3. Interpersonal relations - social and interpersonal function.
4. Perception of change - how did it happen and what caused it.
5. Tools of the model and their impact over the change during therapy.
Interview Analysis According to Stages
The central quotes from the interviews are attached to the present dissertation. This section presents the analysis of the interviews. At the end of each dimension, there will be a summary of the analysis, presenting the stages of development between the stages and the various dimensions.
The interviews were conducted in various areas. The youths in Malkishua were interviewed on site, and an out of the way room was dedicated to this purpose. The atmosphere was comfortable. The members prepared themselves coffee, and I attempted to keep the atmosphere calm. Some felt it was important to hear themselves as recorded on tape. I let them
22 Attached Appendix 2: Interview Questions.
listen to the recording. At the beginning of each interview I introduced the fact that the interview was for research and that nothing would be published. If there were questions that they were not interested in answering, I told them it was all right. The atmosphere was comfortable.
Most of the youths answered very openly. The conversation was to the point. The youths who were interviewed told their friends about the interview. I was then asked by other youths why they were not chosen to be interviewed. This open atmosphere was typical of "therapeutic communities". One of the obvious traits, as already mentioned is the great deal of verbal work that the youths conduct within groups, jumping, conversations, etc. Speaking about emotions and mutual reflection create a dynamic in which everything is spoken about. A type of openness is developed that I felt in the interviews, even though I was a stranger.
The graduates of the community were interviewed where they were. One interview took place at an IDF base in the valley, another in a northern college. Some of the interviews took place in cafes. During interviews with the graduates, there was a warm atmosphere. The graduates were happy to be in contact and to raise memories from the therapy that helped them. The need to belong, even after therapy, was strong. They were looking for contact, and the interviews allowed them to do so.
The type of interview that was used was an open ethnographic interview.
These interviews are a verbal, even similar to a friendly conversation (Spardly, 1979), and therefore they suited this type of research. "In these interviews there are two complementary processes. One is a process of fit and creating a connection between the researcher and the subject. The researcher encourages the subject to speak about his culture, and aims to maintain a harmonious relationship and create a feeling of trust, allowing the free flow of information. The advantage of this type of interview is that through it one achieves a deeper understanding of attitudes and opinions, and better trusting relations are created" (Zabar Ben Yehoshua, 1999)23.
1. Motivation to Change and Responsibility for Therapy
Analysis of Stage A Quotes
About the stage: Stage A is the stage in which the youths first experience community life, learn the principles of the site, and begin to handle their process of addiction., to deepen their awareness regarding what led them to use drugs. At this stage, they still do not play any administrative roles in the community. This stage is typified by the question: "Am I an addict
23 From "Qualitative Research in Teaching and Learning", 1999, p. 64
at all?". The youths are busy finding their place in the group Most attention is external. Moods change frequently.
Abraham
The basic motivation typical of Stage A is external, pleasing parents and following the court order: "What holds me in Malkishua… nothing holds me here except my mother. That I give her joy in life and I developed a relationship with her. I almost lost her.". However, Abraham speaks of an "internal voice" that he cannot identify: "I don't know where the voice is from… something in me saying that clean life without drugs and criminality is the correct way of life".
Abraham experienced the difficulty with different levels of force:
"Everything is difficult and frustrating and a bummer. The question of whether to speak from the stomach or from reality. I have a lot of anger in my stomach, the place is difficult, frustrating, they rip you apart, injustice, they throw the truth in your face, degrade you".
What is typical of the first stage is the difficult encounter with an intensive program, rules, laws, and separation from drugs. This is a frustrating frontal encounter. There are no good or bad or strong and weak. There is coping with habits, behavioral patterns that over years the residents lived with and now must give up relatively quickly.
At this stage the resident requires external motivation, because he still does not have the power to make an internal decision. He still does not understand the significance of therapy. The world from which these youths come allowed them to run away without coping with the true problems which caused them to reach the state of detachment, delinquency and drug use. At Malkishua, there is no possibility to escape. The resident must cope with these patterns: "The place is difficult, frustrating, they tear you apart, injustice, they put the truth in front of you".
At this stage there is no responsibility for therapy, The youth has an
"internal voice". The youths begin to identify the potential for life without drugs and alcohol, without violence, being taken advantage of, etc. But they still have difficulty believing there is an alternative to their previous life. They encounter warmth and love and support alongside criticism and setting very clear boundaries. This dichotomy is very difficult for them as is the therapy process which begins through coercion. The court order is not really something they understand, the contradiction between therapy and coercion concerns them and they cannot reconcile the two.
Yitzhak
Yitzhak also comes through external motivation: "My parents, grandfather and the court. Without the order, I would not have come".
Yitzhak speaks about the fear from separating from the drug world, a legitimate fear that concerns the residents in the first months of therapy.
