Boxing and substance use rehabilitation: building skills and capacities in disadvantaged communities

Boxing and substance use rehabilitation: building skills and capacities in disadvantaged communities Abstract This paper considers the role of the boxing training and mentoring in the context of the change processes for participants engaging in a twenty-week community based integrated fitness and education substance use rehabilitation programme. The study took place in an urban community in Dublin, Ireland within the context of neo-liberal systems of regulation and control of community based organizations. Focus group interviews with participants were carried out at midway (n = 17) and on completion (n = 14) of the programme and with practitioners (n = 8) midway and on completion of the programme. Transcripts were coded and themes associated with the participants’ experience of the programme and its interface with the wider community context: building relationships; physical and emotional impact of boxing skills training; boxing skills training and gender; understanding the mentoring role. The positive attributes associated with the ‘boxer’ identity has the potential to provide an alternative to ‘the addict’ identity within socially disadvantaged communities. It is argued that the boxing gym, particularly when nested within a range of educational and emotional supports, can become an empowering setting within a community. The coaching approach has the potential to challenge gendered norms in relation to sport and fitness, while also supporting participants to utilize their physical bodies with intent and focus. The inclusion of programme mentors is an important consideration for substance use rehabilitation programmes, especially within communities characterized by exclusion and isolation. Introduction The study described in this paper took place in an area of Dublin, Ireland characterized by elevated levels of social and economic deprivation and increasing poly-substance use. Drug issues within some socially excluded urban areas within Ireland remain an intractable and ongoing issue (Saris, 2008), particularly in the aftermath of the recent recession and subsequent funding cuts to community and drug intervention services (Citywide, 2016). It has been argued that the fiscal retrenchment that followed the recession impacted adversely on some communities (O’Gorman et al. 2016), resulting in increased levels of poverty, exclusion and disconnection. Where such social problems coalesce then issues of harmful behaviours associated with drugs are exacerbated: ‘Where poverty clusters at neighbourhood level, drug-related harms cluster too’ (O’Gorman et al. 2016, p. 18). Normative perceptions about non-participation in aspects of community life (Fieldhouse, 2012) and ongoing absence of economic opportunities (O’Brien and Foley, 2017) can reinforce these dynamics. In the Irish context, there is increasing evidence of street drinking, use of new psychoactive substances (NPS) and poly-drug use within such communities (O’Gorman, 2016), yet criticisms remain about perceived failures of public policy to respond effectively to the needs of individuals, families and communities in these circumstances (Butler and Hope, 2015). The literature suggests that a mix of interventions should be used to increase cohesion, social control and empowerment, while also reducing disorder and promoting healthy norms and behaviours (Stevenson, McNamara and Muldoon, 2014) in such contexts. In the last few decades, however, attempts to effect change are often mediated by the regulation and control of communities and community based social organizations, informed by neo-liberal discourses (Geoghegan and Powell, 2008; Fursova, 2016; Onyx, Chame and Dalton, 2016). These tend to emphasize individualism and competition, reframe citizens as consumers of service provision and constrain advocacy and participation within community development practice (Burkett, 2011). Even where interventions appear to employ outwardly inclusive solutions, community organizations often have to amplify and highlight more negative representations resulting in ‘problem directed resources’, approaches which tend to reinforce structural and geographical inequalities (Saris, 2008). Implementing generative interventions that will engage problematic users, without reinforcing stigma or narratives of individual responsibility, while also retaining funding, becomes a game of ‘neoliberal twister’ (Burkett, 2011). While it has been argued that these pervading discourses tend to render invisible the less tangible community development goals of social cohesion, trust and social justice, opportunities remain for community based organizations to utilize alternative funding and time, energy and skills towards work that has greater alignment with these less visible elements (Onyx, Cham and Dalton, 2016). Maintaining empowering and activist elements in the face of the requirement for resources and demands for state or funder accountability, can be a point of strength for organizations and practitioners (Geoghegan and Powell, 2008, p. 445). The connection to those marginalized and excluded from services may be key to counter this hegemony (Fursova, 2016). What is required are diverse, imaginative forms of engagement with communities that enable social change to occur (Burkett, 2011; Fursova, 2016). It has been argued that to achieve the type of community change that also enables individual change, both social innovation and collaboration, as well as the presence of positive bonding ties between people is essential (Dale, 2013; Maton, 2008; Quigley, 2003). Within this complex context, this study was designed to consider and explore both the structural functioning of a twenty-week community based fitness and education substance use rehabilitation programme and the change processes for participants engaging in the programme. The role of education and fitness in relation to substance use recovery capital for programme participants has been reported on (Morton, O’Reilly and O’Brien, 2016). This article explores the findings in relation to the role of the boxing training element and mentoring aspects of the programme, these being of particular relevance to debates in relation to community based drug service intervention (Jemal and Smith, 2015). Boxing, mentoring and peer support in community settings While the use of education and fitness in substance use rehabilitation programmes (Keane, 2011; Morton, O’Reilly and O’Brien, 2016) have been recognized in the literature, concerns remain about how the individualized nature of activities are understood in the context of wider community needs, an issue made more acute at a time when the advance of neo-liberal discourses affect the community sector in Ireland and other jurisdictions (Burkett, 2011). Given the many obstacles to substance use recovery, including individual and community experiences of structural and social disadvantage and inter-generational patterns of substance use, violence and crime (Quigley, 2003), it has been argued that boxing activities can overcome some of these challenges and build important social networks between individual and community (Van Hout and Phelan, 2014). The boxing gym is often constructed as a site of protection (Wacquant, 2004) or a space where social and individual problems can be partially mediated through mechanisms of negotiation and change (Trimbur, 2011). It is also a site where new social experiences can be realized and socio-economic opportunities emerge (Sacha, 2015). On the other hand, it is argued that boxing clubs can reproduce the hierarchies already present in a community (Sabirova and Zinoviev, 2015). The connotation of the boxing gym then is often characterized by polarities and contradictions: exclusions and opportunity; discipline and excess; resilience and injury; violence and control (Woodward, 2004, p. 5). Wright (2008) argues that, despite these ambiguities, boxing can contribute to enhanced life opportunities and well-being outside and within the gym, particularly for young men: This is no paradox: the groups take the familiar experience of fighting they already identify with and sanction it, control it, structure it, refine it, harness it, give the youth ownership of it, and turn it into an art form to be valued and respected. They recognize their new skills, talent and self-worth. By becoming boxers, they choose to keep it in the ring (Wright, 2008, p. 150). Sacha (2015) suggests that the type of regulation and controls that underpin boxing creates the potential to re-orientate young men towards beneficial working class norms rather than alternatives that include crime, drug dealing and violence. The role of coaches appears crucial here, in particular where the older generation mentor young men and seek to challenge expressions of machismo and enhance positive expressions of masculinity, which in turn can benefit individuals and communities (Dortants and Knoppers, 2012). It is important to analyse the role of mentors and mechanisms of peer support in community based interventions that seek to deal with substance use and other social problems (Kurtz and Fisher, 2003). In their review of the literature, Reif et al. (2014) found that peer support reduced relapse rates, increased treatment retention and helped improve relationships between participants and social agencies. Results from a range of studies consistently indicate the value of peer mentors in modelling the success of treatment pathways and recovery (Lawlor et al. 2014; Rhodes, Reddy and Grossman, 2005). Despite this optimism about the role of peer support and mentors, these approaches have rarely been applied to boxing contexts in community based settings. As noted, this paper seeks to explore the boxing skills and mentoring element of an integrated education and fitness substance use rehabilitation programme. In line with Maton’s (2008) appeal for evaluation