1. T.C. as part of a care and treatment system Rehabilitation as part of the chain Ginette Hendriks

2. Introduction  Ginette Hendriks  Head of one of the three rehabilitation units from Addiction Care North Netherlands (VNN).  “The T.C. as part of a care and treatment system”

3. About VNN, for addiction care in the northern part of the Netherlands  catchment area the North of Netherlands  the three northern provinces  approximately 1,5 million inhabitants  treated prevalence is about 9.000 in 2006 * Inpatient 14 % * Daypatient 1 % * Outpatient 97 %

4. Types of care : 1.Probation 2.Prevention ( for example: prevention projects on schools, information programs for teachers and parents) 3.Case management such as Assertive Community Treatment and our heroine project 4.Outpatient care 5.Daypatient care 6.Inpatient care (for example: T.C and the inpatient family treatment) 7.Rehabilitation,sheltered homes and aftercare About VNN, for addiction care in the northern part of the Netherlands

5. The chain of care “from front door to back door” Assessment + referral Outpatient Care TC Aftercare and evaluation Admission -Crisis -Detox -Diagnosis -Motivational treatment Daypatient care Day/outpatient Care Rehabilitation (Work/Home

6. What’s happening after the TC Rehabilitation starts Types of rehabilitation: Inpatient **/*** Different kinds of sheltered homes */**** Support and coaching at home */*** Outpatient */** Chronic recidivism program *** **** = intensity of sheltering * = 1 weekly conversation / contact

7. Some figures 14 beds inpatient rehabilitation 8 beds sheltered homes */**** opiate 36%, cocaine 16%, alcohol 29% and other substance abuse 19% mean age 38 female 29% 20% drop out more than 5 years addicted Aantal BZW plekken Middelen gebruik Gem. Leeftijd Man / vrouw Uitstroom / uitval Duur verslaving

8. Rehabilitation in a few statements  Patient centered  Clients make their own treatment plan  Minimally 1 conversation a week  Each program has his own weekly group  Groups on indication and voluntary like Social Juridical Groups, STEPPS, relapse prevention groups.  (re)entry to work (every client works for 20 hours a week)  Reintegration to work  Coaching instead of treatment  Relapse prevention and relapse management  Every client joins a self-help group like the A.A or create their own  Multidisciplinary team ( psychiatrist, systemic therapist, psycho therapist, reintegration worker, social juridical worker, coaches)

9. The don'ts in attitude 1.Do not advice ( they have to choose themselves) 2.Do not judge (they have to be there own judge) 3.Don’t take over the responsibility (they can en may make mistakes)

10. Aftercare  STEPPS program (VERS I)  Stairways program (VERS II)  4 reunion days a year  Regular and periodically screening  Outpatient care  Short Brake Bed  E health  Other

11. The pathway to rehabilitation T.C. Inpatient **/*** Sheltered homes */**** S & P At home */*** Out and Day pat. */** Chr. Rec. Progr *** Aftercare

12. See YOU in 2009 I hope to see all of you in the Netherlands in 2009,when we will organize together with Parnassia the EFTC 2009. Eyes on the Future