Treatment for homeless relapsers at Krsuvk, Iceland

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Treatment for homeless relapsers at Krýsuvík,
Iceland

• Sigurlína Davíðsdóttir, Ph.D.
• Department of Education
• University of Iceland

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Krýsuvík Treatment Center
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Some background

• Krýsuvík Treatment Center is run by the Krýsuvík
  Association (of which I am chairperson)
• Krýsuvík Association was established in 1986 and
  now counts about 6000 members
• Krýsuvík Treatment Center accepted its first
  client in 1989. At first, the treatment took
  place in a small house, adjacent to the bigger
  house that is now used. It took a few years to
  renovate that house and make it ready for use.
• In 1991 the treatment was moved to the bigger
  schoolhouse, around 2000m2

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Treatment in Krýsuvík

• Clients enter Krýsuvík for a 6 months treatment
  time in a therapeutic community
• Theoretical background is two-pronged
• The 12 steps of AA
• Clients work the steps under counselor guidance
• Cognitive-behavioral principles
• Treatment is set up in 8 phases, each providing
  more rewards than the next one before, through
  which clients move according to their behavior
• A plan is set up for each day, marked by and -

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Treatment objectives

• Help clients to see and admit their powerlessness
  over alcohol and drugs and that they have not
  been able to control their own lives
• Help clients to see the need to change and that
  they can change their lives with the help of the
  12 steps of AA
• Help clients to make an effort here and now, make
  a decision to participate in this change, alter
  their lifestyles and practice those new behaviors
  here in Krýsuvík

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Three pillars in Krýsuvík

• Treatment
• as shown before
• Education
• The Ministry of Education pays a high school for
  sending teachers to Krýsuvík twice a week, where
  they offer two courses per semester. One course
  is mandatory for clients, a second one optional.
  These teachers have worked out a curriculum
  specially designed for the needs of our clients,
  quite unique
• Work
• Clients work for a few hours per week, on
  housework, work on keeping up the facilities, and
  gardening in the summers

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Evaluation of results

• Two MA-students did in 2004 an outcome study in
  Krýsuvík, evaluating the results of treatment
• The time span was from fall 1997 (when the
  present administration took over) through the
  year 2003
• Two groups were compared, those who the staff
  graduated after 6 months as planned (45), and
  those who graduated themselves after 3 months but
  before 6 months (42). Gender and age was
  comparable between those groups
• Those who left treatment (141) or were made to
  leave for various reasons (33) before 3 months,
  were left out of the study, as this group is
  extremely hard to reach

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Results the clientele

• Those who come to Krýsuvík are all relapsers from
  treatments in other settings (admittance
  criteria)
• Most of them are men (72), however, more women
  have lately sought treatment there
• Age range is 17-62, mean age 31
• Most clients are single (64), have no children
  (51), are multiusers (89), have not been to
  grammar school (61), and have been into the
  judiciary system (81)
• Most clients are Icelandic, however, some Swedish
  clients have been treated in Krýsuvík from the
  beginning, their results so far are outstanding
  (most are sober now)
• Treatment dropout is 66,7, other studies have
  found a mean 75 dropout in similar settings

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Number and percentage of sober clients after
treatment
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Sober years when treatment is added
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Livelihood (graduates and dropouts)
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Judiciary system (before and after treatment)
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Treatment after Krýsuvík (graduates and dropouts)
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Active in AA (graduates and dropouts)
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Change in quality of life (graduates and
dropouts)
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Lessons learned from the evaluation

• Clients are very positive about their treatment
  in Krýsuvík, compared to their experience of
  treatments
• However, they asked for more support after
  graduation, a halfway house and more follow-up
• Women said it was difficult to be treated in the
  male community in Krýsuvík. This is changing now,
  as more women are being treated now. All women
  who graduated from Krýsuvík during the past 4
  years are sober (100)
• The longer people stay in treatment, the greater
  are their chances to stay sober after the
  treatment. Hence, we should keep them in!
• The staff was very proud seeing this. They should
  be.

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Thanks for listening!