the ” triple-project ” forensic psychiatric center glostrup copenhagen university hospital
Post on 01-Feb-2016
56 Views
Preview:
DESCRIPTION
TRANSCRIPT
Navn (Sidehoved/fod)Titel/beskrivelse (Sidehoved/fod)
The ”Triple-project”Forensic Psychiatric Center GlostrupCopenhagenUniversity
hospital
The Tripleproject” – New Hampshire Model
Mette Brandt-Christensen, MD, PhD, assistant professorForensic Department,Psychiatric University Center Glostrup, Copenhagen
Navn (Sidehoved/fod)Titel/beskrivelse (Sidehoved/fod)
Integrated treatment for dual disorder works –
Does it also apply for “triple-disorder”-patients?
The Tripleproject” – New Hampshire Model
Mette Brandt-Christensen, MD, PhD, assistant professorForensic Department,Psychiatric University Center Glostrup, Copenhagen
Navn (Sidehoved/fod)Titel/beskrivelse (Sidehoved/fod)
Triple-disorder:Severe mental disorder
Substance abuseForensic status
Navn (Sidehoved/fod)Titel/beskrivelse (Sidehoved/fod)
Developing the ”Triple”project – integrated treatmentfor Triple-disordercostum-fit – one size does not fit all
Navn (Sidehoved/fod)Titel/beskrivelse (Sidehoved/fod)
The NHM – program modified
Stages of the integrated Triple-disorder treatment
– the Glostrup model
END
OF
ABUSE
Pre- consideration
Pre-engagement
Relapse
Maintenance
Relapseprevention
ActionActive treatment
Consideration
Engagement
Preparation
Navn (Sidehoved/fod)Titel/beskrivelse (Sidehoved/fod)
Stages of care and treatment.Definitions and goals:
Mueser, Kim, et al 2006 and Prochaska James O. et al 2008.
Adapted by Retsbo, 2011 NHM - stages NHM - stages NMH - behaviour Lasting change-
stages
Engagement Preengagement
Engagement
No contact with case- manager
No regular contact with case-manager concerning
substance abuse
Pre-consideration
Consideration
Persuasion / prepatarion
Early persuasion
Late persuasion
Regular contact with case-manager, but no reduction in
Substance abuse
Reduction for less than one month
Preparation
Active treatment Early active- treatment
Late active-treatment
Reduced substance abuse for more than one month
No substance abuse for 1-6 months
Preparation
Action
Relapse – prevention Relapse prevention
Improvement or symptom-free
No substance abuse for at least 6 months
No substance abuse for at least one year
Maintenance
Termination
Navn (Sidehoved/fod)Titel/beskrivelse (Sidehoved/fod)
Care and treatment – the stages of NHM in the ”Triple-Project”Inspiration from: Mueser, Kim et al, 2006; modified by Retsbo, august, 2011
Engagement-stage
Preparation-stage
Active care & treatment-stage
Relapse- prevention-stage
Assessment
Case management
Patients´ network
Activation and daily structure
Social – & economic stabilisation
Psychopharmacological treatment
Coercion
Motivational interviewing
”Set out for a better life” – cognitive behavioural therapy individually and as patient-courses
Self-help-groups
Navn (Sidehoved/fod)Titel/beskrivelse (Sidehoved/fod)
Triple-disorder treatment
Goals:
Staff qualification program:All employees (nursing staff and psychiatrists): 3 days
seminar29 employees (nursing staff and psychiatrists): 4 days
seminar followed by supervision sessions
Assessment, care & treatment:Screening of all patients for substance abuse Stage-based care and treatment ad modum NHMCompendium with detailed description of the care- &
treatment program
Navn (Sidehoved/fod)Titel/beskrivelse (Sidehoved/fod)
Triple-disorder treatment
Hopes for the project:
Assessment, care & treatmentExperiencing increased quality of lifeReduction of drug consumptionReduction of criminal activities
Staff qualification program:Change in attitude and more apprecitiavely
approach towards tripple-disorder-patientsIncreased job satisfaction
Navn (Sidehoved/fod)Titel/beskrivelse (Sidehoved/fod)
Triple-disorder treatment
Challenges: A non-confronting and appreciative approach in all
stages Non-consulting approach to patient during the first two
stages Balancing efforts of harm-reduction and obligations
towards judicial system
Navn (Sidehoved/fod)Titel/beskrivelse (Sidehoved/fod)
Triple-disorder treatment
Project ends autumn 2012:Evaluation of selected out-come target from the
NHM program (ASI-data, including patients´ experience of QoL)
Evaluation of staff qualification-program
Navn (Sidehoved/fod)Titel/beskrivelse (Sidehoved/fod)
Integrated treatment for Triple-disorder
Navn (Sidehoved/fod)Titel/beskrivelse (Sidehoved/fod)
Integrated treatment for Triple-disorder
Navn (Sidehoved/fod)Titel/beskrivelse (Sidehoved/fod)
Integrated treatment for Triple-disorder
Thank you for your attention!
Contact: Email: Lisbeth.Henningsen.Retsbo@regionh.dk
top related