Transcript Gerjan Timmerman - European Federation of Therapeutic

EFTC
11th European Conference on Rehabilitation and Drug
Policy
June, 2007
Gerjan Timmerman family-therapeutist
Verslavingszorg Noord Nederland - VNN
Addicion Care North Netherlands
From a vulnerable relation to an
intensive collaboration.
Collaboration of Therapeutic Community,
patient and nucleus system.
De Breegweestee
Therapeutic Community
Target Group: adolescents and youngadults.
Chronic destructive substance abuse.
Severe problems in other life areas.
Comorbitity: Dual Diagnosis.
Features of the target group
• Substance abuse.
• Starts in puberty.
• psychological, emotional, cognitive and
relational developments stops
•Criminality to obtain means.
• Keeping up appearences about
autonomy.
Admission factors and criteria.
1. You cannot hide, neglect or suppress the
problem anymore
2. A huge change in the consisting
structures which can evoke enormous
anxiety
3. It is the beginning of a break-through of
existing behaviour patterns, which can
evoke enormous anxiety.
Admission
1. It is the start of getting free of the direct
control of the nucleus family, which can
evoke enormous anxiety
2. It will open information about topics
which the person wants to keep silent
Factors which inhibit to build up
new relations.
1. Loss of control of the treatment. The
inpatient crew takes it all over.
2. Unfamiliarity with the treatment, the
language of therapists.
3. Inaccessibility of the inpatient
department: from no contact to contact
on appointment.
4. Collusion (Tromp & van de Ree).
The vulnerable part of the relation:
collusions.
1. Collusion: The way in which families and the
admitted person define the inpatient
department.
2. Under-involvement: families are burned out
and give the responsibility to the inpatient
department.
3. Over-involvement: families are doing
everything to maintain control over the
admitted patient.
4. A combination of repulsion and attraction
(mainly in crisis).
How can we strengthen the relation?
1. To recognize the collusions
2. To anticipate on this developments by
respectfull approaches, open
communication
3. Professional attitude: one-down.
4. To consider families and the admitted
patients as co-experts.
Ingredients which are already present
at the TC Breegweestee.
1. Appropriate introduction of the coming patient
2. Families can take a preview in the TC.
3. Systemic screening and systemic diagnosis of
the family involved.
4. Information days for the families.
5. Familytherapy
6. Meetings with other family members for
recognition and support.
With special thanks to Cherda Trügg