Main Points

• Consistent presence in youths’ environments reduces power imbalances and fosters trust compared to office-based settings.
• Balancing supportive roles with necessary control measures is critical, as interventions like mandatory reporting can undermine trust unless handled with integrity and clear communication.
• Enduring rejection is important for getting into a position to reach youth. It requires understanding why rejection occurs, while remaining patient, because building relationships takes time.
• Substance use often holds personal and social meaning for youth. Acknowledging this when meeting rejection enables more equitable and dialogical relationships.
• Professional integrity and continuous reflection on power dynamics are essential for maintaining trust and ethical practice.
• Organizational support and culturally sensitive strategies are needed to help practitioners manage power-related dilemmas and strengthen outreach work and prevent marginalization.

Introduction

In response to growing concerns about substance use among youth in urban areas, outreach youth work (OYW) was established in Norway in 1969. The initiative aimed to address emerging needs that the traditional support system was not equipped to meet. OYW has a long-standing tradition of facilitating contact between services and hard-to-reach youth, aiming to counteract social exclusion (Crimmens et al., 2004; Erdal, 2006). OYW is often directed towards youth who are at risk of, or already facing, challenges related to addiction, substance use and criminal behavior, or youth in challenging life situations, such as newly arrived unaccompanied minor refugees. The purpose of OYW is to identify and support individuals at an early stage, preventing negative development (Erdal, 2006), often by connecting individuals to relevant services, and functioning as bridge builders (Chabchoub et al., 2024). OYW is described with three modes of practice (Skjesol et al., 2026): outreach, follow-up and mapping. In the outreach mode, social workers engage with a broad range of the youth population. In the follow-up mode, they bridge the gap between youth and a diverse selection of support systems. In the mapping mode, they inform decision-makers about youth culture and trends. OYW begins with presence in youth environments to assess needs and approaches, where visibility and continuity foster recognition, predictability, and openness to change (Erdal, 2006, pp. 137-139). Contact is typically initiated by workers approaching youth where they spend time, a process potentially marked by rejection, distrust, or hostility, which outreach workers must be prepared for and, in some cases, respond to by withdrawing for safety reasons (Davidson, 2020; Erdal, 2006; Henningsen, 2009; Strømfors, 2006). Targeting youth based on challenges or risk factors may shape interpretations and reinforce stereotypes, highlighting the need for critical reflection on categorization (Henningsen, 2009). Trust is fundamental to relationship-building, yet particularly complex for youth with histories of broken relationships, placing outreach youth workers in an ongoing tension between relational work and elements of social control (Davidson, 2020; Walsh, 2021).

Both Norwegian and international research emphasizes the importance of relationship-building in OYW (Åkerblom et al., 2026; Andersson, 2013; Connolly & Joly, 2012; Oldeide et al., 2020a). Previous studies have mainly examined trust-building, access to hard-to-reach youth, and the supportive role of OYW (Crimmens et al., 2004; Davidson, 2020). While these studies highlight the value of flexible and voluntary approaches, they pay less attention to how outreach workers handle tension related to rejection, professional authority, and social control in everyday practice. Consequently, there is limited knowledge about how power dynamics shape relationship-building in OYW when working with substance use in marginalized environments.

This article explores how OYW facilitates relationship-building with youth in marginalized environments to prevent substance use, as well as other issues, and how power and control dynamics influence this process. We draw on two qualitative studies (Chabchoub, 2022; Jacobsen, 2022) with overlapping findings, and we reanalyze the data with a focus on methodological and organizational aspects of OYW and how these are shaped by power and control. The purpose of the original studies was:

1. To explore how outreach youth workers experience relational work with youth in high-risk urban environments
2. To understand how OYW can initiate and build relationships between marginalized youth and the helping systems.

This article reanalyzes both studies with a shared focus on methodological and organizational aspects of OYW, examining how these are shaped by power and control, and with an explicit focus on youth with substance-use challenges and youth with refugee and migrant backgrounds. Through this reanalysis, we gain insights that were not explicitly addressed in the original studies. It provides a more critical and structural understanding of how OYW is shaped by different forms of power and organizational conditions. The findings offer insights into improving preventive efforts targeting vulnerable youth.

