The Holyoake DRUMBEAT program as a prevention
and early intervention program for those ‘at risk’ of
problematic drug and alcohol use.
About DRUMBEAT
DRUMBEAT (Discovering Relationships Using Music, Beliefs, Emotions, Attitudes, & Thoughts) was designed by Holyoake in 2003 as an early intervention strategy to prevent, and increase resilience to, drug and alcohol use. The program uses hand drumming to address a range of recognised ‘risk factors’ associated with problematic drug and alcohol use. DRUMBEAT engages participants, builds social kills, increases self-esteem and explores connections between making music together as a group and the development of healthy relationships. The program targets both young people, (from 10 years of age), and adults who are resistant to talk-based therapies. The aims of the program are to:
• Reduce a range of ‘risk factors’ - that are associated with negative health and social
outcomes including drug and alcohol misuse;
• Reduce social isolation and alienation - by increasing social competence and levels of
self-esteem;
• Promote empowerment through responsibility – within a framework of healthy values and
mutual respect
• Build on the therapeutic value of musical expression - by integrating themes and
discussions into the program structure that raise awareness of the social factors that are critical in developing healthy relationships with others.
• Change the life direction of those people by developing ‘protective factors’ and mitigating
the need for drugs and alcohol.
The Holyoake DRUMBEAT program achieves this through a framework of fun, experiential learning using hand drumming, and a cognitive behavioural approach where analogies draw participants’ attention to connections between their experiences in the drum circle, and their relationships in the wider community.
DRUMBEAT involves up to 10 participants in 10, one hour sessions with specific themes including Self-responsibility, Values, Emotional Expression, Identity, Peer Pressure, Harmony and Teamwork. Importantly, participants are engaged in five
core activities that deliver the critical learning outcomes
• Learning drum songs(with interlocking patterns) - that support teamwork through a shared
experience and increase levels of focus, concentration, and commitment
• Playing rhythm based games - that raise awareness of specific relationship issues that
impact critically on an individual’s social health – exercises explore peer pressure, communication, and dealing with emotions amongst others
• Conversations – that promote insight into key relationship issues and connect the group
experience to those in real life
• Improvisation – a music technique that promotes self-belief, creativity and flexibility in
dealing with change
• Performance – that allows for recognition of effort and new potential whilst connecting the
participant to a broader community
In DRUMBEAT, the music created by the group serves as a direct reflection of the participant’s ability to work together and their social competence. The program deliberately avoids any opportunity for competition and instead focuses strongly on teamwork and the benefits of working with others to achieve things unobtainable as an individual; This then transfers into skills and consciousness that support that same young person in a range of other group situations; leading to reduction in social isolation and alienation.
The Holyoake DRUMBEAT program has been designed to address the major ‘risk factors’ associated with drug and alcohol misuse including poor peer relationships, low self-esteem, dislocation from school, alienation, experimental drug use and poor use of recreational time 1(Ryder, Salmon & Walker, 2001). DRUMBEAT incorporates key exercises and conversations that directly address each of these ‘risk factors’; for example – The Peer Pressure Challenge, The Risk game, The Communication game, The Connecting to Community exercise. The music making develops pro-social skills such as sharing, tolerating difference and problem solving which serve the participant well in other social contexts (2Hallam, 2009).
The program has been designed to engage those population groups most ‘at risk’ of drug and alcohol misuse and has been successful in engaging individuals who are reluctant to engage in traditional talk based therapeutic approaches, for example alienated youth, prison populations, people with co-morbid diagnosis and refugees. Despite access to broad prevention initiatives Holyoake recognises that these individuals need more intensive support if they are to reduce the number of ‘risk factors’ that contribute to their over-representation in the statistics associated with problem behaviours and poor health outcomes.
