„Die Fakten sind freundlich“:: Effektivität der Gesprächspsychotherapie unter stationären Bedingungen

Abstract

Subject: In the person-centered approach the development of new concepts and its evaluation is of central interest. In the Essen Psychiatric University Hospital person-centered concepts were developed, and the efficiency and efficacy was proved empirically. Furthermore empirical investigations were made to find out, if there would be an additional benefit when person-centered treatment was combined with behavioral exposure treatment or antidepressant medication.
Methods: The efficacy of inpatient person-centered treatment was studied, integrating a person centered milieu, individual and group therapy, occupational treatment and psycho gymnastics. Included were 371 patients with depressive disorders, anxiety disorders, adjustment disorders, somatoform disorders, eating disorders and personality disorders (ICD-10 diagnoses F3 – F6). Standardized measurements were made at admission, at discharge and at 1-year-follow-up. The treatment period was about 10 – 12 weeks. The investigation was made by extern ratings e. g. the Bech-Rafaelsen-Melancholia-Scale (BRMES) and personality inventories e. g. the Freiburger Personality Inventory (FPI-R) and the Gießen-Test (GIESS). Person-centered treatment alone was compared with a combination with behavioral exposure treatment or with antidepressant medication, which have been proved highly effective.

Results: Inpatient person-centered treatment proved to be highly effective. Significant changes could be observed in terms of symptoms as well as in terms of personality traits, which were stable in the follow-up period. Contrary to our expectations additional behavioral exposure treatment had no superior effect on panic and agoraphobia symptoms in the end of treatment or at one-year-follow-up but superior effects on personality traits on the long term. Additional antidepressant medication had no additional effect on depressive symptoms as well; however, medication slowed down the patients’ critical look on conflicts and it was burdened by considerable side-effects.
Discussion: The results indicate the high efficiency and efficacy of inpatient person-centered treatment under randomized clinical conditions as well as in naturalistic study designs. Thus, person-centered treatment should get more attention in the comparative psychotherapy research. Effects in terms of pathological symptoms and personality traits on the short and on the long term as well as side effects and risks should get more attention in future research.