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Soteria Berne 1984-2011 Basic concepts, practical realisation, results

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Soteria Berne 1984-2011 Basic concepts, practical realisation, results. Prof. Dr. med. em. Dr. h.c. Luc Ciompi Berne / Switzerland IX. Symposium „Early intervention in psychiatry“ Cordoba, March 24-26 th , 2011. Plan of lecture. Historical roots Basic concepts Practical realisation

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Soteria Berne 1984-2011

Basic concepts, practical realisation, results

Prof. Dr. med. em. Dr. h.c. Luc Ciompi Berne / SwitzerlandIX. Symposium „Early intervention in psychiatry“Cordoba, March 24-26th, 2011
plan of lecture
Plan of lecture
  • Historical roots
  • Basic concepts
  • Practical realisation
  • Therapeutic results
  • Hypotheses and open questions

4

long term outcome
Long-term outcome
  • Full recovery 20-30 %
  • Minor residuals 30-40 %
  • Severe chronicity 30-35 %

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three phase model of the long term evolution of schizophrenia
Three phase model of the long-term evolution of schizophrenia
      • biological factors ⇆ pychosocial factors
      • ↘↘↘↙↙↙
      • premorbid vulnerability
  • ↓↓↓
  • stressfull life-events
  • ↓↓↓
    • acute psychotic decompensation(s)
  • ↓↓↓
        • long-term evolution
        • ↙↙↙↓↓↓↘↘↘
        • full recovery minor residuals severe chronicity

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Basic principle:
  • Do everything which lowers the emotional tension!
  • Avoid everything which increases it!
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Eight basic therapeutic principles
  • Small, open, „normal“ family-like setting
  • Relaxing therapeutic approach
  • Specially selected staff
  • Same information for patients, family, staff
  • Therapeutic alliance with family
  • Elaboration of realistic goals and expectations
  • Low medication strategies
  • Systematic post-care and relapse prevention

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Four phases of treatment

  • Calming down (soft room)
  • Reinsertion into everyday reality
  • Reinsertion into external reality
  • Post-care
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global outcome = n.s. relapse rate = n.s.

2-years global outcome and relapse-rates

first column = Soteria second column = controls

blue = favorable lila = unfavorable

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Soteria has neuroleptica-like effects

– but without undesirable side-effects!

5 working hypothesis and open questions
5. Working hypothesis and open questions
  • Soteria acts by naturally induced sustained emotional relaxation
  • lack of long-term follow-ups
  • lack of large scale comparisions
  • lack of formal verifications of the working hypothesis

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Further information
  • www.ciompi.com
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