OYW is a suitable approach for working towards, establishing contact with, and engaging marginalized groups. One of the studies implies that youths from ethnic minority backgrounds were overrepresented among marginalized individuals in contact with that outreach service. Short duration of residency in Norway, language barriers, and cultural differences were identified as risk factors (Chabchoub, 2022).

From the mid-1970s to 2025, Norway has received refugees fleeing war and conflict from different parts of the world. Unaccompanied minors have also been a significant group. Today, Norway has about 965,000 immigrants and 230,000 Norwegian-born with immigrant parents, representing roughly 21% of the population (Statistics Norway, 2025). Norway has become increasingly diverse, with immigrant and refugee youth forming a significant part of this demographic shift. Many of them face unique vulnerabilities in their integration into Norwegian society (Norozi, 2025). In Norway, refugee work is based on a combination of national programs, municipal programs, local initiatives and NGO support. Refugees participate in the Introduction Programme, which provides language training, education, and work-related activities (IMDi, 2024). After this initial phase, refugees have access to the same public services as residents, supplemented by targeted support from NGOs and community-based projects that offer cultural adaptation, mentoring, and social inclusion activities (Norozi, 2025). The latter services and projects often also target Norwegian youth who have developed, or are in the process of developing, substance abuse. Research into unaccompanied minors and youth struggling with substance abuse has found that both groups have a high prevalence of trauma and dysfunctional stress regulation (Daniel-Calveras et al., 2022; Hoffmann & Hoffmann, 2025; Vasic et al., 2021). These vulnerabilities may influence how authority, trust, and support are perceived, making power dynamics particularly relevant in relationships with these groups.

Hence, the research question guiding this article is: How do power and control influence outreach youth workers’ substance use prevention practices through relationship-building with youth in marginalized environments?

We use the term youth in marginalized environments, which acknowledges that vulnerability may stem from poverty, crime, substance use, violence, or other structural factors (Lid et al., 2022). Our perspective is grounded in the view that these youth are in difficult life situations, not inherently difficult themselves. From this standpoint, we examine the scope of opportunity for outreach youth workers to build relationships, with particular attention to the role of power.

Theoretical framework: Critical Youth Studies, Power and Cultural Capital in Substance Use Prevention and Outreach Youth Work

Critical Youth Studies (CYS) is characterized by a critical engagement with theories of individualization and risk that have been influential in youth research (Merchant, 2013; Woodman et al., 2020). Rather than assuming that youths’ life chances are primarily shaped by individual choice, CYS emphasizes the continuing significance of structural inequalities in shaping youth trajectories (Furlong, 2016). It provides a theoretical framework that challenges individualized and deficit-oriented understandings of youth by situating young people’s lives within broader social, cultural, and structural power relations. From this perspective, CYS aligns with Bourdieusian analyses of power and capital, while offering a critical lens on how youth are governed, represented, and engaged within welfare and outreach contexts.

Power is a fundamental aspect of social life, with both positive and negative implications (Payne, 2006). Various theorists highlight the diverse ways power manifests and the importance of its distribution within relationships (Engelstad, 2005). Social work services inherently involve power, as they aim to meet needs, such as housing, financial support, or assessments of care capacity. The social worker’s role, discourse, and context shape how power dynamics unfold and influence relationships (Payne, 2006). Those seeking help are often in vulnerable positions, implicitly holding less power (Engelstad, 2005). Power also influences how youth are perceived and treated, for instance, by categorizing them in specific ways (Henningsen, 2009).

Power exists in all relationships, though it may be negligible in everyday interactions. In more meaningful relationships, vulnerability increases, making individuals more susceptible to powerlessness (Engelstad, 2005). To avoid such positions, people often seek control over situations. Bourdieu (1995) emphasized that social and cultural resources, which he termed cultural capital, determine one’s position within a given context. Those possessing valued knowledge or assets tend to occupy higher positions in social hierarchies (Bourdieu, 1995).

