Klinische Wirksamkeit von „FlexiTeam“ (Home Treatment und intensivierte ambulante Behandlung) – Vergleich einer Behandlung in einem Modellprojekt nach § 64b in Berlin mit der stationären Behandlung

2019 ◽  
Vol 46 (05) ◽  
pp. 249-255
Author(s):  
Stefan Weinmann ◽  
Simon Wiedmann ◽  
Tilo Breidert ◽  
Matthias Bohe ◽  
Jan Pfeiffer ◽  
...  
Keyword(s):  
Home Treatment ◽  
Ambulante Behandlung ◽  
Klinische Wirksamkeit

Zusammenfassung Ziel der Studie Verglichen wurde die klinische Wirksamkeit von „Home Treatment“ (HT) zusammen mit intensiver ambulanter Behandlung (IAB) im Modellprojekt „FlexiTeam“ (FT) mit einer stationär-psychiatrischen Routinebehandlung. Methodik Im Rahmen einer kontrollierten gematchten Vorher-Nachher-Studie wurden Routinedaten von jeweils 83 Patienten im FT und in der stationär-psychiatrischen Routinebehandlung hinsichtlich (teil-)stationärer Wiederaufnahmerate und Verweildauer im 6- und 12-Monats-Follow-up verglichen. Ergebnisse Es zeigt sich keine signifikante Reduktion der (teil-)stationären Verweildauer im Index-Aufenthalt. Durch die Behandlung im FT konnte eine signifikante Reduktion sowohl der (teil-)stationären Wiederaufnahmerate als auch der Verweildauer im 6- und 12-Monats-Follow-up erreicht werden. Schlussfolgerung Eine flexible Kombination aus IAB und HT stellt eine wirksame Ergänzung zur stationär-psychiatrischen Routinebehandlung dar und kann bei geeigneten Patienten das Risiko stationärer Wiederaufnahmen senken.

Neurofeedback-Training bei Kindern mit Aufmerksamkeitsdefizit-/ Hyperaktivitätsstörung (ADHS)

2010 ◽  
Vol 38 (6) ◽  
pp. 409-420 ◽  
Author(s):  
Holger Gevensleben ◽  
Gunther H. Moll ◽  
Hartmut Heinrich
Keyword(s):  
Attention Network Test ◽  
Sich Eine ◽  
Neurofeedback Training ◽  
Attention Network ◽  
Klinische Wirksamkeit

Im Rahmen einer multizentrischen, randomisierten, kontrollierten Studie evaluierten wir die klinische Wirksamkeit eines Neurofeedback-Trainings (NF) bei Kindern mit einer Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) und untersuchten die einem erfolgreichen Training zugrunde liegenden neurophysiologischen Wirkmechanismen. Als Vergleichstraining diente ein computergestütztes Aufmerksamkeitstraining, das dem Setting des Neurofeedback-Trainings in den wesentlichen Anforderungen und Rahmenbedingungen angeglichen war. Auf Verhaltensebene (Eltern- und Lehrerbeurteilung) zeigte sich das NF-Training nach Trainingsende dem Kontrolltraining sowohl hinsichtlich der ADHS-Kernsymptomatik als auch in assoziierten Bereichen überlegen. Für das Hauptzielkriterium (Verbesserung im FBB-HKS Gesamtwert) ergab sich eine mittlere Effektstärke (von 0.6). Sechs Monate nach Trainingsende (follow-up) konnte das gleiche Ergebnismuster gefunden werden. Die Ergebnisse legen somit den Schluss nahe, dass NF einen klinisch wirksamen Therapiebaustein zur Behandlung von Kindern mit ADHS darstellt. Auf neurophysiologischer Ebene (EEG; ereignisbezogene Potentiale, EPs) konnten für die beiden Neurofeedback-Protokolle Theta/Beta-Training und Training langsamer kortikaler Potentiale spezifische Effekte aufgezeigt werden. So war für das Theta/Beta-Training beispielsweise die Abnahme der Theta-Aktivität mit einer Reduzierung der ADHS-Symptomatik assoziiert. Für das SCP-Training wurde u. a. im Attention Network Test eine Erhöhung der kontingenten negativen Variation beobachtet, die die mobilisierten Ressourcen bei Vorbereitungsprozessen widerspiegelt. EEG- und EP-basierte Prädiktorvariablen konnten ermittelt werden. Der vorliegende Artikel bietet einen Gesamtüberblick über die in verschiedenen Publikationen unserer Arbeitsgruppe beschriebenen Ergebnisse der Studie und zeigt zukünftige Fragestellungen auf.

