Freyberger H, Künsebeck H W, Lempa W, Avenarius H J, Liedtke R, Plassman R, Nordmeyer J
Soc Sci Med. 1985;21(12):1391-404. doi: 10.1016/0277-9536(85)90449-6.
Starting from the definitions concerning the concepts 'Liaison medicine' and 'Consultative Psychiatry' we begin with remarks with regard to the Consultation Liaison-Situation in West Germany on the basis of the key-words 'Brief history', 'Independent university units with regard to Psychotherapy and Psychosomatics as well as the connected organization' and 'Teaching procedures'. Following it the Hannover Consultation Liaison model is presented particularly with regard to both the psychosomatic inpatient ward including the functional organization and psychotherapeutic processes as well as the so-called 'Innere Ambulanz' which includes the consultation liaison services in the clinico-medical departments outside Psychiatry and Psychosomatics. Within the 'Innere Ambulanz', which is closely connected to our psychosomatic inpatient ward, the consultation liaison activities and the resulting supportive psychotherapeutic strategies are performed by student auxiliary therapists who are interested in completing their 4-5 months internship-time in our department. We describe both the three supportive psychotherapeutic steps, which may last months to years including subsequent dynamically psychotherapeutic strategies as well as the reactions of the auxiliary therapist function on the students. Furthermore, we may state that there exists no one more optional education procedure of graduate students than the student's confrontation with his partial self-responsibility vis-à-vis a patient who is being supportive-psychotherapeutically treated by him. Specific empirical proofs concerning our patient oriented consultation liaison activities are demonstrated on the basis of previous psychotherapeutic findings in Crohn patients. Here we are able to demonstrate the effectivity of psychotherapy in the case of the supplementarily psychotherapeutically treated patients in comparison to the patients who received medical therapy only. Finally we are able to present quantitative clinico-medical inpatient needs with regard to consultation liaison activities starting from our 'Innere Ambulanz'. On the basis of our conservative estimate, 31-42% of patients showed severe psychosomatic or psychic symptoms who should be treated by psychological means in addition to the medical treatment.
从“联络医学”和“会诊精神病学”概念的定义出发，我们基于“简史”“心理治疗与身心医学方面的独立大学单位及其相关组织”以及“教学程序”等关键词，对西德的会诊联络情况进行阐述。在此之后，特别介绍了汉诺威会诊联络模式，包括身心科住院病房的功能组织和心理治疗过程，以及所谓的“内科门诊”，其中包括精神病学和身心医学以外临床科室的会诊联络服务。在与我们的身心科住院病房紧密相连的“内科门诊”中，会诊联络活动以及由此产生的支持性心理治疗策略由有兴趣在我们科室完成为期4至5个月实习的学生辅助治疗师执行。我们描述了可能持续数月至数年的三个支持性心理治疗步骤，包括后续的动态心理治疗策略，以及辅助治疗师职能对学生的影响。此外，我们可以说，对于研究生而言，没有比让学生面对其对接受支持性心理治疗的患者承担部分自我责任更具选择性的教育程序了。基于之前对克罗恩病患者的心理治疗结果，展示了有关我们以患者为导向的会诊联络活动的具体实证证据。在此，我们能够证明，与仅接受药物治疗的患者相比，接受辅助心理治疗的患者心理治疗的有效性。最后，我们能够从我们的“内科门诊”出发，呈现会诊联络活动方面的定量临床住院需求。根据我们的保守估计，31%至42%的患者表现出严重的身心或精神症状，除药物治疗外，还应采用心理手段进行治疗。
