Clinical Visits

Pre-Congress Clinical Visits on Wednesday 5 October 2022

VISIT A

Meet the experience experts both at the Rotterdam-Rijnmond Care and Safety House and Fivoor outpatient clinic

Rotterdam-Rijnmond Care and Safety House (RR-CSH)

Successfully tackling crime and serious nuisance by individuals and families with complex problems requires more than just care or punitive measures. The Rotterdam-Rijnmond Care and Safety House (RR-CSH) is a regional partnership and offers an integrated approach and part of the 28 Care and Safety Houses of The Netherlands

The RR-CSH makes an important contribution to reducing crime and preventing social and unsafe situations for the person and his or her environment.

Topics addressed at the RR-CSH vary from domestic violence, multiproblem families and juvenile delinquency to aftercare and after detention. Complex problems that lead to crime, unsafe situations, feelings of unsafety or neighborhood nuisance are also part of the scope of the RR-CSH. Fivoor is one of the collaborating partners in the RR-CSH.

Fivoor

Fivoor is a large institution for intensive and forensic psychiatric treatment. Fivoor is located in a large part of (merely in the western part, also called Randstad) the Netherlands. Fivoor has inpatient clinics for forensic patients, and for patients with a low IQ in combination with behavioral problems. Fivoor also has a large number of outpatient clinics for clients from 12 years onward with rule breaking and/or delinquent behavior. Treatment of aggressive behavior and other forms of forensic risks are part of daily practice in Fivoor.

Clinical Visit registration

Clinical Visit

During this clinical visit on Wednesday October 5th, you will both meet the practice of the RR-CSH and Fivoor. On this exciting tour, we will first visit the RR-CSH, located in the heart of the city in Rotterdam, at the shore of the Maas river. The tour starts with a spectacular ride on a fast Watertaxi which brings you to the RR-CSH. At the RR-CSH you learn more about the integrated approach. Furthermore you will meet with the Rotterdam police and a public prosecutor officer, who will proudly present you a peek in their work in our city with several challenging neighborhoods.

After visiting the RR-CSH you will continue your “journey” through Rotterdam by metro to the outpatient clinic of Fivoor Rotterdam at the Diergaardesingel (close to the conference venue). At Fivoor, you will be welcomed by a leading professional of the outpatient clinic who will briefly present their treatment programs. After that, it is time to roll up your sleeves for a workshop in “using pictograms in forensic outpatient treatment”. Finally, we will conclude your Rotterdam experience with an inspiring dialogue with one of our patients, who will tell bravely about her eventful life in the city and what forensic treatment means to her.

Organising team

Willeke van der Eijk (Fivoor), Rosalind van der Lem (Fivoor), Esther Schaddelee (RR-CSH) and Loes Wesselink (RR-CSH).

Special thanks to

Saskia Koster (citizen of Rotterdam/patient of Fivoor).

Practical information

Date: Wednesday 5 October 2022
Time: 13:30 – 18:00 hrs CEST
Start location: entrance of metro at Central Station
Public Transport: Fivoor will guide you to and from the locations
Price per person: €15 incl. transportation, excl. VAT
Maximum number of participants: 25
Deadline registration: Tuesday 4 October, 09:00 CEST

VISIT B

Visit the intensive treatment center in Poortugaal (Antes-CIB)

Antes-CIB

Antes is a specialist in psychiatry and addiction. As a mental health care institution, Antes focuses on the recovery of adults and the elderly with (serious) psychiatric problems.

The aim of Antes is to provide people with psychological problems with the right care, at the right time, as intensively as possible, but no longer than necessary. The recovery of the server users is the starting point. Together with the service user and their close relatives, they work on regaining and maintaining control over life.

Antes wants to minimize the serious consequences of psychological problems, so that the service users can continue on their own, enter into social relationships according to their own wishes and participate in society.

You will have the opportunity to visit Clinic Y(5) Antes Center Intensive Treatment (CIB).

Target group/indications

Persons (23+) who (threaten to) exhibit aggressive and/or dangerous behaviour as a result of a mental illness and/or a mild intellectual disability (minimum IQ 50) and/or acquired brain injury and/or addiction. (at least two criteria must be present for registration).
If somatic problems are in the foreground, the application will be assessed on the feasibility of the required care within the facility.
There is a demonstrable (high) risk of dangerous behaviour towards others/society.
There are long-term, recurring and difficult-to-manage (multi-) problems that cannot be managed sufficiently in existing care and counselling systems.
Partly due to the dominant behavioural problem, there is a need for structuring treatment, guidance and limitation; outpatient treatment is not sufficient.
There is and was a care authorization or as a result of the dangerous behaviour towards others/society.
There is a risk that without a comprehensive offer of outpatient intensive care, appropriate support or housing there is a greater chance of recurrence of the dangerous behaviour that is inextricably linked to the complex problem and can only be treated with coercion.

Purpose of department

Within healthcare, stabilizing and regulating behaviour are central. Treatment is aimed at creating a transferable treatment policy that should counteract new disruption and break through acting-out behaviour. This is done by using a relational approach and by balancing autonomy, structure and boundaries.

Working method

Highly complex care is provided in a closed setting. Working from a recovery-oriented approach in combination with expertise from forensic care and de-escalating work through the Safe Wards methodology. Define the treatment policy together with the client and the referring treatment team. The CIB pays attention to both the client and the referring team; efforts are made to strengthen the competences of both the client and the competences of the care providers in order to be able to deal with the client well. Often there is disruption of the entire system in which the client finds himself. Support and handling of the system is also important. The guiding principle in the treatment is what happens in the relationship between the client and his environment. Non-verbal therapies play an important role within the CIB, especially in the first phase of treatment in which reconnecting with the client is central. Each client receives an individually integrated treatment program according to load capacity, consisting of various components:

Individual talk therapy
Drug therapy
Professional therapies
Skills training
Specific (individual) therapies
Addiction Treatment

There is a diverse range of treatment modules in the field of autism, LVB, emotion (regulation), social skills, addiction and self-image. In addition to activity guidance and attention to sports and exercise, skills are also taught in the field of cooking and healthy nutrition.

Nuisance and drug use will be combated by giving clients only limited (supervised) freedom. This is achieved by the closed setting, as well as the surrounding area of the CIB by means of a high fence.

Capacity

3 units of 8 beds, divided into high intensive care, intensive care and medium care. Total of 24 beds.

Team composition

Within the CIB, psychiatrists and nurse specialists work together as coordinating practitioners. The multidisciplinary team also consists of a remedial educationalist, nurses and counsellors, an experience expert, activity counsellor/exercise counsellor and social worker. If indicated, the expertise of an addiction specialist can be used.

Clinical Visit

You depart together from Rotterdam Central Station and travel to Poortugaal by metro. Upon arrival you will be met by an Antes representative who will accompany you to the location.

The visit starts with an introduction followed by an extensive tour. Afterwards, time is built in to ask questions and for a conversation. You travel back by metro to Rotterdam Central.