1. mr. Hatta Smit mr. Frank Brook

2. Completers and non-completers A question of time Drop-out management in a therapeutic community coping with people who cannot cope EFTC 2009

3. Hatta Smit, psychomotoric therapist TC Hooghullen, (part of VNN) 0ne of three therapeutic community (TC) in the north of the Netherlands for addicted patients Frank Brook VNN Research Department

4. WHAT HAS CHANGED AT TC HOOGHULLEN? - Part of the care chain - End of the care supply and severe co-morbidity - Shorter length of stay - Medication - More multidisciplinary treatment - More patient centered instead of program centered - solution focused

5. WHAT HAS ADDED T0 TC HOOGHULLEN? - More thorough psychiatric diagnosis - Medication given when needed to fit in - More emphasis on motivating clients - More multidisciplinary qualified staff - Better drop-out management - More possibilities for aftercare and rehabilitation - Bodily treatment ( PMT and Running therapy) as an integral part of the daily program

6. TREATMENT FOCUS - Relapse management - Old (rigid) coping styles and the need to survive - Find your own solution in joining the TG group - R ecurring (crisis) situations - N egative life patterns (schemes) - Handling pain and strong emotions - Learning new coping strategies - Adopting new lifestyles and copingstyles - Drop-out management

7. DROP-OUT MANAGEMENT “ Going away is a part of learning to stay.” Leaving (and coming back) is a great learning opportunity - B ack-up system (family and referrer) helps - S eries of ‘leaving rituals’ designed - Explain to peers why they want to go (general meeting) - Organize there own leaving - A temporary stay in another (VNN) setting - Re-intake and encounter (to rejoin the group) - Quick re-admission in peer group and position - Individual attention on change of dysfunctional schemas