Furthermore:
• DRUMBEAT is widely used across the state in a wide range of settings with a diverse
range of ‘high risk’ client groups;
• The program is an empowering strategy building self-esteem, insight and key social skills
that lead to increases in resilience;
• The program, unlike many others, avoids focusing on the negative and the problems of the
behaviour, and instead takes a strength based approach
• The program is highly enjoyed by participants – 95% enjoyment rate 3(UWA Research
Report 2010);
1
Ryder, D., Salmon. A., & Walker.N. 2001 Drug use and drug related harm – a delicate balance. IP Communications, Australia
2
Hallam, S. 2009. The Power of Music: its impact on the intellectual, social and personal; development of children and young people. Paper commissioned by the Performing Right Society, Retrieved 10th August, 2009 from: http://www.ioe.ac.uk/Year_of_Music.pdf
3
Ivery, P., Wood, L., Rosenberg, M., and Donovan, R. 2009. An Evaluation of a Therapeutic Intervention Using Music “DRUMBEAT” Discovering Relationships Using Music – Beliefs, Emotions, Attitudes & Thoughts with Alienated Youth. Health Promotion Evaluation Unit, School of Sport Science, Exercise & Health in conjunction with School of Population Health, The University of Western Australia, (In Press).
• Holyoake has implemented a Facilitator Training Program to enables the benefits of the
program to spread and empower local communities with the resources to deliver it; and
• The program has been fully evaluated, with three published, peer reviewed, journal studies
and has been proven to have a significant impact on participants – refer to selection criterion 2 below.
Holyoake has also developed two adapted versions of the DRUMBEAT program to meet the needs of specific populations.
1. DRUMBEAT as a unit of curriculum – can be studied in several states including WA as a school subject in personal development in years 10, 11 & 12 with credit towards end of school graduation.
2. DRUMBEAT for Complex Needs – developed in conjunction with Bentley Adolescent MH Services and The Department of Child Protection, to meet the needs of young people with complex diagnosis including Autism and Post Traumatic Stress Disorder
Reducing Harm from Alcohol and Drugs
The Holyoake DRUMBEAT program reduces recognised ‘risk factors’ and increases known ‘protective factors’, leading to an increase in a young person’s resilience (4Faulkner et al, 2012). The Key to prevention is risk management - the greater the number of protective factors the less likely the problematic use of drug and alcohol (5Silburn, 2008). Protective factors occur in the same domains as risk factors, and involve connections to pro-social pursuits and relationships inside and outside the family (6Liddle 2002).
‘Risk factors’ have been identified that predict the increased likelihood of problems such as harmful drug use, crime, violent behaviours, school dropout and mental health issues that impact on the healthy development of young people (7Hawkins, Catalano & Miller 1992; 8Bond et al 2000; 9Beyers et al, 2004). Research indicates that higher numbers of risk factors are associated with a higher likelihood that an adolescent will develop a drug problem (10Newcomb 1987; 11 Loxley et al, 2004).
4
Faulkner,S.,Wood.L., Ivery.P., & Donovan, R. 2012 It’s not just music and rhythm... evaluation of a drumming based intervention to improve the social wellbeing of alienated youth, University of Western Australia (In Press).
5
Silburn, S 2008, ‘Chart of protective and risk factors over life developmental stages’, unpublished, ARACY, Perth.
6
Liddle H. (2002). Multidimensional Family Therapy Treatment (MDFT) for adolescent cannabis users: Vol. 5 Cannabis Youth Treatment. (CYT) manual series. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration.
7
Hawkins, JD, Catalano, RF & Miller, JY 1992, ‘Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention’, Psychological Bulletin, vol 112, pp 64–105.
8
Bond, L, Thomas, L, Toumbourou, J, Patton, GC & Catalano, R 2000, Improving the lives of Young Victorians in Our Community: A survey of risk and protective factors, Centre for Adolescent
Health Report prepared for Community Care Division, Department of Human Services, ISBN 174056 001 9.
