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Tossicodipendenza e genitorialita'

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Le problematiche della tossicodipendenza legate agli oneri connessi alla funzione di madre e l'organizzazione del Servizio residenziale per mamme tossicodipendenti "Casa Aurora".

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Tossicodipendenza e genitorialita'

  1. 1. La tossicodipendenza viene intesa come  sistema comportamentale che si instaura in  seguito all'uso cronico e compulsivo di  sostanze stupefacenti. La genitorialità è il processo di sostegno e  supporto dello sviluppo fisico, emotivo, sociale  ed intellettuale del bambino, dall’infanzia all’età  adulta. Numerose situazioni di tossicodipendenza si associano  alla condizione di genitorialità e la situazione diventa  ancora più complessa nel caso di tossicodipendenti  madri, sulle quali ricadono anche gli oneri connessi al  ruolo di genitore.
  2. 2.       Oltre le problematiche tossicologiche, riuscire ad esercitare il ruolo materno in  condizioni di fragilità, all’interno di un contesto familiare e relazionale disfunzionale  o gravemente compromesso diventa assai difficile. COSA OCCORRE? Per poter permettere a queste donne di svolgere la funzione  materna in una forma sufficientemente buona vi è la necessità di poter seguire un  percorso di accompagnamento articolato, coordinato ed integrato, all’interno del  quale vi è la collaborazione con i Servizi del territorio.        LA SOLUZIONE: Il servizio residenziale per donne e figli si occupa di tutto ciò e  durante il percorso svolge un’attività valutativa dello sviluppo delle qualità  relazionali nel rapporto madre/bambino, affronta e risolve i nodi conflittuali  individuali, con la famiglia di origine ed eventualmente con il partner.
  3. 3. Il servizio residenziale per donne tossicodipendenti con figli “Casa Aurora” IL PERCORSO:  L’ingresso: Le ospiti vengono inviate dal Ser.D. e/o dai Servizi di Tutela Minori. La donna viene invitata ad effettuare una serie di colloqui che hanno lo scopo di conoscere la persona, raccogliere un’anamnesi, conoscere la situazione del minore e valutare le fasi e la durata del percorso.  Trattamenti farmacologici: Sono ammesse persone in trattamento farmacologico e sostitutivo che deve essere prescritto dal Ser.D. e deve essere continuamente monitorato.  Le fasi e i tempi del percorso: Il programma e i suoi tempi vengono stabiliti sulla base di un progetto individuale concordato tra operatori della Comunità, Servizi referenti e soggetto coinvolto. (Durata media 18/24 mesi).  Dimissioni: Le dimissioni avverranno al raggiungimento degli obiettivi di cura e di un’autonomia economica ed abitativa che permetterà la gestione indipendente di un proprio nucleo familiare.
  4. 4. Il Progetto Terapeutico Individualizzato (PTI)  Il PTI viene redatto in base alla valutazione interdisciplinare che viene svolta dall’equipe.  Il PTI è un progetto interistituzionale tra operatori dei servizi sociali e sanitari.  Il PTI è indirizzato alle problematiche della tossicodipendenza e a quelle psicopatologiche e alla funzione genitoriale.  Il PTI per adulti ha come finalità la declinazione del tipo di intervento e il coinvolgimento della famiglia.  Nel PTI per minori si svolge una valutazione psicofisica del minore attraverso osservazione libera e somministrazione di test.
  5. 5. Il modello di presa in carico Il modello di presa in carico di madre e bambino è assai complesso e garantisce la presa in cura di tutti i portatori di interesse: madre, bambino e la loro relazione.  LA PRESA IN CARICO DELL’ADULTO: La fase iniziale è quella di osservazione e valutazione in cui si verifica la situazione clinica e diagnostica della paziente. La seconda fase prevede l’attivazione dei dispositivi specialistici a seconda dei bisogni dei pazienti.  LA PRESA IN CARICO DEL MINORE E DELLA RELAZIONE MADRE-BAMBINO: Questa presa in carico ha lo scopo di monitorare e programmare gli interventi sulla genitorialità e sullo sviluppo dei bambini. Questo modello è progettato su quattro fasi: 1) valutazione personalità e competenze genitoriali delle madri; 2) valutazione indiretta del bambino; 3) valutazione diretta del minore; 4) possibili interventi terapeutici da applicare. Questo modello permette la valutazione della diade madre-bambino ma anche di entrambi i membri individualmente per poter attuare un intervento mirato non solo sulle madri ma anche sui loro figli.
