Transdrug project partners meeting in Bratislava

In earlier newsletters we reported on the Transdrug project, funded by the European Union by means of its Leonardo da Vinci fund, in which representatives from four countries (Finland, Italy, Slovakia and The Netherlands) collaborate in developing a methodology to establish the training needs of workers who have contacts with drug addicted people. It has been running for almost two years and is approaching the final stages of implementation and dissemination of the findings.

Many of the participants met (for the fourth "transnational" work meeting) in Bratislava from 19-1 September 2002. The hosting organisation was the CPLDZ, the leading Slovakian treatment organization  in Bratislava, and they made a fine job of it. On the 18^th Dr. Hroznata Zivný took most of the guests on a city walk through the heart of beautiful old Bratislava. That was the first of a number of much appreciated social events that brought participants closer together and gave them a fine insight into the local and national culture. We climbed to the first of three castles that we were to visit during our stay, saw the glorious cathedral and felt the deep bass sound vibrate in our tummies of an open air concert that coincided with the Transdrug meeting and went on for days right in the old city centre. The atmosphere in the city turned out to be very relaxed, people enjoying the mild weather on the many terraces in the historical streets.

Next day the work started. Slovakian representatives gave overviews of some of their activities and research. Next, participants met in groups, exchanging experiences with different methods of training needs assessment and developing methods of presenting the results to national audiences. In several and each time differing constellations representatives would meet and come up with suggestions that next were discussed in plenary discussions. Thus ideas crystallized on what methods would best suit what purposes. In addition the contours of a Toolkit emerged, that will be one of the lasting results of the project. In this Toolkit (or rather Toolkits as they are to be constructed in various languages, tailor made for each participating country) overviews of training needs assessment methods will be presented (such as the Nominal Group Technique, SWOT analysis, Future Workshop and the Survey Method), along with reports on existing training methods in the countries involved, their history and development, and including some information on the addiction patterns and services. A glossary will help readers understand specific issues, and some general articles should put the material presented into perspective.

Great attention was paid to the dissemination of the results. Some of the knowledge that has been developed during the project has already been shared with national partners, to a degree that varies according to culture and history. But how to make the products available to wider audiences (and who should they be?), making use of the Toolkit and possibly other means like Internet, conferences, training sessions? On such issues brainstorm and other creative sessions were held, the results being harvested in the final hours of the meeting. At the mean time some form of evaluation of "where are we now, how much have we progressed" was held. It was noticeable to all that, compared with the early meetings, participants had become more relaxed, were better able to present their results and discuss them, had a better insight in the project as a whole and in their contribution to it. This strengthened greatly the confidence that in the months to come, when the integrating of all results will take place, the Toolkit (that is scheduled to be ready in March 2003) and other products will validate the trust Leonardo da Vinci put in us all. By that time EATI will let you know how to get a copy of the Toolkit and possible other outcomes of the project. As is the case with many EATI-projects you will find a description and links on our website.

Dick Osseman

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Training in the health professions with special attention to the addiction services

This is a highly condensed version of a text for the Transdrug project, concerning aspects in the training of professionals in addiction services. The model used was suggested by Wim Buisman.

What makes the addiction field so special?

Normative elements feature strongly in the discussion on addiction. As a result, much more than in most health care, non-medically oriented people take part in the discussion on "proper practice". So the addiction field encompasses activities from specialists in such diverse fields as medicine, psychology, social work, psychiatry, politics and the judiciary.

An integrative element treatment as well as care facilities grew stronger over the years, and will probably continue to do so, putting pressure on the workers to evolve from specialists to "generalists", or rather "specialists-plus", the plus being an element of holistic thinking, aided by extensive knowledge of the activities of related professionals.

The professional in a holistic setting

Professionals in general, and particularly in the addiction field, do not work in isolation, and are influenced by a host of factors. These factors come in layers, like the skirts of an onion, as illustrated.

Individual characteristics

At the core there is the professional as an individual, with his own individual characteristics. Essential to his functioning is his personality, the conglomerate of "character traits" elementary to his being. Psychotherapists in training sharpen the awareness of how these may influence their work in the individual therapy generally required for qualification. Would-be professionals in the field of addiction should increase this personal awareness likewise.

Related are the professional attitudes, towards job, clients, organisation and the world. These will influence the style of dealing with clients, targets to be set and so on. Again awareness of these opinions should be part and parcel of the professional equipment, brought into the open, particularly because the addiction field is so closely intertwined with the dos and don'ts of society.

Similarly of influence is the satisfaction the job brings. Once a professional has advanced somewhat in his career he will realise what he considers a success, what a failure, and how this affects his well-being. Some people cannot be satisfied unless a client is abstinent, working with persistently relapsing clients will be very unrewarding. They should avoid work with a harm reduction philosophy.

And lastly there are the technical skills. These will largely be acquired during formal training, where one learns a set of basic or general skills (not specific to the addiction field but expected from anyone with an adequate level of training for the health field), and a set of specific skills, often through advanced training. Of course discussion is possible on the grouping of these sets. The point however is that whereas some training can be acquired in general settings, some is specific to the type of job in the addiction service.

Organisation level

On the next higher-level factors that will influence the professional an organisation as a whole can be discerned.

Central is of course the mission statement. Some organisations target specific groups of users of specific drugs in a specific phase of their career. There a worker can afford to specialise in just this one issue. Other organisations deal with almost any aspect of addiction in the general population. Their employees often have a more generalist attitude. Working within a large, multifunctional organisation itself requires social and (self)managerial skills beyond those required in a small organisation.

The mission of the organization will decide what clients will be treated, and clients will themselves limit what the professional can do. Severely disrupted clients are hard to reach and even harder to set in motion. It takes extra training to do so, and not all professionals are willing to make that investment. Even if one is willing, one must realise that character traits will affect how one will handle these clients, stimulate, understand or even stand them. And some cultural groups will avoid professionals with a different background, setting limits the professional may never surmount.

