The EATI is a European training institute, supported by an international network of twelve major European institutions for addiction care and research. The EATI was founded in 1994 by the Jellinek, Amsterdam, The Netherlands.

• Local Xtc prevention policy
• Motivational Interviewing Training Videos
• Challenge for the future; Interview with Dr. Michael Gossop
• The European dimension of EATI
• EATI third phase: 1999 - 2000
• Novelties in European drug field
• Exchange of experience European colleagues
• Drug Service Management in Prison

What are the potential risks of the use of XTC and other designer drugs? How can an effective prevention strategy be developed in the >party scene=? What are the most important elements of a (local) preventive policy?

These were only three of the many questions that were discussed during the first EATI Training Seminar on the theme Atowards a local XTC (prevention) policy@. This three days seminar was organised in Hilversum, The Netherlands, from 13-16 May 1998.

According to the European Union Community Action Plan on Prevention of Drug Dependence, XTC and other synthetic drugs are a first priority in common preventive action in the European member states. Although the addictive potential is general seen as limited, the health risks for users are obvious. Both on short term, but especially in the long run.

The EATI Seminar was aimed at analysing strategic options for prevention and policy. Twelve participants from five countries (Belgium, Finland, Italy, the Netherlands, Slovenia) with a background in prevention and drug policy took part in the seminars programme. This programme existed of expert-presentations on the pharmacology of synthetic drugs (Dr. Henk van Wilgenburg, Medical Faculty University of Amsterdam), reviews of national (Dutch) and local (Hamburg) policy models on XTC and additional introductions on Italian and Belgium experiences with policy implementation.

Intensive discussions were held with special focus on the role of the police and juridical authorities in contrast to more preventive and harm reduction strategies. Does a repressive policy has an impact on the pollution of the black market for designer drugs? If yes, is it legitimate to test pills with the aim to reduce harm to consumers of synthetic drugs?

During the second day of the seminar, presentations were given on prevention projects. The European Model Project on Ecstacy (Hamburg, Amsterdam, Liverpool) was presented by Dr. Manfred Rabes (Germany).

This international project combines a methodology of research and monitoring in the party scene, peer education and attractive information cards and flyers. The discussion focussed on the question how to balance >preventive= information with the aim to prevent or reduce XTC use and >consumer= information aiming at providing users with information of bad quality pills and prevention of excessive use. Participants from countries with only a small XTC scene, concluded to put an emphasis on prevention, while other participants underlined a two-way strategy of risk reduction among frequent users together with an active primary prevention approach.

On the third day, participants formulated key-elements of a comprehensive prevention for policy for their own local and national situation: the main goals, the instruments needed, an implementation plan and supporting evaluation and monitoring. As a result it became evident that the elements of a general prevention policy plan have much in common, but that national and local emphasis very much differ, depending on the actual situation regarding the specific nature and pattern of the use of XTC and other designer drugs.

Participants were very well prepared for this training seminar. They brought with them many cases, actual prevalence figures and experiences on project initiatives. Those experiences included cooperation with organisers of rave-parties, discoclub-owners, bar tenders and local authorities.

During the final evaluation session, the participants as well as the EATI trainers, Ernst Buning and Wim Buisman, concluded that a three day seminar is too short to work out and discuss all aspects of XTC, rave scenes, youth culture and preventive and policy strategies. On the other hand this seminar has brought upon many new information, insights and perspectives to take back home.

The last nightly part of the seminar took participants, as invited international guests, to a big Amsterdam disco, giving them an opportunity to experience and observe a big rave party.

EATI will evaluate this important training seminar and will implement the evaluation outcome in its future training programme.

Wim Buisman, Ernst Buning

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The tapes were not designed to be used as a stand-alone form of training, but from only one part of a thorough presentation of the approach and skills involved in motivational interviewing. Because it is often helpful to see a method demonstrated in various contexts, the tapes show a variety of therapists and counsellors practising the component skills of motivational interviewing.

• The tapes provide an introduction to the subject and are designed as a professional training resource, not as a stand-alone form of training.
• The tapes are produced at low costs, below broadcast standard, but of good quality for training purposes.
• The tapes contain illustrations of interviews with a wide range of clients in a variety of settings.
• For ethical reasons professional actors play the role of clients. They were given general guidelines for their roles. Interviews were filmed without rehearsal Both actors and interviewers knew very little beforehand about how the interview would proceed.

The tapes are distributed in Europe by the European Addiction Training Institute (EATI), in VHS-PAL format. For more information, call, fax or E-mail.

To order the videos please ask for an order form. A brochure, describing each tape, will be included. The complete set of seven tapes costs US$ 135.-. The price of the separate tapes is US$ 25.- each, except for tape No.2 (US$ 35.-), all excluding packaging and mailing costs.