approaches that interrogate strength-based portrayals of such settings and interventions, these elements are explored from the perspective of the practitioners and programme participants, while also bearing in mind programme aims and processes (Kemp et al. 2008). Method The setting Boxing Clever is a twenty week, community based rehabilitation intervention involving up to twenty-five individuals, who undertake seven hours per week of educational, physical and substance use rehabilitation activities, offered on a group basis. The programme is based in a socially disadvantaged urban community in Dublin, Ireland, and is delivered in partnership by seven agencies and nine practitioners, including one boxing coach. The co-ordinating community agency provides support and interventions that aim to reduce the negative impact of drug and alcohol use on the lives of individuals and families, and on the community within which it is located. The programme was developed in response to gaps in the provision of structured rehabilitation, sport and fitness services available within this setting. Although participants must be in contact with community, health or social services for substance use behaviours, there are no further barriers to enter the programme, beyond a commitment to the content and schedule. The programme is offered to both current and abstinent drug users, recognizing the skills mix necessary for mentors in these settings (Litt et al. 2009) and to address the fact that educational courses are often only offered to those who have stabilized their drug use or are currently abstinent (Keane, 2011). Two adult education awards are offered, alongside tailored fitness training and boxing skills training. The boxing skills element occurs every other week over the twenty week duration of the programme. The lead coach designs aspects of the programme according to the participants’ varying fitness levels and historical or current substance use. The boxing skills sessions, which take place in a community gym, include strength and conditioning fitness training, boxing and kick-boxing pad work, shadow boxing, self-defence skills, and technical skills such as stance, blocking and sequences of punches. Within the community where the study was based there are a number of boxing clubs within a small geographical area and a history of both amateur and professional boxing success. Participants All of the participants (n = 24) and practitioners (n = 9) from one cohort of the programme were invited to be involved in the research, with seventeen programme participants and eight practitioners responding. Ten of the programme participants were women and seven men, ranging in age from 19 to 49 years, with the mean age range of 35–39 years. The primary substance used by participants was alcohol (n = 6), followed by prescribed methadone (n = 4), cannabis (n = 3), heroin (n = 2), codeine (n = 1) and benzodiazepine (n = 1). Of the practitioners, two were involved in fitness and boxing elements of programme delivery, four in the educational elements of the programme and two in key working and co-ordination. Procedure Ethical approval was gained from the first author’s University’s ethics committee and all participants provided signed consent. The study utilized a qualitative design involving a semi-structured interview schedule that collected data from programme participant and practitioner focus groups in order to capture their experiences (Finlay, 2006). The questions for the interview schedule were developed by the researchers, focussing on the programme participants’ routes through change processes in their lives, and practitioners’ understanding of these processes. Data were collected between November 2013 and March 2014. Four programme participant focus groups were held, two in January and two in March, lasting on average for approximately one hour. Four practitioner focus groups were also held over the data collection period, with an average of six practitioners attending each group. These differed from the participant focus groups, as the practitioners were also asked to reflect on their practice, engagement with participants and the change processes they observed for participants between groups. Each focus group lasted on average ninety minutes. Focus group responses were taped and transcribed, then subject to thematic analysis (Hardwick and Worsley, 2011). This first involved an open coding approach (Strauss and Corbin, 1998), followed by axial coding (Strauss and Corbin, 1998) to identify relationships between categories. Finally, the themes were considered at an integrative level in order to both construct the relationships between categories, but also overarching themes. The process helped in the analysis of the participants’ articulation of their lived experiences (Hussein, 2008) and practitioners’ understanding of the change processes experienced by participants. The discussion of the emergent themes is supported by reference to illustrative quotations. Given the size and nature of the study, research participants have been allocated pseudonyms. Results While the individual’s experience of boxing and their relationships with links to community life were central to the study, educational and fitness outcomes are also noted, as already reported (Morton, O’Reilly and O’Brien, 2016). Nearly all (n = 16) of the participants reported that they maintained their drug free status or reduced their drug use as attributed to participation on the programme, while all of the participants achieved one (n = 2) or both (n = 15) of the programme qualifications (Morton, O’Reilly and O’Brien, 2016). Fitness outcome measures reported positive changes in physical endurance (n = 9), core conditioning (n = 7) and changes in physical flexibility (n = 9). Along with these outcomes, all participants identified positive improvements in their mood which they attributed to the physical exercise element of the programme (Morton, O’Reilly and O’Brien, 2016). The study was particularly interested in the interface between the participants’ experiences and the role that boxing, peers and mentors played within the programme. With this in mind, four key themes emerged; building relationships; physical and emotional impact of boxing skills training; boxing skills training and gender; understanding the mentoring role. Building relationships Relationship building is a key element in community work practice (Emery and Bregendahl, 2014) as well as in substance use recovery (Duffy and Baldwin, 2013). It supports the development of human and cultural capital, as well as providing a basis for bonding and bridging ties within communities (Emery and Bregendahl, 2014). This issue was often apparent in the way that coaches and participants negotiated roles and relationships. Sometimes this was characterized by caution by coaches who resisted a directive approach as a way of encouraging positive behaviours, instead encouraging participants to develop and understand their own physical limits as well as taking responsibility for self-care. As one coach stated: I don’t say ‘you have to do this' or ‘you have to do that’. Most addicts that I know anyway are rebellious, they have problems around authority figures, the Gardai (police), schools. When you suggest something I find I tend to get more out of them, they are more willing to take part. (Peter, Coach) This attitude was recognized to be positive by the following participant: (Coaches name) is very encouraging, I started to go to the Friday class, there was a familiarity with (coaches name), he would ask you to challenge yourself but not push yourself too hard, to get overall healthy, he was encouraging and had an understanding of where we were all coming from. (Nicole, Programme participant) Practitioners generally agreed a more reflective non-interventionist stance would build confidence and self-determination in participants. As one practitioner pointed out, this may differ from other rehabilitative substance use day programmes where staff were more directive: You have to still perform – we don’t have that expectation of anyone. (Steven, Practitioner) The boxing skills coaches stated that they focussed on completion of the exercise rather than expectations of success and perfection, with a view to not only improving technique and performance, but to help build a culture of care and respect: Through the whole course there is a social thing as well, women would come in and have a chat, the guys weren’t doing that at the start, but as time goes on the guys become more sociable before and after each session. Even after the classes I get great respect, with the lads offering to tidy up and carry stuff out to the car. (Peter, Coach) This appeared to have a positive effect on participants, as one put it: They came to us at our level, they met us where we were at, he (coach) would have a laugh and a joke, it was enjoyable. He would bring us into the gym…then we were getting some chance to do a little bit of boxing…some women were sparring. Whoever wanted to do the gym work could. (Joe, Programme participant) The boxing element of the programme enabled participants to utilize local community venues such as a gym and leisure centre. This allowed for both the building of relationships with coaches and other programme participants, and engagement with community life and personal routines. The effect for some participants was a tentative building of connection to community resources and an increased sense of belonging: They have somewhere to go, by going to the gym, they feel part of the community. The (boxing) training is the tool for building relationships with community in a positive way, it empowers them as well, after the 20 weeks and they go to use the gym and other classes. You can see them thinking, ‘I have the right to do this’, they can be part of a fitness gym, you can go anywhere in the world. They can go and join other clubs and be accepted. (Ben, Practitioner) Physical