9
Beyers, JM, Toumbourou, JW, Catalano, RF, Arthur, M & Hawkins, JD 2004, ‘A cross-national comparison of risk and protective factors for adolescent substance use: The United States and Australia’, Journal of Adolescent Health, vol 35, issue 1, pp 3–16
10
Newcomb M (1987). Causes and consequences of adolescent drug use: Impact on the lives of young adults. California: Sage Publications.
11
Loxley, W., Toumbourou, J., Stockwell, T.R., Haines, B., Scott, K., Godfrey, C., Waters, E., Patton, G.,
DRUMBEAT has been recognised as an innovative and successful way to engage hard to reach populations averse to traditional and often confronting therapies. These groups include Aboriginal and Torres Strait Islander youth, people from other cultures with limited communication skills and people with mental health illnesses. DRUMBEAT has, in a range of independent studies, been found to impact significantly on risk factors, (reductions of 30%) and transfer skills that build resilience and reduce the chance of problematic drug or alcohol use (12Faulkner et al, 2010).
Another important outcome of DRUMBEAT is the introduction of recreational music making into the lives of participants whose unproductive use of their recreational time is a key ‘risk factor’(13Andrews and Bonta, 2003). People today use music regularly to regulate their feelings, for comfort and support, and for energy and exhilaration. Being able to play music with others offers further benefits – a safe connection between people, a sense of belonging and an avenue for creativity. Recreation music making using rhythm based instruments, (drums and percussion), is a growing recreational movement worldwide and enables people to connect to each other across the barriers of culture, age, gender and language. Participation in music-making groups promotes friendship, trust, cooperation and collaboration. Judgements and misrepresentations common to communication through language are avoided in the music group (14Friedman, 2000).
Holyoake has made the DRUMBEAT program available to any agency working with young people and adults ‘at risk’. This has been achieved by Holyoake providing a three-day Facilitator Training Course to individuals wanting to run the program in their own school or agency location. In this way, thousands of people are benefiting through access to the DRUMBEAT intervention each year rather than the hundreds that Holyoake could reach through its own treatment programs.
The DRUMBEAT program is delivered in a format that empowers participants to shape the content of each session. Participants are given control of behaviour, (within boundaries), conversational topics (within boundaries), musical composition, (through improvisation) and the performance element of the program. This provides them with opportunities to express themselves and ensures that the progam content is relevant to their lives.
The DRUMBEAT program is based on Social Learning theory and Family Systems theory which place the social context as a primary influence on behaviour. Participants learn to distinguish between healthy and unhealthy relationships in order to be able to develop the types of relationships and support that foster healthy and happy lives.
DRUMBEAT combines the therapeutic potential of musical expression with cognitive behavioural therapy to deliver a range of social learning outcomes, including emotional control, improved relationships and increased self-esteem. Increasing social competencies is seen as a means of reducing alienation and increasing a young person’s ability to form important social support networks critical to avoiding problematic mental health outcomes and the associated likelihood of drug and alcohol use as a coping strategy (15Mrazek & Haggerty, 1994).
substance use, risk and harm in Australia: A review of the evidence. National Drug Research Institute and the Centre for Adolescent Health.
12
Faulkner, S., Ivery, P., Wood, L., & Donavon, R. 2010. The Australian Journal of Indigenous Education, Vol 39. Pp 98-109
13
Andrews D. A., & Bonta, J. (2003). The psychology of criminal conduct (3rd ed.). Cincinnati: Anderson
14
Freidman, R.W. 2000. The Healing Power of the Drum, White Cliffs Media, Reno, Nevada
15
DRUMBEAT has been embraced by a wide range of organisations working with socially isolated or alienated individuals because of its ability to transfer social learning in an enjoyable and non-threatening way. The experiential focus of the program is in line with traditional Aboriginal learning strategies 16(Trudgen, 2000), and allows for greater engagement. Currently over 200 schools across WA utilise the Holyoake DRUMBEAT program to engage students with attendance and behavioural problems, and promote social inclusion; many of these schools have high levels of Aboriginal students and are in remote or regional locations.