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Although cultural diversity and language problems between countries can slow down the process of exchanging information and expertise, the development of a truly European tradition on addiction research and raising the standards of this research should be considered as a major challenge for the future, is mr. Gossops opinion. ATraining in research is absolutely necessary@ he says. AOf course there are national organisations in Europe and regional initiatives that are producing quite promising material but I think that many national institutions tend to be somewhat complacent about research standards. Therefore an international effort to raise the standards, by means of training, is absolutely urgently needed to prevent the intellectual isolation to which this might lead@ says mr. Gossop. In his opinion the training courses offered by EATI, which focus on the junior level of researchers, will undoubtedly have an effect but will only lead to slow changes.

Broadening the scope to the research done worldwide, it seems quite clear that Europe is falling behind. Mr. Gossop: AWith so many million people in this continent, American research seems overall to be more advanced. The European resistance to this perceived American domination is understandable. But, from a strictly scientific point of view, we should look at and learn from the quality and high standards of their results. The actual European answer is still not very clear. European network activities seem to be important, and they are in general, but too often they get stuck in preliminary discussions on the differences and diversities between countries and regions. In this sense, national and cultural diversity are forming obstacles for progress. This is particular important, since in this frame of time there are a lot of key questions to address: HIV transmission, poly-drug use, treatment resistance and Boutcome, intravenous use of heroin and other substances, new drugs and patterns of drug use.@

Mr. Gossop wonders who is going to formulate priorities, goals and directions to effectively address all these topics. AIf we are all going to wait for the evolutionary outcome of networking processes, we might very well will have to wait a long time@ he says.

As in Mr. Gossops opinion EATI can certainly play a significant role to speed up this process and, at the same time, help facilitate the identification of the direction in which this process can take place. ABesides skill training and disseminating state-of-the-art knowledge throughout Europe, the underlying principle of facilitating the identification of key issues within the addiction field will enable colleagues to raise the standards of their professional efforts.@

Rik Bes.

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Mission to cross borders still remains in force

The EATI Staff Office, established in Amsterdam, organised together with experts fourteen training courses during the last two and a half year. Rik Bes, Training and Education Co-ordinator, emphasises the European dimension of the EATI. "We continually look for opportunities to demonstrate that EATI is a European network organisation. The great demand for a European training institute has been proved by the fact that we actually have to make a selection of participants because most training courses are completely filled. As training courses also serve as an opportunity to establish networks, participants have been able to learn from their foreign colleagues that they do not differ very much in their opinions on treatment, prevention and research. So it cuts both ways, not only skills and theoretical knowledge are gathered, people are able to communicate different views and opinions as well. If there was any resistance against certain approaches, this was usually founded on a shortage of knowledge and experience."

Participants have to fulfil certain conditions of a training course in order to be selected. With this procedure it is possible to ensure the European dimension."In this way we work with a group of trainees who are all motivated and dedicated to the subject. For each training course we follow an application procedure, which means that potential participants have to write a letter of interest and send in a Curriculum Vitae. Then of course we also take into account the country of origin, the professional qualifications, the current position and working experience as well as the command of the English language", says Rik Bes. This procedure seems successful. Twenty five trainers trained 400 participants from fourteen countries on the subject of New Approaches in Drug Care, Motivational Interviewing, Junior Researchers, Prevention, EuropASI, Strategic Management and a Summer School on Drug Policy Planning and Implementation. All training courses have been evaluated orally as well as in writing. Rik Bes: "Our evaluations have proved that the contents, methodologies and quality were highly appreciated. The results of the evaluations also show that some parts of training courses were less appreciated. This information, of course, is being used to adjust the programmes by mutual arrangement with the trainers. In our evaluation we ask participants for future training needs. This has resulted in the development of various new programmes for our next phase."

The European character of EATI is not only expressed by the origin of participants and trainers, co-operation has been realised with expert institutions in four different European countries. These institutions serve as a Focal Training Point (FTP) for EATI. "With the FTP's in Lisbon, Athens, Helsinki and Munich we have made arrangements on co-operation in preparing, organising and executing training courses in their countries. We are grateful for the support of these institutions in organising training courses."

The function of a EATI trainer is not one dimensional but appears to be a multi-functional as well as multi-dimensional task. "As there are no international up to date, training programmes available within the European drug field, EATI trainers have to design a training curriculum, write a course manual, act as a training process moderator and be an expert in a particular field. They also take care of the implementation of an integrative evaluation procedure. We are rather proud to be able to say that most of the 25 EATI trainers combine these different capacities successfully in their training work for EATI. In fact, they appeared to be the leading experts in the European field of addiction like treatment, research and policy making."

With these praising words Rik Bes faces the future of the European Addiction Training Institute full of hope. Not only EATI but all participating countries, FTP's , trainers and participants have crossed borders.