He has difficulty with the fact that at Malkishua they decide to suspend him and send him home to decide what he wants. He raises a number of issues:
Going home to an empty space: "I wanted to come back because I have nothing outside. There is no schedule, you sleep when you want, you walk around. You feel like you aren't fulfilling yourself at all".
The encounter with the outside after intensively staying in Malkishua illustrates the "chaos" from which Yitzhak arrived at therapy. When you are within it, you don't feel a problem with the freedom, lack of schedule, wandering, etc. But when you come back after a period (even two months in the community) outside seems like an unprotected, threatening and scary place. Yitzhak put it well: "For two or three days it's a bit of fun, sleeping, American cigarettes, and some friends. But nothing leads to nothing".
We begin with the assumption that the girls and boys need, and even maybe want a framework. Outside they had no parental authority or school authority. Authority in essence serves as setting boundaries from deviation, but also as something stable and safe that can be depended upon when necessary, and even rebelled against as part of adolescence. When there is no authority, chaos rules (Omar, 2000). The community, in its first stages, is busy creating a framework that will allow a continuum of work. In Yitzhak's case, the idea to send him home to decide what was right for him, was a successful gamble. The difference between the community and the street brought him back to the community. But it is important to note that this gamble does not always work. Not everyone can stand up to the task. Some youths would choose to return to the street, where things are familiar, the rules are known, and it is "easier" to survive.
Yakov
Yakov is also in Malkishua as a result of a court order. At this stage he still does not fully identify with the organization. Yakov wants to finish as quickly as possible: "I feel strangled, I miss home, want to go home".
However, Yakov allows an opening for therapy: "I understand that I need to stay. There are things I have to work on". Yakov understood this through conflict with the youths and the staff: I understood this through the counselors and the youths who brought the truth to my face".
Seemingly this is reinforcement for the clear method that the therapeutic community uses, meaning transmitting clear messages and avoiding language that may be understood in two ways, discussing the problem and not beating around the bush. Therefore, every group conversation begins
with "My name is Yakov and I'm an addict…". There is a message that obligates the resident to cope with his past, and with the knowledge that he has nowhere to run. For some of the youths, it is the first time they are directly confronting their addiction problem.
Joseph:
Joseph came as a result of a court order: "After three months I told myself I would try it, something changed in me. I told myself I will use the opportunity. Either I do something with myself or I go home. Outside will always wait for me."
For Joseph, it is clear that in a relatively short time, there has been an insight that there is nothing to lose, and it is worth it to try. During this period, the youth learns to know who his true friends are. The group plays an important role as a supportive and helpful entity, and the catch phrase is, not to give up on anyone. Veteran youths mentor younger youths.
This allows an encounter with values such as friendship, caring, etc.
(Korczak24).
Sarah
"What holds me here is my parents and the court". Again, we see that motivation is external, but still, at the moment of truth, Sarah says: "There is a little part that wants to stay here".
Sarah describes the struggle between the "good" and "bad" Sarah. This internal struggle accompanies the residents for a long time. There are youths in Stage B who still have this internal struggle. The more the youth experiences success and creates trust with the environment, the greater the chance that these struggles will decline. There are some youths who report this struggle in the years after therapy also.
Summary of Stage A Quote Analysis
Stage A is characterized as being an initial stage. The youths at this stage still have not decided if they are interested in change. They miss the world of drugs and crime to which they feel they belong more than to the new place - Malkishua. Motivation for therapy is therefore, external. The central reason they are in the therapeutic community is a court order which forces them to be in therapy for at least two years. Furthermore, in most cases there is also strong pressure by parents (if parents are significant).
The therapeutic community is perceived to be something large and unachievable. They see special events, friends that in the past were like
24 In Eden, 2000, Heinrich Goldshmidt - Janusz Korczak.
them (some using drugs with them and committing crimes with them), who are free of drugs and play roles in the community. It is difficult for them to see themselves in such a position. This situation is perceived as a scary unattainable challenge. Nevertheless, while being in this stage, they begin to connect to Malkishua, each based on their own personality.
Certain things encourage them and begin to create commitment. Their internal voice tells them that perhaps, there is something positive for them in the community. For the first time, they experience success, keeping to a schedule, and creating friendship not based on interests. They begin to develop understanding that something in the framework is keeping them from deteriorating. At this stage, most of the youths are busy with questions of the here and now. Being busy with this is a sort of therapy because they have no time to think of other matters.
Analysis of Stage B Quotes Aaron
Aaron speaks about successful experiences: "I was one they said would never succeed, and here I am succeeding".
Aaron identifies the opportunities offered by the community that he did not have at home: "Outside I was not able to cope, I was busy with myself, my family. I always failed and didn't have someone to direct me".
"I have an addiction problem and I want to take care of myself".
