Mitchells Plain Phone: (021) 391 0216 Fax: (021) 391 0218 Cape Town Phone: (021) 447 8026 Fax: (021) 447 8818 email: ctdcc@iafrica.com Postal address: PO Box 56 Observatory 7935	TREATMENT We are an outpatient centre that provides confidential assistance to individuals and families experiencing problems with drug abuse. The basic difference between an outpatient and an inpatient centre is that with an outpatient programme people remain integrated in their everyday activities. Which means that as an out patient, you're forced to deal with the situation "on your feet". Whilst you may receive support from family, friends and our staff, a large responsibility lies on your shoulders. Sometimes attending an outpatient programme may not be adequate, depending on the severity of the case. There are state subsidised and private inpatient programmes which cater for such incidences. In the case of a private initiative, access is easier. However, this could cost up to R27 000. Some medical aid institutions do cover this cost. The state subsidised option can cost in the region of R2000 to R3000. We are the only outpatient centre in South Africa to empirically evaluate our treatment services.(See stats 2001) counsellors There are various services that individual counsellors offer. The counsellor's role is to check out what the client's concerns are and what, if anything, they would like to do about it. A lot of clients have been referred here by schools. These people are more often than not angry that they are forced into rehab. But as we go along with the course, people tend to realise that it is for their own benefit. Kids normally have problems realising the effects that drugs have on their lives. The biggest problems that we face are Dagga and Mandrax related. People who approach us are confronted honestly with their problem. It is entirely their choice how they intend to deal with their predicaments - if at all. Some patients come in for a few days, others for a few weeks and some for several years.
WHAT HAPPENS HERE
	A person is usually referred to or sent to us by parents, employers, schools and doctors. In other cases, we are approached by drug abusers who voluntarily want to kick their habits. What normally happens is you would phone and you'll speak to a counsellor. Alternatively, a family member might phone on your behalf. Then you might come in to the clinic. That's on either a Monday or a Thursday but you have to phone and book first. On arriving, you'll sit in the waiting room for a while. There may be waiting involved. You have to be there before eight, however. You're not allowed to attend the Centre if you have any court cases pending. There are three reasons for this. One, your motivation for rehab is questionable. And two, it makes it difficult for the counsellor to work with you knowing that there are legal intricacies involved. But I would say that the major reason for is that, as a counsellor, you get dragged into court when we should be counselling instead. People use us as references to say good things about them in court. They are welcome to come back after the hearing, though. If someone does have a case pending, we refer them to another service, a private service, that specialises in these cases. Okay, so you're in the waiting room. You wait, you watch a video and hear a talk on our services in a larger room. At about 8:45 we show you the orientation video. It informs you about the Cape Town Drug Counselling Centre, addiction and what to expect in rehab. Then we assess you. The objective of the assessment is for the counsellor to get to know the client. We try to address people in their home language when possible. For the first part of the session, the person who brought the client in, will join us for the first ten minutes. In that time we discuss how each party has been affected. The counsellor that assesses you will be responsible for your treatment. You always stick to one counsellor. Unless of course, a counsellor leaves or as in some cases when people prefer to see say, a Muslim counsellor. What kind of questions will you ask me? We will tackle any mixed feelings you may be experiencing. We'll look at the drugs that you are using, how much you are taking and how much money you are spending. "What motivated you come to the centre?" There are certain key things that counsellors always cover. Things like the drugs and family history. We also try to determine if a person is suicidal. Each counsellor will have a different way of doing it. Some would ask, "How, on a normal day, do you feel? Are you sometimes depressed? Have you ever thought of killing yourself?" Normally people let you know if they've been thinking about doing it. In the first session we'll cover the different aspects of the clients life. Towards the end, we'd look at medical problems to determine if the abuser needs medical help. We then ask "How do you see yourself in ten years from now?" "How do you see your life if you stop taking drugs?" "How do you see your life if you don't stop?" We also discuss confidentiality and explain that everything that is said will remain confidential - unless a life-threatening situation arises. We also give you a choice as to how to deal with outsiders (parents/employers etc) phoning in. This is done to establish how much information you as an abuser are comfortable with disclosing. We recommend, in the beginning, that people choose only to disclose that they are attending the centre. Yes, so that's the assessment. It's quite scary for both the client as well as the counsellor. commitment Once the assessment is over the client might have second thoughts. The counsellor will even encourage the client to come at a later stage if the person is not in a position to commit or to make a decision immediately. There's no point in pushing someone into something if you know they are not going to give 100%. Rather have them go away now and come back later when they are ready. three appointments a week If someone does want to make a commitment, then we encourage them commit to a six-week program as a start. They will have roughly three appointments a week, one session with a counsellor, one session with a group and then one with the other services that we offer. These services include Acupuncture, Reiki, Aromatherapy and Art Therapy. We also have a Medical Doctor and a Psychiatrist. a six-week commitment This six-week commitment isn't cast in stone. For some, for instance scholars, might be at school when, say, the Art Therapy is on etc. Besides, for school kids we recommend three weeks because six weeks seems forever. We allow them to extend the time at a later stage. Okay, when this is over, you walk to the front, where all the books are, and the therapists will confirm your attendance to the various sessions. Often, the client will agree to something initially, but when it comes to it they get cold feet. So, we try to get people to make an appointment and stick to it. fees Once you've made an appointment, you get a green card. It has all your appointment times on it. It's like a hospital card with the The Cape Town Drug Counselling Centre's telephone number on it. On the back it says that you have to pay a cancellation fee if you book and don't attend. Rather phone and cancel. Not very nice but that's how it has to be. Fees are charged on a sliding scale per session, according to income. If people have financial problems, we find a way to work out something so that you still can attend. But you have to take responsibility for paying for your treatement. You see a drug abuser will spend this money a lot easier on a rock than on rehab. I think it's tough for people but when they look back it's quite rewarding. None of these things really work on their own but the combination of things are really helpful.
