Does the addition of integrated cognitive behaviour therapy and motivational interviewing improve the outcomes of standard care for young people with comorbid depression and substance misuse?

Background: The high rates of comorbid depression and substance use in young people have been associated with a range of adverse outcomes. Yet, few treatment studies have been conducted with this population. Objective: To determine if the addition of Motivational Interviewing and Cognitive Behaviour Therapy (MI/CBT) to standard alcohol and other drug (AOD) care improves the outcomes of young people with comorbid depression and substance use. Participants and Setting: Participants comprised 88 young people with comorbid depression (Kessler 10 score of > 17) and substance use (mainly alcohol/cannabis) seeking treatment at two youth AOD services in Melbourne, Australia. Sixty young people received MI/CBT in addition to standard care (SC) and 28 received SC alone. Outcomes Measures: Primary outcome measures were depressive symptoms and drug and alcohol use in the past month. Assessments were conducted at baseline, 3 and 6 months follow up. Results and Conclusions: The addition of MI/CBT to SC was associated with a significantly greater rate of change in depression, cannabis use, motivation to change substance use and social contact in the first 3 months. However, those who received SC had achieved similar improvements on these variables by 6 months follow up. All young people achieved significant improvements in functioning and quality of life variables over time, regardless of the treatment group. No changes in alcohol or other drug use were found in either group. The delivery of MI/CBT in addition to standard AOD care may offer accelerated treatment gains in the short-term.

The institutional limits to, and possibility of, understanding young people diagnosed with 'mental disorders', within inclusive teacher-student relationships

A persistent pattern of exclusion of young people with ‘mental disorders’ from school systems, despite the best intentions of schools and teachers, has prompted a call for a more reflexive understanding of their behaviours. This thesis, by describing how institutionally recognised ways of understanding can result in otherwise avoidable moral collisions and exclusion, produces new insights into the nature and processes of understanding required to promote inclusion. These insights were produced through an intensive qualitative examination of a violent classroom episode, identifying key points in the interaction that could make the difference between misrecognition and recognition, turning exclusion into inclusion.

Improving public spaces for young people : the contribution of participatory research

The objectives of this chapter are to examine the contribution of public spaces to the wellbeing of young people and how participatory action research can be used as a process tool for contextually responsive, collaborative, iterative and multi-method community level practice. The addition of a spatial frame to practice can open up unexpected alliances and opportunities for enhancing the wellbeing of people.

Sustainable creative career development pathways for young people in Tanzania : a case study

Tanzania has a rich and diverse cultural history based in community cultural life. However, at present, young people have limited opportunity to exploit this richness of traditional knowledge and engage in creative jobs as their means of future sustainable employment. Hence, the significant challenge remains: how to integrate and enhance the traditional knowledge in a learning strategy, while there is no “inter-ministerial action and institutional mechanisms” (United Nations 2008, 33-35) to promote creative employment for young people. This article reports on a case study that examined how the two Ministries of Culture and Education might work together to support Tanzania’s young people to secure, and engage successfully in creative jobs. The case study employed mixed methods, incorporating questionnaires, interviews and focus groups. The study was undertaken in Dar-Es-Salaam, Mwanza, Bagamoyo, Dodoma, Lindi and Morogoro from July to October, 2012. This paper discusses some of the issues and argues that there is no practical utilization of traditional knowledge and skills in “putting education to work” (UNESCO 2012, 170) for the better prospects of young people and to reveal the story of their lives. Although this study is specific to Tanzania, the case may also apply to other developing countries.

Participation in science and technology : young people's achievement-related choices in late modern societies

Young people���s participation in science, technology, engineering and mathematics (STEM) is a matter of international concern. Studies and careers that require physical sciences and advanced mathematics are most affected by the problem and women in particular are under-represented in many STEM fields. This article views international research about young people���s relationships to, and participation in, STEM subjects and careers through the lens of an expectancy value model of achievement-related choices. In addition it draws on sociological theories of late-modernity and identity, which situate decision-making in a cultural context. The article examines how these frameworks are useful in explaining the decisions of young people – and young women in particular – about participating in STEM and proposes possible strategies for removing barriers to participation.

