welcome to a-senteret!

Welcome to A-Senteret!

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:


Hva er A-senteret?

• 45 employees, Outpatient:12, Inpatient: 24 (half of these parttime)

• Outpatient: 7.475 yearly consultations, Inpatient: 20 beds (7.300)


Our work:

• Assessment of referrals

• Outpatient treatment

• Inpatient treatment

• Supervision/Information/Lectures

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



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


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 ….


Outcomes:

• Increased quality of life• Changes in use /consumption of alcohol/drugs• Relapse prevention


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


Patient population at A-senteret


Referals from:

• General Practitoners, medical doctors• Local Authorities, social welfare office• Other parts of the Health Service, Specialist


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


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


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


Outpatient groups

• Information course

• Mindfullness/Stressreduction course

• Group for adult children of parents with alcohol-/drugproblems

• Group for spouses/partners

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


Inpatient unit- treatment phases

• Assessment phase• Preparation phase• Admission to the inpatient unit• Treatment planning • Treatment phase• Termination phase• Follow-up


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


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


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


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


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


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


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


welcome to a-senteret!

Documents

use of alcohol

high alcohol consumption

tsb treatment

parents alcoholdrugproblems50

high consumption

yrs consumption

norway sirus

ekbergpatient population