Residential therapeutic / rehabilitation community for pathological addictions
This centre started off as a drug rehabilitation centre, subsequently integrated the specific treatment of alcohol dependence into its programme, and has now opened its doors to new addictions. First and foremost of which is Pathological Gambling, given its exponential growth, closely followed by the various forms of Internet Addiction Disorders, Work Addiction and Sex Addiction. The increasing frequency, which we have observed in our residents, of substance abuse associated with various forms of new addictions (mainly alcohol/cocaine/pathological gambling) has prompted to us to make our action more and more specific and even customised. This is achieved with the targeted training of an operational team and through an appropriate multi-professional approach, which puts the resident at the centre of the process of care and rehabilitation. The collaboration with local self-help groups, such as the AA, and more recently, Gamblers Anonymous, has proven to be extremely resourceful.
People suffering from the abuse of, and addiction to alcohol and cocaine, multi-drug addiction, dual diagnosis, pathological gamblers, patients with pathological addiction who benefit from alternatives to incarceration. The programme is designed for adult male users.
Residential Therapeutic/Rehabilitation Programme
RESIDENTIAL THERAPEUTIC/REHABILITATION PROGRAMME
- addiction to illegal drugs of abuse
- alcohol dependence
- gambling addiction
METHODOLOGY AND OBJECTIVES
The residential programme includes:
- Regular health checkups involving specialists
- Gradual reduction of agonist drugs
- Motivational treatment
- Psychoeducational group therapy
- Psychotherapeutic, cognitive-behavioural treatment, individually and in group therapy
- Working with the family and life-partners
- Parenting support
- Craving control
- Improving impulse control and relationship management
- Development of aspects related to self-esteem and to the ability to tolerate frustration
- Overcoming risk behaviours
- Assessment and activation of personal resources
- Achieving levels of autonomy compatible with existing resources and problems
- Acquisition of professional skills
- Reintegration into social and working context
The residential therapeutic/rehabilitation programme includes a module for the treatment of alcohol dependence. The programme is designed for a maximum of 20 adult males, whose addiction has not led to neurological, psychiatric or biological impairment, which would obstruct participation in the programme's activities.
Duration of the programme
The programme lasts 6 months with a possible extension of a further 6 months.
Admission to the programme follows a request from the drug addiction services of the local health service, which must provide a psychosocial and clinical report: the request will be assessed by the team working in the facility.
- After the team has carried out a suitability assessment, an initial interview is arranged with the potential resident, accompanied if possible, by family members. During this phase, assessment tools are used to supplement the information received from the health authority.
Methodology And Objectives
The residential programme includes:
- Continuation of cessation treatment, started during hospitalisation, with the use of other medication agreed with the care providers.
- Motivational counselling
- Psychoeducational group therapy
- Psychotherapeutic therapy involving weekly individual and group interviews coordinated with operational techniques twice a week.
The aim of the psychotherapeutic intervention is to improve the relationship with the outside world, especially interpersonal relationships, by increasing frustration tolerance, reducing conflict and avoiding the activation of the regression mechanism. Objectives: reinforcement of motivation, acquisition of new forms of behaviour.
- Regular health checkups and clinical assessments through examinations and/or consults by alcohologists and psychiatrists.
- Cognitive rehabilitation programmes.
Involve the use of specific techniques of cognitive activation that include a variety of strategies to the treatment of mnesic deficits: memory training, mnemonics.
- Physical rehabilitation programmes.
- Mediation activities aimed at social reintegration outside the facility preceded by participation in existing activities in the Village and vocational training courses. Residents also benefit from this educational experience which has always characterised the activities of the Foundation. The facility offers a number of business activities in which patients will be engaged depending on their capabilities, interests and personal experience, in order to encourage the expression of individual creativity by developing a sense of responsibility and commitment. The facility has arrangements with two Social Cooperatives, valuable resources for re-employment, for those who still need partial protection outside of a secure environment. The aims of this scheme are:
- to improve skills
- to encourage socialisation and the ability to collaborate actively and responsibly in a workgroup
- to achieve levels of autonomy depending on resources and personal issues
- to facilitate reintegration into the social fabric.
- Working with family members or partners:
- working on awareness of the actual deficit
- elaborating issues related to separation - emancipation
(this can be addressed at the Foundation's main facility or by the drug addiction service which directed the resident, if the relationship so provides. In the latter case, every 2 weeks the resident and family members will meet with the healthcare workers). All collaborating family members attend self-help groups.
- Recreational and cultural activities
Residential Educational/Rehabilitation Programme
RESIDENTIAL EDUCATIONAL/REHABILITATION PROGRAMME
Close monitoring of health status is also ensured in this programme.
From a methodological operational point of view, the facility uses tools such as psycho-educational group therapy, individual working groups as well as non-structured individual interviews. It is possible to pass from the therapeutic rehabilitation programme to the educational- rehabilitation programme in order to facilitate the consolidation of achievements and reintegration into the workforce.
The use of work activities (used in both programmes) encourages residents to develop autonomy, a sense of responsibility and improves production and management skills. Even in the most disadvantaged conditions this is an important resource for preserving and enhancing residual abilities, as well as a useful tool to encourage socialization. An important function is carried out by skilled artisans, capable of transmitting knowledge, skills and experience.
Priority is given to craft activities which, through the relationship with external manufacturer, facilitate the creation of employment opportunities in anticipation of social reintegration, which is accomplished by assessing the various levels of autonomy achieved.
- light carpentry
- furniture restoration
- gardening and horticulture
These activities are coordinated by a master craftsman who relies on the collaboration of other qualified professionals.
Objectives of the training:
- Achievement of personal autonomy
- Creation of professional skills
- Facilitating reintegration into society and the workplace
Education and vocational training within the facility:
- Basic and advanced computer training
- Basic and advanced English language courses
- Training on health and safety at work
- Welding Courses
- Basic level bricklayers course - 300 hours
- Painters and Decorators course
Professional training courses outside the facility
The Ravenna School of Construction will assess those considered suitable for this work in terms of personal interests, characteristics and capabilities and they will have the opportunity to attend the following courses:
- Course for forklift operators
- Theory and practical training in the use of earth-moving machinery
- Theory and practical training in the use of tower cranes
- Basic and advanced level courses in Carpentry and Scaffolding
- Course for Construction Workers assigned to the recovery and maintenance of historical buildings and materials
- Basic and advanced AutoCAD course
The programme also includes recreational, cultural and sporting activities.
Residents are discharged when they have achieved their goals. The duration of the therapeutic rehabilitation programme is agreed with the resident's health service on the basis of the characteristics of the shared project and the identified objectives.
Dr. Manuela Ceccarelli
Qualified surgeon with a Master's degree in "Group and Family Psychotherapy", four-year psychoanalytical training period at the International Institute of Social Analytical Psychology -Mestre (Venice) and a Master's degree in "Alcohol-related problems and disorders", at Careggi Hospital, Florence, Italy.