The building block model at Alfa
In the past, we had a fixed treatment programme at Alfa-Fredensborg, and for many years we arranged it to suit the individual residents. We want to change this approach with a fixed programme of only compulsory activities. At the same time, the very mindset of the practitioners has changed with the experience we gained. You could say that the mindset where the therapist knows what each resident needs and often makes the decisions for the resident is becoming a thing of the past. It has always been possible to be exempted from individual activities if the therapist agreed that it was not beneficial for a resident to participate in, for example, a group meeting or other activity. If Feedback Informed Treatment data shows that the resident is not benefiting from the treatment, it is important to adapt it to better suit the resident.
Individual treatment (in reality)
Now we are taking the step to increase user involvement in the treatment activities the different residents undergo while at Alfa-Fredensborg. By having only a few compulsory activities such as breakfast, chores, lunch and dinner, we open up the possibility for each resident to choose a group meeting, workshop, fitness, psychological consultation, one-to-one conversation and various joint meetings. The resident will also have the opportunity to suggest a treatment activity that we do not already have at Alfa-Fredensborg and we will try to accommodate this suggestion.
A treatment programme that a resident organises himself could be a reaction round, group meetings, a psychologist interview and a workshop. It could also be fitness, one-to-one conversation and helping in the garden. Or it could be exclusively one-on-one conversations with her therapist and NA/AA meetings throughout the day. Only the resident’s wishes and experiences set the limits for the treatment activities during their stay at Alfa-Fredensborg.
The benefits of this approach are that it recognises people’s ability to feel and choose what is right for them. It helps to increase the responsibility and motivation of each resident. It puts staff in a helping role and encourages a coaching approach rather than a saving and knowing approach.
Our experience with this approach is that especially repeat users of the treatment system benefit greatly from being able to choose for themselves. They have often been in many treatments where the system and their therapists have taken some of the decisions on their behalf. This can lead to disempowerment and abdication of responsibility by the client, and we want to do away with this by giving them back the responsibility. The therapist will of course help make the plans, but it is ultimately the resident’s choice.
With this approach, it will be possible for residents to increase the intensity of treatment even more than it is at present, if they feel it is good for them. If they find that it may be too little or too much, they can adjust the activities every 14 days.
We keep complete attendance statistics for all activities chosen by the resident. So it is always possible to see how many of their own plans they are able to follow. At Alfa-Fredensborg, if you don’t follow the planned activities, you can’t leave the site that day. On the other hand, if you do all the activities you have chosen, you are free to go to town in your free time.
By using the treatment system Validi, all staff can always see all residents’ different commitments and easily check if they are being followed. This has been one of the biggest sources of misunderstanding in the past, that e.g. weekend or evening guards did not know what each resident was supposed to participate in (unless everyone was supposed to participate in the same thing).