Rutz W
Int J Rehabil Res. 1979;2(2):169-76. doi: 10.1097/00004356-197905000-00001.
The development of psychiatry is at present stormy with discussions dividing, polarising and partly paralysing. Current experience shows that psychotherapeutic approaches are not alternatives to psychopharmacological ones but necessary complements. An integrated therapy which treats the patient as a social, psychological and organic entity has not yet been spread to the poorly-equipped psychiatric periphery but is mainly restricted to the modern richly-endowed psychiatric centers. Modern psychiatric rehabilitation principles according to this integrated synoptic view seem however to be applicable even to custodial-treated patients at peripheral psychiatric institutions. In this article we present the special psycho-social, epidemiological, administrative and economical structure of the island of Gotland due to its geographical isolation. We describe the construction and forming of a rehabilitation program under greatly limited economical conditions. The program combines communication-oriented group therapy with consequent pharmacotherapy and a structured ergotherapeutic and ADL-therapeutic program and is applied to a primarily unselected sample of patients. We also describe the education and supervision of the staff as well as the components of our program. Positive results in spite of limited resources have been achieved. Problems are discussed.
目前，精神病学的发展正处于动荡之中，各种讨论导致分歧、两极分化，部分陷入瘫痪。当前的经验表明，心理治疗方法并非精神药物治疗方法的替代品，而是必要的补充。将患者视为社会、心理和有机整体的综合治疗方法尚未推广到设备简陋的精神病边缘机构，主要局限于现代资源丰富的精神病中心。然而，根据这种综合全景视角的现代精神病康复原则似乎甚至适用于外围精神病机构中接受监护治疗的患者。在本文中，我们介绍了哥特兰岛因其地理隔离而具有的特殊心理社会、流行病学、行政和经济结构。我们描述了在经济条件极为有限的情况下康复项目的构建和形成。该项目将以沟通为导向的团体治疗与相应的药物治疗以及结构化的职业治疗和日常生活活动治疗项目相结合，并应用于主要未经挑选的患者样本。我们还描述了工作人员的培训和监督以及我们项目的组成部分。尽管资源有限，但仍取得了积极成果。文中对问题进行了讨论。
