PHOENIX AFTERCARE Programme for psychosocial reintegration of substance dependent populations Teodora Groshkova Institute for Ecology of Cognition Bulgaria

Institute for Ecology of Cognition

Legal Framework NGO in public benefit Registration No 7806/2002

Programmes Phoenix Therapeutic Community (TC) for substance dependent individuals license 712001, Ministry of Work & Social Policy license 322002, Ministry of Health Three Phoenix Admission Centres & two Aftercare centres across Bulgaria CBT & TC training programmes accreditation, Bulgarian Association CBT

Collaboration in Bulgaria Partnership agreement with Ministry of Work & Social Policy Authorisation No 0802/05 Partnership with Ministry of Health for training of professionals in TC model Part of a national professional network along with National Addiction Centre, Sofia Municipality Centre for Drug Use Prevention, Bulgarian Association for Partnership & Integration, Bulgarian Association for CBT

International Affiliations Member of European Federation of Therapeutic Communities (EFTC) Member of Association of Therapeutic Communities (ATC) Member of Community of Communities – A Quality Network of Therapeutic Communities (Royal College of Psychiatrists, London)

Projects ‘TC Phoenix’ Project No 5632/2007, Ministry of Work & Social Policy, Social Support Agency ‘Psychosocial Rehabilitation of Drug Dependent Individuals from Therapeutic Community’ Project No 021/2007, Ministry of Health ‘Resocialisation of Drug Dependent Individuals’ supported by Grant Contract External Action of the European Community, CSDP 2006 Lot 1 – 031 ‘Socio-labour reinstatement’ in cooperation with Bulgarian Association for Partnership & Integration supported by FICT – Federazione Italiana Comunità Terapeutiche ‘Psychosocial Reintegration Phoenix’ supported by UK Embassy in Bulgaria, Department for International Development, Small Grants Scheme 2003/04

Phoenix Aftercare

The context What extend of needs? lack of consistent systematic monitoring of drug treatment and rehab referral / completion rates data across the country a significant No of drug users seek rehab abroad Expert opinions agreed on existing need of social reintegration services Social reintegration services – almost completely underdeveloped Phoenix aftercare programme was developed as an attempt to answer existing needs in a structured and coordinated manner There is no official data about the number of substance dependent individuals seeking medical treatment and rehabilitation of drug addiction (EMCDDA Report, 2001-2005). Data on referral to TC Phoenix are available but there is a lack of consistem systematic monitoring of referral / drug treatment service usage data across the country and, in addition, a significant number of clients (based on expert opinions) seek rehabilitation abroad. These factors contribute and explain why official data is lacking but expert opinions tend to agree on the fact that there is an existing need of those services – to address the needs of both clinets who seek treatment and rehabilitation within the country and those who go abroad – the latter, upon return are equally, if not more, in need of resocialisation in their own environment. In general, social reintegration is considered to be an integral part of addiction treatment and rehabilitation and a crucial element for the overall success of addiction recovery. However, provision of social reintegration services, as elements of coordinated patient treatment journey in Bulgaria have remained almost completely undeveloped or where these have emerged, they are available as informal interventions by self-help groups. Phoenix Aftercare programme was developed as an attempt to answer existing needs in a structured and coordinated manner. As part of TC Phoenix rehabilitation programme, the Aftercare project is now a full member of the Association of Therapeutic Communities (ATC), UK and of the European Federation of Therapeutic Communities (EFTC). It is also actively involved in “Community of Communities” – a standards-based quality improvement international network, managed by the Royal College of Psychiatrists’ in partnership with the ATC, EFTC amongst others. Active involvement in international projects and initiatives provides staff members the opportunity to be a part of intensive and constant exchange of best practices in the field of social reintegration and hence master in the provision of high quality services – in answer of the ever increasing needs at a national level. The development of the programme has, but partially, met the still existing needs. In addition to the above stated, social and reintegration programmes and actions can and should aim to address not only drug users but other vulnerable social groups in general, such as the street homeless, the street children – issues that are often interwined with substance misuse. It has been identified that these groups are lacking the opportunity to have their needs met due to the lack of availability of social reintegration services nationwide.

Aftercare Programme Sofia and Bourgas National coverage of referrals Varied length of stay but tending to one year 6m intensive support and assertive outreach 6m flexible support (possibility to attend on request following graduation)

Interventions Initial assessment individual needs and aspirations personal strengths and family resources Care coordination as per individual aftercare plan Career guidance Job placement and employment Education and training Individual counselling Groups support groups family/significant others groups social network therapy UDS Crisis interventions

Staffing Two trained ex-drug users in clinical positions Two social workers One applied psychologist Admin support

Support and collaboration FICT Sofia and Bourgas Municipal Addiction Prevention Centres Ministry of Work & Social Policy Programme “Independent again” a nation-wide programme of the Ministry aiming at enabling employment for long-term unemployed people with minority ethnic background and or disabilities (including substance misuse) University of National and World Economy, Sofia Programme for vocational training of young people with history of substance misuse