Aaron understands his problem and defines the nature of the illness. It is clear to him that there is a need for certain conditions to facilitate caring for his illness. Although at first his arrival at Malkishua was because of a court order: "I still have the court order but inside I know that if they remove the order, I will not leave. I reached the conclusion that the community is good for me… It's simply good for me, with treatment I get, the attention, the support…"
It is interesting to look into the issue of court orders. At this stage everyone states that they do not need the order. However, experience proves that it is important to keep it in place as a backup. Crises at this stage often lead to a desire to leave Malkishua. Crises at this stage are generally strong and deep identity crises. Sometimes despair and depression overcome the desire to continue to fight the illness.
Experience has proven that when there is a court order, the youths take care not to deteriorate into a crisis regarding a decision to leave.
The successful experiences that Aaron had at Malkishua are a significant reinforcement keeping Aaron in therapy because Aaron is yearning for belonging and finds it in Malkishua: "… I reached the conclusion that the community is good for me… It's simply good for me, with treatment I get,
the attention, the support". Aaron, is an Ethiopian immigrant, whose integration in Israeli society was difficult and problematic because the ethnic group does not feel like they belong to Israel. Therefore the feeling of belonging in Malkishua is an achievement for him, and he is not willing to give that up.
Shmuel
Malkishua managed to create a "different planet", because of the codes which are opposite of those of "society" outside. The intensive presence provides a feeling of "us and them". This situation is generally typical of groups going through an intensive and significant process in a separate environment outside of the community. This gap is felt at the beginning of therapy. The youths learn that there is life after drug use and that it is possible to function without drugs. With time, the attraction to the drug declines. Shmuel, who was sent home after two months, notices this gap between himself and his former friends. In his case, because of insight and intelligence, Shmuel understands that he must return to the community and get more out of the therapeutic community.
Yehoshua
Yehoshua has a desire to turn over a new leaf and begin his life in a different place. Yehoshua also discusses a court order, but now the order does not concern him and he does not remain in therapy because of it.
Yehoshua speaks about recognizing that he cannot see his own hump, and therefore he needs someone else to help him see himself. Yehoshua identifies the need for help and he also knows how to accept help.
Yirmiyahu
Yirmiyahu compares between Gilam, the closed dormitory from which he arrived, and the therapeutic community of Malkishua. It is an interesting comparison because he came to both places because of a court order and not because of an internal desire.
Yirmiyahu gives the title "Criminal institution" to Gilam, and refuses to call Malkishua the same. The fact that at Malkishua he is treating a specific problem, addiction, is the mandate for the existence of the place.
He perceives his situation as if he has signed a therapy contract between himself and the place: "I came to Malkishua because I used drugs…";
"Gilam is a closed institute for juvenile criminals".
How did you feel there? "I did not feel like a criminal. I was there so I knew I did something I had to pay for.
I came to Malkishua because I used drugs. At first I came because the court made me, but I began to understand that it was for my good and that
it was time to rehabilitate my life. It was time to do something with myself. Today (at Malkishua), I solve my problems with myself. Before I did not succeed in solving them. I learn things about myself, the environment, life in general. I learn how to cope with problems"
Yirmiyahu defines his stay at Gilam as "doing time" - criminal lingo. He also speaks about paying for something, and when you finish paying for it, it is over. He perceives Malkishua as a dialogue, which begins with coercion but continues out of free will: "I began to understand that it was for my good and that it was time to rehabilitate my life." He shows desire to be more active and accept responsibility for his life: "Do something with myself". This is a type of responsibility that Yirmiyahu accepts, I think, for the first time in his life.
Zecharia
Zecharia speaks about the gap between his previous life and in Malkishua:
"… It is good here. The truth, I feel like this is my house. I miss here. It's is good for me here". The central motif in his words is a sense of belonging. It is good for him and he misses it. During adolescence the experience of belonging is existential. Many youths use drugs at this age because they feel a lack of belonging to their family or their peer group (Bandura, 1967). Zecharia simply feels good and he is not willing to give it up. Zecharia is an Ethiopian, and had absorption difficulties. Therefore the fact that Zecharia feels at home is a significant achievement.
Summary of Stage B Quote Analysis
At Stage B, the youths are busy with managing the community. They are in a place that requires being a personal example, and they feel that they have the weight of the entire house on their shoulders. This leads to a change in self image and reinforced self efficacy. For the first time, they feel important and significant to themselves and particularly to their environment. They accumulate successful experiences in studies, in behavioral function and at work. These are all experiences that empower their feeling of ability to cope with difficulty.
A strong sense that arises in these interviews is a feeling of belonging.
For the first time they feel connected to a place where they are not judged and which values them for who they are. The call the community "home"
and the members "family". Between the lines, it can be concluded that the protection and confidence that are given to them by the community are a strong significant feeling. Even if they "mess up", the environment will still accept them. Every behavior has a response, but everything is within the framework of the community or, as is said in the community: "We don't give up on you, but we also don't let you off free".