Needs of professionals

As far as the expectations and needs of professionals are concerned, the follow-ing areas are of particular interest:

- Job satisfaction of those professionals who work in the treatment and care of drug abusers

- Surveys of the specialist public for their assessment of individual addiction care facilities

The general expectations of professionals with regard to the treatment network as well as to professional networking and further training, on the other hand, will be considered in the ADAT part III on professionalism.

For the area of job satisfaction the Dutch instrument BASAM will be presented in the following section. The questionnaire is used within the framework of the com-prehensive quality management in the Dutch Jellinek Centre¹¹² and has proved worthwhile in practice. Furthermore, two german instruments for the assessment of burnout-symptoms (CBM) and symptoms for the development of burnout (CBE) will be described briefly.

112For monitoring job satisfaction further measures are carried out at the Jellinek Centre, such as job func-tioning interviews and the monitoring of sick leave as a part of the personnel information system (see:

Nabitz U, Walburg J (1998) The Jellinek Centre Application Report for the Dutch Quality Award, Public Sec-tor, 1996. Jellinek, Amsterdam.)

4.4.2.1. Basic Personnel Questionnaire Amsterdam (BASAM)

General information:

The BASAM has been developed by the University of Amsterdam to measure the social and psychological impact of management, especially with reference to job satisfaction. The questionnaire has separate forms for profit and non-profit or-ganisations. Both forms can be extended using organisation-specific topics.

The aim of the BASAM is to measure the concept "Job Satisfaction", the amount of pleasure a person receives from his job. The questionnaire results in a de-tailed description of the attitude towards several aspects of the work that have an influence upon management of an organisation. The Non-profit version is some-what more limited than the Profit version and has been developed especially for the Government and affiliated organisations.

Target population: Personnel of profit and non-profit organisations Dimensions of people’s job satisfaction:

Using a number of questions the employee‘s attitude toward the following five main aspects is measured: Properties of the work; Leadership as an element of the group; Satisfaction with pay; Properties of the organisation; Attitude toward physical working conditions. The following scales are included:

Autonomy Stimulating leadership

Information of own job Support by colleagues Importance of the job Receiving information Meaningfulness of the job Giving information Perceived responsibility Correct judgement

Information of the results Attitude towards reward system Role conflicts Functionality of reward system Clarity of roles Accessibility of services

Work stress Structuring

Social-emotional leadership Physical jobsetting Corrective leadership

Type of questions: The assessment is depicted in a horizontal histogram with five categories. The rating scale runs from "very negative=1", through "neutral=3"

to "very positive=5".

Number of items: Background questions: 9; Assessment of statements about work: 100; Organisation-specific questions: 39

Reliability and Validity:

The reliability of the scales of the BASAM can be described (by Cronbach's Al-pha) as good; average for some scales. Cronbach's Alpha ranges between 0.60 and 0.92. Using Confirmatory Factor Analysis (CFA) the validity was examined.

The scales were on average one dimensional. The structure of the scales within the main aspects was confirmed. Extensive research on the criterion-referenced validity was carried out: these examinations also confirmed the validity of the test.

Languages: The instrument is only available in Dutch.

Copyright / address:

Ordering: Further Questions:

Swets Test Publishers Drs. J. Graafland

Postbus 820 Swets Test Publishers

2160 SZ Lisse Haven 3a

Tel: 0252-435900 2161 KS Lisse

Fax: 0252-435901 tel: 0252-435953

email: stp@swets.nl fax: 0252-435671

www.swetstest.nl e-mail: jgraafland@swets.nl

4.4.2.2. Checklist of Burnout Characteristics (CBM) and Characteristics for the Emergence of Burnout (CBE)

Burnout represents a risk for all occupations in therapeutic care and can be de-scribed as a condition of inner exhaustion. When addiction therapists are not only at risk from burnout but are also frequently impaired by burnout, then this will detract from their quality of life and also the quality of their therapeutic work. This is why burnout prevention represents an important part of quality assurance in the treatment of drug abusers.

