in collaboration with the DPSS University of Padua, European Research Institutes, AIPPI, Rome.
TAKING CARE OF ADULTS
The observation and evaluation phase
With respect to adult patients, this phase is based on multiple observations and the administration of tests (Rorschach, SCID, Adult Attachment Interview) that verify the patients’ clinical and diagnostic situations, prior to formulating their Individual Therapy Programme or “PTI”.
The intervention phase
This phase provides specialized assistance activities that are implemented according to the needs and attitudes of the patients and the treatment objectives.
Pedagogical counselling activities
Social/employment reintegration support
Educational projects (the Novaurora (new dawn) project “mothers for mothers”, the “Tango Therapy” project, the “Music” project, and the “Adventure Group” project).
TAKING IN THE CHILDREN AND THE MOTHER-CHILD RELATIONSHIPS
This taking in charge of patients involves a multi-method evaluation and follows a longitudinal approach in order to plan and monitor the interventions on parenting and development of children living in the Community, thereby identifying early any of the risk factors for the development and/or emergence of genuine clinical symptoms.
The theoretical and methodological reference is based on the study of parenting and development according to the current dynamic and multifactorial models of influence (Belsky, 1984; Gabble, Belsky, Crnic 1992; De Palo, 2010), nevertheless it is specifically added into the therapy community and the overall system it represents.
The information gathered from the observations in the Community, which are organised in turn, is a fundamental tool both for understanding the users, the children and their relationships, and for the identifying therapeutic and educational goals that can be monitored over time and altered or reworked according to the individual project and the changes observed during the paths.
Indeed, the same assessment structure foresees to be administered at specific moments of the Community path of the mother-child dyad in order to monitor the actions and the evolutions, and to identify any dangerous and/or risk factors that are high as to require additional measures to those proposed by the Community. This process of assessment and evaluation of the actual interventions is also a tool for clinical and ethical reflection on the advisability of continuing to take charge of the dyad where there are sufficiently serious elements of danger and pathologization, as well as the presence in the children of clinical manifestations of discomfort and developmental difficulties related to a serious inadequacy of maternal care.
As summarized in the following table, this model, has been designed and planned in four phases:
assessment of mothers’ personality and their parental competence;
indirect assessment of the children through information gathered from the perception that the mothers and educators have of the children;
direct assessment of the children;
possible therapy interventions to implement.
The indirect evaluation of the children involves educators’ active participation in the Community. These professionals require suitable training and supervision and are an important resource in evaluating children’s state of psycho-physical health, in evaluating the perception they have of the children in the most varied situations of daily life.
Bearing in mind the information and data that the literature provides with respect to children of addicted women, and starting from the new regulations of the Veneto region on therapy communities for drug-addicted mothers with children, this model proposes a possible way of evaluating the mother-child dyad and both members individually, in order to implement a therapy path aimed no longer only at mothers, but also their children, who are also taken care of by the Community.