Patients' complaints about inpatient psychosomatic rehabilitation: Content, treatment expectancies, therapeutic relationship

Patients' complaints are taken seriously as negative indicators of treatmen t quality by the statutory insurance bodies. Yet scientific investigations are lacking on this issue. Based on the description of special treatment co nditions in inpatient rehabilitation, the content of all complaints of the rehabilitation department, psychosomatic hospital, Bad Neustadt/Saale is ex amined carefully during a 2-year-period with regard to the content of compl aints, complainers' treatment expectancies and their view of the therapeuti c alliance. Patient perceptions of treatment success and satisfaction are c ompared to the other patients and the therapists' ratings. Complainers comp rise a significant proportion of pension applicants. Due to premature termi nation their treatment duration is comparatively short. Com plaints mostly refer to medical treatment, often also to psychological treatment, assessme nt of work capability, therapeutic measures and treatment setting. The lack of an agreement on treatment goals, of a reliable therapeutic alliance and the plea for compensation constitute major determinants of a complaint. On behalf of the patients reservations about psychosomatic referral, passive wishes for physiotherapy and recreation, their somatic illness concept and defensiveness are preconditions. The incompatibility of these attitudes wit h treatment goals and tasks of the therapists contribute to transference-co untertransference conflicts. Treatment approaches and possibilities are dis cussed.