Seeds of cosmopolitan future? Young people and their aspirations for future mobility

Mobility across space is an exemplary characteristic of the global era and an important aspect of the cultural experience of many people in advanced industrialised nations. Mobility evokes powerful images that effectively counter any illusion of stationary life and provide a break from the insularity of the local and parochial. High levels of mobility are simultaneously a fact, a necessity and a cultural aspiration. In recent times, debates about mobility in social theory have considered the relationship between mobility and cosmopolitan culture and identities (Hannerz, 1990, Urry, 1990, 2000, Beck, 2006). Against this backdrop, this paper also draws on some of the more recent discussions about the emergence of globalised and cosmopolitan identities among young people (Beck and Beck-Gernsheim, 2009). Using data from a longitudinal study of young people in Queensland, this paper provides an insight into young people���s aspirations about future mobility. The data affirm Skeggs’ (2004) comment that mobility is an unequal resource, and demonstrate that aspirations of future mobility reflect numerous social, economic and cultural realities of young people���s lives. This inevitably leads us to problematise the established, and often abstract, nexus between cosmopolitanism and mobility in contemporary debates about cosmopolitanism.

Effect of the increase in "alcopops" tax on alcohol-related harms in young people : a controlled interrupted time series

Objective: To measure alcohol-related harms to the health of young people presenting to emergency departments (EDs) of Gold Coast public hospitals before and after the increase in the federal government "alcopops" tax in 2008. Design, setting and participants: Interrupted time series analysis over 5 years (28 April 2005 to 27 April 2010) of 15-29-year-olds presenting to EDs with alcohol-related harms compared with presentations of selected control groups. Main outcome measures: Proportion of 15-29-year-olds presenting to EDs with alcohol-related harms compared with (i) 30-49-year-olds with alcohol-related harms, (ii)15-29-year-olds with asthma or appendicitis, and (iii) 15-29-yearolds with any non-alcohol and non-injury related ED presentation. Results: Over a third of 15-29-year-olds presented to ED with alcohol-related conditions, as opposed to around a quarter for all other age groups. There was no significant decrease in alcohol-related ED presentations of 15-29-year-olds compared with any of the control groups after the increase in the tax. We found similar results for males and females, narrow and broad definitions of alcoholrelated harms, under-19s, and visitors to and residents of the Gold Coast. Conclusions: The increase in the tax on al copops was not associated with any reduction in alcohol-related harms in this population in a unique tourist and holiday region. A more comprehensive approach to reducing alcohol harms in young people is needed.

The quik fix study : a randomised controlled trial of brief interventions for young people with alcohol-related injuries and illnesses accessing emergency department and crisis support care

Background: Alcohol is a major preventable cause of injury, disability and death in young people. Large numbers of young people with alcohol-related injuries and medical conditions present to hospital emergency departments (EDs). Access to brief, efficacious, accessible and cost effective treatment is an international health priority within this age group. While there is growing evidence for the efficacy of brief motivational interviewing (MI) for reducing alcohol use in young people, there is significant scope to increase its impact, and determine if it is the most efficacious and cost effective type of brief intervention available. The efficacy of personality-targeted interventions (PIs) for alcohol misuse delivered individually to young people is yet to be determined or compared to MI, despite growing evidence for school-based PIs. This study protocol describes a randomized controlled trial comparing the efficacy and cost-effectiveness of telephone-delivered MI, PI and an Assessment Feedback/Information (AF/I) only control for reducing alcohol use and related harm in young people. Methods/design: Participants will be 390 young people aged 16 to 25 years presenting to a crisis support service or ED with alcohol-related injuries and illnesses (including severe alcohol intoxication). This single blinded superiority trial randomized young people to (i) 2 sessions of MI; (ii) 2 sessions of a new PI or (iii) a 1 session AF/I only control. Participants are reassessed at 1, 3, 6 and 12 months on the primary outcomes of alcohol use and related problems and secondary outcomes of mental health symptoms, functioning, severity of problematic alcohol use, alcohol injuries, alcohol-related knowledge, coping self-efficacy to resist using alcohol, and cost effectiveness. Discussion: This study will identify the most efficacious and cost-effective telephone-delivered brief intervention for reducing alcohol misuse and related problems in young people presenting to crisis support services or EDs. We expect efficacy will be greatest for PI, followed by MI, and then AF/I at 1, 3, 6 and 12 months on the primary and secondary outcome variables. Telephone-delivered brief interventions could provide a youth-friendly, accessible, efficacious, cost-effective and easily disseminated treatment for addressing the significant public health issue of alcohol misuse and related harm in young people. Trial registration: This trial is registered with the Australian and New Zealand Clinical Trials Registry ACTRN12613000108718.

