Reducing the harmful effects of addiction

Louise McCarthy meets a priest who has pioneered a programme for helping children in Zambia

A Dublin Capuchin friar is behind the success of a specialised type of counselling or trauma intervention programme for children, which has been recognised internationally.

In December, the SHARPZ programme (Serenity Harm Reduction Programme Zambia) was awarded the 2014 Klaus J. Jacobs Best Practice Prize in Zurich for its therapy methods, which address the severe needs of trauma-affected children and their families in Zambia.

Fr Philip Baxter, a family therapist and theologian, is the founder of SHARPZ and has now returned to Ireland for a new appointment in Dublin.

Located at Raheny Capuchin friary since July, Fr Philip first went to Zambia in 1982. He joined the Capuchin Friars in 1969 at the age of 19 and was due to take up a teaching post in Rochestown, Co. Cork, when Zambia called him.

“I certainly knew I did not want to spend my life in an Irish secondary school. I wanted something that was responding more to the world and society. I was disenchanted with the function of Catholic education in Ireland,” he says.

Cycle of poverty

Zambia is one of the African countries that are most badly affected by the HIV/Aids pandemic. Almost 8% of the population (approximately 1.1m) is HIV-infected. This has led to many families and young people being trapped in a cycle of poverty, and alcohol or drugs abuse has become a means of coping with social and economic stress.

In the 1980s, Fr Philip first began to learn how to identify HIV, which was unknown at the time in Zambia.

“Firstly, we did not know how the infection was spread. The stigmatisation around HIV was enormous. Care programmes were established, so that people could be managed in their homes. We moved from managing the disease to prevention. We are now supporting people to manage their lives,” he says.

Influenced by the social and medical realities of the response to the HIV/AIDS pandemic in Zambia, SHARPZ was founded, under the umbrella of the Capuchin Franciscan Friars, in 2007. It is a collaborative agency offering comprehensive alcohol and drug abuse prevention, treatment and rehabilitation services as well as targeted programmes to promote mental health and prevent harmful substance use.

Evidence of various forms of problems for which clients receive treatment at SHARPZ includes experiences of traumatic events, depression, schizophrenia, family dysfunction, behaviour disorders, professional misconduct, co-dependency issues, developmental challenges, sex addiction and substance abuse, marital and relationship problems. However, its most concentrated efforts have been directed towards addressing issues related to childhood trauma, using the Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) as an evidence-based approach.

As a family therapist, Fr Philip has been spearheading the TF-CBF approach. The method, advocated by the World Health Organisation, offers therapeutic support to children and their families. TF-CBT offers up to 16 weeks of therapy for children ranging in age from four to 18, along with their families in a bid to teach them coping methods. John Hopkins University asked Fr Philip to assist in supervising the initial cohort of local counsellors being trained in TF-CBT, and now the university subsidises the programme.

Fr Philip points out that many children may be trying to cope with sickness, the death of parents, uncertainty about school, violence and sexual exploitation. “Often symptoms include the inability to sleep, inability to eat, withdrawal, suicidal ideation, nightmares and bed-wetting,” he says.

According to Fr Philip, TF-CBT has been hugely successful, with none of the children using antidepressants to cope with the effects of trauma.

Ten years ago Fr Philip undertook a training course at Arbour House in Cork, and has been instrumental in implementing the ‘normal reduction’ approach instead of ‘total abstinence’ to substance abuse.

“Our CBT approach works on people’s capacity to choose. The rules are clear, no more than three units of alcohol in 24 hours. Many people are abusers of alcohol, rather than addicts,” he says.

The Zambian government supports Fr Philip’s methods of treating alcoholism. However, it disagrees with his belief that marijuana should be legal in Zambia.

“Marijuana grows in every Zambian garden and has been used by traditional healers for centuries. As a public health approach, we continued to treat people using illegal drugs. I have been threatened with expulsion by government officials on two occasions.

“There is money in pursuing the American war on drugs policy,” he says.

Fr Philip is deeply concerned about the “atrocious” conditions in Zambian prisons where many addicts can end up.

“There are people sleeping on bare floors in prisons in close bodily contact with people who may be approaching full-blown AIDS. All the vomiting, itching and diarrhoea.

“A quarter of the prison population is there because they were found in possession of marijuana,” he says.

Life is very different now for Fr Philip with new challenges facing him in “a very different Ireland” to the one he left behind in the 1980s.

“In some respects, it is a better Ireland. The Church is de-institutionalised. Our approach to the media is much better and, when I left Ireland in 1982, it was more conventional,” he says.