Breisacher Susanne, Ries Holger, Bischoff Claus, Ehrhardt Margit
Psychosomatische Fachklinik Bad Dürkheim.
Psychother Psychosom Med Psychol. 2003 Jul;53(7):302-9. doi: 10.1055/s-2003-40494.
The changes in the public health system in Germany have led to an increasing number of in-house patients in clinics for psychotherapy, whose attitudes towards their disorders can be described as medically orientated and who are less motivated towards psychotherapy. To integrate these patients with low motivation or little experience and knowledge of behavior therapy, therapists of the Fachklinik Bad Dürkheim developed a special program for group therapy ("Psychosomatic Group Therapy", PSG). The goals of this program, which consists of 10 sessions, are: 1. Teaching the basics of psychosomatic medicine and behavioral therapy, 2. imparting a bio-psycho-social model of psychosomatic disorders, and 3. initiating and supporting basic capabilities of self management, thereby increasing the motivation for behavior therapy and reducing the symptoms of the patients. This empirical study follows a one-group pre-post design. The results show several positive outcomes of the program: In the eyes of the patients, the sessions themselves and the exercises between the sessions ("homework") are didactically excellent and personally relevant. The patients' knowledge about and their attitudes towards psychosomatics change in a positive direction. Furthermore, the motivation for psychotherapy increases and general improvements in physical and psychological symptoms can be shown. However, these changes in motivation do not correlate with changes in knowledge of and attitudes towards psychotherapy. The reasons for these results are critically discussed.
德国公共卫生系统的变化导致心理治疗诊所内住院患者数量增加,这些患者对自身疾病的态度可被描述为以医学为导向,且对心理治疗的积极性较低。为了让这些积极性不高或对行为疗法缺乏经验和了解的患者融入进来,巴特迪克海姆专科诊所的治疗师们开发了一个特殊的团体治疗项目(“心身团体治疗”,PSG)。这个由10节课程组成的项目的目标是:1. 教授心身医学和行为疗法的基础知识;2. 传授心身疾病的生物 - 心理 - 社会模型;3. 启动并支持自我管理的基本能力,从而提高行为治疗的积极性并减轻患者症状。这项实证研究采用单组前后测设计。结果显示该项目有几个积极成果:在患者眼中,课程本身以及课程之间的练习(“家庭作业”)在教学方面非常出色且与个人相关。患者关于心身医学的知识和态度朝着积极方向改变。此外,心理治疗的积极性增加,身体和心理症状也有普遍改善。然而,这些积极性的变化与心理治疗知识和态度的变化并无关联。文中对这些结果的原因进行了批判性讨论。