DRUMBEAT is now a part of the therapeutic resources of schools, youth centres, mental health clinics, refugee trauma centres, child protection units, and custodial facilities across Australia. In WA, its usefulness has been demonstrated by the wide variety of organisations that incorporate it into their work. These include the Banksia Hill Juvenile Detention Centre, The Department of Child Protection, Disability Services Commission (Complex Needs Section), Refugee Trauma Association, Princess Margaret Children’s Hospital, Sir Charles Gardiner Hospital Psychiatric Unit, Bentley Mental Health Family Unit, Goldfields Sexual Assault Referral Centre, plus many more.
The DRUMBEAT program is also used by many Australian drug and alcohol services including in Western Australia: the Pilbara Drug, Alcohol, & Mental Health Service, The Wheatbelt Community Drug Service Team, Cyrennian House; The Youth Substance Abuse Service (YSAS) in Melbourne and the Drug and Alcohol Service of South Australia (DASSA), among others.
Innovation and Best Practice
‘Psychosocial interventions are a key component of any comprehensive prevention or treatment
program and can involve group therapy or individual counselling. …counselling alone is not usually sufficient to change the drug taking behaviour of most clients’ 17(Jarvis et al., 1995). Teaching effective self-management skills and social
skills (improving personal and social competence) offers the potential of producing an impact on a set of psychological factors associated with decreased drug abuse risk (by reducing internal motivations to use drugs and by reducing vulnerability to pro-drug social influences), (18Botvin, 1999).
The DRUMBEAT program uses an innovative approach to engaging young people and adults that are currently not engaging in mainstream preventative approaches. Best practice research supports a multi-dimensional approach to prevention initiatives and treatment, and emphasises the need for flexibility; particularly in relation to reaching young people, (19Marsh, Dale & Willis, 2007). Agencies and counsellors must be creative and flexible in their approach to young people. Working with alternative mediums, (such as music), and outside the traditional treatment setting are often important components of effective treatment with adolescents.
Prevention Intervention Research, National Academy Press, Washington, DC.
16
Trudgen, R. (2000). Why Warriors Lie Down and Die. Darwin, NT: Aboriginal Resource and Development Services Inc.
17
Jarvis, T.R., Tebbutt, J. & Mattick R.P. 1995, Treatment Approaches for Alcohol and Drug Dependence. An Introductory Guide, John Wiley & Sons Ltd., Chichester, England.
18
Botvin, G. 1999. Preventing Adolescent Drug Abuse through Life Skills Training: Theory, Evidence of
Effectiveness, and Implementation Issues. Institute for Prevention Research, Cornell University Medical College. Accessed June 18th 2012 http://www.tanglewood.net/projects/teachertraining/Book_of_Readings/Botvin.pdf
19
Marsh, A., Dale, A., & Willis.L. 2007 Evidence Based Practice Indicators for Alcohol and Other Drug Interventions: Literature Review 2nd Edition, West Australian Drug & Alcohol office Publication.
The use of music based approaches in the drug and alcohol prevention and treatment sector is now widespread and accepted by many as a useful complimentary therapy (20Winkleman, 2003). Keen (212004) demonstrated the use of music during treatment to be a useful mechanism for gaining the trust and confidence of adolescent clients.
Developed in conjunction with Aboriginal workers in the Wheatbelt region of Western Australia the DRUMBEAT program replicates best practice principals in working with Aboriginal youth (Casey & Keen, 200522), including utilising social learning theory and complimenting traditional modes of learning through an experiential modality. The program has a strong relationship focus that is directly linked to the best practice focus on building stronger families, strengthening autonomy and empowerment through responsibility. The DRUMBEAT program has a strong reputation in Aboriginal and Torres Strait islander communities across Australia.