Ineke Hurkmans.

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• Increasing the impact of training courses
• Strengthening European trainers network
• Dissemination of high quality and tailor made training materials
• Ongoing needs assessments among addiction and health care professionals
• Certification according to the ISO 9001 norm
• Designing a European addiction diploma course

• Psychiatry and addiction
• Ecstasy and other synthetic drugs; strategic options for prevention and policy
• Cocaine and other (new) stimulants, options for tailored treatment
• Drug service management in prison
• Harm reduction management

• New Approaches in Drug Care
• EuropASI
• Advanced Training in Addiction Research
• Follow-up New Approaches in Drug Care

• Quality and Leadership
• Motivational Interviewing
• Telematic methods in drug prevention

More detailed information about the training seminars can be obtained from the EATI Staff Office. Special mailings will be sent out on the occasion of new training courses.

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As there is a great demand for training seminars EATI will increase the number of training courses during the third phase. Wim Buisman, head of the EATI, emphasises that the quality of existing training curricula will be improved by refining and fine tuning the existing training formats. AWe will perform a continuous needs analysis based on the information we have gathered by evaluating seminars as well as active involvement of our trainers network and the needs assessment which has been carried out in the period 1997-1998@ he says. ADuring our annual Trainers Forum we will discuss the development of new training courses and innovative adaptations, for which of course we need the co-operation of our trainers network.@

Now that the position of EATI in the European field of addiction has become clear it is time to adopt new methods. The operational policy of EATI for the next two years will be to further develop the role and position of EATI as a European training and educational network. AEATI=s goal is to innovate, implement and facilitate training activities in all fields of addiction on a European level@ says Wim Buisman. AWe will not only continue to implement and produce training courses and materials with a specific European nature, we will also complementary act as advisory and advocacy partner on other training services on a regional as well as national level. With our European network we will be able to provide for innovative training activities. The central mission in our work is to improve quality of our products in order to make interventions in prevention, care and treatment more effective.@

EATI wants to acquire a formal certification according to the ISO 9001 standards. In order to obtain this the process on the development of the institute has been described on the basis of the system of the European Foundation of Quality Management. Next to this certification it will be a complete novelty for Europe to issue a comprehensive European diploma. Wim Buisman: AWe observed that the countries of the European Union have a lot in common. Together with the European Ministries of Health and national organisations on addiction we will explore the possibilities to develop a diploma course on care and cure. To obtain this diploma participants will have to attend several basic training courses, which all will be offered by EATI.@

Based on needs assessment procedures and evaluation reports EATI will continue to offer the training courses which already have been developed. For the third phase new training seminars have been developed as well. AAs an increasing number of addicts in Europe also suffer from psychiatric disorders many therapists deal with the dilemma how to manage two different syndromes. For this reason we will offer a three day course on Psychiatry and Addiction@ says Wim Buisman. AWe also observed that synthetic drug use is becoming an increasing problem all over Europe. Although the addictive potential of these drugs is considered as limited, the health risks for users are obvious. Especially prevention officers and local policy advisors will benefit from more knowledge about strategic options. So the training seminar Ecstasy and synthetic drugs will focus on pharmacology as well as youth subcultures, research, community prevention and local policy.@

Other training seminars which will be operational during the third phase are Cocaine and other stimulants, especially for addiction and health care professionals. For middle managers who are responsible for drug services within the prison system two different training seminars on the subject of Drug Service Management in Prison will be organised, based on the pilot course which has been given in 1998. ADuring the pilot it became clear that there are considerable differences between EC Member States regarding the number and structure of drug services within the prison system. Therefore we will offer two different sessions@ says Wim Buisman.

On the threshold of a new century EATI will keep crossing borders, not only by facilitating training seminars but also by consolidating professionalism in the European drug field.

Ineke Hurkmans.

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The Finnish A-Clinic Foundation in Helsinki offers services like treatment and rehabilitation activities for people with alcohol or drug problems and their families as well as prevention, training and supervision. Mr. Rauno Mäkelä, medical director, attended the EATI training New Approaches in Drug Care and a follow-up seminar. He expected to get an overview about the new trends, both concerning attitudes and practical skills, in drug care in different European countries. AI was especially interested about the harm reduction approach which was then, and still is, a very ambivalent area in the Finnish drug policy and treatment facilities@ he says. AMy expectations were fulfilled and I recommended the training to my colleagues in the A-Clinic Foundation as well as other alcohol and drug care systems. I must say that I have worked much more purposeful with many development and training projects now that I have a larger European view as a background.@

