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2008, Priklausomybių reabilitacijos centras "Meikštų dvaras". dvaras@erdves.lt
Applicable programme
Major principles of community activities

One of the major conditions for the activities of the therapeutic community is a voluntary personal decision to start treatment: drug and alcohol addicts come to the community on their free will after making a decision to change their lives. To ensure the activities of the therapeutic community and the improvement of community patients, drug and alcohol addicts take responsibility for treatment and commit themselves to observe all community rules.  
Order. The patients undergoing treatment in the community are required to observe the order and rules established. The patient appointed the head of the community is responsible for the order in the premises and the territory of the community, which is maintained by the patients themselves. Every day, all patients have to clean a part of the community premises and territory assigned by the head of the community. According to the schedule, Mondays are devoted to a large-scale housekeeping aimed at thorough cleaning of all community premises. Smoking is not allowed in the premises. All living rooms have to be clean and tidy. Any non-observance of the order and refusal to keep order shall be treated as a violation of community rules, which may result in the disciplinary punishment provided for in community regulations. Social workers and their assistants are responsible for the order within the community.
Daily routine. The patients of the community are required to observe the established daily routine. Everything has to be carried out on time. The time for sleeping is 23:00; the time for getting up is 7:00, except weekends. Every activity and work is also done on the given time and patients are required not to be late for activities. The schedule partially regulates the free time and time for rest. This helps a patient to get used to a well-balanced and healthy way of life since a person knows what and when he/she is supposed to do. The observance of the schedule is supervised by social workers and their assistants.
The rules regulating behaviour and interpersonal relations. The community rules regulate the interpersonal relations and behaviour of the community members. The community members are expected to be tolerant. Neither physical nor psychological aggression is tolerated within the community. In case any community member uses physical or psychological aggression (e.g., threatening), he/she may be excluded from the community. This rule is especially important since the therapeutic success can only be achieved if the security and cooperation of all community members is guaranteed. In other case, tension may prevail within the community, which would eliminate any desired therapeutic effect. Any conflicts have to be settled during community meetings or in therapeutic groups – that is the only way to learn to reduce tension in interpersonal relations by not expressing it in aggressive actions. Any intimate and sexual relations are not tolerated in the community as well. Persons linked by intimate relations are usually interested in each other only – their concern about personal treatment reduces and thus their way to sober life is at risk. Therefore, it is attempted to prevent any intimate relations within the community. The observance of these rules is supervised by social employees and their assistants.
Procedure and principles of patient’s admission to the community. Addicted persons willing to undergo treatment in the community must be sober, i.e. they have to be after the course of detoxification treatment (removal of all drug metabolites). Every newly-arrived addicted person is interviewed by a psychologist; a social worker conducts an interview concerning the motivation of a person, clarifies social and health-related problems, introduces the community rules, etc. Addicted persons willing to undergo treatment are accepted to the community upon the decision of the therapeutic community meeting. Candidate’s motivation for treatment is assessed during this meeting. This is carried out through comprehensive questioning about the reasons to quit abusing drugs, reasons to come to the community, etc. Addict’s motivation for treatment is usually “negative”. That means that an addicted person determines to undergo treatment not because he/she values the life without drugs (i.e. “positive motivation”) but because drug addiction causes so much pain and so many problems that drugs can no longer suppress them. Similar issues arise during the conversation with a patient. Thus, it is important to evaluate whether the motivation for treatment of an addicted person is sufficient and whether he/she came to the centre forced by serious problems, which he/she expects to distance from if he/she spends some time in the community. The motivation of an addict is usually assessed from the very beginning of his/her contact with the community: who takes care of his/her admission to the community – a person him/herself or his/her parents; how often he/she shows interest in the community, how much effort he/she puts into being admitted. After the conversation with a candidate, community members decide whether a patient seems motivated for treatment and for the life in the therapeutic community. If so, a new person is admitted for a two-week trial period. This period is devoted to his/her closer acquaintance with the community. The community appoints a guardian to him/her, i.e. a patient, who is in the second or the third stage of treatment, who is responsible for newcomer’s supervision and a more thorough acquaintance with the community. During the trial period, the newcomer can have a closer look and a better understanding of the community life from the interior side and to make a final decision whether he/she agrees with such a treatment. The community can also get familiar with a newcomer and to form the opinion about him/her. A psychotherapist consults a patient, makes conclusions about a patient’s psychological condition and gives recommendations during the trial period already. Two weeks later, the community meeting again evaluates newcomer’s will to undergo treatment and the decision is made whether he/she will be accepted for a further rehabilitation. Upon admission, the patient signs an agreement with the manager of the community, whereby he/she commits him/herself to observe the internal rules of the community. The agreement also provides that if a patient decides to terminate treatment, he/she can appeal for the help of the community after half a year. However, if a person is excluded from the community for the breach of rules, he/she can come back to the community after a year. In case the therapeutic community and the therapeutic team do not meet the needs of a patient (e.g. it emerges that the patient has a mental disease), he/she is transferred to an adequate institution, where a person could receive a proper assistance.








 


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