and emotional impact of boxing skills training How we inhabit and experience our own bodies can be a key element in both engaging in personal change processes and in providing leadership to others in our community (Sinclair, 2005: 403). Both the boxing coaches and the participants spoke about the positive, physical impact of the boxing skills training on their well-being. As one participant put it: With the boxing, that worked, we knew that we could push ourselves. (Adam, Programme participant) One of the practitioners explained how he thought the boxing skills training appeared to have had a profound impact on educational and physical well-being: It is the discipline involved, not just sport or the education component. The discipline from the boxing skills is infused across the program, when people come onto the program they can make major changes physically and educationally within 20 weeks, that is a big driver for me. Clients can sit around in programs for years and not attain those outcomes, so for us the physicality of the boxing is an important part. (Ben, Practitioner) An interesting finding from the study was how the experiences of participants’ personal developmental issues appeared to bridge into perceptions of community life. In becoming part of the local leisure centre they appeared to have access to hitherto unavailable community space. As many of the participants live in situations where personal and community violence are everyday risks, the discipline and skills involved in the boxing enabled them to defend themselves from violence and find ways to contain and express anger and other emotions in safe ways. The practitioners offered a number of explanations about how the training might be enabling the participants to deal with the challenges and threats they experienced in their community: For some of the men, the program has transformed them. They are not as fearful because they are able to defend themselves better. They might have been going around (the community) in fear, now they are not as fearful and less likely to use a weapon, they can defend themselves in an honourable way. (Peter, Coach) The importance of introducing principles and practices of discipline appeared central to these processes: Giving them discipline is important. Some of the participants might be swinging punches but the program gets them to focus their minds and have a clear idea of where they are going. A few guys thought they were invincible and there is learning for them on the program. They realize in the boxing that somebody can beat you and not to be putting themselves in danger. (Peter, Coach) Boxing skills training and gender Popular discourses on gender and sports often suggest that men and women have different capabilities, occupying different roles, spaces and activities (Martos Garcia, Devis-Devis and Sparkes, 2009). The Boxing Clever programme sought to challenge such stereotypes, led by the boxing coach, in particular in articulating non-binary views on traditional and non-traditional notions of gender. Mirroring some of the participants’ experiences, he spoke of being bullied or subject to physical violence as a way of interpreting how he related to them: Well, I came from that space myself, where if I wasn’t trained I would’ve been bullied; even today, I would feel I could be bullied as a man, even on building sites or whatever where I have worked; but when they know you’re a boxer you wouldn’t be bullied. It’s kind of primitive in a way, but a man’s world is different that way. (Peter, Coach) It was not surprising that some men in the group were sceptical about the capacity of women to complete the programme; such perceptions tend to be reproduced where coaches and educators reinforce gender stereotypes and when sporting activities are divided on lines of gender (Martos-Garcia, Devís-Devís and Sparkes, 2009). The practitioners felt that boxing had the potential to challenge such gendered norms, one way of dealing with this was to try to understand, and deal with problems of self-consciousness expressed by women, particularly at the start of the programme. The boxing coach described how he split the group according to their fitness level and previous experience of sport, rather than gender, to break down such norms: They are all together in the same boat, actually enjoying it, the women were talking about it, they were all being challenged in the same way. (Ben, Practitioner) Another practitioner agreed with this approach: You never hear them (the participants) saying that the men do this, and the women do that. The women are offered the same program …it is not the men can do the boxing and the women can do the water aerobics, we are not already setting them up, this is a program and it’s an option for everybody. (Catherine, Practitioner) The boxing coach also explained how he had enabled women to use the medium of boxing to express anger and frustration with the problems of everyday life: With women it is about them realizing it is ok to get in touch with anger, some will be placid like they are afraid to show aggression, for me, saying to them it is ok, this is an opportunity to release anger. (Peter, Coach) Understanding the mentoring role The way in which the mentoring role developed in the program was relatively unstructured. Initially the practitioners had observed that men in the community would seek informal support from peers who had substance use problems but were also involved in sport. In their responses, practitioners considered and identified the qualities needed for a mentor that included being trustworthy and reliable, to have addressed their own substance use issues and to have a connection with sport, preferably boxing: They need to have sport in their lives and be in recovery and they have to able to link with other people and are open to providing the supports that people would need. (Ben, Practitioner) As the mentor also participated in the program, they needed to be able to complete the educational elements, as well as provide leadership and guidance. Practitioners also felt it was important that the mentor had the capacity to ‘be one of the group’ as well as provide leadership, which they noted was a difficult dynamic to negotiate: Yes, and that can take away from the group idolizing them as well, not making them vulnerable, putting them on a pedestal; I do think it took people a while to get used to that initially; he was almost among them before they realized he was a mentor. (Eleanor, Practitioner) Another practitioner added: Its role modelling really, being able to say ‘I’m not perfect’ and having that sort of humility to be able to say that to the group as well and look for help if you need it. It gives them a hope, when they see the mentors have gone on ahead, can relate to them, a lot the people are coming from a place of mistrust and then they see this happening and it gives them hope. (Peter, Coach) Impact of mentoring Beyond the mentoring style of the boxing coach, participants sometime spoke about ways in which peer mentors had affected them and their participation within the program. It helped that mentors often had also been involved in problematic substance use and drug related crime. These experiences could be viewed as positive: I only ever had a negative impact on my community. Now I am helping rebuild the community that I was destroying. (Jason, Programme participant and mentor) Other positive experiences were attributed to the mentoring role, for example in terms of personal development and engagement with difficult thoughts and experiences: I did not know what to expect, I had never done anything like that before, I had to push past a lot of uncomfortable feelings, but it was something I wanted to do…… I just kept doing what I thought was right. (Jason, Programme participant and mentor) Participants found the involvement of peer mentors to be generally positive. Although there were moments of discomfort in discussing their worries and problems with peer mentors, initial conversations usually paved the way to more open, trusting relationships between the participants and the practitioners. Because the mentor was perceived to be both ‘one of them’ they were better able to provide guidance and help: I found it was nice to have someone there, because (mentor’s name) is very calm, he would always say it is all ok, we will get it sorted. He (mentor) had to get the work done…he was always part of the group. It was a great thing to have a mentor. (Nicole, Programme participant). Discussion The findings from the study suggest that the boxing component of the programme, although challenging, appeared to create opportunities for personal growth, self-awareness and self-knowledge amongst participants, all important aspects of sustained recovery from substance use (Best et al. 2012), and social problems that often affect marginalized communities (Sacha, 2015). Peer support within the gym, which could also be maintained through the coaching relationship, allowed the participants to build relationships based on principles of discipline provided by boxing. Those with substance use histories may have a history of fractured relationships, internalized stigma and shame (O’Reilly, 2014). The coaching relationship enabled the participants to experience both physical and emotional intimacy, but in a context contained by rules and boundaries and within a setting that had status within the community. However, it could be argued that this dichotomy of the ‘disciplined’ body (Wacquant, 2004) verus the ‘undisciplined’ drug user only serves to reinforce yet another set of restrictive, binary identities for those seeking recovery from substance use. The positioning that the coach took in relation to accepting the participants’ limitations and digressions may be key in negotiating this dilemma. The ability to experience and manage one’s own mental and physical well-being in a positive way and develop a