Decontextualisation: Inpatient Addiction Treatment In South Africa For Dutch Patients

The Dutch healthcare system differs fundamentally from the German health care system because of the regulated market economy and the integration of addiction treatment in the somatic health care system. Innovations such as inpatient addiction treatment in South Africa have been supported within this framework. However the new forms of treatment must provide evidence of their effectiveness.The aim of the present explorative cohort study is to document the treatment effects of an addiction clinic in South Africa, where Dutch patients are treated along the principle of 'decontextualization'. The 152 patients with the DSM IV diagnosis of alcohol, cocaine, cannabis addiction or a behavioral addiction were treated in a 6- to 8-week intensive inpatient setting in South Africa and a aftercare in the Netherlands.The follow-up survey was conducted by telephone interview 12 months after the intake interview. 79 patients were reached, of which 66 % were abstinent. In retrospect, patients rate three therapy components as the most effective: 'decontextualization' (to be away from one's own familiar surroundings), individual psychotherapy and the contact with other patients. These results are a first step to study the effectiveness of addiction treatment abroad. It is also an impetus to further clarify the concept of 'decontextualisation' as part of addiction therapy.