Die therapeutische Beziehung im forensischen und allgemeinpsychiatrischen Setting

Zusammenfassung

Einleitung Da die therapeutische Beziehung im Maßregelvollzug bzw. in der Forensischen Psychiatrie aufgrund des Zwangscharakters sowie der Doppelrolle des Therapeuten als Behandler und als Sachverständiger besonders belastet ist, wurde die therapeutische Beziehung im Maßregelvollzug mit der therapeutischen Beziehung in der Allgemeinpsychiatrie verglichen.

Material & Methoden 52 Patienten des Maßregelvollzugs und 65 Patienten der Allgemeinpsychiatrie beantworteten das Psychopathy Personality Inventory – Revised (PPI-R), das Inventar zur Erfassung interpersonaler Probleme - Deutsche Version (IIP-D), den Fragebogen zur Erfassung der Psychotherapiemotivation (FPTM) sowie das Working Alliance Inventory – Short Revised (WAI-SR). Statistisch wurden deskriptive Analysen durchgeführt, univariate t-Tests, multivariate T-Tests sowie verallgemeinerte lineare Modelle gerechnet.

Ergebnisse Die Qualität der therapeutischen Beziehung wird von den Patienten des Maßregelvollzugs genauso positiv wahrgenommen wie von den Patienten der Allgemeinpsychiatrie. Patienten des Maßregelvollzugs sind tendenziell sogar eher davon überzeugt, dass die in der Therapie angewandten Techniken der Erreichung ihrer Therapieziele dienen.

Diskussion Die therapeutische Beziehung im Maßregelvollzug ist genauso tragfähig wie in der Allgemeinpsychiatrie. Dies könnte auf die längeren, zumeist mehrjährigen Unterbringungszeiten im Maßregelvollzug zurückgeführt werden, in deren Rahmen deutlich mehr Zeit auf den Beziehungsaufbau verwendet werden kann als im Rahmen einer zeitlich auf wenige Wochen begrenzten Therapie in der Allgemeinpsychiatrie.

Abstract

Introduction Therapeutic relationship in forensic psychiatry is believed to be affected by the coercive setting and the role conflict of the therapists as both treaters and court-appointed experts. The aim of the study was to examine and compare the therapeutic relationship in forensic and general psychiatric settings.

Material and Methods 52 forensic patients and 66 general psychiatric patients filled in the Psychopathy Personality Inventory – Revised (PPI-R), the Inventory of Interpersonal Problems – German Version (IIP-D), the Questionnaire on Motivation for Psychotherapy (Fragebogen zur Erfassung der Psychotherapiemotivation (FPTM)) as well as the Working Alliance Inventory – Short Revised (WAI-SR). We applied descriptive analyses, calculated univariate t-tests as well as multivariate T-tests and performed general linear models.

Results The quality of the therapeutic alliance does not differ significantly between forensic and general psychiatric patients. Moreover, patients of forensic psychiatry consider therapeutic techniques applied by their therapists as more valuable for achieving their therapeutic aims than patients of the general psychiatry.

Discussion The therapeutic relationship in forensic psychiatry is as viable as in general psychiatry. This can be regarded as a result of the long-term therapy in the context of forensic psychiatry which allows more time to be spent on relationship building than in a general psychiatry setting where therapy is limited to a few weeks.

Schlüsselwörter

therapeutische Beziehung - therapeutische Allianz - Maßregelvollzug - Forensische Psychiatrie - Allgemeinpsychiatrie

Key words

therapeutic relationship - therapeutic alliance - forensic psychiatry - general psychiatry

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