sense of self-efficacy are further aspects of building personal capital for those seeking recovery from substance use (Kadden and Litt, 2011). Developing the ability to be physically present can free participants from worrying about the future or having regrets about the past, and can connect people to their emotions and feelings (Sinclair, 2005). As many of the participants live in situations where personal and community violence are everyday risks, the discipline and skills involved in the boxing element provide both a way for participants to defend themselves from violence and a contained way to experience and express anger and other emotions. It has been argued, however, that there may be paradoxical effects of boxing in community settings where substance use is prevalent (Wright, 2008). Being able to ‘handle yourself’ in the face of violence or threat, and using boxing to channel and manage anger can be the very qualities that are attributed with value by gangs involved in the drugs trade (Garot, 2015). In negotiating this paradox, it may be that the boxing skills training has been refined and developed by the coaches to forefront personal limits and emotional regulation that ensures the experience is generative rather than reinforcing of negative community and personal norms (Wright, 2008). Approaches to sport and fitness within rehabilitation programmes can reinforce traditional gender norms, and these are often underpinned by coaching narratives about machismo and ‘hardness’; these understandably tend to create barriers that women can find difficult to negotiate (Martos-Garcia, Devís-Devís and Sparkes, 2009; Sabirova and Zinoviev, 2015). It appears the contradictions endemic within boxing, this time in relation to gender (Mennesson, 2000) did affect the structure and processes associated with the programme. The practitioners did try to create opportunities for women to participate in meaningful ways in activities normally restricted to men, however, the assertion that women are better able to defend themselves and manage physically threatening behaviour implicitly places responsibility with women to contain or manage men’s violence (Hollander, 2005). Whether the presence and participation of women in the boxing skills training was in anyway disruptive of traditional norms was not a question explicitly explored in this study. However, Deuchar and colleagues (2016) found that even the ‘subtle introduction’ of women into the boxing gym created opportunities for the men to ‘perform broader versions of the locally dominated enactment of masculinity’ (736). Beyond this, the boxing skills training did encourage participants to use their bodies intentionally and at times with determination, something women were less likely to have experienced in growing up and in their lives (Mennesson, 2000). For both men and women this intentional use of the body may provide a contrast to disconnecting from their physical body through substance use (Price et al. 2012). Training in intentional physicality may be particularly positive for women beyond being a release of anger and other emotions; this experience of being physically strong and/or capable can help revised notions of the self at this immediate, visceral level (Hollander, 2005). The findings suggest that participating in boxing skills training offered participants the opportunity to reframe existing identities and, at times, seek rapprochement with their community; a ‘boxer’ rather than ‘addict’ identity seemed to bridge this space. This construction of a non-addict identity is an important feature of substance use recovery processes (McIntosh and McKeganey, 2000; Neale et al., 2015), and works to actively challenge the stigma and shame individuals may have internalized from being labelled as ‘addict’ (Radcliffe and Stevens, 2008). This also provides an alternative to the person identifying as a ‘recovering addict’, which can also be associated with stigma (Larkin and Griffiths, 2002). There has been little focus in the substance use literature to date on how a non-addict identity connects with inclusion within one’s community. However, in considering identity and inclusion within mental health services, Fieldhouse (2012) found intentional use of social capital development was critical in supporting people’s recovery. Fieldhouse refers to the ‘restorative potential of community’ (2012, p. 584) and the importance of creating a ‘robust bridge’ from clinical and intervention settings to ordinary settings characterized by community engagement and participation. It can be argued that the boxing gym is such a bridge, particularly for those seeking to build an alternative identity within communities where fragmentation, disadvantage and exclusion are features. The boxing gym can be both understanding and transforming of daily tensions, challenges and difficulties of seeking recovery within socially disadvantaged communities. It could be argued, once nested within other educational and emotional supports, gyms can become an ‘empowering setting’, which Maton (2008) maintains can be critical in enhancing quality of life and achieving social justice for those marginalized or oppressed within society. The study also indicates the crucial role that coaches play in this mentoring role in supporting positive change, allowing for conflict and digressions in terms of substance use and sustaining positive engagement with peers and, indirectly, their communities. For the participants, it was important the mentor was ‘one of them’, yet also offered role-modelling in terms of leadership and enactment of personal agency (Dale, 2013) that could potentially support long term, positive life changes in others. For the practitioners, the ability of the mentor to manage personal and professional boundaries within this mentor role contributed to the success of the programme and positive outcomes for participants (Morton, O’Reilly and O’Brien, 2016). This role may differ from traditional approaches to peer support that are based on shared experience (Kurtz and Fisher, 2003), as the mentor also supports participants to negotiate systems such as education and community support by both evidencing their own pathways and by encouraging progression. Conclusion Seeking generative and participatory solutions to drug issues within socially excluded communities remains an ongoing challenge, particularly in the face of neo-liberal pressures that prioritize individual treatment episodes and substance use abstinence as key success indicator, rather than progressive support and community re-integration. The programme considered in this paper is a low cost inter-agency intervention that provides support to those typically excluded or restricted to certain types of service provision. Boxing and the boxing gym hold a certain status within many disadvantaged communities, which may provide a unique motivational hook for those seeking to address their problematic substance use. The positive attributes associated with the boxer identity has the potential to provide a pathway to an alternative to ‘the addict’ identity, particularly in communities characterized by violence and risk (McIntosh and McKeganey, 2000; Morton, O’Reilly and O’Brien, 2016). Boxing skills training, particularly when associated within a range of educational and emotional supports can contribute to the development of an empowering setting within a community. The approach of the boxing skills coach may also be a critical element in encouraging self-efficacy and self-regulation in these contexts, as well as aiding in building recovery capital (Cloud and Granfield, 2008) and supporting the development of identity based on more generative aspects of the self. The coaching approach and techniques have the potential to challenge gender norms in relation to sport and fitness, while also supporting all participants to utilize their physical bodies with intent and focus. The inclusion of programme mentors is an important consideration for substance use rehabilitation programmes, as it can illustrate progression, motivating programme participants and helping sustain positive change. Limitations This was a qualitative study, utilizing a convenience sample of participants and coaches within one cohort of a substance use rehabilitation programme. For this reason, the findings cannot be generalized to wider populations. 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( 2008) Keep it in the ring: using boxing in social group work with high-risk and offender youth to reduce violence, Social Work with Groups , 29 ( 2–3), 149– 174. Author notes Dr Sarah Morton is an assistant professor and director of the Community Partnership Drugs Programme in the School of Social Policy, Social Work and Social Justice at University College Dublin. She has a special interest in the intersection of drug policy and practice. Karl O'Brien is a community addiction counsellor in Ballymun Youth Action Project. With many years of experience delivering substance use interventions within communities in Dublin, he has a particular interest in the practice–research interface relating to drugs intervention. Dr Laura O'Reilly is the co-ordinator of Urrús Addiction Training Centre, Ballymun Youth Action Project. With many years delivering professional skills development in the drug and alcohol sector, recently her research interests have focused on practitioner and organisational capacity building to respond effectively to drug issues within communities. © Oxford University Press and Community Development Journal. 2018 All rights reserved. For permissions, please email: journals.permissions@oup.com http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Community Development Journal Oxford University Press

Boxing and substance use rehabilitation: building skills and capacities in disadvantaged communities

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Oxford University Press
