Building a Therapeutic Alliance

Dianova participated in the 2nd edition of the “International Symposium on Drug Policy and Public Health” in Istanbul (Turkey)

International Symposium on Drug Policy and Public Health

International Symposium on Drug Policy and Public Health in Istanbul (Turkey)

By Rita Ferendeles – The event was held on 26 and 27 November 2018 in the splendid setting of the city of Istanbul, superbly organized by Yesilay/Green Crescent Society, a nonprofit NGO operating in the fields of addiction treatment and prevention. The event brought together numerous speakers from around the world – professionals, experts and representatives of the scientific and academic world -and saw the active participation of a numerous public and a wide audience. The schedule of speakers was rich and intensive: a total of about 60 scientific contributions with parallel thematic sessions.

The first day was inaugurated by Gilberto Gerra, Head of the Health and Drug Prevention Office of UNODC), who opened the works with a speech about “The complex neurobiological vulnerability for drug disorders: an unexplored territory essential for prevention and treatment”.

The event provided an opportunity for a forum of discussions by promoting the exchange and sharing of experiences and best practices in the field of addictions, specifically on prevention, treatment, rehabilitation, monitoring and evaluation, with a special attention on issues such as youth and addiction, and the impact of gender-oriented concerns in programmes targeting women.

The Therapeutic Alliance in Residential Treatment

As a representative of Dianova, I participated in the Symposium with an intervention about “The central role of the Therapeutic Alliance in Residential Care”. The presentation first highlighted the mission, vision and values shared by the members of the Dianova network before explaining how the organization’s therapeutic communities endeavour to respond the complexity of the addiction problem through individualized residential programmes based on an in-depth assessment of individual needs and expectations and a person-centred biopsychosocial approach.

The speech continued with a brief digression on the process of change of the therapeutic community treatment model – which currently address the needs of a vast array of people with different needs – in order to capitalize on its residential nature and use it as a distinctive feature in the addiction treatment network. This process of change also aims to attract additional scientific and professional support through the implementation of evidence-based practices.

Emphasis was placed on the multidimensional construction of the Therapeutic Alliance at various stages of the stay, as a basis for initiating a process of care that takes into account not only the users and group dynamics, but also the Dispatching Services and Healing system, until “release” from CT is achieved. In this delicate phase the maturity of the healing System lies in the ability to accept and promote the process of differentiation, in a perspective of functional Alliance for emancipation, understood as possible maximum autonomy.

In the concluding part, I also endeavoured to show the emotional dynamics peculiar to the therapist and User relationship and the Mission problem, in its antithetical polarity, from excess to shortage, both with clear implications on planning the Therapeutic Alliance intended as a secure base for the evolution of the relationship. To summarize, the message I meant to convey is: we need to work towards building a Therapeutic Alliance capable of addressing the challenges that arise daily in the “maze” of addiction that imprisons the individual. The therapist’s task is to find the Arianna’s “thread” which would lead the person to the exit, with the highest possible autonomy.

Aware of the increasing trend of abuse and the decreasing age of addiction onset, we wanted to highlight the fact that the issue of addictions is much more vast and complex and involves more and more areas than thought, from the abuse of substances to internet addiction. As a result, we believe that we need to introduce a broader reflection on this deeper malaise which involves several factors: lifestyle, disregard of or from society, and loneliness are often the triggers of substance use and addiction. This is why it behooves us to think of the most fragile people and consider structuring appropriate integrated interventions.

To work well, to work with passion, to work with determination and willingness, to work to feel useful in relation to the world that surrounds us and that awaits adequate responses; to work for the ethical, moral, cultural potential, to feel part of the history.

This is what has united us: working with passion, we can and we must continue. That’s our biggest challenge.

"The March for Peace", Dianova

“The March for Peace” with the participation of staff and users of the Palombara TC (Rome, Italy)