Psychiatria środowiskowa między romantyzmem a pozytywizmem — próba integracji podejść

This paper will attempt to address the following question: What should modern community psychiatry entail? I will try to discuss key issues, of which the most basic and important can be summed up as: What is mental illness? Is it a permanent change in the brain with all its social consequences, or a way in which we define “others”? Should we build a system of care “for life” or only plan for a crisis? Are the problems associated with “mental illness” within the bounds of the medical system/social assistance, or rather in the area of human rights? Is it possible to integrate these seemingly contradictory attitudes? These basic problems of community psychiatry are discussed in the areas of diagnoses, treatment, forced treatment, housing, work, and patients’ organizations. The challenge ahead now becomes not the deinstutunalisation of hospitals but a complete change of view of what constitutes “mentally ill”.Autorka niniejszej pracy próbuje zmierzyć się z pytaniem: jaka ma być współczesna psychiatria środowiskowa? Próbuje omówić podstawowe kwestie, w których prześwituje w tle dyskusja podstawowa: czym jest choroba psychiczna; czy jest trwałą zmianą mózgu z wszystkimi tego społecznymi konsekwencjami; czy sposobem w jaki określamy „innych”; czy należy budować system opieki „na całe życie” czy tylko na wypadek kryzysu; czy problemy związane z „chorobą psychiczną” mieszczą się w obszarze system medyczny/pomoc społeczna czy raczej w obszarze praw człowieka; czy jest możliwa integracja tych, wydawałoby się, sprzecznych postaw? Te podstawowe problemy psychiatrii środowiskowej omówione są w obszarze — diagnoza, leczenie, stosowanie przymusu leczenia, mieszkanie, praca, organizacje pacjentów. Aktualnym wyzwaniem psychiatrii środowiskowej staje się nie deinstytucjonaliza, ale całkowita zmiany widzenia „chorego psychicznie”

Group psychotherapy of Holocaust survivors : authors' own experience

Autorzy artykułu, w oparciu o ponad 14-letnie doświadczenia pracy z grupami ocalałych z Holocaustu, prezentują szeroki zakres zagadnień obecnych w procesie psychoterapii tych osób. Realizowany program ma swój początek w badaniach naukowych dotyczących następstw Holocaustu u ocalonych i ich dzieci prowadzonych przez zespół pod kierownictwem prof. Marii Orwid, która była również inicjatorką terapii indywidualnej i grupowej osób ocalałych z Holocaustu.The psychotherapy of children of survivors of the Holocaust is conducted in Poland within the framework of a programme leaded by professor Maria Orwid. Such group psychotherapy is conducted in intensive courses of 3 days, 6 hours a day in meetings held two or three times a year, and takes in around 60 people. One of the basic goals of psychotherapy is to restore the destroyed connection between the present and the past and make the survivors aware of their strengths allowing them to survive. These people need psychotherapeutic intervention helping them to change their self-perception, and replace their self-image of a weak and helpless person into that of someone strong who managed to survive the worst. The power of group psychotherapy lies in survivors’ common experiences giving them a sense of being understood, and facilitating their acceptance of interpretations proposed by other group members. Besides, it is the reverse of the trauma situation where the survivors were in isolation. In survivor psychotherapy the therapist is painfully confronted with a sense of helplessness and with questions about possibilities and boundaries of psychotherapy, with existential problems - possibility of a life after the loss of one’s world and leaving the world regained

Rationale, component description and pilot evaluation of a physical health promotion measure for people with mental disorders across Europe

Introduction: The HELPS project aimed at developing a toolkit for the promotion of physical health in people with mental disorders to reduce the substantial excess morbidity and mortality in the target group. Methods: The HELPS toolkit was developed by means of national and international literature reviews, Delphi rounds with mental health experts and focus groups with mental health experts and patients/ residents in 14 European countries. The toolkit was translated into the languages of all participating countries, and usability of toolkit modules was tested. Results: The toolkit consists of several modules addressing diverse somatic health problems, lifestyle, environment issues, patient goals and motivation for health-promotion measures. It aims at empowering people with mental illness and staff to identify physical health risks in their specific contexts and to select the most appropriate modules from a range of health promotion tools. Discussion: The HELPS project used an integrative approach to the development of simple tools for the target population and is available online in 14 European languages. Preliminary evidence suggests that the toolkit can be used in routine care settings and should be put to test in controlled trials to reveal its potential impact