HOME TREATMENT OF HAEMOPHILIA A FOLLOW‐UP STUDY

1981 ◽  
Vol 2 (1) ◽  
pp. 21-23 ◽  
Author(s):  
Henry Ekert ◽  
Michelle Moorehead ◽  
Graham Williamson
Keyword(s):  
Home Treatment ◽  
Haemophilia A ◽  
Follow Up Study

Gender-Responsive Intervention for Female Juvenile Offenders: A Quasi-Experimental Outcome Evaluation

2016 ◽  
Vol 14 (1) ◽  
pp. 24-44 ◽  
Author(s):  
Valerie R. Anderson ◽  
Brinn M. Walerych ◽  
Nordia A. Campbell ◽  
Ashlee R. Barnes ◽  
William S. Davidson ◽  
...  
Keyword(s):  
Juvenile Offenders ◽  
Juvenile Justice System ◽  
Juvenile Court ◽  
Group Home ◽  
Outcome Evaluation ◽  
Home Treatment ◽  
Policy And Practice ◽  
Female Juvenile Offenders ◽  
Quasi Experimental

The increasing proportion of girls in the juvenile justice system has prompted courts to develop gender-responsive services. The present study examined data from a mid-sized county juvenile court to examine the effects of a group home intervention for girls. The study compared group home participants ( n = 172) with girls who did not receive group home treatment ( n = 814) using propensity score matching (PSM). Girls who received group home treatment were significantly less likely to re-offend in the 2-year follow-up period. Policy and practice implications for gender-responsive services as well as future directions for research are discussed.

scholarly journals International differences in home treatment for mental health problems

2002 ◽  
Vol 181 (5) ◽  
pp. 375-382 ◽  
Author(s):  
Tom Burns ◽  
Jocelyn Catty ◽  
Hilary Watt ◽  
Christine Wright ◽  
Martin Knapp ◽  
...  
Keyword(s):  
Mental Health ◽  
North American ◽  
American Studies ◽  
Mental Health Problems ◽  
Home Treatment ◽  
European Studies ◽  
Location Service ◽  
The Usa ◽  
Meta Analyses

BackgroundIt is perceived that North American home treatment studies reveal greater success in reducing days in hospital than do European studies. There are difficulties in extrapolating findings internationally.AimsWe aimed to determine whether North American studies find greater reductions in days in hospital and whether experimental service patients in North American studies spend less time in hospital.MethodThe results of a systematic review were analysed with respect to study location. Service components ascertained through follow-up were utilised to interpret the meta-analyses conducted.ResultsMost of the 91 studies found were from the USA and UK. North American studies found a difference of one hospital day (per patient per month) more than European studies but there was no difference in experimental data between the two locations.ConclusionsNorth American studies demonstrate greater differences in days in hospital but patients in their experimental services seem to spend no fewer days in hospital, implying a disparity in control services.

scholarly journals Intensive home treatment for adolescents in psychiatric crisis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jet B. Muskens ◽  
Pierre C. M. Herpers ◽  
Caroline Hilderink ◽  
Patricia A. M. van Deurzen ◽  
Jan K. Buitelaar ◽  
...  
Keyword(s):  
Mental Health Problems ◽  
Treatment Time ◽  
Primary Diagnosis ◽  
Home Treatment ◽  
Control Group ◽  
Long Term Effects ◽  
New Model ◽  
Combined Application