CLINICAL SERVICES
	People can leave at any stage. There is no one stopping them. Some people don't even get to their sixth week. Okay, there are people who stay for years. But even if the person doesn't complete the six-week period, it's not a disaster - provided that they know that we're there if they change their minds. They can come back and can do it again.
COMPLEMENTARY HEALTH SERVICES
	general medical treatment Over the years I am seeing more and more young patients. I have a strong interest in psychiatry and always wanted to study psychiatry. After practicing for years, I actually planned to do it, but then I became very ill and wasn't able to. But I still have a strong interest in psychiatry and psychology, so working at The Centre has been very interesting for me. As the Centre's consulting doctor, it I see the clients and attend to their medical needs. Most of the clients I see are at the Centre for Dagga and Mandrax related problems. The first thing I would do is ask them about their health and discuss any medical problems they may be having. Then I would do a general physical examination. If necessary I will prescribe drugs to help them with any medical problems and also to deal with the side effects of drug withdrawal. My role is to discuss and explain any medical problems they might have and to provide treatment. acupuncture Acupuncture has been developed by the Chinese over thousands of years. Chinese medicine is an holistic approach to illness and encompasses physical, emotional and mental aspects of the human condition. It sees them as intrinsically linked. All living things have a vital energy which provides conditions of soft and hard, warm and cold etc. These conditions are linked to our well being and when they are out of balance or disproportionate to each other, we become ill. There are of course environmental factors, both physical and mental, and our ability to cope with them is important to health. The Chinese developed the use of needles to control and manipulate this vitality and balance it according to principles developed over aeons of empirical observation of man and his environment. The use and abuse of drugs can be influenced in a positive and lasting way by the use of acupuncture. The body and mind are encouraged to return to a healthy and positive state in a natural way. Often people with substance abuse problems have other disabilities as well. This is all treated accordingly to aid the client in returning to a positive and productive life. reiki and aromatherapy The whole thing behind it is that the therapy is holistic (body, mind and spirit). I knew somebody, who knew somebody who was connected to the Cape Town Drug Counselling Centre. And they needed somebody for one session a week. I had a free morning so I came and did a session. It was quite scary because the first client I had was this huge foreign guy. He asked if he must take off his shirt. I said, "Yes". And then he had this huge gun strapped on his body which he unstrapped. And I thought "Uh oh. Is this what it's all about?" So my first client on an energy level was very hectic and I thought, well I have tried it and that's it. Then they (The Centre) wanted to know if I would like to work here on a more permanent basis. But then I thought not everyone could be like the foreigner. And obviously they weren't. The others that I saw thereafter were actually quite good. Now I do four sessions a week - three aromatherapy and one Reiki. The aromatherapy is essentially a back and neck massage. The whole thing behind it is that the therapy is holistic (body, mind and spirit). Quite often people don't open up verbally to a counsellor. They lie here and I massage them and they kind of dissolve into tears, because it enables them to release more and get more in touch with their feelings. Physically it helps with blood circulation, improves the function of the organs involved in detoxification, and on an emotional and spiritual level it is very nurturing. I also choose the oils very selectively for the client. If somebody is very hyped up I would use oils such as Marjoram or some of the oils from trees like Sandalwood that are quite grounding and sedating. If someone is really down and depressed I would use oils like citrus oils that are very uplifting. Reiki is just hands on. Through the clothes. Very static. You stand and lay your hands on the person for a few minutes in one position on the person's body, allowing the energy just to flow from a higher spirit. But it is kind of the understanding that there is something higher. I just allow the energy to flow through me into that person. It is very balancing and relaxing. Often they would fall asleep within minutes, snoring away. It often opens up spiritual questions and people find themselves answering these questions.