Transcript Welcome to A

Welcome to A-Senteret!
A-Senteret:
• Part of «The City Mission », founded in 1855
• CM: running 40 different projects, 1200 employees, 1350
volunteers,
• A-senteret founded in 1957
• Since 2004 fully funded by the regional Health Authority
(State ), before 2004: Local Authority. So: privatly owned but
on contract with HA, non-profit
• 2004: TSB= Specialised interdisciplinary treatment for
substance abuse/addiction
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Hva er A-senteret?
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45 employees, Outpatient:12, Inpatient: 24 (half of these parttime)
Outpatient: 7.475 yearly consultations, Inpatient: 20 beds (7.300)
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Our work:
• Assessment of referrals
• Outpatient treatment
• Inpatient treatment
• Supervision/Information/Lectures
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Alcohol in Norway (SIRUS):
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Most people drink alcohol (87%)
2009: 6,70 l alcohol sold per adult (Finland 10,0)
10% consumes half of the total consumption
Over the last 15 yrs consumption has increased by 40%
We still binge drink on weekends but continental drinking
patterns has also emerged
• Around 1.5 million Norwegians are affected by high alcohol
consumption
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Alcohol in Norway (SIRUS):
• 50-150 000 children affected by parents alcohol/drugproblems
• 50- 100 000 spouses/partners affected
• 2010: 414 deaths caused by alcohol , high consumption over a
long period of time (317 male,97 female), this is only a
fraction of all deaths that fully or in part are caused by
alcohol
• 2011: 6788 admissions to somatic hospitals with alcohol
related underlying diagnosis (4678 male, 2110 female)
• 2010: 23000 patients in TSB treatment, 36% inpatient
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A-senteret – understanding, ideology and methods
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Psychological perspectives
Medical perspectives
Social perspectives
Spiritual /existential perspectives
No «one fits all approach»
Motivational interviewing, mentalization, psychodynamic,
mindfullness, cognitive ….
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Outcomes:
• Increased quality of life
• Changes in use /consumption of alcohol/drugs
• Relapse prevention
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Who can receive treatment at A-senteret?
• People with problems related to use of alcohol, illegal
substances or medication
• People with problems as above combined with mild or
moderate psychiatric illnesses
• Relatives/ people who are being affected by anothers
dependency/alcohol problems
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Patient population at A-senteret
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Patient population at A-senteret
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Referals from:
• General Practitoners, medical doctors
• Local Authorities, social welfare office
• Other parts of the Health Service, Specialist
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Assessment of referrals
• Assessment of statutory rights to health services/treatment
within TSB
• Outcomes: statutory right, treatment without statutory right,
refusal
• Assessment team: psychologist, social worker and medical
doctor (Interdisciplinary)
• Guidlines from Directorate of Health
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Outpatient unit
• Examination and further assessment
• Individual treatment plan
• Time in, and intensity of, treatment varies with individual
needs
• Individual therapy
• Couple and/or family sessions
• External liaison and collaboration
• Internal interdisciplinary collaboration
• In addition: Group therapy or course for some patients
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Outpatient groups:
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Awarness group
Womens group
Course in how to cope with depression and prevent relaps
Gay/lesbian group
Course in Mindfullness and stressreduction
Psychoterapy group
Transition group/follow-up from in-patient
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Outpatient groups
• Information course
• Mindfullness/Stressreduction course
• Group for adult children of parents with alcohol/drugproblems
• Group for spouses/partners
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Inpatient unit
• 20 patients in the unit
• 7 days a week but most have weekend leaves
• 3 social workers, 3 nurses, 3 psychologists, 2 doctors and the
unit leader
• Main treatment method is group therapy
• Patients have 2 individual consultations/ week
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Inpatient unit- treatment phases
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Assessment phase
Preparation phase
Admission to the inpatient unit
Treatment planning
Treatment phase
Termination phase
Follow-up
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Inpatient unit- structure
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Private rooms
Morning meeting (mandatory)
Group therapy x 6 per week (mandatory)
Daily chores assigned to all patients
Expectation that everyone is back on the unit 2230
Most patients are on weekend leaves
No addictive medications are distributed
We expect that patients abstain from alcohol and drug use
during treatment
• Cooperation with referrers, GP’s, other specialists
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Detox before admission
• All patients has to be detoxified of all substances before
admission to the inpatient unit
• This leads to different detox facilities and length of time
which is discussed in the preparation phase.
• Also possible with 5 days of alcohol testing/ urine samples
before admission
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Group treatment at the inpatient unit
• Mandatory group treatment 6 times per week
• Monday: Mentalization/ psychodynamic based groups
• Tuesday: Physical activity group and Mindfulness based
group
• Wednesday: Psychoeducational group with focus on
psychological health
• Thursday: Physical activity group
• Friday: Psychoeducational group with focus on addiction,
change process, high-risk situations, relapse
• Also other, optional groups: Yoga, Physical activity, Art
therapy
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Why group treatment?
• People with addictions often have problems when it comes to
healthy attachments
• Group psychotherapy work both with the difficult
relationships, and in them
• Participants use each other to improve their understanding of
their own and others mental processes -> improved
relationships
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Why group treatment?
• Patients in groups
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Can get a sense of belonging and a installation of hope
Participate w/o use of substances in social setting which
improves social skills and interpersonal functioning
Experience that some of their problems are universal
Get to help others in their treatment
Can learn from others mistakes and successes
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Individual treatment
• All patients has an individual therapist assigned from the
beginning
• Patients are presented and discussed at team meetings which
ensures that interdisciplinary aspects are taken into
consideration
• When necessary, team members with other backgrounds
complement the individual therapist
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Individual treatment
• In the treatment phase, family members including children
are often invited
• Contact is also established with the workplace
• Termination date is set at the beginning and planning for life
afterwards start already in the treatment planning stage
• Individual therapists has different theoretical backgrounds
and adapt to patients needs
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A-Senteret 13 september 2013
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A-Senteret 13 september 2013
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