EFTC 11th European Conference on Rehabilitation and Drug Policy June, 2007

Gerjan Timmerman family-therapeutist Verslavingszorg Noord Nederland - VNN Addicion Care North Netherlands

From a vulnerable relation to an intensive collaboration. Collaboration of Therapeutic Community, patient and nucleus system.

De Breegweestee Therapeutic Community Target Group: adolescents and young- adults. Chronic destructive substance abuse. Severe problems in other life areas. Comorbitity: Dual Diagnosis.

Features of the target group Substance abuse. Starts in puberty. psychological, emotional, cognitive and relational developments stops Criminality to obtain means. Keeping up appearences about autonomy.

Admission factors and criteria. 1.You cannot hide, neglect or suppress the problem anymore 2.A huge change in the consisting structures which can evoke enormous anxiety 3.It is the beginning of a break-through of existing behaviour patterns, which can evoke enormous anxiety.

Admission 1.It is the start of getting free of the direct control of the nucleus family, which can evoke enormous anxiety 2.It will open information about topics which the person wants to keep silent

Factors which inhibit to build up new relations. 1.Loss of control of the treatment. The inpatient crew takes it all over. 2.Unfamiliarity with the treatment, the language of therapists. 3.Inaccessibility of the inpatient department: from no contact to contact on appointment. 4.Collusion (Tromp & van de Ree).

The vulnerable part of the relation: collusions. 1.Collusion: The way in which families and the admitted person define the inpatient department. 2.Under-involvement: families are burned out and give the responsibility to the inpatient department. 3.Over-involvement: families are doing everything to maintain control over the admitted patient. 4.A combination of repulsion and attraction (mainly in crisis).

How can we strengthen the relation? 1.To recognize the collusions 2.To anticipate on this developments by respectfull approaches, open communication 3.Professional attitude: one-down. 4.To consider families and the admitted patients as co-experts.

Ingredients which are already present at the TC Breegweestee. 1.Appropriate introduction of the coming patient 2.Families can take a preview in the TC. 3.Systemic screening and systemic diagnosis of the family involved. 4.Information days for the families. 5.Familytherapy 6.Meetings with other family members for recognition and support.

With special thanks to Cherda Trügg