Gewalt und Missbrauch in der Psychotherapie

Starting from the fundamental ethical principles of medicine, the different forms of abuse in psychotherapy are described and discussed in the context of particular case studies. Besides sexual abuse, also the more subtle violations of basic ethical principles are taken into consideration. These include especially orally-exploitative forms of abuse, therapists’ improper acting-out of their own desires for close attachment or dominance conflicts, and narcissictic abuse. Finally, a particular type of narcissistic abuse is dealt with: the over-emphasis on the therapist’s own therapeutic method, with a tendency to dismiss alternative treatment strategies that might be more appropriate for the individual patient.     

Standards der sozialmedizinischen Leistungsbegutachtung in der Psychosomatischen Medizin und Psychotherapie

Sociomedical problems are playing an increasingly important role in both psychosomatic medicine and psychotherapy and in psychiatry. The present article examines the standards relating to content and method in sociomedical assessments, primarily in the discipline of psychosomatic medicine and psychotherapy. The focus is on the assessment of performance, highlighting the fact that performance and performance deficits cannot primarily be derived from the medical diagnosis; instead, psychosocial variables that influence the processes of dealing with disease in particular affect the actual performance status. The article pays particular attention to aspects that aggravate or dissimulate performance competence. Finally, the principles of integrating the various findings and results that are incorporated into the assessment report are outlined.     

Aktuelle Probleme der Krankenhausplanung in der Psychosomatischen Medizin und Psychotherapie

Ohne Zusammenfassung

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Kombination von Settings und Verfahren in der Psychotherapie

Literature research and own clinical experiences confirm the significance of a combined use of settings and methods in the area of inpatient and outpatient psychotherapy. For inpatient treatment, the combined use of methods, such as individual psychotherapy, group therapy, creative therapies, and sport, are an essential part of the treatment. In outpatient treatment, the regulations of the German insurance do not permit such combinations. Nevertheless, they occur and are often proactively initiated by the patients. The various combined use of psychotherapy and psychotropics is very well studied, but also the combination of settings, i.e. supplementary inpatient treatment, day treatment, and outpatient treatment have to be considered. While administering their therapies, psychotherapists should keep in mind possibly concurrently ongoing treatments as well as former therapies and their effects on the patients. With the exception of combinations with psychotropic treatment, there exist almost no empirical data in this important field.