Holyoake has a strong commitment to validating practice through research and the DRUMBEAT program has been developed in large part through an action based research approach that continues today. Over the past two years, four research projects have been conducted in relation to the DRUMBEAT program. The most significant was an independent study by the University of Western Australia in 2009 (Ivery et al, 2009)23, that traced the impact
of the program with over 190 young people, many indigenous and many from regional WA.
All had significant risk factors and many were recreational drug users.
Both the quantitative and qualitative components of the evaluation reflected positive changes on a number of measures that serve as indicators of ‘risk’ for young people. For example, there was a 10% increase in self-esteem scores by the end of the program, 29% of participant’s had a decrease in behavioural incidents and 33% had a decrease in half-day unexplained absenteeism. The feedback provided by teachers in the open ended questionnaire and in the interviews provides a valuable complement to the empirical findings, with many of the comments and quotes capturing insightful glimpses of the positive ways in which the program impacts on both students and the school.
The Summary to this report concluded:
‘While drumming per se can provide much fun and enjoyment, it is clear that the success of the Holyoake DRUMBEAT program is due to much more than this. Both the content and mode of delivery have been developed with sound consideration of evidence relating to risk factors, student learning models, group processes and behavioural outcomes. Although many arts programs report anecdotal accounts of positively impacting on participant’s wellbeing, there is often a dearth of evidence. DRUMBEAT is an exception in this regard, with a comprehensive range of measurement and evaluation tools used with participants each time the Holyoake DRUMBEAT program is delivered’.
20
Winkelman, Michael, “Complementary Therapy for Addiction: Drumming Out Drugs,” American Journal of Public Health; Apr 2003, Vol. 93 Issue 4, p647, 5p 9.
21
Keen, A. W. (2004). ‘Using music as a therapy tool to motivate troubled adolescents’. Social Work in Health Care, 39: 361-373.
22
Casey W & Keen J (2005). Strong Spirit Strong Mind, Aboriginal alcohol and other drugs worker resource: A guide to working with our people, families and communities. Aboriginal Alcohol and other Drugs Program, WA Drug and Alcohol Office
23
Ivery, P., Wood, L., Rosenberg, M., and Donovan, R. 2009. An Evaluation of a Therapeutic Intervention Using Music “DRUMBEAT” Discovering Relationships Using Music – Beliefs, Emotions, Attitudes & Thoughts with Alienated Youth. Health Promotion Evaluation Unit, School of Sport Science, Exercise & Health in conjunction with School of Population Health, The University of Western Australia, (In Press).
A study conducted by occupational therapists working with comorbid patients at Sir Charles Gardiner Psychiatric Unit found that participating clients reduced their level of anxiety, improved their level of mood and had improvements in cognitive clarity and focus. Additionally,
DRUMBEAT has positive health impacts including improving emotional regulation, (Featherstone, 2009)24’
For a visual overview of the DRUMBEAT program, please refer to the video (8 minutes) produced by Holyoake http://www.holyoake.org.au/content-red.php?CID=37
Involving Key Stakeholders
The Holyoake DRUMBEAT program is a unique intervention developed in Western Australia and is in demand across Australia with over 2,000 trained facilitators. The program engages with key stakeholders through a range of strategies including:
• Facilitators Newsletter (refer to attachment) – produced monthly, the DRUMBEAT
Newsletter is designed for facilitators who have completed the three day training program. It provides up-to-date news and information on key developments and a forum for sharing news and achievements of DRUMBEAT facilitators from all over Australia.
• DRUMBEAT Accredited Facilitators Guild – the quality delivery of the Holyoake
DRUMBEAT program is managed through an accreditation system which enables trained facilitators to progress through several levels of qualification in DRUMBEAT. Accredited facilitators are eligible to join the DRUMBEAT Guild at no charge, and have access to a secure part of the Holyoake website at http://www.holyoake.org.au/content-red-login.php?CID=35 where they have access to the latest information, resources and the ability to share research and evaluation with other facilitators.
