Multimodal therapy in an inpatient setting |
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Authors: | M G T Kwee H J Duivenvoorden R W Trijsburg and J H Thiel |
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Institution: | (1) Het Sint Joris, Delft, The Netherlands;(2) Erasmus University Rotterdam, The Netherlands;(3) Klinisch-Psycholoog Voor Psychotherapie, Alpenroos 2, 2317 Ex Leiden, The Netherlands |
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Abstract: | Inpatient Multimodal Therapy (imt) is a residential treatment program, lasting a maximum of 36 weeks, for patients with severe neurotic symptoms. A group of
44 chronic obsessive-compulsive patients and a group of 40 chronic phobic patients were treated in order to assess the outcome
and the process of treatment and to identify prognostic factors associated with the effect. At follow-up—on average, eight
months after discharge—it was found that 60% had improved, 32% had remained the same, and 8% had deteriorated, indicating
that, in general, the treatment was beneficial. That these effects were long-lasting is supported by the fact that, at follow-up,
78% of all patients were no longer receiving treatment, 18% were receiving outpatient or day treatment, and 4% were receiving
inpatient treatment. Phobic patients appear to have gained more from the multimodal approach than did obsessive-compulsive
patients, as indicated by the fact that the severity of symptoms decreased as they improved in rational thinking, assertiveness,
and arousal. By contrast, obsessive-compulsive patients relapsed more than phobic patients did. This was attributed to the
fact that the former gained less from the rational-emotive training, denied problems with assertiveness, and did not practice
the acquired relaxation skills. It further appeared that a favorable outcome could be induced in patients who (1) expressed
relatively mild symptoms in this otherwise severe group, (2) reported relatively few additional complaints, (3) could clearly
indicate interpersonal problems, and (4) did not use psychotropic drugs. These prognostic factors are so widespread that not
much weight can be ascribed to them. Yet they are useful for indication ofimt until better predictors are found. |
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