Welcome to A-Senteret!
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Transcript of Welcome to A-Senteret!
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Welcome to A-Senteret!
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A-Senteret 13 september 2013 E.S.Hubbuck/A.Ekberg
• 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
A-Senteret:
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A-Senteret 13 september 2013 E.S.Hubbuck/A.Ekberg
Hva er A-senteret?
• 45 employees, Outpatient:12, Inpatient: 24 (half of these parttime)
• Outpatient: 7.475 yearly consultations, Inpatient: 20 beds (7.300)
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A-Senteret 13 september 2013 E.S.Hubbuck/A.Ekberg
Our work:
• Assessment of referrals
• Outpatient treatment
• Inpatient treatment
• Supervision/Information/Lectures
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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
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A-Senteret 13 september 2013 E.S.Hubbuck/A.Ekberg
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 13 september 2013 E.S.Hubbuck/A.Ekberg
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 ….
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A-Senteret 13 september 2013 E.S.Hubbuck/A.Ekberg
Outcomes:
• Increased quality of life• Changes in use /consumption of alcohol/drugs• Relapse prevention
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A-Senteret 13 september 2013 E.S.Hubbuck/A.Ekberg
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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A-Senteret 13 september 2013 E.S.Hubbuck/A.Ekberg
Patient population at A-senteret
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A-Senteret 13 september 2013 E.S.Hubbuck/A.Ekberg
Patient population at A-senteret
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A-Senteret 13 september 2013 E.S.Hubbuck/A.Ekberg
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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A-Senteret 13 september 2013 E.S.Hubbuck/A.Ekberg
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:
• 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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A-Senteret 13 september 2013 E.S.Hubbuck/A.Ekberg
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
• Assessment phase• Preparation phase• Admission to the inpatient unit• Treatment planning • Treatment phase• Termination phase• Follow-up
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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
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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• 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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