The purpose of substance use can be connected to power and powerlessness. Skjælaaen (2019) explains that there are multiple perspectives on the meaning of substance use. What represents joy and a sense of community for some may be seen as deviance and criminality by others. Although substance use is a subjective experience, it is important to consider the social and cultural surroundings, as they influence the individual’s own meaning-making. The act of using substances to escape, often referred to as getting high to get away, rather than to feel good, reflects a psychological and social dimension of substance use. It can come from a desire to escape from themselves and from others, seeking relief from emotional distress, social isolation, or the monotony of everyday life (Edland-Gryt et al., 2025).

Methods

Design and Approach

This article is based on two master’s theses written by the first and second authors. Both studies explored outreach youth workers’ experiences with relationship-building in marginalized urban environments: one through two focus groups, each with four participants, and the other through four individual interviews. Due to overlapping findings, we reanalyzed the data sets from the original studies to examine how power and control influence relational work when working with substance use and youth. The reanalysis followed an inductive approach, where themes related to power and control emerged from the data. Relevant theoretical concepts were subsequently introduced to interpret the findings.

Participants and Data Collection

Participants were recruited through purposive sampling, targeting individuals with direct experience in outreach youth work. Inclusion criteria required a professional background as a social worker, child welfare worker, social educator, or peer support worker, and a minimum of three years of experience. The total sample consisted of 12 participants. All participants were employed in a large outreach service in a major Norwegian city. Data were collected through semi-structured individual interviews and focus groups using comparable interview guides covering methods, dilemmas, power dynamics, and relational perspectives in OYW (Chabchoub, 2022; Jacobsen, 2022). Interviews and focus groups lasted between 45 and 90 minutes and were conducted in person. The sample consisted of four women and eight men, reflecting a gender imbalance skewed towards men compared to the broader population of social workers in Norway (Statistics Norway, 2024).

Ethical Considerations

Both studies were approved by Sikt, the Norwegian agency for shared services in education and research, and conducted in accordance with submitted protocols (ref. nos. 918630 and 439669). Participants’ anonymity was ensured throughout the research process and informed consent was obtained.

Data Analysis

We applied Malterud’s (2012) method of systematic text condensation in both the original studies and the reanalysis. Systematic text condensation is a stepwise, cross-case thematic analysis aimed at identifying, condensing, and synthesizing meaning across qualitative data (Malterud, 2012). The method involves four main steps: gaining an overall impression, identifying meaning units, condensing these into thematic codes, and synthesizing them into analytical descriptions. It provides a structured and transparent analytical procedure and is particularly suited for descriptive, practice-oriented research. It was chosen because it facilitates systematic comparison across datasets and supports the development of shared categories in reanalysis. An overview of the analytical process, from initial coding to synthesis and presentation of findings, is provided in Table 1.

Audio recordings were transcribed before analysis. Data from focus groups and individual interviews were analyzed using the same analytical procedure and treated as complementary sources in the cross-case comparison. Each dataset was first analyzed separately, followed by a comparison that identified similarities and differences between themes. Overlapping themes related to power, control, and relationship-building were merged into shared analytical categories, which formed the basis for the combined interpretation. The reanalysis led to the emergence of new themes and subgroups, particularly related to power and control. An overview of the main themes, subgroups, and analytical codes identified in the analysis is presented in Table 2.

Results

OYW, like other forms of relational work, is shaped by power structures, among other things, by influencing trust, openness, and how youth interpret professionals’ authority. This is particularly evident as practitioners must navigate the tension between relationship-building and social control (Davidson, 2020; Henningsen, 2009), hold information that may trigger interventions (Erdal, 2006), and operate within problem-oriented frameworks that risk reinforcing stereotypical interpretations of youth unless they are critically reflected upon (Henningsen, 2009). Our analysis shows that several aspects of the practice can contribute to reducing the influence of these power dynamics.