In Finland the addiction institutions co-operate in the field of prevention and the connections with other alcohol and drug care institutions in Finland and Europe are quite good. AWhat worries me most@ says Mr. Mäkelä Ais that the education of social and health care staff in alcohol and drug matters is scarce in Finland. It includes too many old fashioned elements. The views are quite moralistic and rather unbalanced. The organisation of follow-up education is not very well organised and the quality and appreciation varies. What I consider a big problem in Finland is the reluctance of physicians to become interested in prevention and treatment of substance abuse. So I think EATI could help us improving the qualities of our activities. Perhaps training organisations in different countries can collaborate and train-the-trainer courses can be organised. There is a need for knowledge on planing larger training programmes at a basic as well as a specialist level. But, on the other hand, we do have expertise in all these matters and some of our experienced trainers might be interested to assist as a co-trainer in EATI training courses@ concludes Mr. Mäkelä.

Another Finnish organisation is STAKES in Helsinki, an institution for social welfare. Stakes is focal training point for EATI in the prevention field. Mrs. Saini Mustalampi attended the training course on XTC and other synthetic drugs. APrevention projects and campaigns are developed together with local organisations@ says mrs. Mustalampi. ASince there are 453 municipalities and regional offices in Finland it is quite an organisation to co-ordinate prevention activities on a local level. A five year pilot project has been started to develop drug prevention projects in smaller cooperative networks of fifty municipalities. Since Finland as well as other countries is being confronted with the new phenomenon of XTC the training course has been very valuable for us. All information I can gather about the latest state-of-the-art on the policy and prevention in other countries is useful. Stakes facilitates training courses in Finland but the participants have to do the actual work. We distribute the principles on a local level.@ In Mrs. Mustalampi=s opinion EATI really has a European approach where every country is able to contribute its own expertise and experience and where the views of different countries are respected. She hopes EATI stays European.

The Health Office Frankfurt am Main runs two ambulances for Methadone substitution for 150 clients. Mr. Wolfgang Guggenberger co-ordinates the further implementation of this programme. He attended the training seminars on Strategic Management, New Approaches in Drug Care and the follow-up training. AI expected to get a good basic knowledge both theoretical as well as practical and I must say that my expectations were completely fulfilled. As it is always a challenge for me to provide optimal services in any field of work I was very motivated to learn through lectures, as well as by comparison and introduction of other European addiction related projects.@ Asked for his view on the future of EATI Mr. Guggenberger would appreciate an extended programme or more follow-up courses. AOur work of course is always based on theories but I think it is very important to put this in practice. I expect from EATI that a European network on addiction related work will be improved. The international exchange of experience with other colleagues is very important and helpful.@

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The pilot workshop Drug Service Management in Prison, held on 19, 20 and 21 March 1998, London, United Kingdom, provided the participants with improved understanding and knowledge to manage innovations in their services. Professionals, being middle management staff in prisons, Senior Officers, Junior Governors, Managers of Health Care Services and Drug Strategy Co-ordinators were introduced to key issues in the field of addiction care within the prison system.

This workshop was a result of the intention of both the European Addiction Training Institute (EATI) and the European Network of Drug and HIV/AIDS Services in Prison (ENDHASP) to co-operate on the field of training and education. Both partners developed a format for this pilot workshop and disseminated the results, taking into account the participants' experience and insights.

In the workshop, the experience of the participants from different EU member states have been used and the trainers/facilitators and guest-lecturers introduced their state-of-the-art expertise. Trainers/facilitators were Mrs. Theresa Holman, ENDHASP, London, United Kingdom and Mrs. Astrid Bödeker, EATI consultant, Amsterdam, The Netherlands. Experts from EU Member States were invited as guest lecturers on the following topics: Health Care Issues ( Paul Wells, United Kingdom), Planning and Management of Services (Geoff Cooke, United Kingdom) and Staff Burn-Out prevention (Rik Bes, The Netherlands).

For the three-day workshop, a set of objectives was formulated. Participants have been enabled to:

• Examine attitudes and beliefs about the social and cultural context in which people use drugs
• Identify best practice for different types of prisons and prisoners, and the barriers to its implementation
• Develop individual action plans, relevant to each participant's prison.

These objectives were met in general, according to the evaluation of the participants. Specific remarks indicated an improved understanding of drug use and its context, an improved technical knowledge of the theory and practice of drug treatment in prisons and its management and an improved ability to plan and implement drug treatment strategies in prison.

The big question however is what to do next. Has this been a one-off event for the participants and trainers? Was it a "taster" session, in which participants will have learned something but, returning to their every-day practice, get overwhelmed by their daily routine? Is it a good idea to plan a follow up; to give the participants support in their implementation strategies to innovate their services? These are all questions to be answered by EATI and its trainers. The answer?

Depending on the granting of funds for EATI's third period of funding (1999 - 2000), two new sessions of "Drug Service Management in Prison" will be offered.

Rik Bes.

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