Teletraining Research and Information around Dual Diagnosis


TRIADD training: Luxembourg

Supporting a person with Dual Diagnosis
(Encadrement d’une personne avec un Double Diagnostic)

Face to face training course

1st, 2nd and 3rd October 2003

Dr Germain WEBER, Professor of Psychology, University of Vienna
Johan DE GROEF, Director Zonnelied, Psychologist
Paul BERRY, Psychotherapist & TRIADD observer

UFEP – Domaine du Château, Bettange-sur-Mess, Luxembourg.

A three day in-house training course with a combination of expert exposés and participant input, attended by TRIADD observer and therapist, who also discussed case studies presented.

· Key words and basic understanding of dual diagnosis
· Analysis of existing service solutions in Luxembourg
· Consideration of the different means of support available in Luxembourg and the educational readjustment necessary to support people with dual diagnosis in the various structures catering for them


Staff issues: the effect of dual diagnosis on the support staff and the user concerned
· The effect of psychological problems on the disabled person
· Comments on certain notions and basic texts
· Methodologies of observation and analysis
· Understanding behaviour and emotional aspects
· Reactions of support staff faced with dual diagnosis
· Reactions of counter-transference
· Value of educational objects used

Readjustment of the educational/support approach
· Adapting the educational objectives in relation to the person with dual diagnosis
· Flexibility in educational approach
· Reaching the educational objectives despite the illness(es) of the person cared for
· The different interventions possible
· The multidisciplinary team
· The systemic approach

· Theoretical exposés, case studies
· Presentation of experiences and critical evaluation
· Work in small groups

Key words, TRIADD

Support staff, workshop monitors, psychological staff.


German and Letzeburgisch

There were 12 participants in the Luxembourg course which took place in October 2003. This group differed from the others in that 11 of the 12 participants had actually visited the web site and all 12 had read the key words (which were given to the participants before the course in hard copy). Most participants were well trained front line staff working with at least some clients with dual diagnosis. Two were psychologists, one of whom also presented an overview of services for those clients with dual diagnosis in the service in which most participants worked.
The participants rated their knowledge of dual diagnosis as (mean) 3.0/5.0 before the course and (mean) 3.7/5.0 after the course. It seems that this group was generally better informed of the nature of this problem than participants in the other groups.

The course, which was held over three days had five lecturers (the evaluator being present for the whole course and participating in 2 half days). On the first day several formal instruments for diagnosis were presented (e.g. PASS-ADD) together with a discussion on the issues of ‘challenging behaviour’. In the second day a presentation was held on psychiatric services in Luxembourg for this group and one of the participants presented information on current services in one specific organisation. Case studies within a psycho-dynamically orientated framework comprised the rest of the course, with some time (although not enough) for the participants to present their own cases.

Other general results were:
1. course objectives 39 positive points 8 negative (23 no response)
2. course organisation 50 positive points 15 neutral/negative points
3. learning effectiveness 34 positive points 14 neutral/negative points

The participants in this group provided a good deal of general and quite specific feedback in their comments. These can be listed as follows:
1. more time needed for discussion of case studies
2. more time needed for the presentation and discussion of cases which the participants were currently dealing with
3. more time in general – three days was not enough
4. follow up study days with specific course staff
5. more on psycho-pharmacy
6. more on the issue of ageing, especially dementia
7. more on the need for and the ways to address the problem of psychotherapy for the difficult clients with dual diagnosis
8. more on how to establish and co-ordinate work in multidisciplinary teams.


Follow-up questionnaires filled in by participants six months after the course confirm the benefit of the course to their general understanding of dual diagnosis and their work directly with clients. What still needed improvement was work in multidisciplinary teams.


Dual diagnosis, educational approach, ageing, psycho-pharmacy, case studies, counter-transference.

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