Triple-C works on 'restoring life to normal'
Triple-C does not focus on controlling problem behaviour, which is in contrast with other treatment models. Instead, our focus is on ‘restoring life to normal’ Care workers, behaviour specialists, managers and doctors build unconditionally supportive relationships together with the clients. On the basis of that relationship, clients participate in a meaningful day program together with care workers. This relationship increases their self-confidence and they develop competencies that have a therapeutic effect.
Triple-C in a nutshell
- We enter into an unconditionally supportive relationship with our clients
- We provide meaningful daytime activities
- We do not focus on the behavioral problems
Triple-C requires thinking differently, seeing differently and acting differently. Because we give priority to our clients’ human needs (thinking differently), we see behavioral problems as the tip of the iceberg (seeing differently), and we deal with our clients differently (acting differently). Exactly how we do that – and everything that is needed for that – can be found in the book Triple-C. A different approach to care and treatment of people with intellectual disabilities.
The book The Triple-C Treatment Method; a pathway to experiencing a normal life was published at the end of 2015. In this book, Hans van Wouwe and Dick van de Weerd describe the Triple-C treatment method and the preconditions that are necessary to implement the Triple-C method successfully. Moreover, it is based on twenty years of development of and experience with Triple-C at the ASVZ. In Triple-C: A different approach to care and treatment of people with intellectual disabilities.
We're constantly looking over our clients' shoulders. We keep an eye out for potential obstacles, difficult situations and confrontations. We assess what they have to deal with and adapt the care to that. Sometimes we take the backseat, sometimes we take them by the hand. And sometimes we step in front of them in order to protect them.Care worker ASVZ
A normal, dignified environment elicits normal human behaviour. In other words, when you put people in an inhumane situation – for example in solitary confinement – you cannot expect them to demonstrate normal human behaviour. According to Triple-C, isolation and confinement are, therefore, absolutely unacceptable.
In our opinion, behavioural problems are the tip of the iceberg – an expression of underlying problems. That is why we do not think it is a good idea to root out behavioural problems by means of protocols, medication, fixation or separation. That is why we create an unconditionally supportive relationship, provide clients opportunities and challenges, give them tasks, responsibilities, and room for them to take initiative. By doing so, clients acquire more experience with being successful, more self-confidence, and they develop their competencies. This causes the behavioural problems to fade into the background. More important, the underlying problems – the ones that cause the behavioural problem – diminish.
Training and coaching
Triple-C requires constant education for everyone working with this model. That is why all Triple-C care workers, team leaders, managers, behavior specialists and doctors at ASVZ receive constant support to implement the model successfully
Application of the Triple-C model incidentally does not work. When the focus of the treatment remains on counteracting and managing behavioral problems, nothing really changes. A care worker who does not think differently or see differently, will not dare to act differently. The same goes for a team leader, manager, behavior specialist, doctor or director. Working with Triple-C requires an organization in which everyone shares the same values and thinks, sees and acts from those values.
In the past twenty years at ASVZ, we have created the preconditions necessary to work with Triple-C successfully. We have developed the treatment model, realized the culture shift, and we train and coach all co-workers at ASVZ who work with Triple-C. For more information, you can buy the book Triple-C: A different approach to care and treatment of people with intellectual disabilities or you can sign up for one of our excursion day tours.
Do you want to see and witness how Triple-C works in actual practice? That is possible. ASVZ organizes a tour once every six weeks free of charge. The tours take place on Friday mornings.
•After a welcome reception with coffee and tea, you get a brief presentation about the origins and method of Triple-C. You also have plenty of opportunities to ask questions.
•We take a tour by way of different houses and groups based on the composition, the questions and the specific interests of the participants.
•If you want, you can have lunch in our restaurant or bring your own lunch.
Participation in this excursion is free of charge. You can sign up by sending an E-mail to Caroline Snell at,
firstname.lastname@example.org. After you sign up, you receive an E-mail from us with practical information.
When signing up, please include your name, job position, telephone number of a potential contact person, organization or what your interest is in taking the tour.
Triple-C was developed in 1991 during a treatment consultation in the office of behaviour specialist Hans van Wouwe. The topic of the consultation was the stagnated treatment of a client. We were at a loss as to what to do with her. Were isolation and confinement our only answers to the problems presented by a powerless person? There must be something else...
After talking with the team, we concluded that together we should be able to get somewhere with the client. She must do some activities, just like every other person does every day. From that moment on, the ABC-triangle of Client with Care worker (Begeleider in Dutch) that undertake the same Activities, became the basis of our treatment and supportive care. The big question in the beginning was: is it at all possible to get anything done with such complicated clients? We began with one-hour activities three times a week with a client who was constantly fixated: weeding a little garden, washing a car. We only wanted to see if it was possible. It was. Then we started expanding, step by step. More patients, more care workers, more groups. We now work with 500 clients, distributed across 90 homes that have about 7 to 9 co-workers per home.
Dick van de Weerd has been intensively involved in the development of Triple-C since the very beginning. First he was a care worker, later a team leader and coach of the co-workers. Dick van de Weerd has played a big role in translating the vision of the remedial care and treatment into the practical application in the social care organization. Triple-C only works if you do it right. At ASVZ we now manage the entire program, which focuses on recruitment, training, an educational course and coaching for the people who work with Triple-C. This includes everyone from the behaviour specialists to the managers and care workers, according to Van de Weerd. In 2004, ASVZ was invited to a congress in Montpellier. From that moment on, the model has had the internationally recognizable name Triple-C. The Client develops Competencies in an unconditionally supportive relationship with his Coach.
Trial and error
The history of Triple-C is one of trial and error. We work, of course, with very complicated people, according to Van Wouwe. Initially, we were dealing with severe aggression, the care workers were injured and there was a large turnover of staff. We have, however, received a lot of support right from the beginning. That came from professors, Centers for Consultation and Expertise, and our own management. The results that we have achieved with our clients over the past twenty years mean that Triple-C is still gaining ground. These advancements are in the health care sector and in the political arena.
The effects of disability care are difficult to prove, says Van Wouwe. Whereas everyone can see that our clients are no longer sitting fixated and they have a better quality of life. In order to gain insight in how Triple-C works, we are currently working on a detailed efficacy study. It’s a unique, scientific approach for a unique model.