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Biomedical subjects

Almut Zeeck

Publications and source records attributed to Almut Zeeck.

5 recordsLinked to original sources

Psychotherapy in a day clinic: results of a 1.5 year follow-up.

OBJECTIVE: In a prospective, naturalistic 1.5 year follow-up study of N= 114 consecutively admitted day clinic patients efficacy of the program and predictors of outcome are evaluated. METHODS: Patients had severe neurotic disturbances and personality disorders. Interviews and questionnaires (SCL-90-R, EDI) were used for evaluation at admission, discharge and follow-up. RESULTS: From 79.8% of the patients information could be obtained. In the main diagnostic categories between 30 to 50% of the patients showed complete remissions at follow-up. Patients at least kept improvements at follow-up. The rating of the "transition phase" after discharge was predictive for outcome. The group of patients that rated this phase as difficult showed higher levels of psychopathology at admission. CONCLUSIONS: It is possible to treat severely disturbed patients in a psychotherapeutic day clinic with good and lasting effects. A more disturbed group of patients needs special help to cope with the transition into the outpatient situation.

Adaptation, Psychological↗

[Status, possibilities and limitations of therapies in psychosomatic day clinics].

During the past few years, several psychosomatic day clinics have been established. The goal of this paper was to research the programs these day hospitals offer, their general set-up, as well as their indication criteria. We surveyed 18 day clinics, which we had identified via internet. Most of the day clinics have the capability to treat between ten and twenty patients and work mainly with group concepts. Mean treatment duration ranges from 7 to 12 weeks. Although having patients with different diagnoses, most day clinics treat them together, while some day clinics concentrate on special diagnoses (eating disorders, anxiety disorders, personality disorders). Overall, the day clinics' main diagnoses, therapeutic programs, and treatment durations are comparable with those of in-patient hospitals in Germany. It appears that day clinic treatment is especially appropriate for patients who have difficulties in incorporating their experiences from an (in-house) therapy into the real world, as well as patients who have to care for family members (e. g. children) while in treatment. An enquiry to the federal states of Germany showed that, in the area of psychotherapeutic medicine, there are 324 day clinic places as well as 2,639 beds for acute inpatient treatment available. Six federal states, however, do not allocate beds for psychotherapeutic medicine in particular, but assign them to the area of psychiatry.

Day Care, Medical↗

[Inter-session-processes].

We do not know much about how patients internalize, remember or use psychotherapeutic experiences between psychotherapy sessions and how they use them for change. What happens with in-session-experiences after a session ("inter-session-process") is of main importance for outcome. The inter-session-process describes the work on psychotherapy between sessions. Although inter-session-processes are a central element connecting psychotherapy process and outcome, they remain a neglected area of research. Previous studies examined individual outpatient settings only. This paper gives an overview over theory, instruments for measurement, previous studies and relevance of inter-session-processes for the field of psychotherapy research.

Humans↗

[The Intersession Questionnaire--an inventory for the measurement of patients' processing of psychotherapy between sessions].

In the intervals between psychotherapy sessions, patients often make use of the experiences that they have during sessions with their therapists, but these "intersession processes" (ISP) have been largely neglected in psychotherapy research. This study presents a German version of the Intersession Experience Questionnaire (IEQ, Orlinsky et al. ) called the Inter-Session-Fragebogen (ISF). The ISF was used to study a total of 3.778 intersession intervals in 249 therapy episodes involving 229 patients. The factor structure of the ISF appears to be stable over therapy (up to 25 or even 50 sessions), and also over therapy settings (outpatient, day clinic, inpatient). Just as in the original American samples, there were evidently cross-culturally invariant factors like "Recreating the therapeutic situation", "Applying therapy," and "Relationship fantasies". The emotional qualities of ISP are assessed by two independent factors, called "Remoralizing emotions" and "Negative emotions" (regarding therapy). Differences between therapy settings are evident concerning intensity and trajectories of the factor scores over time.

Emotions↗

[Partial hospitalisation -- indication and characteristic aspects of the setting, shown by the example of the day clinic in Freiburg/Germany].

Until now, in comparison to psychiatric day clinics, there is only a limited amount of psychotherapeutic day clinics which offer an intense, multimodal treatment on a psychodynamic basis comparable to that of inpatient settings. We present the example of the day clinic in Freiburg to discuss characteristic aspects of the setting and criteria for indication. Preliminary empirical results indicate, that even severely disturbed patients can be adequately treated. The combination of an intense therapy program with the daily involvement in the outside reality has substantial advantages for some groups of patients and eases the transition at discharge.

Day Care, Medical↗