Quartier F
Ann Med Psychol (Paris). 1986 Nov;144(9):931-40.
Long-term psychiatric treatments still present unsolved problems. They are interesting as far as we do our best to keep them within the general frame of reference in the working practice of our sector. Our aim here, therefore, is not to define a model which could be used everywhere, but mainly to describe the ever-questioned research of a team involved in today's psychiatry. That team chose to organise their reflexion around two polarities representing good illustrations of the whole situation as they are faced with everyday: "Crisis" and "Continuity". The purpose of "continuity" is to find out and maintain a therapeutical position which would not oversimplify the difficult problems of psychosis--that is to say avoiding the care to psychotic patients to become a routine. In order to do so, we try to use at their best the current abilities of each team member, whose multi-disciplinary capabilities allow for an individualized and diversified approach; the care-givers also try to maintain a permanent and coherent dialogue between them. This therapeutical stance is time-consuming for all members of the team, but does not require any extra equipment. The point is to organise and maintain the function of a group of caregivers around and together with a specific patient and his environment. Today's psychiatry cannot but raise the question of iatrogenicity in its interventions, of which "Chronicity" might well be one of its end-results. With the "Continuity" concept, we intend to maintain a fairly clear therapeutical relationship both with the patient and his environment, thus preventing, as far as possible, defects in the future.
长期的精神科治疗仍然存在尚未解决的问题。只要我们尽力将其保持在本领域工作实践的总体参照框架内，这些问题就很有意思。因此，我们这里的目的不是定义一个可在任何地方使用的模式，而是主要描述一个参与当今精神病学研究的团队不断受到质疑的研究情况。该团队选择围绕两个极端情况来组织他们的思考，这两个极端情况很好地说明了他们每天所面临的整个情况：“危机”和“连续性”。“连续性”的目的是找出并维持一种治疗立场，这种立场不会过度简化精神病的难题——也就是说避免对精神病患者的护理变成一种常规。为了做到这一点，我们努力充分利用每个团队成员当前的能力，其多学科能力允许采用个性化和多样化的方法；护理人员也努力在他们之间保持永久且连贯的对话。这种治疗立场对团队的所有成员来说都很耗时，但不需要任何额外的设备。关键是围绕特定患者及其环境组织并维持一组护理人员的功能，并与他们一起开展工作。当今的精神病学不可避免地会引发其干预措施中医源性问题的疑问，而“慢性化”很可能是其最终结果之一。通过“连续性”概念，我们打算与患者及其环境保持相当清晰的治疗关系，从而尽可能防止未来出现缺陷。
