CHANGING MINDSETS? EVOLUTION OF A REHABILITATION PROGRAMME FOR CHEMICALLY DEPENDENT MALE STREET ADOLESCENTS IN A MAJOR INDIAN CITY Barnabe D’Souza, sdb A thesis submitted in partial fulfilment of the University’s requirements for the Degree of Doctor of Philosophy APRIL, 2008 Coventry University in collaboration with University of Worcester TABLE OF CONTENTS CHAPTER ONE INTRODUCTION AND CONTEXT Part 1.1 Starting Out 1 Part 1.2 My Journey 5 1.2.1 My Platform 7 Part 1.3 Growth of the Organisation 8 Part 1.4 Branching Out 9 Part 1.5 Locating the Study 12 Part 1.6 Street Drug Consumption in Mumbai 12 Part 1.7 Lifestyle of a Street Addict 14 Part 1.8 Five Phase Therapeutic Programme 15 1.8.1 Phase I 18 1.8.2 Phase II 18 1.8.3 Phase III 19 1.8.4 Phase IV 19 1.8.5 Phase V 20 Part 1.9 Behaviour Modification 20 Part 1.10 Ethical Considerations 21 Part 1.11 Nature of the Study 22 Part 1.12 The Chapters 22 Part 1.13 My contribution 24 CHAPTER TWO REVIEW OF LITERATURE Part 2.1 The Phenomenon of Street Children 1 Part 2.2 Debates on defining Street Children 2 Part 2.3 The Magnitude of the Problem 6 Part 2.4 Role of Causative Factors 7 Part 2.5 Profile of street children—Defining Traits 9 2.5.1 Self – worth 9 2.5.2 Lifestyle 11 2.5.3 Empowerment and Participation in their Development 13 2.5.4 Movement 14 2.5.5 Impulsive Behaviour 15 2.5.6 Instant Gratification 15 2.5.7 Decision making 16 2.5.8 Role Models 18 2.5.9 Coping Strategy 18 Part 2.6 Inhalant Abuse 20 2.6.1 Treatment Programmes 22 Part 2.7 Dependency on the Institution 23 Part 2.8 Changing Behaviours 23 Part 2.9 Mindsets 25 CHAPTER THREE METHODOLOGY 1 Part 3.0. Introduction 5 Part 3.1 Participatory Action Research Part 3.2 Reflection 9 Part 3.3 Key Components Of The Research 9 3.3.1 QUALITATIVE RESEARCH 9 3.3.2 AUTOETHNOGRAPHY 10 Part 3.4 Participant Selection 12 Part 3.5 Data Collection 13 3.5.1 Naturally occurring Ethnographic Data 13 3.5.2 Focus Group Discussions (FGDs) 14 3.5.3 Formal and Informal Meetings with the Team Members 15 3.5.4 Unstructured Interviewing 15 3.5.4.1 Locating an Informant 16 3.5.4.2 Gaining Trust 16 3.5.4.3 Establishing Rapport 16 3.5.5 Narrating and Documenting Personal Experiences 17 3.5.6 Group Interviews 18 Part 3.6 Data Analysis 19 3.6.1 Categories and Themes 19 3.6.2 The Need for Grounded Theory 20 Part 3.7 Describing the Sample Population 21 3.7.1 Interpretation and Coding of Data 21 3.7.2 Drawing Conclusions 21 3.7.3 Establishing Validity 22 Part 3.8 Defining Roles 22 Part 3.9 Informed Consent 23 Part 3.10 Establishing Standards 24 CHAPTER FOUR SELF WORTH Part 4.1 Introduction 1 Part 4.2 Identities of a Street Child 2 Part 4.3 Collective vs. Individual Identities 5 Part 4.4 Components of Self Worth on the Streets 8 4.4.1 External Appearance 8 4.4.2 Perception of Freedom on the Streets 9 4.4.3 Socialization Process 10 4.4.3.1 Relationships with Peers/ Older Boys 10 4.4.3.2 Relationships with Police/Figures of Authority 13 4.5.4 Societal Perceptions Towards Street Children 15 4.5.6 Shadows of the Past 16 Part 4.6 Causes of Low Self Worth 16 4.6.1 External Environment: An Exploitative Set up 18 4.6.2 Fear 19 4.6.3 Internal Environment 19 Part 4. 7 Consequences of Low Self worth 20 4.7.1 Self Destructive Behaviour 20 4.7.2 Adoption of Defense Mechanisms/ Hiding Identities 21 4.7.3 Inability to Make Informed Decisions 23 4.7.4 Fatalistic Attitude/ Acceptance of Unfairness 23 Part 4.8 Factors Related to High Self Worth on the Streets 25 4.8.1 Age 26 4.8.2 Money/ Job 26 4.8.3 Physical Prowess/ Aggression/ Sexual Activity 27 4.8.4 Higher Educational Pursuits 28 4.8.5 Resilience 29 4.8.6 Empathy with Street Animals 29 Part 4.9 Transition to High Self Worth 30 4.9.1 Contact with Influencers/Outreach Staff 30 4.9.2 Peer Influence 32 4.9.3 Awareness of Options 33 Part 4.10 Promoting High Self Worth 33 4.10.1 Education/ Training 33 4.10.2 Role Models 34 4.10.3 Learning New Value Systems 36 4.10.4 Living