Influencing Power Dynamics through Presence and Contact on Youths’ Arenas

The outreach youth workers describe being present in youths’ own environments as a cornerstone of outreach practice, shaping both how relationships begin and how power is experienced:

”The fact that we are on their turf, I believe, has a significant impact on power structures and the experience of powerlessness. For the youth, meeting someone where they hang out, compared to entering an office… it provides a completely different starting point for building relationships and trust.” (Participant 1, individual interview)

Consistent presence is seen as essential for accessibility and trust. Spending time where youth are, makes outreach workers recognizable and approachable: “It can help us get to know someone who has been difficult to even say hi to.” (Participant 2, individual interview). Visibility also reduces the likelihood of being mistaken for police and creates opportunities for spontaneous contact:

”We also need to be visible where they are and make ourselves approachable. So that the youth can talk to us. These things are important to break the ice. It’s important that, for them to trust us, we who are out doing outreach youth work are trustworthy adults.” (Participant 4, focus group 1)

Being present over time in the youths’ environments is considered to contribute to a more balanced power dynamic between youth and social workers:

“The power balance is perhaps more equal when I work out on the street with relationships than if, for example, I were a caseworker or worked in a child protection institution. That automatically creates a different kind of power dynamic. So those kinds of structural conditions tied to the professional role… they can have an impact.” (Participant 3, individual interview).

Although the outreach youth workers stress the importance of presence and continuity for building relationships, some also point to challenges. These included the risk that some youth might feel surveilled by constant presence: “You’ve already assessed that this might be a vulnerable youth or young adult. So, there’s a reason why you’re initiating contact.” (Participant 3, individual interview). If outreach youth workers observe without engaging, their presence may be misinterpreted. Some reflected on their professional power to define and frame what they see: “We have the power to define, and the ability to frame young people’s challenges to the broader support system or to society in general.” (Participant 1, individual interview). These reflections describe how participants considered both the possibilities and the challenges associated with being present in young people’s environments.

Exercising Power and Control

Some outreach youth workers describe the control aspect of their role as challenging and potentially damaging to their ability to build relationships. At the same time, they say that control can be necessary in acute situations, particularly when youth place themselves in potentially dangerous circumstances and need immediate help. It is important for them to assess what needs urgent referral and what can wait: ”How much are we really helping the youth if we call the police right away? What if we could establish a dialogue with them and have them tell us what might make life a little better for them?” (Participant 3, individual interview)

Another outreach youth worker explains the tension between support and control with the following example:

”There was a person we met who we thought was 19… It turned out he was 16, and then the duty to report to child welfare applies. He wanted support in a court case, a school placement, a job offer, but after the report of concern, he cut off contact.” (Participant 3, focus group 1)

The impact of such acute control interventions is described by several outreach youth workers, though with differing perspectives. One explains that in some cases, building a strong relationship was not necessarily part of their role, and they instead relied on the trust placed in the broader support system: ”In that moment, I may not have defined my professional role as building a strong relationship, and therefore I leaned on the trust in the rest of the system.” (Participant 3, focus group 2)

This highlights a core dilemma in the control role, deciding what constitutes the best form of help at a given moment. Is immediate intervention necessary, or is it better to allow time to work toward change through the relationship? The outreach youth worker in the case of the 16-year-old reflects: ”I understand the duty to report, but at the same time, I wonder whether it might have been better if I could have continued working based on the relationship I had established.” (Participant 3, focus group 1). Another outreach youth worker explains how control can lead to rejection and a lost opportunity to help:

”I’ve experienced rejections where I never gained access again because the first contact was dramatic. That’s a dilemma for the entire system’s ability to gain a foothold, because the rest of the system doesn’t always manage to fix these young people’s lives.” (Participant 3, focus group 2)

Other outreach youth workers describe how setting clear boundaries does not have to conflict with relationship-building. In some cases, it could even strengthen the relationship. One says: ”We have to work together. I’ve experienced that it works, to both have a control role and build a relationship.” (Participant 2, individual interview), emphasizing the importance of involving the youth in the process. Because the outreach role involves power and control functions, clarifying expectations and maintaining transparency is seen as essential: ”It’s a lot about integrity, not promising things you can’t deliver, and not doing things behind the youths´ backs.” (Participant 4, individual interview). This helps reduce the risk of broken trust and prevents misunderstandings later.

