Zusammenfassung
In den letzten Jahren hat eine Veränderung der medizinischen Vorstellung vom Patienten als Träger einer Krankheit stattgefunden; heute wird er zunehmend als jemand gesehen, der mit verschiedenen Formen des sozialen Lernens beschäftigt ist (Levinson und Gallagher, 1964). Der in der Klinik praktizierte Behandlungsansatz widerspiegelt diese Veränderung: Es hat eine Umstellung stattgefunden, die von einem medizinischen Modell der Verwahrung (custodial-medical model), dessen theoretische Betonung auf der Intervention in die organische oder psychische Struktur lag, zu einem soziopsychologischen Modell geführt hat, das die Auswirkungen und Folgen der Erkrankung durch die Bestätigung der,nichterkrankten’ Strukturen zu beherrschen versucht (Cumming und Cumming,1962). Obwohl auch nach dem älteren Verwahrungsmodell Therapien durchgeführt wurden, war die übliche Behandlung doch die Isolierung der Störung — das, was man als Sicherheitsverwahrung oder schlicht Einsperren des Klienten bezeichnen könnte. Bis heute ist die Milieutherapie der wichtigste in der Klinik eingesetzte Behandlungsansatz, der sich aus dem soziopsychologischen Modell herleitet und die entscheidende Wirkung der Umwelt bei der Kontrolle und Mäßigung von psychotischem Verhalten betont. Sie versucht, das symptomatische Verhalten durch die Modifikation oder Akzentuierung von Umweltbedingungen abzuschwächen, um so Möglichkeiten für das Auftreten von früher geübtem sozialem Verhalten oder für das Lehren von neuen, besser angepaßten Fähigkeiten zu schaffen. Sie versucht, die Reizelemente in der Umgebung des Klienten auf der materiellen Ebene oder auf dem Niveau der Autoritätsstrukturen zu ändern, um das Experimentieren mit einer größeren Skala von früheren oder neuen Reaktionen, als in der eingeschränkteren Verwahrungssituation möglich wäre, zu erlauben.
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Magaro, P.A., Lazarus, A.A., Jacobson, G.F., Strickler, M., Morley, W.E. (1976). Überlegungen zur Therapie. In: Goldstein, A.P., Stein, N. (eds) Massgeschneiderte Psychotherapien. Steinkopff. https://doi.org/10.1007/978-3-642-85301-2_10
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