Destinations: 3 Large Cast Plays for Young People

This book is a collection of three large-cast plays written in response to a very specific problem. My work as a teacher of drama often required me to locate a script that would somehow miraculously work for a cast of unknown number and gender, and most likely uneven skills and enthusiasm, who I hadn’t even met yet. It’s a familiar dilemma for teachers and students of drama in education contexts, at whatever level you’re teaching. I’d first addressed this creative problem with scripts such as Gate 38 (2010). I had tried using scripts that already existed, but found they required such extensive editing to suit the parameters of cast and performance duration that I may as well have been writing them myself. Even in the setting of a closed studio, in altering these plays I felt I was bending the vision of the playwright, and certainly their narrative structure, out of shape. Everyone who’s attempted to stage a performance with a large cast of students in an educational setting knows it takes time to truly connect with a play, its social contexts, themes and characters. It also takes a lot of time to get on top of the practicalities of learning, rehearsing, directing and running a performance with young people. Often the curtain goes up on something unfinished and unstable. I was looking for ways to reduce the complexity of staging a script, while maintaining the potential of this process as a site of rich, enjoyable learning. Two of the plays (Duty Free and Please Be Seated) are comprised of multiple monologues, combined with music-driven ensemble sequences. The monologues enable individuals to develop and polish their own performances, work in small groups, and cut down on the laborious detail of directing naturalistic scenes based in character interaction. The third (Australian Drama) involves a lot of duologues, meaning that its rehearsal process can happily employ that mainstay of the drama classroom: small group work. There’s plenty of room to move in terms of gender-blind casting as well. Please be Seated is mainly young women. The scripts also contain ensemble-based interludes which are non-verbal, music driven, with a choreographic element. They have also springboarded further explorations in form. The ethical and aesthetic complexities of verbatim works; the interaction between music and theatre; and meta-concerns related to the performing of performance: ‘how can the act of acting ‘acted’. The narratives of all three of these plays are deliberately open, enabling the flexible casting and on-the hop editing that large-group, time-poor processes sometimes necessitate. Duty Free is about the overseas ‘adventures’ of young people. Please Be Seated is based in verbatim text about young people falling in and out of love. Australian Drama is about young people in a drama classroom trying to connect with each other and put their own shine on dull fragments of the theatrical canon. The plays were published as a collection in hardcopy and digital editions by Playlab Press in 2015. Please be Seated is a co-write with a large group. These co-author’s names are listed in the publication, and below in ‘additional information’.

Marketing unions to young people : recruiting and ‘rusting on’

In light of declining trade union density, specifically amongst young workers, this paper explores how trade unions are servicing and organising young people. Our specific focus is the way in which trade unions market their services to the young. We use, as a lens of analysis, the services marketing literature and the concept of an ‘experience good’ to explore trade union strategies. Based on interviews with a number of Queensland union officials, it is clear unions see the issue of recruitment of young people as significant, and that resources are being targeted on the development of innovative strategies at least in some unions.

Daggy shirts, daggy slogans? marketing unions to young people

In light of declining trade union density, specifically among young workers, this article explores how trade unions recruit, service and organize young people. Our focus is the way in which trade unions market their services to the young. We use, as a lens of analysis, the services and social marketing literature and the concept of an ‘unsought, experience good’ to explore trade union strategy. Based on interviews with a number of union officials in the state of Queensland, it is clear that unions see the issue of recruitment of young people as significant, and that innovative strategies are being used in at least some unions. However, the research also indicates that despite union awareness, strategies are uneven and resource allocation is patchy. While the research was carried out in one state, the results and conclusion are broadly applicable to the Australian labour movement as a whole, and have implications for union movements in other Anglophone countries.