Enduring Rejection to Build Relationships?

Being rejected by youth is a common part of outreach youth work. Such rejection may reflect previous negative experiences with the support system and a sense of powerlessness.

The outreach youth workers describe the importance of understanding that rejection does not necessarily mean something has been done wrong. They highlight how negative past experiences, low trust in services, and the use of defense mechanisms are common in youth environments. When discussing rejection, it becomes clear that being able to tolerate it is essential for building relationships over time: ”Tolerating rejection and still trying to say hello again and again… We must not give up. We must see them. A simple ‘hello’ can change someone’s life one day.” (Participant 4, focus group 1)

They stress that outreach youth workers must be able to endure rejection over time and think systematically:

“The way we got in touch with them was by spending a lot of time on the streets. We spent a lot of time with others in that environment… with repeated attempts to make contact… We can spend three weeks getting there.” (Participant 2, individual interview)

The quote shows that repeated and prolonged efforts are used to initiate contact, including spending time and approaching the same youth multiple times.

Discussion

Our analysis shows that OYW provides a distinct framework for gaining access to youth who struggle with substance use, particularly by being positioned in youths’ own environments and allowing time for trust to develop. Across the dataset, individual interviews and focus groups revealed similar themes, but with different emphases. Individual interviews highlighted personal dilemmas related to power, while focus groups produced more collective reflections on shared practices and organizational norms. Together, these perspectives show how power is experienced both individually and collectively within OYW. The findings, viewed through a CYS perspective (Merchant, 2013; Woodman et al., 2020), challenge individualized and risk-oriented understandings of youth access and engagement by emphasizing relational and contextual processes.

The study contributes to existing literature by demonstrating how these practices not only facilitate contact but also shape power dynamics at play in everyday interactions between outreach youth workers and young people. Through presence, availability, flexibility, and continuity, relationship-building becomes possible. Yet these same features also structure how authority, influence, and vulnerability are negotiated in practice. These findings build on and extend earlier research and literature on OYW (Andersson, 2014; Crimmens et al., 2004; Davidson, 2020; Erdal, 2006) by showing how relational access and power are intertwined in specific outreach encounters.

Physical presence is central to relationship-building. Outreach youth workers describe how the ability to spend time in youth environments allows trust to develop gradually, which aligns with previous research (Chabchoub et al., 2024). However, in high-risk situations, such as hard substance use or abuse by minors, time may not always be available, requiring that outreach youth workers to balance patience with the need for immediate intervention. This tension can be understood as navigating unequal power relations by seeing presence as symbolic capital, while acute situations can lead to reinforcing youths’ vulnerability and powerlessness (Bourdieu, 1995; Engelstad, 2005). From a CYS perspective (Furlong, 2016; Woodman et al., 2020), this can illustrate how relational access is shaped by power relations, and not necessarily by individual motivation for change.

Being present in youths’ own environments can reduce feelings of powerlessness by shifting the interaction into an arena where young people hold greater cultural capital. In Bourdieusian terms, outreach youth workers temporarily move from an institutional field, characterized by professional authority, into youth-defined fields where knowledge of local norms and networks constitutes valued capital. However, such presence may also be perceived as surveillance or intrusion, especially in communities with strong skepticism toward authority, like environments characterized by trade in and use of illegal substances. While visibility can foster familiarity and trust (Erdal, 2006), it must be carefully balanced and adapted to the context. Maintaining transparency about roles and intentions is therefore essential to avoid reinforcing power dynamics. Youth emphasize that it’s important not to be judged for their actions but rather to be recognized for who they are (Oldeide et al., 2020b, p. 3).

