WDP and Shannon Trust’s groundbreaking pilot scheme to make one-to-one peer-led reading support sessions available to WDP clients is a lifeline for those struggling with literacy, says Scott Haines.

Being able to read is something that many of us take for granted. We have likely been doing it from an early age and it’s a skill that we use every day. Just this morning, within an hour of waking up, I’d read the news, checked my emails, scanned through my social media and reviewed some paperwork I needed to sign. Shortly afterwards I plotted a public transport route to visit a WDP drug and alcohol service in Greenwich, where today I will be delivering training to staff and volunteers.

During the training, a comment from one member of the group really got me thinking – ‘It’s difficult to even visualise what it would be like to not be able to read. I can only imagine how horrible that must feel.’ What would life be like if you couldn’t read? How difficult might you find it to complete many of the routine tasks you undertake each day? How would it affect your ability to communicate with others or get access to important information? What type of jobs would you be able to do? How would it make you feel about yourself? Reading is fundamental to so many aspects of our day-to-day lives, and yet struggling with reading is a reality for far too many people.

Shannon Trust is a literacy charity that currently operates in every prison in England, Wales and Northern Ireland. We train prisoners who can read to become mentors and teach those who can’t using a phonics-based programme called Turning Pages (DDN, July/August, page 4), that we designed specifically for working with adults. Over the past 20 years we have helped thousands of people to improve their reading, achieving some fantastic outcomes in the process.

Current stats suggest that around 50 per cent of the UK prison population has a reading level below that of the average 11-year-old. A significant proportion of this number struggle to read anything at all. These numbers are alarming, and we are determined to do what we can to help reduce them through our work inside and outside of prison.

We know that there are lots of reasons why people end up struggling with reading. For some, they had a troubled and disrupted childhood. For others, they didn’t go to school or were excluded. In other cases, people may have undiagnosed problems such as dyslexia or visual impairments, which made the task of reading difficult. It could also be a combination of such factors.

When someone struggles with reading, we know that the impact on their lives can be significant. As well as not being able to do many things, learners regularly tell us about how this has severely damaged their confidence or has been detrimental to their relationships with family. It’s also common to hear about the frustration and resignation that comes with not being able to access opportunities which may help them to move forward positively in their lives, such as employment.

Our data shows that those who take part in one-to-one sessions report improvement in their confidence and self-esteem, and 90 per cent of our learners also go on to access further education and training opportunities.

Despite this issue being fairly common within the prison system, we find that many people are still reluctant to disclose that they struggle with reading (often because of embarrassment and concerns about how others will respond). And even when things are out in the open, it’s also not always the case that people want or will accept support when it’s offered. This is particularly true if the support involves a classroom, where experiences for many in the past may not have been overwhelmingly positive.

However, we find a peer-based approach can be effective. It appeals to those who might be resistant to accessing support, with many preferring to engage if it’s on a one-to-one basis, working with someone that they can trust and where sessions can take place in a safe and confidential space.

Working in prisons remains vital to us, but we also know there exists a significant need for people to access this type of support on the outside. According to the National Literacy Trust around 7.1m people in England – 16.4 per cent of the population – struggle with poor literacy (below Level 1). At Shannon Trust we regularly get approached by community-based services looking for help to support clients or advice to develop their own programmes. Therefore, we are really keen to expand our work beyond prison walls. We think everyone should be offered the chance to access support to improve their reading if and when they need it, no matter where they are. This is why we think our new partnership with WDP is such an exciting and important one.

We are currently setting up peer-based reading programmes in several WDP services, in areas such as Islington and Merton, which we will pilot over the next 18 months. These will be delivered by WDP staff and volunteers like those I met today in Greenwich, who will offer one-to-one support sessions to clients in-house. We will also provide training/guidance to wider staff teams to help them better identify and support clients who may benefit from taking part. We will work collaboratively to share learning, track outcomes and plan ongoing development, the aim being to have a community model which is effective in responding to need and which can be replicated across more services.

Before joining Shannon Trust I’d spent 14 years working in drug and alcohol services. I remembered working with a few clients who I knew struggled with reading and who I’d tried to refer to local classroom-based programmes. Some point blank refused to go. Others said they would attend but did not.

I wonder whether I might have worked with some who struggled with reading but didn’t wish to disclose it? Perhaps I never offered them the chance. If so, might things have been different if I’d had a better understanding of the issue and had been able to offer them access to a peer-based support programme within the service? Would they have been more likely to engage with it? Could this have improved their outcomes? I believe the answer to each of these questions would be yes, and which is why I have no doubt that our pilot will be a great success.

Chatbots are non-human agents, programmed using artificial intelligence (AI) to talk to a person as if a real-life conversation is taking place. It’s common to visit a website and be greeted with an invitation to chat about its commodities – whether suggesting products, offering technical support, or assessing customer satisfaction, chatbots have established their place in assuming a role traditionally undertaken by humans.

Healthcare is no exception. Here chatbots have been used to educate, diagnose, and support a technically savvy and demographically diverse population. The use of chatbots in addiction services has yet to be appreciated however, with research showing little traction in this area in the last five years. This is contrary to the upward trend seen in other areas of healthcare, for example with anxiety, depression, and obesity. This gap is perhaps most surprising given the target population and model of interaction offered – interaction that’s free of judgement and prejudice and that can reach people reticent to openly discuss their problems. This gap presents an untapped opportunity, a blank canvas for developing chatbots to serve those needing support with drug and alcohol addiction, including those in recovery.

