Capability Expansion: A new policy and practice approach to working with young people in AOD care?

Background:
This research project draws on the Capability Approach to identify young people’s aspirations and their opportunities to achieve these. Our purpose was to use the Capability Approach to widen the scope of current AOD approaches which can be overly focussed on clinical treatments, to ones that grow young people’s capabilities to manage their substance use.

The Capability Approach has been used to guide policy and practice in the mental health, homelessness and education sectors, but is yet to be widely explored for its value in health or Alcohol and Other Drug sectors. Originating in economics (Sen, 1997) and philosophy (Nussbaum, 2011), the Capability Approach emphasises two key dimensions: the relevance of opportunities (whether they align with people’s values and aspirations) and the capacity to convert these opportunities into desired outcomes. Specifically, it identifies 1) ‘functionings’ or the kind of lives that are valued and sought out, and 2) ‘capabilities’ or the practical and real opportunity within the conditions of a person’s life to achieve their aspirations. The approach helps to extend focus beyond substance use outcomes, and give attention to quality of life, diverse recovery pathways, self-determination and long-term wellbeing. It also enables identification of gaps between resources and their effective use, pointing to opportunities for more sustained and holistic support.

The Study:
This study draws on qualitative, modified life history interviews with 17 young people in New South Wales and Victoria who have completed intensive AOD treatment and are engaged in outreach support. Interviews explored participants’ aspirations and understandings of a “good life,” as well as the opportunities that enabled them to reach their current circumstances. Guided loosely by Nussbaum’s (2011) framework, questions addressed domains such as safety, work, education, family, and belonging, while remaining open to participants’ own interpretations and priorities.

Policy and practice focussed on ‘capability-expansion’:
The research hopes to broaden the scope of AOD policy and practice in ways that focus on cultivating capabilities to manage substance use. A policy and practice framework focused on ‘capability-expansion’ might include:
· outcomes that are based on the preferences of young people themselves;
· investing resources to create sustained opportunities that are meaningful to young people (for housing, employment, respect and recognition, and to address mental health needs)
· support young people to convert these capabilities into desired outcomes (e.g., opportunities for ongoing mentoring and institutional support).