Our findings confirm that early assessments influence how youth are understood and supported. Potentially differing perspectives on substance use (Skjælaaen, 2019) can influence the power dynamics between outreach youth workers and youth who find meaning in their use. We see connections between substance use and a way to turn the feeling of powerlessness into power. In environments affected by illegal drug use and trade, substance use may also serve to gain a sense of control and belonging. From a Bourdieusian perspective, such practices can function as symbolic or cultural capital within specific youth fields, where participation in substance-related activities may provide recognition, status, and inclusion. This reframes substance use not only as risk behavior but also as a strategy for negotiating position and agency within marginalized social spaces. This aligns with CYS by reframing substance use as a socially situated practice rather than solely an individual risk behavior (Merchant, 2013; Woodman et al., 2020). A problem-oriented approach to substance use may unintentionally reinforce hierarchical relationships that limit the youth’s voice and agency. Conversely, acknowledging the subjective and contextual meanings of substance use can open space for more equitable and dialogical relationships. In such relationships, power is not only exercised but also negotiated, allowing youth to participate actively in shaping the support they receive.

While Henningsen (2009) warns against the risks of categorization, other research shows that youth often perceive outreach youth workers as supportive and resource-oriented (Oldeide et al., 2020b). Our findings support this view, suggesting that even when power is exercised, it can be done in ways that youth experience as empowering. Henningsen’s (2009) concept of the “gaze of concern” highlights the definitional power reflected in our findings, where youth are often viewed through a lens of risk. At the same time, Bergheim (2019) emphasizes tacit knowledge and professional experience as counterbalances, ensuring that outreach efforts remain focused on those with genuine needs. This interplay between critical reflection and structured supervision is essential to prevent this gaze from dominating (Gunnarsdóttir & Haugstvedt, 2023), reinforcing outreach workers’ role as bridge-builders (Chabchoub et al., 2024). Such tensions reflect a key concern within CYS regarding how care-oriented practices can produce categorization (Furlong, 2016; Woodman et al., 2020). Linked to the power perspective, this suggests that outreach youth workers can exercise institutional and symbolic power in ways experienced as empowering by youth through the use of professional knowledge and cultural capital, while also risking the reproduction of categorization and powerlessness if such power is not exercised with awareness and caution.

Our findings show that the control function in OYW is both necessary and challenging. It often conflicts with the helper role and can undermine trust (Crimmens et al., 2004). Outreach youth workers must balance their structural responsibility to facilitate interventions with the ethical need to maintain trust. As Henningsen (2009) argues, this balancing act is essential yet difficult. Integrity was highlighted as key to maintaining relationships while exercising power. Integrity can also empower youth by giving them greater control over the content of conversations (Bukhari et al., 2021). This approach signals that their perspectives are valued, helping to build more sustainable and empowering relationships.

Rejection is a common and expected part of OYW (Erdal, 2006; Henningsen, 2009). From a CYS perspective, rejection may be understood as an expression of resistance to asymmetrical power relations (Furlong, 2016; Woodman et al., 2020). Migrants, who may distrust Norwegian public institutions due to negative experiences with authorities in their countries of origin, and those struggling with substance use, can be more likely to reject outreach youth workers. Rejection can be a way for youth to regain agency in a relationship marked by asymmetry (Engelstad, 2005) and may be interpreted as resistance to the definitional power held by social workers. Davidson (2020) notes that initial contact is often marked by mistrust or hostility, reflecting the youth’s perception of professional authority. Accepting clear rejection is both a safety measure and a recognition of youth’s right to set boundaries (Strømfors, 2006). Our findings suggest that managing rejection requires patience and systematic effort, as it often reflects ongoing negotiations of power and control.

