Richmond J S, Ruparel M K
J Clin Psychiatry. 1980 Nov;41(11):370-3.
The authors discuss a systems approach for managing violent psychiatric outpatients. Multiple care-giving and brief, as needed visits within an outpatient walk-in clinic setting can provide empathic care for those violent patients who become too threatened by the intimacy of individual therapy, and who often reject treatment. The walk-in clinic can provide the violent patient and his therapist sufficient "distance" from each other, so that excessive transference and countertransference reactions--which can lead to acting out and violence--are diluted. Case vignettes illustrate how the walk-in clinic can treat violent patients falling under a variety of diagnoses, and prepare them for eventual acceptance of more traditional therapies. This approach may assist community clinics who are increasingly involved in the treatment of violent patients.
作者们讨论了一种管理暴力精神科门诊患者的系统方法。在门诊即时诊疗环境中进行多次护理及根据需要进行简短问诊，可以为那些因个体治疗的亲密性而受到过度威胁且常常拒绝治疗的暴力患者提供共情护理。即时诊疗门诊可以在暴力患者及其治疗师之间提供足够的“距离”，从而淡化可能导致冲动行为和暴力的过度移情和反移情反应。案例 vignettes 说明了即时诊疗门诊如何治疗各种诊断下的暴力患者，并为他们最终接受更传统的治疗做好准备。这种方法可能会帮助越来越多地参与暴力患者治疗的社区诊所。
