-worker and I had to crawl through a fence in order to literally sit in a field of grass where a group of children were receiving their lessons from a Butterflies street educator. The area we were working in is adjacent to the temple for the Hindu monkey-god Hanuman so the field was also inhabited by dozens of monkeys as well as a few stray dogs. My co-worker Monica and I were out with the mobile health van to care for the sick children as always, but we were also recruiting children for a newly-created support group for children with drug addictions.

Drug use and addiction is widespread among the children. Inhaling correction fluid is one of the most common modes of drug use, sometimes with dire consequences. Just today I met a 8 or 9 year-old boy named Anand who lost both of his legs after falling asleep on the train tracks at the New Delhi Railway Station after using an inhalant (he was run over by a train). Since his discharge from the hospital, he has been living at the Butterflies Crisis Center, where I have started assisting the doctor in the mornings. Anand is awaiting prosthetic limbs, and currently gets around by swinging himself along the ground with his hands. He is really clingy with the staff and always wants to sit in the office instead of participating in group activities, yet all he wants to do is leave the crisis center. In his current state, he would not be able to survive back on the streets. Tomorrow I’m going to talk more to the doctor about what the long-term plan for him will be, because there is no foster care system in India.

Monica and I have spent the last few days intensively planning an all-day workshop for the addictions support group which will take place on Friday of this week. I was really happy to be able to use some of my knowledge of addictions counseling from my MS in psychology to plan the events.

We decided to borrow from a few empirically successful drug treatment approaches and adapt them to the specific needs of our population. We are planning to pair the children in a manner similar to the sponsor system of Alcoholics Anonymous so that each child has someone at his contact point in Delhi who he is accountable to and can turn to for support. The key difference here is that both members of the pair will be children with an addiction they wish to end, and will have an equivalent role to play to one another in assisting each other to stay off of drugs. The other general approach we are using borrows from Dr. William Miller’s Motivational Interviewing theory. One element of this approach is for the counselor to attempt to get the addicted patient to arrive at their own internal motivation for changing their maladaptive behavior by gently eliciting the pros and cons of using as well as those of quitting and allowing them to reach their own decision about use. This approach fits in really well with Butterflies philosophy of empowering children to make good choices for themselves. Once again, one of the key differences between the way this approach is traditionally applied and what we will do is that here each member of the pair will play the counselor role for his partner. Of course, plenty of adults are going to be present to supervise and pull the group together at appropriate points to share and summarize what the pairs have been discussing. And since this workshop is for children, there will also be plenty of food as well as games and prizes. I am really curious to see how successful this approach will be. We are planning to follow the pairs for 6 weeks after the workshop to monitor their intake patterns. Besides the obvious goal of helping the children eliminate or reduce their drug use, we are hoping that at the end of a few months, a few of the children at each contact point will have progressed to the point where they can serve as drug counsellors to their peers who are using. These children will receive further training as time progresses. I’ll keep you posted as to how the workshop goes.