Keeping in constant touch : the predictors of young Australians’ mobile phone involvement

Little is known about the psychological underpinnings of young people���s mobile phone behaviour. In the present research, 292 young Australians, aged 16–24 years, completed an online survey assessing the effects of self-identity, in-group norm, the need to belong, and self-esteem on their frequency of mobile phone use and mobile phone involvement, conceptualised as people���s degree of cognitive and behavioural association with their mobile phone. Structural equation modelling revealed that age (younger) and self-identity significantly predicted the frequency of mobile phone use. In contrast, age (younger), gender (female), self-identity and in-group norm predicted young people���s mobile phone involvement. Neither self-esteem nor the need to belong significantly predicted mobile phone behaviour. The present study contributes to our understanding of this phenomenon and provides an indication of the characteristics of young people who may become highly involved with their mobile phone.

‘My people right here…’ Indigenous young people, alienation and paint sniffing in inner Brisbane

This paper describes and explains the social worlds of a group of young Murris who are engaged in chroming (paint sniffing) and who sleep rough in inner Brisbane. In particular, the paper considers the ways young Indigenous drug users describe their marginalisation from wider society and its structures of opportunity, but it also includes some reflections from their youth worker and a young man who frequents the young people���s squat. The paper demonstrates the centrality of racism and material disadvantage to the experience of a group of young Aboriginal and Torres Strait Islander sniffers, a perspective largely unreflected in the literature on Indigenous volatile substance misuse. Further, the young people���s ways of interacting with the broader society are described to explain the ways their rejection of mainstream norms form a significant political response to their marginality and reflect, at least in part, the wider Indigenous historical experience. The work draws on theories of alienation and subculture to analyse the young people���s descriptions of their social estrangement and the formation of the ‘paint sniffer group’. It is concluded that paint sniffing among urban Indigenous youth is, at least in part, an obnoxious and encoded distillation of a wider Indigenous rebuttal of broader societal norms, and that the dominant — normalising — modes of treatment risk further alienating an already oppositional group of young people.

Children, young people and their social and spatial citizenship rights

The use of public space by children and young people is a contentious issue in a number of developed and developing countries and a range of measures are frequently deployed to control the public space which usually deny the rights of children and young people to claim the space for their use. Child and youth curfews, oppressive camera surveillance and the unwarranted attentions of police and private security personnel as control measures in public space undermine attempts to secure greater participation by children and young people in constructing positive strategies to address concerns that impact on them and others in a local area. Evidence from research in Scotland undertaken by Article 12 (2000) suggests that young people felt strongly that they did not count in local community matters and decision making and the imposition on them of a curfew by the adult world of the local area created resentment both at the harshness of the measure and disappointment at an opportunity lost to be consulted and involved in dealing with perceived problems of the locality. This is an important cluster of linked issues as Brown (1998:116) argues that young people are ‘selectively constructed as “problem” and “other” with their concerns marginalised, their lifestyles problematised and their voices subdued’, and this flows into their use of public space as their claims to its use as an aspect of social citizenship are usually cast as inferior or rejected as they ‘stand outside the formal polity’ as ‘non persons’. This has major implications for the ways in which young people view their position in a community as many report a feeling of not being wanted, valued or tolerated. The ‘youth question’ according to Davis (1990) acts as a form of ‘screen’ on which observers and analysts project hopes and fears about the state of society, while in the view of Loader (1996:89) the ‘question of young people��� sits within a discourse comprising two elements, the one being youth, particularly young males, as the ‘harbinger of often unwelcome social change and threat’ and the other element ‘constructs young people as vulnerable’. This discourse of threat is further exemplified in the separation of children from teenagers as Valentine (1996) suggests, the treatment of younger children using public space is often dramatically different to that of older children and the most feared stage of all, 'youth'

Risk-taking, harm and help-seeking : reported by young people in treatment at a youth alcohol and drug counselling service

Regarded as a normative component of development, risk-taking by young people is a well-researched subject, and some risk-taking behaviours, such as substance use, are particularly well covered because of their potential to adversely affect health and wellbeing. What has remained unclear is the extent of young people's risk-taking while engaged in alcohol and other drug (AOD) treatment, their awareness of the related harms of risk-taking behaviours, and their prior help-seeking for these harms - information which may have a significant impact on the quality and relevance of the care they receive. This paper reports the findings from a brief pilot study exploring those factors in a clinical sample of young people engaged in ongoing AOD counselling.