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© Oxford University Press and Community Development Journal. 2018 All rights reserved. For permissions, please email: journals.permissions@oup.com
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0010-3802
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10.1093/cdj/bsy006
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Abstract

Abstract This paper considers the role of the boxing training and mentoring in the context of the change processes for participants engaging in a twenty-week community based integrated fitness and education substance use rehabilitation programme. The study took place in an urban community in Dublin, Ireland within the context of neo-liberal systems of regulation and control of community based organizations. Focus group interviews with participants were carried out at midway (n = 17) and on completion (n = 14) of the programme and with practitioners (n = 8) midway and on completion of the programme. Transcripts were coded and themes associated with the participants’ experience of the programme and its interface with the wider community context: building relationships; physical and emotional impact of boxing skills training; boxing skills training and gender; understanding the mentoring role. The positive attributes associated with the ‘boxer’ identity has the potential to provide an alternative to ‘the addict’ identity within socially disadvantaged communities. It is argued that the boxing gym, particularly when nested within a range of educational and emotional supports, can become an empowering setting within a community. The coaching approach has the potential to challenge gendered norms in relation to sport and fitness, while also supporting participants to utilize their physical bodies with intent and focus. The inclusion of programme mentors is an important consideration for substance use rehabilitation programmes, especially within communities characterized by exclusion and isolation. Introduction The study described in this paper took place in an area of Dublin, Ireland characterized by elevated levels of social and economic deprivation and increasing poly-substance use. Drug issues within some socially excluded urban areas within Ireland remain an intractable and ongoing issue (Saris, 2008), particularly in the aftermath of the recent recession and subsequent funding cuts to community and drug intervention services (Citywide, 2016). It has been argued that the fiscal retrenchment that followed the recession impacted adversely on some communities (O’Gorman et al. 2016), resulting in increased levels of poverty, exclusion and disconnection. Where such social problems coalesce then issues of harmful behaviours associated with drugs are exacerbated: ‘Where poverty clusters at neighbourhood level, drug-related harms cluster too’ (O’Gorman et al. 2016, p. 18). Normative perceptions about non-participation in aspects of community life (Fieldhouse, 2012) and ongoing absence of economic opportunities (O’Brien and Foley, 2017) can reinforce these dynamics. In the Irish context, there is increasing evidence of street drinking, use of new psychoactive substances (NPS) and poly-drug use within such communities (O’Gorman, 2016), yet criticisms remain about perceived failures of public policy to respond effectively to the needs of individuals, families and communities in these circumstances (Butler and Hope, 2015). The literature suggests that a mix of interventions should be used to increase cohesion, social control and empowerment, while also reducing disorder and promoting healthy norms and behaviours (Stevenson, McNamara and Muldoon, 2014) in such contexts. In the last few decades, however, attempts to effect change are often mediated by the regulation and control of communities and community based social organizations, informed by neo-liberal discourses (Geoghegan and Powell, 2008; Fursova, 2016; Onyx, Chame and Dalton, 2016). These tend to emphasize individualism and competition, reframe citizens as consumers of service provision and constrain advocacy and participation within community development practice (Burkett, 2011). Even where interventions appear to employ outwardly inclusive solutions, community organizations often have to amplify and highlight more negative representations resulting in ‘problem directed resources’, approaches which tend to reinforce structural and geographical inequalities (Saris, 2008). Implementing generative interventions that will engage problematic users, without reinforcing stigma or narratives of individual responsibility, while also retaining funding, becomes a game of ‘neoliberal twister’ (Burkett, 2011). While it has been argued that these pervading discourses tend to render invisible the less tangible community development goals of social cohesion, trust and social justice, opportunities remain for community based organizations to utilize alternative funding and time, energy and skills towards work that has greater alignment with these less visible elements (Onyx, Cham and Dalton, 2016). Maintaining empowering and activist elements in the face of the requirement for resources and demands for state or funder accountability, can be a point of strength for organizations and practitioners (Geoghegan and Powell, 2008, p. 445). The connection to those marginalized and excluded from services may be key to counter this hegemony (Fursova, 2016). What is required are diverse, imaginative forms of engagement with communities that enable social change to occur (Burkett, 2011; Fursova, 2016). It has been argued that to achieve the type of community change that also enables individual change, both social innovation and collaboration, as well as the presence of positive bonding ties between people is essential (Dale, 2013; Maton, 2008; Quigley, 2003). Within this complex context, this study was designed to consider and explore both the structural functioning of a twenty-week community based fitness and education substance use rehabilitation programme and the change processes for participants engaging in the programme. The role of education and fitness in relation to substance use recovery capital for programme participants has been reported on (Morton, O’Reilly and O’Brien, 2016). This article explores the findings in relation to the role of the boxing training element and mentoring aspects of the programme, these being of particular relevance to debates in relation to community based drug service intervention (Jemal and Smith, 2015). Boxing, mentoring and peer support in community settings While the use of education and fitness in substance use rehabilitation programmes (Keane, 2011; Morton, O’Reilly and O’Brien, 2016) have been recognized in the literature, concerns remain about how the individualized nature of activities are understood in the context of wider community needs, an issue made more acute at a time when the advance of neo-liberal discourses affect the community sector in Ireland and other jurisdictions (Burkett, 2011). Given the many obstacles to substance use recovery, including individual and community experiences of structural and social disadvantage and inter-generational patterns of substance use, violence and crime (Quigley, 2003), it has been argued that boxing activities can overcome some of these challenges and build important social networks between individual and community (Van Hout and Phelan, 2014). The boxing gym is often constructed as a site of protection (Wacquant, 2004) or a space where social and individual problems can be partially mediated through mechanisms of negotiation and change (Trimbur, 2011). It is also a site where new social experiences can be realized and socio-economic opportunities emerge (Sacha, 2015). On the other hand, it is argued that boxing clubs can reproduce the hierarchies already present in a community (Sabirova and Zinoviev, 2015). The connotation of the boxing gym then is often characterized by polarities and contradictions: exclusions and opportunity; discipline and excess; resilience and injury; violence and control (Woodward, 2004, p. 5). Wright (2008) argues that, despite these ambiguities, boxing can contribute to enhanced life opportunities and well-being outside and within the gym, particularly for young men: This is no paradox: the groups take the familiar experience of fighting they already identify with and sanction it, control it, structure it, refine it, harness it, give the youth ownership of it, and turn it into an art form to be valued and respected. They recognize their new skills, talent and self-worth. By becoming boxers, they choose to keep it in the ring (Wright, 2008, p. 150). Sacha (2015) suggests that the type of regulation and controls that underpin boxing creates the potential to re-orientate young men towards beneficial working class norms rather than alternatives that include crime, drug dealing and violence. The role of coaches appears crucial here, in particular where the older generation mentor young men and seek to challenge expressions of machismo and enhance positive expressions of masculinity, which in turn can benefit individuals and communities (Dortants and Knoppers, 2012). It is important to analyse the role of mentors and mechanisms of peer support in community based interventions that seek to deal with substance use and other social problems (Kurtz and Fisher, 2003). In their review of the literature, Reif et al. (2014) found that peer support reduced relapse rates, increased treatment retention and helped improve relationships between participants and social agencies. Results from a range of studies consistently indicate the value of peer mentors in modelling the success of treatment pathways and recovery (Lawlor et al. 2014; Rhodes, Reddy and Grossman, 2005). Despite this optimism about the role of peer support and mentors, these approaches have rarely been applied to boxing contexts in community based settings. As noted, this paper seeks to explore the boxing