Welcome to Tactus Addiction Treatment
We are available for all your questions or problems about alcohol, drugs, medications and gambling. We call these addiction agents. This brochure tells you what we have to offer you as our client. We provide information and advice. You can approach us about any question you have on addiction agents. We can also give you support regarding any psychological problems associated with the use of addiction agents. And we can help you with problems involving work, school and relationships which have arisen through the use of addiction agents.
We are there for people who themselves take the decision to seek our help. We also help people who have got into trouble with justice authorities because of their use of addiction agents. In the latter case, treatment can be ‘forced’. In addition we support partners, family, school or employers, and also care providers. We strive to find a solution to your problems together with you and those around you.
This brochure summarizes what we have to offer. Whether we can be of service to you is something we can decide only by actually meeting you. And that of course is your decision too.
How does Tactus work?
Simply put, Tactus works according to the following principle: no more help than necessary, but no less than is responsible. We call this approach the “stepped care” method. We show you a diagram illustrating how we work. The following paragraphs explain this.
Registration by telephone or visit to a registration centre
↓
Making an initial appointment
↓
Introductory meetings
↓
Advice
↓
Intake phase
(occasionally diagnostic phase as well)
↓
Commencement of treatment
Making appointments; the letter of referral
It is up to you to take the initiative to make an appointment. You can do so at one of our registration locations. Contact an assistant at one of these locations. The telephone numbers are listed on page 19.
For the first appointment you need a letter of referral from your general practitioner. We require a letter of referral in order to declare to the health insurance companies the care and treatment we provide. It can sometimes be difficult to get hold of a letter of referral immediately. It can usually be arranged afterwards. If you do not have a letter of referral, contact us anyway. We can possibly find a solution together.
Family, relations and others around you who have questions or wish to avail themselves of our services are advised to get in touch with the assistant you yourself are in contact with. This could, for instance, be your care provider.
Introductory meeting and intake phase
To determine the minimum help you require, you will first have a number of meetings with us. This is the intake phase and normally comprises three meetings. The first two are long introductory conversations, usually with a social worker employed by Tactus. The first meeting takes place ten days after your first contact with us. During these meetings you have the opportunity to say why you got in touch with Tactus and to explain the issues and problems you are facing. We also try to find out what you expect from us. The third meeting is an advisory one in which you are given recommendations on the kind of treatment best suited to your situation.
Occasionally the introductory conversations need to be longer and more intensive. If this is the case, you may be referred to outpatients diagnosis or even for a diagnostic admission. Outpatients diagnosis means you will have a number of meetings over the course of which your problem will be defined. If necessary, a psychologist or family practitioner could be present. If you are referred for a diagnostic admission, you will be admitted to the addiction clinic for three weeks. The purpose of this is also to detoxify you, i.e. cease your use of the addiction agent in question.
We sometimes have to refer you to another establishment or organization if it turns out that your problem does not involve the use of addiction agents, but rather is of another nature.
Recommendation
One of our teams will discuss your question or problem. These teams include a medical psychologist, a social worker and a psychiatric nurse. In a meeting with you we let you know what we are able to offer and decide on further steps and possibly the kind of treatment we will start giving you. You will receive an invitation for this. All admissions and choices regarding treatment are voluntary.
Commencement of Treatment
Following your intake and the diagnostic phase, several treatment possibilities are available. These are shown in the following illustration:
Commencement of treatment
/ \
A. Outpatient B. Clinical
/ \ / \
Individual Groups Mixed Women
/ \ / \
Full time Part time Full time Part time
Tactus also offers:
A. Outpatient treatment and counseling;
B. Clinical Treatment and counseling;
C. Social integration: Tactus can help you with things such as training programmes, work and accommodation in order to help you further on your way.
D. Forensic addiction clinic: Under certain conditions, clients who have received a court sentence for an offence can be admitted to the forensic addiction clinic.
E. Addiction rehabilitation: this is for clients who have been in trouble with justice authorities.
The kind of admission and treatment we recommend you is entirely dependent on your situation and the help you yourself need, as established during the intake or the diagnosis phase.
A. OUTPATIENT TREATMENT AND COUNSELLING
You could be given either short-term or long-term treatment and counselling. Usually you will continue living at home and come to one of our locations for discussions or meetings. The treatment we provide is specially tailored to your needs. We also provide help for people around you. We make a distinction between individual and group treatment.
