ISSN:0254-4962    

DOI:10.1159/000283690

出版商:S. Karger AG    

年代:1977

数据来源: Karger

ISSN:0254-4962    

DOI:10.1159/000283691

出版商:S. Karger AG    

年代:1977

数据来源: Karger

ISSN:0254-4962    

DOI:10.1159/000283693

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

An analysis of the concept of crisis cannot ignore that it is often used in a highly suggestive way, nor should it neglect to look at its historical roots. The psychosocial crisis concept as it is used in psychiatry, psychotherapy, social work, etc. has two historic roots: one root lies in the medical-natural-sciences tradition; the other in the dramaturgical Le. healing tradition, and they both flow together in the concept as commonly used. At present, there are numerous crisis definitions each of which emphasizes a different aspect. Greater precision, models and operational definitions are indispensable for exact research. Crisis precipitation, disposition (crisis proneness) of the system, environment and reaction of the system are discussed as separate aspects of a crisis. Finally, the innovative and constructive role is stressed which the crisis concept plays in research and practice.

ISSN:0254-4962    

DOI:10.1159/000283695

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

Crisis intervention is one of the programmatic terms of psychiatry which are ment to initiate impulses of thinking and new orientations for acting. The term has two aspects: based on a comprehensive crisis theory, crisis intervention is understood as help in stressful life events which makes use of enlarged possibilities of reorientation and aims at preventing from chronification by supporting an adequate respondent behaviour. Against this broad concept of crisis intervention, which includes culturally institutionalized and other potentials of self-aid, we have the concept of psychiatric crisis intervention in a closer sense, which goes back to Querido. It comprises social crises in chronical disorders, attempted suicides and other psychiatric emergency cases up to the acute alcoholic delirium.

ISSN:0254-4962    

DOI:10.1159/000283696

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

After describing the principles and structure of the psychiatric services in Bulgaria, the author goes in more detail into the organizational and administrative conditions of psychiatric crisis intervention. It is emphasized that the main basis for psychiatric crisis intervention must be the psychiatric out-patient service which includes and coordinates all service branches and works together with the non-psychiatric services. The author stresses two channels of information about crises: ‘passive’, when psychiatric services receive information from the family or non-psychiatric agencies associated with crisis interventions (e.g. general medical agencies, councelling centres, administrative authorities, etc.); ‘active’, if the dispensary itself collects information as e.g. by regular observation of registered patients, by psychiatric or general medical field investigations as may be carried out by the Prevention Department, etc.). A few ideas are also offered concerning the organization of a subsystem for crisis intervention within the entire psychiatric service delivery

ISSN:0254-4962    

DOI:10.1159/000283697

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

Based on the various principles of crisis intervention, a model of it is designed which divides it into four phases: (1) beginning of intervention (establishment of a relationship, assessment of the client’s condition, estimate of the gravity of the problem, and design of the plan of action along the lines of minimal difference); (2) actual intervention; (3) conclusion of the crisis intervention, and (4) follow-up. This system conveys a good insight into the activities of a crisis centre, and it can contribute to the difficult and up to now unsolved problem of how such institutions can be evaluate

ISSN:0254-4962    

DOI:10.1159/000283698

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

The author demonstrates the therapeutic possibilities of a technique of ‘provoked crisis’ on the ground of theoretical models and practical examples. Such a technique seems mainly indicated in situations of chronified and stagnant equilibrium in individual patients, families or groups, which cannot be changed by stepwise proceedi

ISSN:0254-4962    

DOI:10.1159/000283699

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

‘Nihil est in intellectu quid non antea fuerit in sensibus’, said Hume. And Freud formulated the hypotheses concerning the translation of experience into personality under the influence of drives and other somatic variables. Psychoanalytic treatment is predicated upon reversing that process and restructuring maladaptive gestalten. This therapeutic process can and must be carefully conceptualized in terms of our knowledge of propositions concerning personality and psychopathology. Brief psychotherapy can accomplish a good deal of the necessary unlearning and re-learning when it is especially carefully conceptualized and areas and methods of intervention and their optimal sequence clearly formulated. Pharmacotherapy can aid psychotherapy in general and brief psychotherapy in particular if its use is also carefully integrated into the overall therapeutic process. A relatively simple clinical use of psychotropic drugs consists of employing them as enabling conditions for patients who could not communicate otherwise because of a depression, impulse disorder, disordered thought process, etc. In other instances it may enable patients to tolerate phobias and other circumstances to avoid reality complications until the psychotherapeutic process does the necessary work – using the drugs as if they were analgesics. At times they are used like anesthetics to perform psychotherapeutic interventions which might otherwise cause more pain and anxiety than the patient could tolerate without breaking off treatment, becoming too disturbed or block because of approach anxiety. A dynamic, in fact, a metapsychological, use of drugs can be made if one gives a drug to decrease drive pressure, as with chlorpromazine in the case of aggression. It is possible that lithium performs its particular function by increasing the stimulus barrier externally and internally. Antidepressants may generate energy and are thus seen by some as changing the psychic economy. A combination of major tranquilizers and energizers is sometimes indicated for optimal synergistic effect. The ability of phenothiazines and relatives to suppress primary process modes of thinking can be seen from either a dynamic or topographical perspective. It would be desirable to have a drug that could weaken superego forces. While the superego may be dissolved in alcohol, the process is neither reliable nor practical. A psychobiological basis for using drugs in psychotherapy is inherent in the catechol-amine hypothesis and others conceptualizing the etiology and pathogenesis of the psychoses in biochemical terms. There is little doubt that there is a continuous interaction between experience and a broad spectrum of biochemical processes, including cortisol and growth hormone excretion. Diurnal variations of secretions have almost certainly an effect on cognition and eventually drugs and psychotherapy related to these biochemical changes are likely to become especially efficacious. Similarly neurophysiological factors in disturbances, like minimal brain disfunction, need special medication to optimize the ability to communicate in psychotherapy and control impulses, concept formation and an

ISSN:0254-4962    

DOI:10.1159/000283700

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

An institute for adolescents can meet the specific adolescent crises in all their manifold manifestations. The crisis intervention model in the form of a youth centre for information and counselling as described here has the task of giving information and advice anonymously and free of charge in a way appropriate for young people, while being non-bureaucratic and not under the direct influence of the civil authorities. The work methods of the Info-Centre in Vienna are described.

ISSN:0254-4962    

DOI:10.1159/000283701

出版商:S. Karger AG    

年代:1977

数据来源: Karger