A starting point for dealing with the theme of "burnout" at personal and institu-tional level is provided by the checklists Burnout Characteristics (CBM) and Characteristics for the Emergence of Burnout (CBM). The two instruments pro-vide the basis for detecting the main burnout symptoms as well as for identifying influencing factors which encourage burnout in addiction care. Whilst with the construction of the CBM it was possible to make use of existing burnout ques-tionnaires, the CBE was completely newly developed in order to be able to do justice to the special stress factors within addiction care¹¹³.

113Since the CBE is oriented towards the therapy of persons with alcohol problems, slight changes are needed in the case of two statements: "after the ‘first drink‘ following a phase of abstinence things inevitably take a turn for the worse” is changed to "After the first relapse after a phase of abstinence things inevitably take a turn for the worse”, and "if the course of therapy runs well, I secretly assume that the client will no

CBM: The CBM consists of 26 statements which the employees can assess us-ing a semantic differential with a six-point ratus-ing (examples of statements: "I feel worn out by my work" or "worrying about work impairs my sleep”). The statements are divided into the three scales "Emotional exhaustion", "Reduced personal effi-ciency" and "De-personalised attitude towards Clients". The reliability of the scales can be described as good. Cronbach’s Alpha ranges between 0.68 and 0.91.

CBE: The CBE contains 27 statements on possible causes of "burnout" which are also assessed using a semantic differential with a six-point rating (examples of statements: "I regularly work beyond working hours” or "When a client has a relapse, I sometimes think that there is no point to my work"). The statements are classified under the five scales "Personal characteristics", "Client characteristics",

"Myths”, "Institutional characteristics and Team characteristics. The CBE was de-veloped on a heuristic basis; there are currently still no reliability calculations available.

Languages: The questionnaires are only available in German.

Copyright / address Prof. Dr. Joachim Körkel

Evang. Stiftungsfachhochschule Bärenschanzstr. 4

90429 Nürnberg Germany

Tel: +49 (0) 911 272 53 829 Fax: +41 (0) 911 272 53 813

E-mail: Joachim.Koerkel@evfh-nuernberg.de

4.4.2.3. Assessing the satisfaction of the specialist public

By conducting surveys of the specialist public (i.e. social and health care spe-cialists from within and outside the system of treatment and care), their satisfac-tion with the services, and the collaborasatisfac-tion with one or more treatment facilities can be measured. Furthermore, it can be ascertained as to how far services meet the current needs in a region according to the questioned professionals. And fi-nally, the specialist public’s needs for information can also be identified. The fol-lowing survey variants can be distinguished:

- Satisfaction with a definite treatment facility v. satisfaction with a treatment system: The survey can be conducted as part of the quality assurance of an establishment. Thus the questions will manly refer to the satisfaction with the

longer drink for a period of several months becomes "If the course of therapy runs well, I secretly assume that the client will no longer consume over a period of several months" cf. (Wettach, 1997).

services of this one establishment. It is also possible, however, to measure the satisfaction with several establishments of a treatment system.

- Survey of current allocators vs. Survey of potential allocators: On the one hand it is possible to survey only the group of persons which has come into contact with a treatment facility at a professional level, e.g., as allocators of a drug abuser. On the other hand it is also possible, however, to survey all po-tential allocators of a facility irrespective as to whether there has been any contact. In the following section current and potential allocators will be de-scribed as specialist public.

Possible content of a survey:

- Knowledge of services and organisation of the treatment facility /information sources used

- Utilisation of the facility or the treatment system (contact with the facility yes/no, frequency of referrals, reason for contact being ceased, etc.)

- Satisfaction with the services of the facility (competence of the personnel, usefulness of the information received, accessibility of the responsible per-sons, treatment outcome, etc.)

- Evaluation of the concrete services of the facility (assessment of the impor-tance of the individual programme components)

- General needs regarding services in the field of addiction care (met and un-met)

- Attitude to drug policies