skills and mentoring element of an integrated education and fitness substance use rehabilitation programme. In line with Maton’s (2008) appeal for evaluation approaches that interrogate strength-based portrayals of such settings and interventions, these elements are explored from the perspective of the practitioners and programme participants, while also bearing in mind programme aims and processes (Kemp et al. 2008). Method The setting Boxing Clever is a twenty week, community based rehabilitation intervention involving up to twenty-five individuals, who undertake seven hours per week of educational, physical and substance use rehabilitation activities, offered on a group basis. The programme is based in a socially disadvantaged urban community in Dublin, Ireland, and is delivered in partnership by seven agencies and nine practitioners, including one boxing coach. The co-ordinating community agency provides support and interventions that aim to reduce the negative impact of drug and alcohol use on the lives of individuals and families, and on the community within which it is located. The programme was developed in response to gaps in the provision of structured rehabilitation, sport and fitness services available within this setting. Although participants must be in contact with community, health or social services for substance use behaviours, there are no further barriers to enter the programme, beyond a commitment to the content and schedule. The programme is offered to both current and abstinent drug users, recognizing the skills mix necessary for mentors in these settings (Litt et al. 2009) and to address the fact that educational courses are often only offered to those who have stabilized their drug use or are currently abstinent (Keane, 2011). Two adult education awards are offered, alongside tailored fitness training and boxing skills training. The boxing skills element occurs every other week over the twenty week duration of the programme. The lead coach designs aspects of the programme according to the participants’ varying fitness levels and historical or current substance use. The boxing skills sessions, which take place in a community gym, include strength and conditioning fitness training, boxing and kick-boxing pad work, shadow boxing, self-defence skills, and technical skills such as stance, blocking and sequences of punches. Within the community where the study was based there are a number of boxing clubs within a small geographical area and a history of both amateur and professional boxing success. Participants All of the participants (n = 24) and practitioners (n = 9) from one cohort of the programme were invited to be involved in the research, with seventeen programme participants and eight practitioners responding. Ten of the programme participants were women and seven men, ranging in age from 19 to 49 years, with the mean age range of 35–39 years. The primary substance used by participants was alcohol (n = 6), followed by prescribed methadone (n = 4), cannabis (n = 3), heroin (n = 2), codeine (n = 1) and benzodiazepine (n = 1). Of the practitioners, two were involved in fitness and boxing elements of programme delivery, four in the educational elements of the programme and two in key working and co-ordination. Procedure Ethical approval was gained from the first author’s University’s ethics committee and all participants provided signed consent. The study utilized a qualitative design involving a semi-structured interview schedule that collected data from programme participant and practitioner focus groups in order to capture their experiences (Finlay, 2006). The questions for the interview schedule were developed by the researchers, focussing on the programme participants’ routes through change processes in their lives, and practitioners’ understanding of these processes. Data were collected between November 2013 and March 2014. Four programme participant focus groups were held, two in January and two in March, lasting on average for approximately one hour. Four practitioner focus groups were also held over the data collection period, with an average of six practitioners attending each group. These differed from the participant focus groups, as the practitioners were also asked to reflect on their practice, engagement with participants and the change processes they observed for participants between groups. Each focus group lasted on average ninety minutes. Focus group responses were taped and transcribed, then subject to thematic analysis (Hardwick and Worsley, 2011). This first involved an open coding approach (Strauss and Corbin, 1998), followed by axial coding (Strauss and Corbin, 1998) to identify relationships between categories. Finally, the themes were considered at an integrative level in order to both construct the relationships between categories, but also overarching themes. The process helped in the analysis of the participants’ articulation of their lived experiences (Hussein, 2008) and practitioners’ understanding of the change processes experienced by participants. The discussion of the emergent themes is supported by reference to illustrative quotations. Given the size and nature of the study, research participants have been allocated pseudonyms. Results While the individual’s experience of boxing and their relationships with links to community life were central to the study, educational and fitness outcomes are also noted, as already reported (Morton, O’Reilly and O’Brien, 2016). Nearly all (n = 16) of the participants reported that they maintained their drug free status or reduced their drug use as attributed to participation on the programme, while all of the participants achieved one (n = 2) or both (n = 15) of the programme qualifications (Morton, O’Reilly and O’Brien, 2016). Fitness outcome measures reported positive changes in physical endurance (n = 9), core conditioning (n = 7) and changes in physical flexibility (n = 9). Along with these outcomes, all participants identified positive improvements in their mood which they attributed to the physical exercise element of the programme (Morton, O’Reilly and O’Brien, 2016). The study was particularly interested in the interface between the participants’ experiences and the role that boxing, peers and mentors played within the programme. With this in mind, four key themes emerged; building relationships; physical and emotional impact of boxing skills training; boxing skills training and gender; understanding the mentoring role. Building relationships Relationship building is a key element in community work practice (Emery and Bregendahl, 2014) as well as in substance use recovery (Duffy and Baldwin, 2013). It supports the development of human and cultural capital, as well as providing a basis for bonding and bridging ties within communities (Emery and Bregendahl, 2014). This issue was often apparent in the way that coaches and participants negotiated roles and relationships. Sometimes this was characterized by caution by coaches who resisted a directive approach as a way of encouraging positive behaviours, instead encouraging participants to develop and understand their own physical limits as well as taking responsibility for self-care. As one coach stated: I don’t say ‘you have to do this' or ‘you have to do that’. Most addicts that I know anyway are rebellious, they have problems around authority figures, the Gardai (police), schools. When you suggest something I find I tend to get more out of them, they are more willing to take part. (Peter, Coach) This attitude was recognized to be positive by the following participant: (Coaches name) is very encouraging, I started to go to the Friday class, there was a familiarity with (coaches name), he would ask you to challenge yourself but not push yourself too hard, to get overall healthy, he was encouraging and had an understanding of where we were all coming from. (Nicole, Programme participant) Practitioners generally agreed a more reflective non-interventionist stance would build confidence and self-determination in participants. As one practitioner pointed out, this may differ from other rehabilitative substance use day programmes where staff were more directive: You have to still perform – we don’t have that expectation of anyone. (Steven, Practitioner) The boxing skills coaches stated that they focussed on completion of the exercise rather than expectations of success and perfection, with a view to not only improving technique and performance, but to help build a culture of care and respect: Through the whole course there is a social thing as well, women would come in and have a chat, the guys weren’t doing that at the start, but as time goes on the guys become more sociable before and after each session. Even after the classes I get great respect, with the lads offering to tidy up and carry stuff out to the car. (Peter, Coach) This appeared to have a positive effect on participants, as one put it: They came to us at our level, they met us where we were at, he (coach) would have a laugh and a joke, it was enjoyable. He would bring us into the gym…then we were getting some chance to do a little bit of boxing…some women were sparring. Whoever wanted to do the gym work could. (Joe, Programme participant) The boxing element of the programme enabled participants to utilize local community venues such as a gym and leisure centre. This allowed for both the building of relationships with coaches and other programme participants, and engagement with community life and personal routines. The effect for some participants was a tentative building of connection to community resources and an increased sense of belonging: They have somewhere to go, by going to the gym, they feel part of the community. The (boxing) training is the tool for building relationships with community in a positive way, it empowers them as well, after the 20 weeks and they go to use the gym and other classes. You can see them thinking, ‘I