To decide what groups can be treated by whom, and what qualifications this requires, is one of the tasks of management. Many professionals will for at least part of their job find themselves in a managerial role, and for those who don't it is essential to know the mechanisms of management, as these will leave their mark on many aspects of ones work.

Management may itself provide information on developments concerning the job, but a reliable network within and without the organisation is essential for any professional, both in doing his job and in detecting what way the wind blows. Being able to network, use the grapevine and weave a web of contacts is a requirement that should be part of any training program (and often is not).

A training program will be limited by resources, be they money, time or otherwise. Knowledge on the subject of resources is an asset. Many professionals will have to at least partly provide their own resources. He who knows how to tap sources of money (or labour, for instance volunteers or unemployed) and how to keep them flowing, creates a better job opportunity. This requires a wider vision of society and its resources.

Finally, an overview of the major factors within an organisation should not forget the team. A complex body, containing professionals from a variety of training backgrounds, each with their own point of view, personality and probably a slightly different perception of the mission of the team. To work within or to lead and manage a team begs for serious social abilities and should be required training for many professions.

The society level  

Both the organization as a whole and the professional there employed will increasingly be confronted by the role society plays in their functioning. Since, with a few exceptions, almost all addiction work is somehow financed by "society", the professional must be aware of and react to the needs of society as they are made more or less explicit in several guises. To put it more strongly, addiction services have become one of the essential ingredients of modern society and as such are expected to share the burden of maintaining and improving the "civil society". And just like others in the public eye this will imply that workers in the field may be scrutinized by the media, their work be the subject of (and formative to) public opinion, drawing the attention (and only sometimes the funding) of policy makers.

The professionals' is a Janus head, one side facing the client, the other society, and how he speaks to either side may differ in content and complexity. Dealing with his clients the professional by implication deals with society. His work may come under public scrutiny, and he may find his work discussed in the media. Training may heighten his awareness of the role of the media, and if he is called upon to appear in person he may come prepared: specialised media skills training for addiction workers now exist.

When on the air he may be paralysed by the sudden influence he has on public opinion. The public receives much of its wisdom about addiction from the very media he is now appearing for. This is a sensible training subject for workers in this field. It may benefit them on television, in the papers, it will certainly benefit them in the everyday contacts with "the man in the street", whom they will meet if accompanying a client to find him a job, or speaking to the neighbours.

The client will probably not be around when the professional deals with policy makers proper, the politicians and the civil servants who help them develop a policy. Yet the professional may well assist in policy making. He can advocate a certain policy or be invited to contribute to designing a new concept.

He may also be invited to join such a group, as a career alternative. Large organisations nowadays are aware that "employees are their major asset" and try to help them plan ahead, just like they have to plan ahead as organisations. For example: the organisation expects to employ more professionals in a certain setting in the near future, and knows that the number of  professionals reaching pension age is high. So they start to train promising young professionals into that direction. Smart professionals will have seen this coming.

In this overview we sketched the complexity of the addiction field, some possible levels of analysis and some factors involved. Each can be extended. We hoped to make it clear that a professional in this field cannot work in isolation, and must realise this and train accordingly.

Dick Osseman

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ADEPT SEMINAR “DRUG POLICY IN THE EUROPEAN CONTEXT”

In the period between 23 September and 12 October 2002, the (second) ADEPT Seminar on Drug Policy in the European Context was held in the Netherlands. This seminar is designed for civil servants and representatives of Ministries (Health, Justice, Interior) and leading NGO’s from the accession countries in Central and Eastern Europe and implemented by the Trimbos Institute in cooperation with EATI.  

The main objectives of this seminar are:

- To provide information on the European approach and frameworks of the drug problem  (Acquis   Communautair, European Action Plan)
- To provide training in relevant skills (designing policy plans, negotiation, evaluation)
- To support interministerial cooperation in participating countries
- To support networking, cooperation and information exchange between accession countries

Fifty participants took part in this dynamic training event, that took place in the biggest conference centre of the Netherlands, near the coast of the North Sea. They had a background in public health, justice, police, customs, research, education or management.

During the 3-weeks period, the seminar programme followed the logic of the drug policy cycle. Central to the first cluster was the framework and content of the drug policy on both a European and a national level. A second cluster consisted of translating the national policy measures into local/regional policy and practice. In the third cluster the collection of policy-relevant information through research, monitoring and evaluation was addressed.

Participants attended more then 45 lectures -some given in The Hague (Ministries, Europol), Utrecht (Trimbos, local police), Amsterdam (Jellinek/EATI, Amsterdam Prison- and also made site-visits to a number of services and facilities (user rooms, outreach work, coffeeshops etc). Working in small groups (6 groups), participants prepared their own drug policy plans, following the drug policy cycle of defining objectives, policy measures, implementation strategies and evaluation and monitoring methods.

The outcomes of the work of the small groups were presented in plenary sessions. All (12) delegations presented during this seminar the main features and drug policies of their country.

Special attention was paid to the different cultural backgrounds of the countries (including the current member states), an important feature (and often an obstacle) in European communication and cooperation.

Furthermore a number of cultural events were organised (Rijksmuseum Amsterdam, trip along the Dutch sea coast and a “European contest” in which the 12 countries could present their cultural blessings.

During the final evaluation session, most of the participants took the floor to express their appreciation and satisfaction about the seminar that had provided them with so much (new) information, skills and “food for thought”.

The final act of the seminar was the handing out of the ADEPT certificates to all participants. It is highly probable that in 2003 a next edition of this ADEPT Seminar will be organized.  

Wim Buisman
ADEPT coordinator on behalf of EATI

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