Individual
Self-control techniques and relapse prevention
Discussions about self-control and the prevention of relapses focus on having you regain control of your use of addiction agents or your gambling habit. You set your own targets: reduced use or stopping altogether. In these discussions we work towards your target step-by-step. One means of doing this is to give you homework assignments.
Lifestyle training
Tactus offers a training programme consisting of four discussions and a longer programme comprising ten discussions. These discussions are intended to help you change your use of agents or your gambling habit. You set a target for yourself, e.g. reduced use or stopping altogether. You are given homework assignments. We also examine ways to break your pattern of addiction and to prevent your relapsing into problematic use. You learn to shield yourself better against the risk of relapsing.
Discussions with spouses
These discussions are intended for spouses who face problems relating to alcohol and/or drugs use and/or gambling. Problems of use are dealt with in group discussions. Spouses are given tips and recommendations about how to deal with the use of addiction agents and receive advice regarding other problems in their relationships.
System discussions
We use the word system to refer to people who live in a family, i.e. a person with addiction problems who lives with parents, a partner and/or children. In discussions with you and other family members we examine your use of addiction agents and the problems that arise as a result. Participants are given tips and recommendations on how to cope with their use of addiction agents and receive advice on other possible family problems.
Groups
Addiction agents discussion group
You can benefit a great deal from sharing experiences of problems with alcohol, drugs or gambling. Such experiences also include stopping, reducing, or controlling your use of agents. These you can share in the addiction agents discussion groups. The object of these groups is to learn from one another and to stimulate one another to tackle problems. A maximum of eight men and women 20 years of age or older are admitted to these groups. In theory you attend ten sessions. It is a half-open group, meaning that after five sessions new clients are admitted.
Women’s group
For women with addiction problems with alcohol, drugs, medication or gambling there is a separate group, which meets ten times. In this group you are given information, advice and support. You also learn to change your behaviour through certain techniques such as role play. You learn to discover where your boundaries lie, and how to deal with them.
Assistance programme for eating disorders
If in addition to an addiction you also have an eating disorder, or suffer from a food addiction, you have the choice of registering for a special programme. In practice it is mostly women who do so. Once a week over a period of twenty weeks you gather together with other participants. You are given therapy and learn (better) how to cope with diets, the intention being that you resume normal eating patterns. After a number of gatherings, psychological problems often surface as well. Obviously we devote attention to these as well. Another important factor is that you learn to experience your body in a positive light.
Partner relationships group
An addiction often results in relationship problems. If you wish to tackle your problems with your partner alongside you, the partner relationships group could be the answer for you. Together with your partner you talk with other couples about your problems, how to deal with them and how to resolve them. Subjects of discussion include admission to a clinic, relapse into addiction, risk situations, upbringing, work, consequences for your partner and trust in one another. The partner relationships group meets eight times.
Partners group
For those whose partner has an addiction, this group offers an opportunity to talk about the perceived problems. It is a place for recognition, acknowledgement, support, advice and information. The partners group meets twelve times and discusses all manner of problems faced by partners.
Relationship and family therapy
Addiction problems affect not only your own life but – in a negative way – those of the people immediately around you: your partner, family, and also your extended family. Relationship and family therapy discusses these problems, doing so in conversations with a therapist in a group situation. Prior to this treatment you can make an appointment with the therapist in question to discuss your own wishes and help requirements.
Family group
Children, brothers and sisters often encounter problems related to the use of addiction agents by their parent(s), or a brother or sister. In family groups we provide support and counselling, giving information about the use of gambling agents (alcohol, medication, drugs, gambling), frequently occurring problems, relapse into use, and ways in which Tactus deals with these issues. We also discuss how a family should cope with an addicted family member and what they themselves can do. A family group also offers the opportunity to talk about experiences and feelings. In theory the group meets eight times.
Parents’ group
For parents who encounter problems related to the fact that their son or daughter is addicted, there is a parents’ group. This is for parents of children (young addicts) who are registered in a part-time or clinical programme. Meeting every two weeks, the group is given information about the use of addiction agents as well as support and counselling.
B. CLINICAL TREATMENT AND COUNSELLING
Our clinics aim at assisting men and women who have problems with the use of alcohol, drugs and medication, or problems with gambling or eating. We offer clinical treatment for mixed and women’s groups.
