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35th Annual Alcohol Epidemiology Symposium of the Kettil Bruun Society (KBS 2009) Copenhagen, Denmark, June 1-5, 2009 www.kbs2009.dk A training oriented approach for a customised alcohol treatment program ( Education and Change). Allaman Allamani* Alberto Centurioni* Canio Lomuto*
35th Annual Alcohol Epidemiology Symposium of the Kettil Bruun Society (KBS 2009) Copenhagen, Denmark, June 1-5, 2009www.kbs2009.dkA training oriented approach for a customised alcohol treatment program(Education and Change)
Allaman Allamani* Alberto Centurioni* Canio Lomuto*
Carmen Lenci+* ACA Training Group, Florence Italy+ CE.R.AS.AL Research Center, Senigallia Italy
Addiction represents many interests by individuals as well as by systems. The individual consumer is a subject of needs and part of a system – family, society and culture.
(2) Rehabilitation: including short-term residential programs (30-90 days),
therapeutic communities (3-12 months), outpatient programs (a few mths- years)
(3) Continuing care, generally in an aftercare setting, typically in association with mutual help groups activities.
(Mc Lellan 2006)
- avoiding the one/to one therapeutic relationship
- promoting e.g. “rotation of therapists”
and the “Therapeutic Milieu”.
Such an approach requires a reconceptualization and a re-organization of the therapeutic setting, and a training that addresses the new needs.
An ethical focus is also necessary when training professionals in the addiction area.
(Krampe et al, 2004 ,Yalisove 2006 ,
Chemtob and Levy,2009)
On the other hand, a training process that involves a “down-top” approach for professionals, who are capable of tailoring existing SUD programs to their own needs and to those of the clients, appears relevant. .
June 2008 - April 2009
This project aimed at inducing changes within the hospital, the hospital manager being interested to make the therapeutic system more efficient.
(one coordinator, two teachers,
the hospital social worker - who functioned
as a local facilitator)
agreed on 5 project phases .
ANALYSIS OF NEEDS- a synthesis 1
The needs reported by the personnel were:
ANALYSIS OF NEEDS- a synthesis2
Projecting and Experimenting
25 people (1/2 of the clinic staff) attended.
One outcome of the training was
co-planning and implementing
a “daily morning meeting ”
involving the entire staff.
This meant changing
a hierarchical/vertical organisation
into an horizontal one
- also making a better circulation
of the information possible.
the hospital personnel was asked
to write down their opinions and impressions about the training.
Following is a synthesis
of the reports of some professional groups
The training course has been an opportunity to know each other, outside of our working roles, and also to know the activity of every professionals better then before, openly expressing our problems… (kitchen & cleaning personnel)
It has allowed us to develop the ability to introduce ourselves to the patient implementing a positive communication, which takes in consideration the particular needs and feelings of the ill person and permit to enter in tune listening and accepting , and not judging him/her…(nurses)
... The daily morning meeting appears to be a constructive co-operation among professions, to favour a better motivation to work, and to give professionals greater cohesion and consistency of participation…(psychologists and social worker)
One of the more interesting aspects of the course has been that a good part of the staff who operate in the Hospital Unit to have been involved…Thus, having decided about he daily morning meeting with all the professions attending, in spite of initial difficulties and “resistances”, we were able, as a group, to..make a decision..that until just months ago seemed quite difficult to imagine… (medical doctors)
At the end of this Training
the improvement of communication
both among professionals
and among professional groups
was a most positive change
as perceived by participants .
Participants were able to appreciate
the chance of self-observing
when applying the communication skills
both with their clients
and their colleagues
at the laboratory level
and in the working context as well.
Any organizational system has an “inertia”
that operates as an institutional barrier
against the forces for needed change.
The success of the training in introducing an organisational change (dmm)
is attributable to the combination
of the personnel motivation and to the management’s clear determination
to pursue the on going changes.