Ksenija Ramovš Alcoholism: problem solving in a counselling office for alcoholism 11th EFTC European Conference on Rehabilitation and Drug Policy Ljubljana, Slovenia 2007 Anton Trstenjak Institute

Some of the basic facts on which we base our work. 1.Slovenia is one of the »wet cultures«, just as Mediterranean countries are: high wine production, consumption and a tolerant attitude towards alcohol drinking. 2.What is the reason for today’s increasing substance abuse? The “circle of social dazed society” ;the consumer social reality are making profit - new desires must be evoked – the tools are: The sustenance of the space for imagination and virtuality (games, alcohol, drugs..) the state of a narrowed consciousness and irresponsible behaviour In the period of awareness the consciousness is increased a person experiences of meaningless or/and confused and frightened escape into “safe” world of apathy and fascination 3. Holistic approach is an important method when recognizing and solving alcohol related problems.

Alcohol related problems are not only a medical domain. Hudolin and some other psychiatrists and social workers (Hudolin,1991; Ramovš,1988; Rugelj,1983) discussed about multidimensionality of alcoholism long before in ex- Yugoslavia an official concept of the syndrome was adopted. In the 50s, the scientific research of alcoholism pointed on damaged relations within families where one family member had a drinking problem. Green or ecological concept considers system interdependence between drinking, human behaviour and human relations.

The majority of people with drinking problem, that in the process of motivation decide for a life style changes, start their therapy: 1. in the alcohol department within psychiatric hospital 2. in the AA – Alcoholic Anonymous groups and 3. in the NGO’s therapeutic groups coordinated by social- oriented psychiatrists and social workers based on socio- andragogic method.

More and more people turn for help to a non- governmental organisations and systems of self-help. The reason for that probably lies in the good quality of those programmes, functionality and the fear from stigmatisation. One of such systems of professional and complex help to people with drinking problems is offered by Alcohol Abuse Counselling Service in Ljubljana.

One of such systems of professional and complex help to people with drinking related problems is offered by Alcohol Abuse Counselling Service in Ljubljana, that works since 1998 under the two non-governmental organisations Social forum for addictions and Anton Trstenjak Institute.

MAIN PROGRAMS: Type of programme: Informing the public on the possibilities to help with the problems of overdrinking. Activities for achieving the goals of the programme: - brochures in Health Centres and Centres for Social Work - advertising through media

MAIN PROGRAMS: Type of programme: Informative counselling: - to people who feel insecure and in distress because of alcohol abuse - to people who are in distress because of alcohol abuse of some of their family members, relatives, friends. Activities for achieving the goals of the programme: Standardised and non-standardised questionnaires for autoanalysis of one’s attitude to alcohol.

MAIN PROGRAMS: Type of programme: Counselling with finding an adequate help system. Activities for achieving the goals of the programme: Presenting the existing models of help and self-help aimed to alcoholics and their relatives and offering support when searching for the most adequate programme.

MAIN PROGRAMS: Type of programme: Individual, partner and family counselling Activities for achieving the goals of the programme: Needs and expectations assessment of users, searching the source of “empowerment” for solving a distress and giving the expert support when accepting meaningful decisions

MAIN PROGRAMS: Type of programme: Organizing social support in “urgent self-help groups”. Activities for achieving the goals of the programme: In the case of a complex acute distress social worker after a common evaluation organises the urgent self- help group: help of the volunteers who had similar crisis experience and successfully overcame it.

MAIN PROGRAMS: Type of programme: Social family therapy of alcohol related problems in the three years programme. Activities for achieving the goals of the programme: It is conducted in a group of 16 alcoholics and their relatives; the group and individual programme for learning good habits, experiencing and learning how to solve conflicts. We use a systematic, reality therapy, logotherapy, psychodrama and other modalities.

MAIN PROGRAMS: Type of programme: Fellowship groups of treated alcoholics and their family. Activities for achieving the goals of the programme: - family self-help groups, maintain and developing a life style and protection from recidivation.

Fellowship groups (FG) of treated alcoholics and their family The main reason for the study of FG’s is the presumption that the group can be assured of a permanent viability in the wet culture only by reorganisation from artificial, t.i. therapeutic group, into natural, friendly group. The system of six FG’s, with total 33 members, were processed with a method of qualitative analysis, based on the complex systems theory, so that we determined and defined functional and instrumental categories, typical for small groups. The study was longitudinal. It captured 18 years of development of FG’s. The measurements were conducted in 1986, 1999 and 2004; data were processed in 2006.

Main findings: 1. FG’s turned their negative social capital into positive through the years of inclusion. Through the self-help of FG's, members gained a larger number of positive qualities that they could use in relations with closer family members and members of FG's. Mainly in the last five years, they consciously invested the surplus of their altruistic orientation in new areas of their activities: activities in their wider family or voluntary work for the community. 2. FG's do not have a clearly marked system with strong internal rules, that is typical for the clubs for treated alcoholics or therapeutic groups.

Social therapy and rehabilitation of alcohol addiction is suitable for people without health problems. The advantage of social workers and people of other working profiles that work with addicted people in smaller non-governmental organisations is probably in our high sensitivity to the condition and needs of people and also in our flexibility; we can quickly adopt the help- programmes to the changed ways of life. The fast response to the changes can also be a trap; it can come to a departure from the basic principles of addiction. This can be avoided with regular assessment of knowledge and with supervision.