Point of need

It is here we introduce Foxbot, a recovery friend. Foxbot was born from the idea to personify the online delivery of recovery interventions – interventions that combine recovery knowledge with positive psychology, and concepts from positive computing, to use technology to improve wellbeing. The basic design requirements for Foxbot were to be friendly and easy to form a connection with, to allow users to direct their own experience based on what they’re facing and how they’re feeling, and to provide a fresh, accessible, and engaging way of supporting people in recovery.

Foxbot’s purpose is to help people at their point of need by supporting them with some of the common difficulties encountered in recovery. Foxbot achieves this by offering suggestions, and quick and easy interventions, that can be used and re-used to bolster recovery. Unlike more conventional chatbots that form part of a larger online strategy to promote or sell products and services, Foxbot’s intentions are entirely altruistic. Foxbot’s goal is to connect with and understand what people in recovery are commonly challenged with and respond with an intervention that can help them in the present moment.

Feeling supported through connection and understanding is highly valued in recovery, so these characteristics were considered rudimentary to Foxbot’s design, and embedded through the content of his knowledge base and the relaxed style of communication he’s programmed to use. It was decided that if Foxbot was to be a genuine and successful recovery friend, he should exhibit his own character strengths – social intelligence, self-regulation, gratitude, humour, and creativity. Social intelligence for fluent social function and mature judgement; self-regulation for limitless patience and satisfaction with friendly relationships; gratitude to express positive emotions and optimistic prosocial behaviour; humour to promote positive mood and endurance, and creativity for his novel delivery of recovery interventions. These signature strengths were programmed into Foxbot’s communication patterns to enable him to support people who wish to talk about things like having cravings, being in a bad mood, needing a reality check on what it means to be in addiction, having been triggered, or looking for a recovery boost.

Common experience

The interventions delivered by Foxbot take common experiences from recovery and amalgamate them with positive psychology theory to offset and enhance the user’s current frame of mind. For example, if someone tells Foxbot they’re having a craving, he does two things – firstly, he suggests a mindful practise for letting the craving pass, one that uses positive imagery to represent the craving as a process that has an end. Secondly, he involves the user in an activity that will refocus them. In this case, an online matching game, where they do not need to feel self-conscious about participating, one that gives them feedback, and is rewarding. This intervention equips the user with a strategy to deal with cravings, where they are encouraged to participate in an activity that distracts them after visualising the craving as a process that comes to an end.

Another common experience for people in recovery is having unhelpful thoughts – that they don’t really have a problem with alcohol or drugs, and that everything will be okay this time. Here Foxbot helps by offering a reality check in the form of an adage that can challenge the unhelpful inner voice with a relatable example of something that’s apparent with the hindsight of recovery. For example, ‘you can’t drink away alcoholism’ or ‘do you recall sobering up when you patted your pockets and couldn’t find your phone’.

If you tell Foxbot you are in a bad mood, he will attempt to raise a positive emotion using humour. Whilst his sense of humour may have been influenced by his design team, the jokes have been tested on a wider audience before they made the cut.

Recovery boost

If a user is not experiencing a particular challenge but would still like to do something positive for their recovery, Foxbot offers the option of receiving a recovery boost. Research has shown that life appreciation and gratitude play a fundamental role in sustained and successful recovery. Foxbot capitalises on this by offering recovery boosters, powerful reminders of the things that are easy to take for granted or lose sight of in recovery, for example, ‘see you later hangover’, ‘welcome back energy’, ‘adios shaking hands’ and ‘goodbye bloodshot eyes’. This is to remind users of the positive outcomes they’ve acquired thanks to living in recovery, outcomes that can only be preserved by sustaining that recovery.

By providing an unlimited willingness to engage in conversation, Foxbot frequently relays the message that talking is important to recovery. His conversational style includes phrases such as ‘It’s good to talk’, ‘talking to you brightens my day’, and ‘don’t struggle in silence’. Foxbot also gauges how useful an intervention is proving to be through the acquisition of real-time feedback, where, if necessary, an extended version of the intervention is presented to the user. For example, if a user has asked for a recovery boost, Foxbot will check-in during the intervention to ask if they feel they have had a boost, offering feedback options of ‘yes, boosted’ or ‘no, power me up’. If ‘no’ is selected, another set of recovery boosters are presented to the user.

To keep the conversation fresh, and avoid anticipated chat, Foxbot has a continually developing knowledge base. The AI component of his programming assigns different conversational experiences to the user to avoid ‘hackneyed dialogue.’ As an example, when a user opts to ‘chat again’, a randomised response is given, such as, ‘talking opens your mind to new ideas’ or ‘it’s always a good time to talk to me about recovery’. This ensures the user experience is unpredictably different with each encounter.

Foxbot can be considered as being in his formative years – he is undergoing significant developmental change, which includes a growing knowledge base and repertoire of recovery suggestions. In addition, Foxbot can also remember his past conversations, so as he matures historic chats will be analysed to better inform how he should evolve. For example, if a disproportionate number of users engage in a specific intervention, this area will be prioritised with greater investment made to enrich the support available. Foxbot will also become wiser by gathering feedback on his own strengths, including his performance as a recovery friend. When he reaches this level of maturity, he – like his recovery friends – will be learning how to better use and develop his own strengths.

To get to know Foxbot and find out what else he can do, visit positivelysober.org where you can also look at the work being done to create a positive approach to recovery.

Lisa Ogilvie is a PhD student, Julie Prescott is reader in psychology, and Jerome Carson is professor of psychology, all at the University of Bolton