have the right to do this’, they can be part of a fitness gym, you can go anywhere in the world. They can go and join other clubs and be accepted. (Ben, Practitioner) Physical and emotional impact of boxing skills training How we inhabit and experience our own bodies can be a key element in both engaging in personal change processes and in providing leadership to others in our community (Sinclair, 2005: 403). Both the boxing coaches and the participants spoke about the positive, physical impact of the boxing skills training on their well-being. As one participant put it: With the boxing, that worked, we knew that we could push ourselves. (Adam, Programme participant) One of the practitioners explained how he thought the boxing skills training appeared to have had a profound impact on educational and physical well-being: It is the discipline involved, not just sport or the education component. The discipline from the boxing skills is infused across the program, when people come onto the program they can make major changes physically and educationally within 20 weeks, that is a big driver for me. Clients can sit around in programs for years and not attain those outcomes, so for us the physicality of the boxing is an important part. (Ben, Practitioner) An interesting finding from the study was how the experiences of participants’ personal developmental issues appeared to bridge into perceptions of community life. In becoming part of the local leisure centre they appeared to have access to hitherto unavailable community space. As many of the participants live in situations where personal and community violence are everyday risks, the discipline and skills involved in the boxing enabled them to defend themselves from violence and find ways to contain and express anger and other emotions in safe ways. The practitioners offered a number of explanations about how the training might be enabling the participants to deal with the challenges and threats they experienced in their community: For some of the men, the program has transformed them. They are not as fearful because they are able to defend themselves better. They might have been going around (the community) in fear, now they are not as fearful and less likely to use a weapon, they can defend themselves in an honourable way. (Peter, Coach) The importance of introducing principles and practices of discipline appeared central to these processes: Giving them discipline is important. Some of the participants might be swinging punches but the program gets them to focus their minds and have a clear idea of where they are going. A few guys thought they were invincible and there is learning for them on the program. They realize in the boxing that somebody can beat you and not to be putting themselves in danger. (Peter, Coach) Boxing skills training and gender Popular discourses on gender and sports often suggest that men and women have different capabilities, occupying different roles, spaces and activities (Martos Garcia, Devis-Devis and Sparkes, 2009). The Boxing Clever programme sought to challenge such stereotypes, led by the boxing coach, in particular in articulating non-binary views on traditional and non-traditional notions of gender. Mirroring some of the participants’ experiences, he spoke of being bullied or subject to physical violence as a way of interpreting how he related to them: Well, I came from that space myself, where if I wasn’t trained I would’ve been bullied; even today, I would feel I could be bullied as a man, even on building sites or whatever where I have worked; but when they know you’re a boxer you wouldn’t be bullied. It’s kind of primitive in a way, but a man’s world is different that way. (Peter, Coach) It was not surprising that some men in the group were sceptical about the capacity of women to complete the programme; such perceptions tend to be reproduced where coaches and educators reinforce gender stereotypes and when sporting activities are divided on lines of gender (Martos-Garcia, Devís-Devís and Sparkes, 2009). The practitioners felt that boxing had the potential to challenge such gendered norms, one way of dealing with this was to try to understand, and deal with problems of self-consciousness expressed by women, particularly at the start of the programme. The boxing coach described how he split the group according to their fitness level and previous experience of sport, rather than gender, to break down such norms: They are all together in the same boat, actually enjoying it, the women were talking about it, they were all being challenged in the same way. (Ben, Practitioner) Another practitioner agreed with this approach: You never hear them (the participants) saying that the men do this, and the women do that. The women are offered the same program …it is not the men can do the boxing and the women can do the water aerobics, we are not already setting them up, this is a program and it’s an option for everybody. (Catherine, Practitioner) The boxing coach also explained how he had enabled women to use the medium of boxing to express anger and frustration with the problems of everyday life: With women it is about them realizing it is ok to get in touch with anger, some will be placid like they are afraid to show aggression, for me, saying to them it is ok, this is an opportunity to release anger. (Peter, Coach) Understanding the mentoring role The way in which the mentoring role developed in the program was relatively unstructured. Initially the practitioners had observed that men in the community would seek informal support from peers who had substance use problems but were also involved in sport. In their responses, practitioners considered and identified the qualities needed for a mentor that included being trustworthy and reliable, to have addressed their own substance use issues and to have a connection with sport, preferably boxing: They need to have sport in their lives and be in recovery and they have to able to link with other people and are open to providing the supports that people would need. (Ben, Practitioner) As the mentor also participated in the program, they needed to be able to complete the educational elements, as well as provide leadership and guidance. Practitioners also felt it was important that the mentor had the capacity to ‘be one of the group’ as well as provide leadership, which they noted was a difficult dynamic to negotiate: Yes, and that can take away from the group idolizing them as well, not making them vulnerable, putting them on a pedestal; I do think it took people a while to get used to that initially; he was almost among them before they realized he was a mentor. (Eleanor, Practitioner) Another practitioner added: Its role modelling really, being able to say ‘I’m not perfect’ and having that sort of humility to be able to say that to the group as well and look for help if you need it. It gives them a hope, when they see the mentors have gone on ahead, can relate to them, a lot the people are coming from a place of mistrust and then they see this happening and it gives them hope. (Peter, Coach) Impact of mentoring Beyond the mentoring style of the boxing coach, participants sometime spoke about ways in which peer mentors had affected them and their participation within the program. It helped that mentors often had also been involved in problematic substance use and drug related crime. These experiences could be viewed as positive: I only ever had a negative impact on my community. Now I am helping rebuild the community that I was destroying. (Jason, Programme participant and mentor) Other positive experiences were attributed to the mentoring role, for example in terms of personal development and engagement with difficult thoughts and experiences: I did not know what to expect, I had never done anything like that before, I had to push past a lot of uncomfortable feelings, but it was something I wanted to do…… I just kept doing what I thought was right. (Jason, Programme participant and mentor) Participants found the involvement of peer mentors to be generally positive. Although there were moments of discomfort in discussing their worries and problems with peer mentors, initial conversations usually paved the way to more open, trusting relationships between the participants and the practitioners. Because the mentor was perceived to be both ‘one of them’ they were better able to provide guidance and help: I found it was nice to have someone there, because (mentor’s name) is very calm, he would always say it is all ok, we will get it sorted. He (mentor) had to get the work done…he was always part of the group. It was a great thing to have a mentor. (Nicole, Programme participant). Discussion The findings from the study suggest that the boxing component of the programme, although challenging, appeared to create opportunities for personal growth, self-awareness and self-knowledge amongst participants, all important aspects of sustained recovery from substance use (Best et al. 2012), and social problems that often affect marginalized communities (Sacha, 2015). Peer support within the gym, which could also be maintained through the coaching relationship, allowed the participants to build relationships based on principles of discipline provided by boxing. Those with substance use histories may have a history of fractured relationships, internalized stigma and shame (O’Reilly, 2014). The coaching relationship enabled the participants to experience both physical and emotional intimacy, but in a context contained by rules and boundaries and within a setting that had status within the community. However, it could be argued that this dichotomy of the ‘disciplined’ body (Wacquant, 2004) verus the ‘undisciplined’ drug user only serves to reinforce yet another set of restrictive, binary identities for those seeking recovery from substance use. The positioning that the coach took in relation to accepting the participants’ limitations and