INVITED SYMPOSIUM: Psychotherapy within a day-hospital or inpatient setting: the strength of a therapeutic milieu!
Submission type
Symposium
Scheduled
Parallel Session VI: Effectenbeurszaal, 09-06-2018, 13:00 - 14:30
Beknopte samenvatting van de totale bijdrage
Europe's long tradition to treat personality disorders within a (day)clinic is questioned today since more outpatient programs were introduced. This symposium shows the main principles of current (day)clinical psychotherapy programs, its (cost-) effectiveness, arguments for their economic justification, and outlines for rational selection and treatment allotacion.
Auteurs
Effectiveness of day-hospital and inpatient psychotherapy for personality disorders: a systematic review on outcome research
Bartak, A. (Anna)
Abstract ID
1301
Submission type
Oral only
Introductie
Most outcome research in personality disorders (PD) focuses on outpatient treatment and on comparing theoretical schools. Day-hospital and inpatient psychotherapy offers unique features to help this patient group improve their lives, not only on a symptom level but also in a more structural way. However, research on this intensive and costly treatment has long been neglected.
Materiaal en methodes
Overview of the available evidence on effectiveness of day-hospital and inpatient psychotherapy for PD, based on a systematic qualitative review with keywords ‘inpatient’, ‘day hospital’, ‘psychotherapy’, ‘treatment’, ‘personality disorders’.
Resultaten
Good effect sizes are found in RCT’s on evidence-based day-hospital treatment methods. The largest quasi-experimental study on psychotherapy in PD was conducted in the Netherlands (N=922), and found effect sizes for patients with cluster C PD of 0.62 and 1.78 for improvement of symptoms in day-hospital and inpatient psychotherapy, respectively. For cluster B and A patients, day-hospital and inpatient psychotherapy yielded good results in terms of symptom improvement and interpersonal functioning. Most effects remained stable at 5-years follow-up.
Conclusie
Day-hospital and inpatient psychotherapy are effective treatments for PD patients, justifying more research effort in this area.
Auteurs
Positioning Inpatient psychotherapeutic programs in the Dutch Mental Healthcare system: from a single solution policy towards a network framework perspective
Kamsteeg, F. (Frans)
Abstract ID
1302
Submission type
Oral only
Introductie
After decades of high economic grow rates, Dutch mental healthcare is in a much more restricted Financial context nowadays. Policymakers at all levels (boards of healthcare organizations, health insurance compagnies, politicians) are looking for arguments to limit the wide range of healthcare supply that has developed during the past century. Cost effectiveness is the key criterion in this effort. In this proces inpatient treatment programs for personality disorders are targeted as ‘questionable’. This can lead to a short sighted view on these programs, leading to the wrong conclusions and decisions. A broader policy perspective with open eyes for financial and professional insights can give input towards a more integrated view.
Materiaal en methodes
Overview of policy and financial context development in Dutch mental healthcare and the perspectives and interests of key role players in it.
Conclusie
From both professional, financial, policy as well as patient perspectives it is necessary to create an integrated provision of treatment programs. This can’t be realized without the proven effective inpatient and daycare psychotherapeutic programs, as discussed in this symposium.
Auteurs
Rational treatment selection for personality disorders in outpatient and (day)clinical settings: what is indicated for whom?
Ingenhoven, T. van (Theo)
Abstract ID
1303
Submission type
Oral only
Introductie
Treatment selection in personality disorders and other complex mental disorders is often an instinctive process in clinical practice since there is a general lack of empirical evidence to decide which treatment is best for which patient in which phase of his life.
Materiaal en methodes
Overview of diagnostic and socio-economic factors that contribute to a reasonable practice based decision algorithm for indicating outpatient psychotherapy or (day)clinical treatment programs for patients with severe personality disorders.
Conclusie
Treatment selection and treatment allocation is a complex clinical process that integrates a variety of personalized diagnostic variables as well as socio-economic and mental health system factors.
Auteurs
A mileutherapeutic approach in psychotherapeutic treatment of personality disorders
Segaar, J. (Jaap)
Abstract ID
1300
Submission type
Oral only
Introductie
In the Netherlands there is a long psychodynamic tradition to treat personality disordered patients by group-psychotherapy within a therapeutic community or a day hospital milieu, whenever possible and necessary. Since more outpatient programs, especially for borderline personality disorder (like DBT, SFT, TFP and MBT), were introduced, these day-clinical and inpatient psychotherapeutic programs were prioritized only stepped care for the most serious cases. Because of costs and limited financial resources, today these effective programs are questioned.
Materiaal en methodes
This presentation offers you an overview of the main milieu-therapeutic principles of current (day)clinical psychotherapy.
Conclusie
A grouppsychotherapeutic milieu offers a fundamental environment for an integrated multimodular and multidisciplinair treatment of personality disorders.
Auteurs