You can participate in part-time or full-time treatment. Part-time treatment is a 3-day-a-week programme. Full-time treatment is clinical treatment and does not differ radically from part-time treatment, but is much more intensive in terms of time. The fact is that you remain in the clinic in the evenings and overnight. If possible you are at home on weekends.
Clinical diagnosis
In some cases two introductory conversations in the intake phase are insufficient to determine the kind of help that would most benefit you. In such cases further diagnosis is necessary. This is possible in one of our clinics, where you are diagnosed on an outpatient basis, which comprises a number of conversations, or you are admitted for diagnosis for a period of four weeks. The latter is only for clients who are reducing their use of methadone and, in some cases, medication, and will always be decided upon by the doctor. Outpatient’s diagnosis is conditional upon the fact that you do not use any agents during the period of the diagnosis, or that your use of such agents is under control. Before being admitted for diagnosis, you will have an exploratory meeting with us. The purpose of this is for both parties to determine whether you really do require help.
In the event that you are admitted for diagnosis, we take you through a certain programme primarily in order to ascertain precisely what your problems are, as well as their causes and consequences. We also decide what you can do about them and what targets you should set for yourself. To qualify for admission you need to have taken the decision to stop using agents. Admission for diagnostic purposes has three aims:
1. detoxifying your body;
2. identifying your problems;
3. making a choice regarding further treatment.
These aims are accomplished through various individual and group activities.
Physical detoxification
On the day you are admitted you will have a conversation with our general practitioner about your physical condition. If necessary he or she may prescribe medication for a brief period in order to help you break your addiction. You can consult him about this. With the general practitioner you can also discuss any requirement you may have for other medication.
Problem identification
During the time you are admitted for diagnosis we devote a good deal of attention to your problems and list them. The emphasis is on the extent and function of your use and your control of it. With you we investigate and discuss both the causes and consequences of your use. You also set your own personal targets.
The programme consists of both individual and group activities. Examples are diary discussions, creative therapy, sport, information about further treatment at Tactus, information about the origins of agents, an addiction agents group, contact with other group members, and household activities.
Deciding on further treatment
The last week is devoted to the issue whether you wish to undergo further treatment and drawing up a plan on how you are going to spend your time once you are discharged. Now that your physical detoxification is complete and your problems have been identified, you are in a position to make an appropriate decision about further treatment. Staff of the inpatients’ department advise you, while you take the actual decision. Further treatment may be outpatient contact with a body that provides assistance, or one of Tactus’s further treatment programmes, which can be either part-time or clinical.
What do you need for your stay in a clinic?
- valid health insurance card or insurance policy;
- adequate clothing;
- sports clothing and sports shoes;
- pocket money;
- toiletries;
- pen and paper.
Crisis intervention programme
If you are going through a crisis, we try to find a solution to the problem as soon as possible, involving both you and those around you. In the near future this will include the possibility of admitting you immediately admission to one of our clinics if your case is particularly urgent. We counsel and assist you in order to prevent a crisis recurring, taking any requisite measures. Programmes of this kind take four to ten days.
If you have problems involving drugs it could be the case that you merely wish to be detoxified. If so you can register for a so-called detoxprogramme. You will then be called up for detoxification as soon as possible. This is always preceded by an exploratory meeting.
Part-time treatment
Part-time treatment is a three-day-a-week programme given in one of our clinics. This programme is conducted during daytime hours.
We work with a programme that helps you get to grips with you addiction, gain control over your use of addiction agents, and resolve your problems and learn new skills.
A major difference with full-time treatment is that in part-time treatment you have to be more stable because you spend more time at home. You could be placed in part-time treatment in one of our clinics after having been admitted for diagnosis, or following intensive treatment in a clinic. On a part-time treatment programme you are taught to apply in practice what you have discovered during your clinical diagnosis.
A number of conditions apply to part-time treatment:
- part-time treatment takes 16 weeks and may not be interrupted for a vacation;
- treatment is given three days a week in either Enschede or Zutphen.
- participants may not use any agents or alcohol.
It is also important that you are able to exercise and apply what you learn in your own living situation. Another important factor is that you are able to fall back on people around you in difficult situations.
