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CONCLUSIONS OF THE COURSE OF SENSIBILISATION

ON THE SOCIAL ECOLOGICAL APPROACH

TO ALCOHOL RELATED AND MIXED PROBLEMS

(Hudolin’s Method)

Firenze, 1 - 6 September 2003

 

From 1 to 6 September 2003 the Course of Sensibilisation on the social ecological approach to alcohol related and mixed problems was held in Firenze organised by A.N.P.A.S. Solidarietà Internazionale, Scuola Europea di Alcologia e Psichiatria Europea, Università degli Studi di Firenze, Associazione Eurocare Italia, Associazione Provinciale Club degli Alcolisti in Trattamento di Firenze, in cooperation with Italian Association of the Clubs of Treated Alcoholics – A.I.C.A.T., Regional Association of the Club of treated Alcoholics – A.R.C.A.T. Toscana, Centre of Alcohology, University of Florence (Careggi Hospital), Collaboration Centre for Research and Health Promotion on Alcohol Related Health Problems – Istituto Superiore di Sanità, Rome (Italy), Local Association of the Club of Treated Alcoholics, Florence, with founding from CESVOT Tuscany, under sponsorship of Tuscany Region.

 

The participants thank Dr. Valentino Patussi as Director of the Course,  the group leaders Tiziana Codenotti, Annabella Muckermann and Angela Tilli, Sandra Tempestini for secretarial work,  the teachers Guido Guidoni, Franco Marcomini, Francesco Piani and Daniele Pieralli. A special thank to all the families and servant teachers in the Clubs that have been visited.

The participants to the Course came from Byelorussia, Greece and Italy, with total number of 17.

 

The presentations, the discussions in the groups, the friendly and warm relationship among the participants and the visits to the Clubs, have led to the following conclusions:

1.  The core of Prof. Hudolin’ s methodology is the Club of Treated Alcoholics.

2.  The Club of Treated Alcoholics is structured in a simple way: between 2 and 12 families gather once a week in a multi-family community within the local community, based on the family approach.

3.  The Club of Treated Alcoholics must follow these fundamental rules:

a)  Fixed meetings, date, time, place and punctuality;

b)  Smoking is not allowed during the Club meetings;

c)  When the Club reaches 13 families, it must be split up. It is advisable that this happen at least once  a year, to encourage more families to join the Club.

d)  The discussions  within the Club are confidential.

4.  The servant-teacher should provide simple and clear information to the new families joining the Club, at the Local School on Alcohol Related Problems.           The Local School on Alcohol Related Problems is structured in three levels:

  1st level: 10 meetings for new families (no more than 10 families). The teacher must always be the same.

  2nd level: 1 updating meeting every two  years  with the same teacher for those families who are already in the CTA programme.

  3rd level: 2 to 4 meetings for the general population.

5.  Training and updating of servant-teachers are organised as follow:

a)  Basic training: a Course of Sensibilisation on alcohol related and mixed problems;

b)  Updating courses on alcohol related and mixed problems (alcohol and drugs, alcohol and psychiatry, etc.)

c)  Intermediate Courses of two/three days (relapse, family approach, etc.)

d)  School of Specialisation, the so-called “300-hours School”.

6. Prof. Hudolin’s methodology includes the possibility to introduce families with alcohol related problems and mixed problems in the Clubs, maximum 20% of the total number of families . Mixed problems are the combination of an alcohol-related problem and the use of psychoactive substances, psychiatric disorders, homelessness and other particularly complicated situations.

        The conditions for such families to enter the Club are:

        Families with mixed problems have to inform the Club about their own situation and the Club has to decide whether such families are to be accepted.

  The Club and the servant-teacher must be specifically trained and updated on mixed problems.

  The servant-teacher must also co-operate with the professionals (for example psychiatrists) who are actually treating the people with mixed problems.

 

7. Families entering the Club must have the opportunity to have the first interview with the servant-teacher.  This first interview can not be substituted by previous interviews by any other.

 

8. The Club works well in the handling of relapse which is not a tragedy but a common evolution in the history of families with alcohol related problems. Relapse has an important role in the work of the Club. Usually relapse is considered in terms of drinking alcohol again. Yet, a more frequent form of relapse is a withdrawal to the old  behaviour and lifestyle. The alcoholic’s whole family may relapse. Other forms of relapse may be caused both by the behaviour of the servant teacher as well as of the whole Club, and by the relapse of the local community where the Club works. Relapse is an acceptable situation in the Club, it should not be emphasized, but everything should be done to eliminate it. Besides, we should not forget that Clubs are there for people who drink and consequently also for people who relapse.

 

9. It is important to stress that this methodology is based on the family and its spiritual and material bonds. If a member has no family it is necessary to find a substitute family, which has the same responsibilities as the other families.

 

10. The principles the Club’s methodology are based on and fit very well into the health promotion principles included in many international documents, such as the Alma Ata Declaration, the Ottawa Charter, the Adelaide Conference, the Principles of Health for All in 21st Century, the Copenhagen Declaration, the Jakarta Declaration, the European Charter on Alcohol and the latest Stockholm Declaration.

 

11. During the Course most participants from foreign countries said they would start a Club of Treated Alcoholics as soon as they return to their countries, however within 6 months, and also that they would do their best to disseminate the Clubs methodology.

 

12. All participants will be informed about any International Course of Sensibilisation organised in Italy. They will do their best to spread the news about this course in their community in order to encourage people to attend it.

 

13. The organizers will provide all the support that participants will require, both in terms of information and promotion materials (in italian and/or english language), and in terms of general collaboration.

 

14. ANPAS Association will visit Byelorussia in the early 2004. At that time a monitoring about the situation of Clubs in that country will be done.

         

15. The participants coming from Greece said they will meet together at the end of September with the other Greek servant-teachers to discuss about the development of the Club movement in their country and to start the monthly meeting of servant-teachers.

 

16. The conclusions of this Course will be published on “Camminando Insieme”, AICAT News, “The Globe”, ANPAS News and other international publications and in web side’s www.aicat.net, www.arcattoscana.org. e www.anpas-internazionale.org  Besides, a short communication will be sent to scientific reviews, which will report on the initiative.

 

17. Each participant has the duty to spread these conclusions in their own country to health and social authorities and to non-governmental organisations.