digressions may be key in negotiating this dilemma. The ability to experience and manage one’s own mental and physical well-being in a positive way and develop a sense of self-efficacy are further aspects of building personal capital for those seeking recovery from substance use (Kadden and Litt, 2011). Developing the ability to be physically present can free participants from worrying about the future or having regrets about the past, and can connect people to their emotions and feelings (Sinclair, 2005). As many of the participants live in situations where personal and community violence are everyday risks, the discipline and skills involved in the boxing element provide both a way for participants to defend themselves from violence and a contained way to experience and express anger and other emotions. It has been argued, however, that there may be paradoxical effects of boxing in community settings where substance use is prevalent (Wright, 2008). Being able to ‘handle yourself’ in the face of violence or threat, and using boxing to channel and manage anger can be the very qualities that are attributed with value by gangs involved in the drugs trade (Garot, 2015). In negotiating this paradox, it may be that the boxing skills training has been refined and developed by the coaches to forefront personal limits and emotional regulation that ensures the experience is generative rather than reinforcing of negative community and personal norms (Wright, 2008). Approaches to sport and fitness within rehabilitation programmes can reinforce traditional gender norms, and these are often underpinned by coaching narratives about machismo and ‘hardness’; these understandably tend to create barriers that women can find difficult to negotiate (Martos-Garcia, Devís-Devís and Sparkes, 2009; Sabirova and Zinoviev, 2015). It appears the contradictions endemic within boxing, this time in relation to gender (Mennesson, 2000) did affect the structure and processes associated with the programme. The practitioners did try to create opportunities for women to participate in meaningful ways in activities normally restricted to men, however, the assertion that women are better able to defend themselves and manage physically threatening behaviour implicitly places responsibility with women to contain or manage men’s violence (Hollander, 2005). Whether the presence and participation of women in the boxing skills training was in anyway disruptive of traditional norms was not a question explicitly explored in this study. However, Deuchar and colleagues (2016) found that even the ‘subtle introduction’ of women into the boxing gym created opportunities for the men to ‘perform broader versions of the locally dominated enactment of masculinity’ (736). Beyond this, the boxing skills training did encourage participants to use their bodies intentionally and at times with determination, something women were less likely to have experienced in growing up and in their lives (Mennesson, 2000). For both men and women this intentional use of the body may provide a contrast to disconnecting from their physical body through substance use (Price et al. 2012). Training in intentional physicality may be particularly positive for women beyond being a release of anger and other emotions; this experience of being physically strong and/or capable can help revised notions of the self at this immediate, visceral level (Hollander, 2005). The findings suggest that participating in boxing skills training offered participants the opportunity to reframe existing identities and, at times, seek rapprochement with their community; a ‘boxer’ rather than ‘addict’ identity seemed to bridge this space. This construction of a non-addict identity is an important feature of substance use recovery processes (McIntosh and McKeganey, 2000; Neale et al., 2015), and works to actively challenge the stigma and shame individuals may have internalized from being labelled as ‘addict’ (Radcliffe and Stevens, 2008). This also provides an alternative to the person identifying as a ‘recovering addict’, which can also be associated with stigma (Larkin and Griffiths, 2002). There has been little focus in the substance use literature to date on how a non-addict identity connects with inclusion within one’s community. However, in considering identity and inclusion within mental health services, Fieldhouse (2012) found intentional use of social capital development was critical in supporting people’s recovery. Fieldhouse refers to the ‘restorative potential of community’ (2012, p. 584) and the importance of creating a ‘robust bridge’ from clinical and intervention settings to ordinary settings characterized by community engagement and participation. It can be argued that the boxing gym is such a bridge, particularly for those seeking to build an alternative identity within communities where fragmentation, disadvantage and exclusion are features. The boxing gym can be both understanding and transforming of daily tensions, challenges and difficulties of seeking recovery within socially disadvantaged communities. It could be argued, once nested within other educational and emotional supports, gyms can become an ‘empowering setting’, which Maton (2008) maintains can be critical in enhancing quality of life and achieving social justice for those marginalized or oppressed within society. The study also indicates the crucial role that coaches play in this mentoring role in supporting positive change, allowing for conflict and digressions in terms of substance use and sustaining positive engagement with peers and, indirectly, their communities. For the participants, it was important the mentor was ‘one of them’, yet also offered role-modelling in terms of leadership and enactment of personal agency (Dale, 2013) that could potentially support long term, positive life changes in others. For the practitioners, the ability of the mentor to manage personal and professional boundaries within this mentor role contributed to the success of the programme and positive outcomes for participants (Morton, O’Reilly and O’Brien, 2016). This role may differ from traditional approaches to peer support that are based on shared experience (Kurtz and Fisher, 2003), as the mentor also supports participants to negotiate systems such as education and community support by both evidencing their own pathways and by encouraging progression. Conclusion Seeking generative and participatory solutions to drug issues within socially excluded communities remains an ongoing challenge, particularly in the face of neo-liberal pressures that prioritize individual treatment episodes and substance use abstinence as key success indicator, rather than progressive support and community re-integration. The programme considered in this paper is a low cost inter-agency intervention that provides support to those typically excluded or restricted to certain types of service provision. Boxing and the boxing gym hold a certain status within many disadvantaged communities, which may provide a unique motivational hook for those seeking to address their problematic substance use. The positive attributes associated with the boxer identity has the potential to provide a pathway to an alternative to ‘the addict’ identity, particularly in communities characterized by violence and risk (McIntosh and McKeganey, 2000; Morton, O’Reilly and O’Brien, 2016). Boxing skills training, particularly when associated within a range of educational and emotional supports can contribute to the development of an empowering setting within a community. The approach of the boxing skills coach may also be a critical element in encouraging self-efficacy and self-regulation in these contexts, as well as aiding in building recovery capital (Cloud and Granfield, 2008) and supporting the development of identity based on more generative aspects of the self. The coaching approach and techniques have the potential to challenge gender norms in relation to sport and fitness, while also supporting all participants to utilize their physical bodies with intent and focus. The inclusion of programme mentors is an important consideration for substance use rehabilitation programmes, as it can illustrate progression, motivating programme participants and helping sustain positive change. Limitations This was a qualitative study, utilizing a convenience sample of participants and coaches within one cohort of a substance use rehabilitation programme. For this reason, the findings cannot be generalized to wider populations. 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( 2008) Keep it in the ring: using boxing in social group work with high-risk and offender youth to reduce violence, Social Work with Groups , 29 ( 2–3), 149– 174. Author notes Dr Sarah Morton is an assistant professor and director of the Community Partnership Drugs Programme in the School of Social Policy, Social Work and Social Justice at University College Dublin. She has a special interest in the intersection of drug policy and practice. Karl O'Brien is a community addiction counsellor in Ballymun Youth Action Project. With many years of experience delivering substance use interventions within communities in Dublin, he has a particular interest in the practice–research interface relating to drugs intervention. Dr Laura O'Reilly is the co-ordinator of Urrús Addiction Training Centre, Ballymun Youth Action Project. With many years delivering professional skills development in the drug and alcohol sector, recently her research interests have focused on practitioner and organisational capacity building to respond effectively to drug issues within communities. © Oxford University Press and Community Development Journal. 2018 All rights reserved. For permissions, please email: journals.permissions@oup.com

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Community Development JournalOxford University Press

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