Fixed components of the programme include the weekends (???) devoted to preliminary and subsequent discussions, the addiction agents group, theme group, social skills training, and psychomotoric therapy. You are also expected to take part in the following theme groups:
- partner relationship group;
- family group and
- parents’ group.
These groups are discussed under heading A. Outpatient Treatment.
After care group
Once you have completed part-time treatment, you receive after care in the form of a weekly group meeting at which we ask you and others about and discuss events of the previous week.
Intramural Motivation Centre (IMC)
The IMC is a clinic with low-threshold entry conditions. It exists for three kinds of clients:
- those who have indicated to justice authorities that they wish to change their lives. By participating seriously in the programme they can have their punishments reduced;
- long-term addicts who have a resistance to regular clinics;
- clients from ethnic minorities groups.
The aim of the IMC is to introduce regularity, possibly improve your physical condition, and help motivate you to try to break your addiction. At the IMC we commence the process of kicking your addiction and/or we try to get your use of agents under control. You are not actually required to come clean. The therapy provided is chiefly aimed at the individual. There are, however, group activities, which include sport, free time and social recovery. You look after yourself. This means that you must do your own grocery shopping, cook, clean, wash, iron etc. The programme takes ten weeks. During this time we also outline a further programme with you.
Walk-in Centre
During daytime hours you can drop in at walk-in centres for a breather. No appointment is necessary. Nor do you have to be under treatment or be scheduled for treatment. You can have a drink there (non-alcoholic) and a hot meal. You can also talk to an assistant or someone in a similar position to you. You can also take part in group activities (e.g. making music or playing sport). At walk-in centres methadone is provided to clients who are eligible for it. You can also exchange syringes and obtain free condoms.
Reception and Treatment Centre (‘OAC’)
Reception and Treatment Centres offer shelter for the whole day. If you are homeless or without shelter, we provide you the possibility of using drugs or alcohol under staff supervision. You can also go to an OAC for advice, information and further care.
Provision of methadone
Under certain conditions we can provide you with methadone. Using methadone we can help you put your drugs use in equilibrium and get it under control. This can be an initial step towards resolving your problems, including addiction problems. It will also help you regain better control of your life.
Protected accommodation
If you wish to live independently (again) but are having difficulties doing so, Tactus can offer you help. We have a special procedure for this. With our protected accommodation we provide structure and shelter. If accommodation is not a problem for you, you can concentrate on other aspects or problems. We can also help you find meaningful daytime activities. Stable accommodation and work are important conditions for you to tackle your problems. To qualify for protected accommodation you must be enrolled in a training programme or have work. You social network should be separate from the users’ world.
Work and training programmes
It is difficult to find and hold on to paid work if you have been unemployed for a long time. We can help you find meaningful daytime activities and, based on this, paid work as well. We can also give you guidance on employment training programmes. Another thing we can do is train you to function in work situations, e.g. as an employee working under a supervisor.
The Forensic Addiction Clinic (‘FVK’) is meant for men who have got into trouble with justice authorities (more than once) because they have committed punishable offences, are long-term addicts, and wish to break the habit. The FVK can treat these men while they are sitting out their sentences. Treatment can also be given as a substitute for detention, or forced transfer to a clinic.
The FVK has space for about 50 clients of this sort and has two sites. One is a closed institution in Apeldoorn, the other more open, in Beneden Leeuwen. There is also an (intensive) protected accommodation programme.
At the Apeldoorn location we provide a course of treatment aimed at behavioural change as well as the prevention of recidivism and use of addiction agents. At the Beneden Leeuwen location patients are given subsequent treatment and are resocialized. Various after care possibilities are also available.
If you would like more information or you wish to register, ask your referring practitioner to contact the FVK, tel. +31 55 378 8300.
We offer assistance to clients who are in remand prisons and penal institutions, or who are having outpatient care aimed at social rehabilitation. We also see to it that community service orders are carried out.
In rehabilitating addicts, we try to limit the individual and societal damage caused by criminal activity. Rehabilitation workers ensure that you are given suitable care which, furthermore, leads to social re-integration. This might be a course, imposed on you as a community service order, which you are taking at Tactus. Examples of these are the ‘Alcohol Delinquency Training Course’ (‘TAD’), the ‘Addiction Agents and Offences Course’, and the ‘Alcohol and Traffic Educational Order (‘EMA’) for road users who have driven under the influence of excessive quantities of alcohol.
