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„Insights“ publication concept Therapeutic communities and residental care

„Insights“ publication concept Therapeutic communities and residental care. EMCDDA Scientific Committee Meeting 15 – 16 November 2010 Lisbon Gerhard Bühringer. Preliminary assumptions. Philosophies and concepts of TC‘s have changed in the last 40 years Concepts of TC‘s differ between MS

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„Insights“ publication concept Therapeutic communities and residental care

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  1. „Insights“ publication conceptTherapeutic communities and residental care EMCDDA Scientific Committee Meeting 15 – 16 November 2010 Lisbon Gerhard Bühringer

  2. Preliminary assumptions Philosophies and concepts of TC‘s have changed in the last 40 years Concepts of TC‘s differ between MS The relevance of TC‘s within MS treatment service systems differ The publicaton must provide information on practical topics like:concepts, practical problems and solutions, costs, outcome, challenges

  3. 1. History and current definitions of TC‘s in Europe • Selection of typical MS concepts: (1) Scandinavia, (2) UK, (3) Mediteranean, (4) German speaking countries and (5) Eastern Europe • Appendix with selected TC concept / programme descriptions 1.1 Origins and historic developments in selected MS 1) 1.2 Current core definition characteristics 2) • Abstinence and treatment entry • Residential / impatient • Comprehensive treatment philosopy / concept • Heroine and other hard drug users • Graduation of patient involvement in TC management and treatment 1.3 Special TC‘s • Outpatient • Other drugs (cannabis) or comorbid disorders or drug-unspecific • Self-help concepts • Accepted drug use at treatment entry

  4. 2. Core structural characteristics 2.1 Location 2.2 Size 2.3 Staff • Staff education • Staff-patient ratio 2.4 Financing • Costs • Reimbursement

  5. 3. Core treatment characteristics 3.1 Access criteria 3.2 Treatment concept • Scientific basis 1) 3.3 Weekly schedule 3.4 Discharge criteria 3.5 External control • Supervision • External approval 1) Appendix withexemplatorydescriptions , group / individual therapysessions

  6. 4. Treatment components 4.1 Psychotherapy • Concept • Therapy provision • Group, individual, family • Degree of indivitualized therapy • Problem analysis • Therapy plan • Process analysis • Therapy adjustment 4.2 Occupational therapy 4.3 Other fields

  7. 5. Aftercare 5.1 Offers, structure 5.2 Targets 5.3 Daily / weekly schedule 5.4 Staff 5.5 Access criteria 5.6 Discharge criteria

  8. 6. Policy for critical incidents 6.1 Intoxicated at treatment entry 6.2 Relapse during treatment 6.3 Misconduct 6.4 Lack of treatment progress

  9. 7. Special concept TC‘s 7.1 Outpatient / day-care 7.2 Other target groups • E.g. cannabis, drug-unspecific • Drugs and … (conduct disorders) 7.3 Self help or, lay personell 7.4 Drug maintenance (e.g. MM)

  10. 8. Outcome 8.1 National access rate 8.2 Patient characteristics 8.3 Treatment characteristics 8.4 Outcome

  11. 9. Appendices 9.1 Selected TC concept descriptions 9.2 Selected therapy descriptions 9.3 References • Multi care studies • Meta analyses

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