Patienten- und therapeutensicht auf abbruchgründe bei therapien nach § 64 StGB - Kurztitel: Abbruchgründe für therapien nach § 64 StGB

Abstract

Introduction: German forensic psychiatric hospitals according to section 64 of the penal code struggle with high patient numbers and high drop-out rates. Previous research sought to identify specific treatment predictors as required by the law; some were found, but it remains difficult to predict treatment outcomes for individual cases. Subjective causes and motives of treatment termination by patients and their therapists have not yet been scientifically investigated. Aim: To describe how patients and their therapists account for premature treatment termination. Methods: 37 patients whose treatment was terminated prematurely rated statements with respect to different motives and possible causes of treatment termination. 29 double ratings of patients and their therapists were obtained. Results: The patients indicated more reasons for treatment termination than the therapists. First and foremost, the patients mentioned their own psychological tense- and aggressiveness, frequent arguments with fellow patients, and other negative influences in relation to a bad therapeutic environment. The therapists highlighted the patients' own behaviours as the principal cause of failure. Conclusions: Patients and therapists should be encouraged to monitor their thoughts and feelings in relation to treatment on a regular basis. Clear differences should be viewed as evidence that more work is needed to improve therapeutic relationships.