  6. 6. Le attività  Le attività educative: Le ospiti svolgono attività quotidiane di gestione della Comunità. Ad ognuna, a turno, vengono affidate delle responsabilità quali: la preparazione dei pasti, la pulizia dei locali collettivi e generali, le gestione della spesa per il vitto e la gestione delle necessità per i bambini. Tutte le attività, in cui l’utente è sostenuta dall’educatore, sono pensate per permettere un accompagnamento e sostegno educativo al percorso terapeutico delle ospiti.  Le attività di formazione: L’accompagnamento alla formazione e all’inserimento lavorativo viene condotto dagli educatori che si avvalgono di specifici progetti o di collaborazioni con agenzie esterne. Gli educatori seguono le pazienti nelle varie fasi di curricula, di scelta del percorso formativo e di ricerca di lavoro.  Le attività lavorative: La comunità propone un percorso di orientamento professionale teso ad indirizzare al meglio le ricerche per il percorso del reinserimento lavorativo. Durante i colloqui di orientamento vengono realizzate delle azioni concrete che affiancano la riflessione sul futuro lavorativo della persona e sulla valorizzazione delle competenze ed esperienze formative e lavorative acquisite.
  7. 7. Progetto gruppo terapeutico sulla genitorialità Questo gruppo rappresenta un ulteriore modalità d’intervento finalizzata al supporto delle difficoltà relazionali tra le madri e i loro figli con l’ausilio del CIRCLE OF SECURITY PARENTING TRAINING. IL CIRCOLO DI SICUREZZA: è uno strumento che prevede un programma d’intervento precoce per migliorare la sicurezza d’attaccamento tra genitori e figli. L’OBIETTIVO: è quello di cercare di ampliare le capacità materne di elaborazione sia dal punto di vista emotivo, che cognitivo e comportamentale.
  8. 8. La formazione del personale La Cooperativa riconosce un diritto/dovere di formazione degli operatori e dei professionisti attraverso due direttrici: 1. La capacità di lavorare in equipe e di relazionarsi con le persone; 2. L’acquisizione di metodi e strumenti di lavoro. Il diritto/dovere alla formazione si concretizza attraverso i seguenti dispositivi: la supervisione clinica e specifica per il personale psicologi/psichiatri con cadenza mensile, la supervisione clinica e specifica per il personale operatori/educatori, la supervisione clinica e istituzionale per tutte le figure dell’equipe con cadenza mensile e le attività di formazione specifica programmata dall’Ente Gestore stesso e da altre organizzazioni nazionali e/o internazionali.
  9. 9. Il lavoro di rete  Servizi Ospedalieri (Pediatra- Neonatologia, Ginecologia, Malattie Infettive);  Medicina e Pediatria di Base;  Consultori Familiari;  Neuropsichiatria Infantile;  Scuole Materne- Asili Nido;  Enti e Associazioni del Territorio Veneziano (CdQ, Associazione Auser, Rete Antiviolenza del Comune di Venezia); •Organizzazioni di imprenditoria sociale (consorzi e singole cooperative sociali di reinserimento lavorativo); •IPAB (“I.R.E”, “Opera Pia Istituti Riuniti Patronato di Castello e Carlo Coletti”, Istituto S. Maria della Pietà, Istituzione Veneziana). La Comunità madre-bambino si deve integrare appieno nel sistema dei servizi socio sanitari cittadini e per tale motivo partecipa alla rete dei servizi del Dipartimento per le Dipendenze ULS 12, per la presa in carico delle madri tossicodipendenti con figli e alla Rete Antiviolenza promossa dal Comune di Venezia. I servizi prevalentemente coinvolti anche nel progetto di cura in Comunità sono:

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