In rehabilitating addicts, Tactus cooperates with the Dutch Probation Service and the Salvation Army’s rehabilitation programme. It also cooperates with bodies involved in tackling crime (e.g. justice authorities), municipalities, the health care sector (including mental health care institutions), forensic psychiatrists, the welfare sector and youth assistance services.
Privacy
Tactus attaches a great deal of importance to privacy. We therefore administer and protect your file containing all your personal particulars with the utmost care. This we obviously do in accordance with statutory norms for the protection of personal data and administration of medical files. The most important laws involved here are the Personal Data Protection Act (‘WBP’), the Medical Treatment Contracts Act (‘WGBO’) and the Psychiatric Hospitals (Compulsory Admissions) Act (‘WBOPZ’).
We have drawn up a set of regulations containing information about:
- the way in which personal data is stored and processed and who may use or consult it;
- rules for inspecting and using this data;
- retention periods and the effect any individual may have on the way data about them is kept and administered.
If you wish you can request these regulations through your contact person or treating practitioner at Tactus.
Clients’ Participation Council
The Participation (Clients of Care Institutions) Act (‘WMCZ’) obliges every institution to have a Clients’ Participation Council. Through the Tactus Clients’ Participation Council you can influence our policy. This council is made up of present and former clients and regulates participation for all clients. The council represents your interests, offers you support with regard to complaints, and ensures that clients’ rights are observed. It goes without saying that you can have an active role in the Clients’ Participation Council. If you would like to do so, register with the Clients’ Participation Council, P.O. Box 154, 7400
Costs/payment for our assistance
The costs for the assistance Tactus provides are in theory paid for from the Exceptional Medical Expenses Act (‘AWBZ’). In some cases they are paid for by your health insurance fund or health insurance, or occasionally the municipality in which you reside. If you remain in a clinic for over a year, you are obliged by the AWBZ to pay an individual contribution.
Complaints regulations
There is of course the possibility that you are not satisfied with the way Tactus has informed, treated, counselled and dealt with you. Should this be the case we hope that you will make it clear as soon as possible so that we can find out what the problem is. It enables us to find a solution or remedy a fault. Try first of all to resolve any problem through your contact person. If you are unsuccessful, ask for the manager and try to resolve the issue with him or her.
If you are still not satisfied, you can consult a patient counsellor (‘PVP’). PVPs inform clients about their rights and offer them support in claiming their rights. Their duties explicitly include assisting clients who have complaints, and acting as intermediaries in such situations. PVPs are not employed by Tactus but by an independent national foundation. PVPs take the wishes of the client as their guidelines.
If you are not satisfied with the way a contact person or the manager deals with a complaint, you can submit an official complaint to the complaints committee. This committee is independent and is made up of external experts. The committee will always find out first of all whether Tactus itself has dealt with the complaint adequately. If not, its members shall attempt to arrange a meeting between you as complainant and Tactus . This meeting may include Tactus' own intermediary. Only if such action produces no result, or if you do not cooperate with it, will the complaints committee institute an investigation, hear both parties, and issue a statement within two months of your submitting your complaint. This statement will be sent to you and the management alike.
The address of the Complaints Committee is: Tactus Addiction Treatment, P.O. Box 154, 7400
Information
You can telephone us for information, help or advice. You can also visit us for a talk with an assistant. Please telephone beforehand to make an appointment. During office hours Mondays to Fridays you can reach us on the following telephone numbers:
Almelo +31 546 879 600
Apeldoorn +31 55 581 5250
Enschede +31 53 486 4500
Deventer +31 570 667 200
Hengelo +31 53 486 4500
Vaassen +31 578 569 730
Zutphen +31 575 511 891
Outside office hours you are best advised to telephone your general practitioner in urgent situations.
If you do not live in an area of operations covered by Tactus, you can contact the addiction care centre in your own region. See the links on our website http://web.archive.org/web/20080317185040/http://www.tactus.nl/, or ask your general practitioner for information.
Coordination: Jeanette Ooink and
Concept and text: Reinier van de Vrie, metofzonder, Utrecht
Photography: Ewout Staartjes
Design and layout: Werkplaats De Akker, Hengelo
Printing: Hassink Printers, Haaksbergen
