Zusammenfassung
Die Studie gibt einen Überblick über die häufigsten Behandlungsmethoden in der Rehabilitation Alkohol- und Medikamentenabhängiger und deren Bezug zu ICIDH-2-Beta-2-Dimensionen (WHO, 1999) am Beispiel von 6 Fachkliniken. Die Studie greift auf das „Verzeichnis therapeutischer Leistungen” der Suchtkliniken der Allgemeinen Hospitalgesellschaft, Hilden, zurück, das ca. 300 verschiedene therapeutische Leistungen differenziert. Es werden die Leistungsdaten aller regulär entlassenen Patienten des Entlassjahrganges 1998 (n = 2923) ausgewertet und in Bezug zu den Dimensionen der ICIDH-2-Beta-2 gesetzt. 237 verschiedene therapeutische Leistungen wurden eingesetzt. 47 der auf der zweiten Gliederungsebene ausgeführten Teilbereiche der 8 Aktivitätskapitel und 30 Teilbereiche der 9 Partizipationskapitel der ICIDH-2-Beta-2 sind in den Therapiemaßnahmen berücksichtigt. Die Konzepte der Kliniken weisen einen hohen Grad der Differenzierung und ein breites Spektrum von Behandlungsmethoden auf, in dem Gruppentherapien überwiegen. Die Soziotherapie sollte aufgewertet werden.
Which Treatment Methods are Used in the Inpatient Rehabilitation of Alcohol and Drug Addicts, and how are the Concepts of the ICIDH-2-Beta-2 taken into Consideration - An Evaluation of the Performance Spectrum of 5 Rehabilitation Clinics in Germany
Objective: Inpatient treatment in rehabilitation clinics is regarded as the most important treatment approach of addictive disorders within a differentiated care network in Germany. The inpatient treatment may take between 4 and 26 weeks, with so-called short-term therapies of 8 weeks duration and so-called long-term therapies of 16 weeks duration being the most common categories. Due to differing traditions in treatment and different orientations in therapy, the inpatient programs are comprised of various methods, which may differ from clinic to clinic regarding their application or main foci. The purpose of this study is to give an overview of the services most commonly taken up in 6 rehabilitation clinics with short-term and long-term treatments and to examine if the therapy services take into account the diagnostic foci of the ICIDH-2-Beta-2 dimensions ”activities“ and ”participation“ (WHO, 1999).
Method: In order to record both the common features and differences of the treatment programs as well as to ensure a obligatory description basis for the evaluation of treatment programs, a performance catalogue was developed by the clinics of the Allgemeine Hospitalgesellschaft, which distinguishes between 300 different individual services in all. The services are assigned to sectors of therapy and described by qualitative features as well as application criteria. The study records the complete services data of all regular discharged patients (N = 2923) in the 6 rehabilitation clinics for 1998. In addition, the exemplary services are assigned according to their main foci of treatment to the items of two of the ICIDH-2-Beta-2 dimensions: ”activities“ and ”participation“. Exemplary results are referred.
Results: All services except medical services were recorded. 237 different services were applied, 147 of which reached more than 2 % of the patients. 47 of 62 on the two level classification specified categories of the 8 ICIDH-activities-chapters and 30 of 40 categories of the 9 ICIDH-participation-chapters were covered by the services (residual categories not taken into account). All rehabilitation clinics provided a broad spectrum of therapy services but showed different performance profiles and therapy foci. Common group therapy, specific group therapies, sports and individual psychotherapy were the most widespread services, each of them reaching more than 95 % of the patients. Sociotherapy reached 91 % of the sample but only small quantities of sociotherapy services were applied in average, although measures were often related to ICIDH-2-Beta-2 dimensions.
Conclusions: The individualized concepts of all 6 clinics show a high degree of differentiation and a wide spread spectrum of treatment services. Group therapies are central in the spectrum of therapy methods. The clinic concepts take into account most of the diagnostic foci of ICIDH-2-Beta-2 by providing adequate therapy services. Sociotherapy should be upvalued.
Schlüsselwörter
Rehabilitation Alkohol- und Medikamentenabhängiger - Therapeutische Leistungen - ICIDH-2
Key words
Rehabilitation - Alcoholism - Treatment Methods - ICIDH-2
Literatur
1 Die diesem Beitrag zugrunde liegende Untersuchung wurde bzw. wird auf folgenden wissenschaftlichen Kongressen vorgestellt: Zemlin U & Missel P (2000) Therapeutische Leistungen in der stationären Rehabilitation Alkohol- und Medikamentenabhängiger. [Therapeutic services in the rehabilitation of alcohol- and drug addicts.] Lecture for the 13th congress of the Fachverband Sucht e.V. from the 10th to the 25th May, 2000, in Heidelberg. Scheduled for publication for: Fachverband Sucht e. V. (Ed) Rehabilitation Suchtkranker - mehr als Psychotherapie. Schriftenreihe des Fachverbandes Sucht e. V. - German Council on Alcohol and Addiction GCAA - 24.Zemlin U, Dornbusch P, Missel P, Ackermann K (2000) Which treatment methods are used in the inpatient rehabilitation of alcohol and drug addicts, and how are the concepts of the ICIDH-2-Beta-2 taken into consideration - An evaluation of the performance spectrum of 6 rehabilitation clinics in Germany. Poster presented at the Ninth International Conference on Treatment of Addictive Behaviors, Cape Town, South Africa, September 21-25, 2000.
