Strukturierte Nachbesprechung von Zwangsmaßnahmen mit Patienten – Überblick und aktueller Stand

TY - JOUR

T1 - Strukturierte Nachbesprechung von Zwangsmaßnahmen mit Patienten – Überblick und aktueller Stand

AU - Krieger, Eva

AU - Fischer, Rabea

AU - Moritz, Steffen

AU - Nagel, Matthias

N1 - Publisher Copyright: © 2020, Springer Medizin Verlag GmbH, ein Teil von Springer Nature. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/1

Y1 - 2021/1

N2 - Background: Research on measures to prevent or reduce the use of coercive measures is steadily gaining momentum in research. Post-seclusion/post-restraint debriefings with the affected patients are recommended in treatment guidelines but the effectiveness as an intervention has so far only scarcely been studied. Aims and methods: This article briefly outlines the existing literature on post-seclusion/post-restraint debriefings, the legal basis in Germany, recommendations by various treatment guidelines as well as the existing evidence of the effectiveness. Furthermore, challenges pertaining to the implementation of debriefings are discussed. Results: Various treatment guidelines recommend post-seclusion/post-restraint debriefings with patients and the individual Mental Health Laws (PsychKG) of the German federal states provide more or less specific guidance on how to implement the intervention. So far, hardly any scientific studies on the effectiveness of post-seclusion/post-restraint debriefings exist but they are already carried out in a variety of complex treatment concepts. Various parameters, e.g. who participates and when the debriefing is conducted, also vary across implementations. Initial pilot studies have shown indications for positive effects in terms of reducing coercive measures through the implementation of post-seclusion/post-restraint debriefings; however, structured debriefings are not yet part of routine practice. Conclusion: Structured post-seclusion/post-restraint debriefings with patients constitute a possible intervention to reduce coercive measures, but as of now there is little scientific evidence for the efficacy. Incorporating them into complex therapeutic treatment concepts for ward programs appears to be meaningful.

AB - Background: Research on measures to prevent or reduce the use of coercive measures is steadily gaining momentum in research. Post-seclusion/post-restraint debriefings with the affected patients are recommended in treatment guidelines but the effectiveness as an intervention has so far only scarcely been studied. Aims and methods: This article briefly outlines the existing literature on post-seclusion/post-restraint debriefings, the legal basis in Germany, recommendations by various treatment guidelines as well as the existing evidence of the effectiveness. Furthermore, challenges pertaining to the implementation of debriefings are discussed. Results: Various treatment guidelines recommend post-seclusion/post-restraint debriefings with patients and the individual Mental Health Laws (PsychKG) of the German federal states provide more or less specific guidance on how to implement the intervention. So far, hardly any scientific studies on the effectiveness of post-seclusion/post-restraint debriefings exist but they are already carried out in a variety of complex treatment concepts. Various parameters, e.g. who participates and when the debriefing is conducted, also vary across implementations. Initial pilot studies have shown indications for positive effects in terms of reducing coercive measures through the implementation of post-seclusion/post-restraint debriefings; however, structured debriefings are not yet part of routine practice. Conclusion: Structured post-seclusion/post-restraint debriefings with patients constitute a possible intervention to reduce coercive measures, but as of now there is little scientific evidence for the efficacy. Incorporating them into complex therapeutic treatment concepts for ward programs appears to be meaningful.

KW - Compulsory treatment

KW - Debriefing

KW - Emergency psychiatry

KW - Restraint

KW - Seclusion

KW - Mental Disorders/etiology

KW - Humans

KW - Patient Isolation

KW - Restraint, Physical

KW - Coercion

KW - Germany

UR - http://www.scopus.com/inward/record.url?scp=85088692700&partnerID=8YFLogxK

U2 - 10.1007/s00115-020-00969-y

DO - 10.1007/s00115-020-00969-y

M3 - SCORING: Review

C2 - 32725493

AN - SCOPUS:85088692700

VL - 92

SP - 44

EP - 49

JO - NERVENARZT

JF - NERVENARZT

SN - 0028-2804

IS - 1

ER -