INPATIENT BEHAVIORAL-THERAPY IN THE PSYCHOSOMATIC HOSPITAL

The Federal Republic of Germany has eight specialist behavioural thera py hospitals which have altogether 1,400 beds. The possibilities and l imits of in-patient treatment will be elucidated using the example of the Specialist Psychosomatic Hospital in Bad Pyrmont. A biosocial unde rstanding of illness serves as the theoretical and ideological basis a s well as a means of communication for all health workers. We understa nd Behavioural Therapy/Medicine as being the clinical application of k nowledge and techniques derived from the experimental analysis of huma n behaviour (e.g. learned behaviour theory). This knowledge and these techniques are applied to the diagnosis and treatment of mental or psy chosomatic illnesses or disorders. It is important to investigate the functional relationship between the courses of their in-patient psycho therapy, our patients are made into,,experts'' for their own problems (through guidance in self-observation, diary-recording, recognition of own coping strategies etc.). A functional systems-model of his illnes s must be made available to the patient in simple and lay terms so tha t he may himself understand it clearly. By,,motivation work'', we unde rstand that the patient should be actively encouraged to use all his p otential and skills to get to grips with his psychological and social problems. Our motto is,,act, donxt be acted upon''. The total treatmen t programme should remain clear to the patient in each phase. He is mo tivated by us to responsible activites of his own. Psychotherapy doesn xt take place primarily in the consulting room, it is rather the way i n which the patient puts experiences newly-won during individual and g roup psychotherapy into action which is decisive for the further cours e of the treatment (Behaviour testing and practice). Organisational As pects: Thirty doctors and psychologists are responsible for 180 patien ts. Twenty nurses are specially trained in the diagnosis and modificat ion of behavioural problems. Adjacent to individual psychotherapy we d ifferentiate between three forms of behavioural group therapy: 1. Prob lem-solving groups; 2. So-called standard groups (muscle relaxation an d assertiveness training) and 3. Groups with special indications such as e.g. behavioural therapy of pain, depression, eating disorders etc. Ten people work in the so-called rehabilitational/educational departm ent. This consists of social therapy, occupational therapy, sport and movement therapy, physiotherapy and remedial gymnastics. The psychopat hological and behavioural medical data of all patients are recorded by computer to form a basic documentation which may later be used for re trospective investigations.