• Facebook - The DRUMBEAT Facebook page www.facebook.com/HolyoakeDRUMBEAT
was launched to the public at the start of May 2012, and up to early June had received 137 ‘Likes’ – this means that 137 individuals had linked their Facebook profiles to Holyoake’s DRUMBEAT page to receive notification of any news, posts, videos or photos in the services first month. The DRUMBEAT Facebook page is seen as a conduit between clients and a means of providing ongoing support in keeping with Holyoake’s resilience model that focuses on offering support across the lifespan. Young people can connect to the DRUMBEAT Facebook page and win prizes as well as talk to DRUMBEAT counselling staff and locate additional support services. DRUMBEAT staff have commenced including the Facebook page into the facilitator training program, encouraging trainees, to encourage their clients to engage with the page and enabling Holyoake to provide additional online support to those who choose to connect online.
• You Tube Channel – stakeholders have the opportunity to visit and/or subscribe to the
Holyoake DRUMBEAT Channel on You Tube located at
http://www.youtube.com/user/holyoakedrumbeat?feature=results_main Through this medium, stakeholders can view videos, upload their own videos as well as post comments about DRUMBEAT.
24
Featherstone, J. 2008. A Formative Evaluation of the Therapeutic Intervention DRUMBEAT with Patients from the Psychiatric Ward at Sir Charles Gardiner Hospital., Unpublished report to Sir Charles Gardiner Hospital, Perth W.A.
Achievements
The DRUMBEAT program has made a difference in the lives of many people, young and old, and become embedded in schools, youth services, mental health services, drug and alcohol rehabilitation facilities and prisons. Demand for this training in regional and remote Australia continues to grow with a growing number of services utilising the program.
Since 2009, the DRUMBEAT program has been recognised through the following key awards:
• West Australian Community Services Excellence Awards in 2010 - The DRUMBEAT
program won the category for best program design and delivery for a medium sized organisation; and
• National Drug and Alcohol Awards in 2009 – The DRUMBEAT program was a finalist in
category for service to young people.
• Invitation as Keynote presentation at the USA National ‘At Risk’ in Education conference,
Florida, February 2013
A number of Government Departments have also incorporated DRUMBEAT into their therapeutic models of care. These include:
• Education Department (Attendance Directorate) – several regions have incorporated
DRUMBEAT as part of their core student attendance strategy;
• Department of Child Protection - incorporated DRUMBEAT into each of its residential units
and trained all of its 150 residential staff; and
• Princess Margaret Children’s Hospital – Holyoake has trained over 20 clinical staff who are
using DRUMBEAT in both inpatient and outpatient settings.
The success of the DRUMBEAT program is reflected in the inspiring feedback provided by numerous facilitators and participants in the program – recent program feedback includes:
"Very solid program, just what our young people need to get them to a place where they can make healthy choices, where they can safely experience being a valued member of the community, and where
they can take control of their lives in ways that are meaningful to them”. Melissa Sellick, Psychologist, Head Space
The Holyoake DRUMBEAT Program is highly valued in our school community, especially the focus on relationship issues which include looking at boundaries, values, peer pressure, rumour & innuendo, communication, bullying, identify, social responsibility, harmony and teamwork. Every participant gains
valuable recognition for their skills, the effort they put into the performance as well as increased acceptance and self-esteem.
Jo Talbot, Teacher O’Connor Primary School, Kalgoorlie
I have delivered the DRUMBEAT program to Aboriginal adults in Broome prison and in the local Drug and Alcohol rehabilitation facility. During these programs I have seen first-hand the benefits of this program
both in being able to engage extremely alienated young people and people from a range of cultural backgrounds as well as impact positively on their behaviour and self-esteem.
In my work I see the harm done when people facing social challenges such as drug and alcohol abuse, get no support. Programs such as DRUMBEAT provide the first barrier to ongoing lives of harm and
destruction that impact on all community members Jo Tighe – Kimberly Mental Health Service
