Alanen Y O, Lehtinen K, Räkköläinen V, Aaltonen J
Department of Psychiatry, University of Turku, Finland.
Acta Psychiatr Scand. 1991 May;83(5):363-72. doi: 10.1111/j.1600-0447.1991.tb05557.x.
This article describes a psychotherapeutically oriented approach to schizophrenia developed especially to meet the needs of the community psychiatric field. Because of the heterogeneous nature of the schizophrenic psychoses, the authors emphasize that these patients should always be treated based on case-specific premises. The main principles of the need-adapted approach are: 1. The therapeutic activities are planned and carried out flexibly and individually in each case so that they meet the real and changing needs of the patients as well as of their family members. 2. Examination and treatment are dominated by a psychotherapeutic attitude. 3. The different therapeutic activities should support and not impair each other. 4. The process quality of therapy is clearly perceived. A family-centred initiation of the treatment is especially emphasized for both diagnostic and therapeutic reasons. The positive experiences of this led the Finnish national programme for the treatment and rehabilitation of schizophrenic patients to recommend the establishment of family- and environment-oriented acute psychosis teams (APT) in the mental health districts. In later phases of treatment, the significance of individual psychotherapy is increased. The preliminary results of the approach are presented and compared with an earlier sample of patients.
本文描述了一种专门为满足社区精神病学领域需求而开发的、以心理治疗为导向的精神分裂症治疗方法。由于精神分裂症性精神病的异质性,作者强调这些患者应始终根据具体病例的前提进行治疗。需求适应性方法的主要原则如下:1. 治疗活动针对每个病例灵活且个性化地规划和实施,以满足患者及其家庭成员的实际和不断变化的需求。2. 检查和治疗以心理治疗态度为主导。3. 不同的治疗活动应相互支持而非相互损害。4. 能清晰感知治疗过程的质量。出于诊断和治疗原因,特别强调以家庭为中心启动治疗。这方面的积极经验促使芬兰全国精神分裂症患者治疗与康复计划建议在精神卫生区设立以家庭和环境为导向的急性精神病治疗小组(APT)。在治疗后期,个体心理治疗的重要性增加。文中展示了该方法的初步结果,并与早期患者样本进行了比较。