Evaluatie van een behandeling voor personen met zwakbegaafdheid en verslaving

Borderline intellectual functioning (BIF) is a frequently unrecognised comorbid condition relevant to the diagnosis and treatment of psychiatric disorders (Wieland et al., 2014). Several studies show an increased risk for psychiatric disorders in people with BIF, including substance use disorders (SUD), compared to the general population. Neglect of BIF has been shown to increase the duration of treatment, and number of crisis interventions, and reduce treatment effectiveness in general psychiatry (Wieland & Zitman, 2016). There are indications that clients with BIF and comorbid SUD can benefit from an adjusted treatment program (Duijvenbode et al., 2015). Over the years, the Salvation Army has developed an adjusted treatment and recovery program for these clients. The program contains four phases (stabilisation, treatment, recovery, and transfer and resocialization). The first two phases focus on stabilisation and treatment (including interventions based on CRA, Cognitive Behavioural Therapy). These interventions have been adapted to the level of BIF by offering the treatment in smaller steps with a lot of repetition so that new behaviour and skills can be integrated. Phase 3 and 4 are developed to consolidate learned skills and to increase the chance of a successful transfer to outpatient care and living. However, this treatment program has never been evaluated and financing the last two phases is difficult. The overall aim of this study is to further develop and evaluate the adapted program of Salvation Army for persons with BIF, comorbid SUD and other psychiatric disorders, in order to ensure sustainable availability of this program on a national level. The project is divided into four phases: 1) Further development of the treatment program based on current practices, in which databases, literature, professional, stakeholders and experts in the field of BIF and SUD are consulted. By means of focus groups recent experiences of professionals and patients of the Salvation Army will be inventoried. 2) The program will be analysed by following approximately 65 clients during treatment. Clients are asked to complete different questionnaires during each treatment phase to determine the degree of recovery (clinical, functional, social and personal) and to evaluate transfer to outpatient care and living. Differences between completers and non-completers will be explored, in terms of baseline characteristics, recovery progress, financial coverage, system circumstances and financial treatment coverage. 3) The implementation process will be evaluate in terms of 1) adoption of the program and 2) barriers and facilitators for implementation (from the perspective of clients, professionals, experts and stakeholders). 4) During the final phase, we will disseminate the results (reports, articles and congress) and give recommendations for strategies to implement (parts of) the adapted program. With this project we aim to develop, implement and evaluate a treatment program that has national support. The project approach involves professionals, stakeholders and experts who have a lot of experience with BIF and SUD, and with the development of treatment methods. Clients and experiential experts are involved in the project throughout the project by participating in the Guidance committee (design and output), focus groups and interviews.