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Welcome to A-Senteret!

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

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Welcome to A-Senteret!

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  1. Welcome to A-Senteret!

  2. 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 E.S.Hubbuck/A.Ekberg

  3. Hva er A-senteret? • 45 employees, Outpatient:12, Inpatient: 24 (half of these parttime) • Outpatient: 7.475 yearly consultations, Inpatient: 20 beds (7.300) E.S.Hubbuck/A.Ekberg

  4. Our work: • Assessment of referrals • Outpatient treatment • Inpatient treatment • Supervision/Information/Lectures E.S.Hubbuck/A.Ekberg

  5. Alcohol in Norway (SIRUS): • 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 E.S.Hubbuck/A.Ekberg

  6. Alcohol in Norway (SIRUS): • 50-150 000 childrenaffected by parentsalcohol-/drugproblems • 50- 100 000 spouses/partners affected • 2010: 414 deaths caused by alcohol , highconsumption over a long periodof time (317 male,97 female), this is only a fractionof all deaths thatfully or in part arecaused by alcohol • 2011: 6788 admissions to somatic hospitals withalcoholrelated underlying diagnosis (4678 male, 2110 female) • 2010: 23000 patients in TSB treatment, 36% inpatient E.S.Hubbuck/A.Ekberg

  7. A-senteret – understanding, ideology and methods • Psychological perspectives • Medical perspectives • Social perspectives • Spiritual /existential perspectives • No «one fits all approach» • Motivational interviewing, mentalization, psychodynamic, mindfullness, cognitive …. E.S.Hubbuck/A.Ekberg

  8. Outcomes: • Increased quality of life • Changes in use /consumption of alcohol/drugs • Relapse prevention E.S.Hubbuck/A.Ekberg

  9. 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 E.S.Hubbuck/A.Ekberg

  10. Patient population at A-senteret E.S.Hubbuck/A.Ekberg

  11. Patient population at A-senteret E.S.Hubbuck/A.Ekberg

  12. Referals from: • General Practitoners, medical doctors • Local Authorities, social welfare office • Other parts of the Health Service, Specialist E.S.Hubbuck/A.Ekberg

  13. 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 E.S.Hubbuck/A.Ekberg

  14. 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 E.S.Hubbuck/A.Ekberg

  15. Outpatient groups: • 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 E.S.Hubbuck/A.Ekberg

  16. Outpatient groups • Information course • Mindfullness/Stressreduction course • Group for adult children of parents with alcohol-/drugproblems • Group for spouses/partners E.S.Hubbuck/A.Ekberg

  17. 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 E.S.Hubbuck/A.Ekberg

  18. Inpatient unit- treatment phases • Assessment phase • Preparation phase • Admission to the inpatient unit • Treatment planning • Treatment phase • Termination phase • Follow-up E.S.Hubbuck/A.Ekberg

  19. Inpatient unit- structure • 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 E.S.Hubbuck/A.Ekberg

  20. 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 E.S.Hubbuck/A.Ekberg

  21. 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 E.S.Hubbuck/A.Ekberg

  22. 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 E.S.Hubbuck/A.Ekberg

  23. Why group treatment? • Patients in groups • 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 E.S.Hubbuck/A.Ekberg

  24. 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 E.S.Hubbuck/A.Ekberg

  25. 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 E.S.Hubbuck/A.Ekberg

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