a Life of Dignity 37 Part 4.11 My Reflections 37 CHAPTER FIVE PERSONAL OWNERSHIP Part 5.1 Introduction 1 Part 5.2 Concept of Personal Ownership 2 Part 5.3 Concept of ‘Freedom’ 3 Part 5.4 Concept of Personal Possessions 5 Part 5.5 Concept of Personal Inclinations 5 Part 5.6 Concept of Group Cohesiveness 6 Part 5.7 Factors in Personal Ownership 8 5.7.1 Emotions and Fears 8 5.7.2 Perceived Regimentation of an Institutional Lifestyle 8 5.7.3 Need Fulfilment 9 5.7.3.1 Allure of the Streets 9 5.7.3.2 Peer Influence 10 5.7.4 Patterns of Behaviour 15 5.7.5 Role of Staff 17 5.7.6 Role of External Factors 19 Part 5. 8 Factors hindering Exercise of Personal Ownership 19 Part 5.9 Decision to Drop out 21 Part 5.10 Reflections 23 CHAPTER SIX MOVING OFF THE STREET Part 6.1 Introduction 1 Part 6.2 Patterns of Movement 3 Part 6.3 Factors hindering Movement off the Streets 5 Part 6.4 Stressors in a Street Child’s Life 7 6.4.1 Stress related to Food 8 6.4.2. Stress related to Work 9 6.4.3 Stress related to Money 10 6.4.4 Stress related to Health 12 6.4.5 Age related Stress in Street Children 14 6.4.6 Stress related to Physical Environment 15 6.4.7 Stress Related to Police Harassment 16 6.4.8 Stress related to Peer Influence and Friendship 17 6.4.9 Stress related to Street Gangs 18 Part 6.5 Changing Mindsets 19 Part 6.6 Motivation towards Self- Development 24 6.6.1 Working with his Present for a Future 25 6.6.2 Education 25 6.6.3 Employment 26 6.6.4 Focusing on the Future 27 Part 6.7 The Rehabilitation Process 27 6.7.1 The Settlement Phase 27 6.7. 2 Home Repatriation 29 6.7. 3 Relapse 31 Part 6.8 Back to the Addiction Cycle 32 Part 6.9 Consequence of Institutionalization 34 Part 6.10 My Reflections 37 CHAPTER SEVEN ORGANISATIONAL ISSUES Part 7.1 Introduction 1 Part 7.2 Organisations as Primary Care Givers 2 Part 7.3 Spectrum of Service Provision 3 Part 7.4. Admission and Exclusion Concerns 4 7.4.1 Restricting Entry 4 7.4.1.1 Specific Target Groups 4 7.4.1.2 Age Criterion 5 7.4.1.3 Problem Behaviour 6 7.4.1.4 Special Needs 8 7.4.2 Effects of Restricting Entry 9 Part 7.5 Orientation: Induction of Street Adolescents 10 7.5.1 Orientation at Outreach 12 7.5.2 Orientation at the Residential Home 12 7.5.3 Orientation towards Detoxification 13 7.5.4 Orientation towards Training 16 7.5.5 Orientation towards Independent Living/Repatriation 17 Part 7.6 Exit Policy 18 Part 7.7 Multiplicity of NGOs on the Streets 19 Part 7.8 Organisational Dilemmas 19 7.8.1 Quantity versus Quality: Numbers or Specialised Care? 20 7.8.2 Holistic versus Individual Care 21 7.8.3 Staff Issues within the Organisation 22 7.8.3.1 Staff Profiles 22 7.8.3.2 Staff Training 23 7.8.3.3 Lack of Coordination between Staff and Management 23 7.8.3.4 Staff Monitoring and Evaluation 24 7.8.3.5 Staff Burn out 24 7.8.3.6 Mutual Dependence between Staff and Beneficiaries 25 Part 7.9 Management Concerns 26 Part 7.10 NGOs as Agents of Development 26 7.10.1 Knee-jerk Responses 26 7.10.2 Symptomatic Responses 27 7.10.3 Consequential Responses 27 7.10.4 Campaigning Responses 27 7.10.5 Root Cause Responses 28 Part 7.11 Role of Volunteers in the Organisation 28 Part 7.12 Funding Pressures on Organisations 29 Part 7.13 Recommendations 30 7.13.1 Staff Induction and Training 30 7.13.2 Staff Expectations 31 7.13.3 Avoiding Dependency 31 7.13.4 Programme Performance 32 Part 7.14 Advocacy and Policy Measures 32 CHAPTER EIGHT MINDSET 1 Part 8.1 Introduction 4 Part 8.2 Street Life and Changing Mindsets 6 8.2.1. Creating Exercises in Thinking 6 8.2.2. Stimulating Productive Reasoning 8 8.2.3. Shedding Old Myths and Taboos 9 8.2.4. Learning from Other’s Experience 10 8.2.5. Relating Experiences to Self 11 8.2.6. Reflecting and Analysing Experiences 13 8.2.7. Envisioning a Future 14 8.2.8. Changing Mindsets 15 8.2.9. Developing New Identities 16 8.2.10. Building Capacities 17 8.2.11. Coping Strategy- Resilience 18 8.2.12. Sustaining New Lifestyles 19 8.2.13.