Rejection can also be culturally motivated, linked to shame associated with substance use. Drawing on Bourdieu (1995), it may serve as a strategy to maintain social status and avoid “losing face” within peer environments. Outreach youth workers must therefore be attuned to the cultural norms of the environments they work in and adjust their strategies accordingly. In some contexts, continued substance use can represent cultural capital and a way to escape (Edland-Gryt et al., 2025). The meaning of substance use can be intertwined with feelings of both power and powerlessness, where escaping through substances represents a reclaiming of agency and a response to structural exclusion. Our findings indicate that recognizing these underlying dynamics enables outreach youth workers to tolerate and manage rejection, which is essential for gaining access and engaging in long-term processes of change.

Nevertheless, critical reflection remains essential. These findings demonstrate, through a CYS lens (Furlong, 2016; Merchant 2013), how OYW holds the potential to reduce power imbalances and amplify youths’ voices, but only when social workers remain aware of how their roles, actions, and assumptions shape the relationships they seek to build.

Limitations, Recommendations, and Future Research

This study highlights key challenges in OYW, particularly related to power and control. Greater awareness of these dynamics can strengthen professional understanding and improve relationship-building with youth. Social workers play a role in shaping how youth are perceived and categorized, which underscores the need for critical reflection. We recommend that responsibility for addressing power-related issues lie with professional management, not individual practitioners, to ensure consistent and informed practice across services.

Some limitations should be noted. The sample is relatively small and relies on secondary analysis of data, which may limit the depth and scope of the interpretations. Since all participants worked within the same local outreach service, organizational norms may have shaped the perspectives expressed. These factors should be considered when assessing the transferability of our findings.

The study is based on a large outreach service in a major Norwegian city. To broaden the knowledge base, we recommend similar research in smaller communities and services. We also encourage studies that explore refugee and migrant youths’ own experiences and what they value in their encounters with outreach youth workers. These perspectives can enrich our understanding of effective outreach practices.

Conclusion

OYW is a well-established and effective strategy for reaching and building trust-based relationships with youth in marginalized environments, including those from migrant backgrounds and those with substance use issues, who may face multiple vulnerabilities. This study examined how power influences substance use prevention through relationship-building. While power can challenge trust, we identified several practices that help reduce power imbalances. Among these are continued presence and enduring rejection. Integrity and reflection also support outreach youth workers in managing the tension between support and control, showing that control does not necessarily undermine relationships. A patient approach can strengthen orientation toward youths’ own perspectives and priorities, thereby challenging the power imbalance in the relationship and enabling a deeper understanding of the meaning that substance use may hold for them, which is essential for effective prevention.

Our findings indicate that it is crucial for outreach youth workers to reflect on and remain aware of the situations in which they exercise power, how they do so, and how this may affect the relationships they build. As we have demonstrated, within this complex and demanding landscape lies the potential to reduce power disparities between youth, society, and the support system, ultimately giving this group a stronger voice. The complex situations that outreach youth workers encounter require high professional competence, ethical awareness, and a professional community that continuously develops the field of practice.

Author contributions

Conception and design: J.C., C.S.J.; Data acquisition: J.C., C.S.J.; Data interpretation: J.C., C.S.J., H.H.; Drafting of the manuscript: J.C., C.S.J., H.H.; Critical revision of the manuscript: J.C., C.S.J., H.H. All authors reviewed the results, approved the final version of the manuscript, and agreed to be accountable for all aspects of this study.

Ethical approval

This study was approved by the SIKT – The Norwegian Agency for Shared Services in Education and Research (Date: October 2020, Decision/Protocol No: 918630 and 439669). Informed consent was obtained from all participants involved in this study.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Conflict of interest

The authors declare that this study was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Funding

The authors declare that this study received no funding.

Generative AI statement

The authors declare that during the preparation of this study, the following AI-assisted technology was used: Microsoft Copilot has been used since 15.11.2025 and throughout the process with writing the article. Extent of Use: It has been used to get proposals and help when translating our original Norwegian article to English. The authors confirm that they have critically reviewed and edited any AI-generated content and take full responsibility for the integrity, accuracy, and originality of the publication. The authors certify that the original human contribution is maintained and that AI-assisted tools are not listed or cited as authors.