Abstract Background Adolescents with acute psychiatric disorders are typically treated with long-term clinical admission. However, long term admission may be associated with a variety of negative outcomes. This pilot study presents a new model of care, that is, the combined application of intensive home treatment and the possibility of short term stay at a psychiatric high & intensive care. Methods In total 112 referred adolescents with mixed diagnoses participated in this longitudinal observational design. Clinical outcome was measured by the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) which measures the severity of multiple mental health problems. The HoNOSCA was clinician-rated at intake, after two months and after four months at discharge. Change in HoNOSCA total score was analysed with paired t-tests. Outcome moderators were gender, age, primary diagnosis, clinical admission, home treatment-time, medication and additional therapies. Follow up data were completed for 62 patients after two months and for 53 after four months. Results Participants aged between 11 and 18 years (M = 14.8 years, SD = 0.3; 52% female). Mean HoNOSCA total score at intake was 18.8 (SD = 5.2), after two months 13.0 (SD = 5.0); after four months resulting in a score of 9.3 (SD = 5.2). None of the moderators tested showed a significant effect on HoNOSCA scores. However, a control group could not be used because of the severe psychopathology and high risk for suicidality and the lack of an effective treatment intervention for a comparable study group. Conclusion With a symptom decrease of over 50% within four months as measured by the HoNOSCA, including less risk for hospitalization, this new model appears promising and of clinical relevance. Nevertheless, further research regarding stability of treatment outcome is warranted and evaluation of long-term effects of this model in follow-up studies is needed.

Synkopen auf einem universitären Notfall – ist die ambulante Behandlung der Patienten sicher?

Praxis ◽  
2013 ◽  
Vol 102 (8) ◽  
pp. 451-456 ◽  
Author(s):  
Simone Haltmeier ◽  
Gregor Lindner ◽  
Aristomenis Konstantinos Exadaktylos ◽  
Monika Haberkern
Keyword(s):  
Ambulante Behandlung

Synkopen sind ein häufiger Einweisungsgrund auf einer Notfallstation. Zwei Scoring-Methoden sind geprüft bezüglich klinischer Entscheidungsfindung, Indikation zu weiterführender Diagnostik und Hospitalisation. Ziel der Arbeit war die Qualitätskontrolle bei ambulanter Behandlung von Synkope-Patienten auf unserer universitären Notfallstation. 200 konsekutive Synkopen-Patienten wurden dokumentiert, bei 109 Patienten mit telefonischem Follow-up über zwei Jahre. Die Entscheidung zu ambulanter oder stationärer Behandlung oblag dem Dienst-Oberarzt. Die Altersverteilung im Patientenkollektiv war biphasisch, bis 25-jährig waren es vor allem Frauen, in der 6. bis 8. Lebensdekade überwiegend Männer. Die Ursache der Synkopen blieb diagnostisch weitgehend ungeklärt, mit benignem Verlauf für die nachkontrollierten Fälle. Selten wurde eine neurologische (n=3) respektive eine kardiale Ursache (n=5) gefunden, mit therapeutischer Konsequenz.

scholarly journals Motivation to Change in the Course of a Pilot Study of a Step-Down Treatment Approach of Inpatient and Anorexia Nervosa-Specific Home Treatment and Its Effects on Treatment Outcome

2021 ◽  
Vol 12 ◽  
Author(s):  
Kathrin Sophie Heider ◽  
Astrid Dempfle ◽  
Sophie Altdorf ◽  
Beate Herpertz-Dahlmann ◽  
Brigitte Dahmen
Keyword(s):  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Inpatient Treatment ◽  
Treatment Approach ◽  
Illness Severity ◽  
Home Treatment ◽  
Motivation To Change ◽  
Sum Score ◽  
Step Down

Introduction: Anorexia nervosa (AN) is a serious mental disorder that typically manifests in adolescence. Motivation to change is an important predictor for treatment outcome in adolescent AN, even though its development over the often long therapeutic process, with transitions between treatment settings, has not yet been studied. In this pilot study, the course of motivation to change and its effect on treatment outcome were investigated over the course of a step-down treatment approach during a 12-month observation period.Methods: Twenty-one adolescents admitted to inpatient treatment because of AN received multidisciplinary home treatment (HoT) with several weekly visits after short inpatient stabilization. Eating disorder (ED-)specific cognitive [Eating Disorder Inventory 2 (EDI-2) subscales] and physical [% expected body weight (%EBW)] illness severity and motivation to change [Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ)] were assessed at the time of admission, discharge from hospital, at the end of HoT, and at a 12-month follow-up. Changes in motivation over time and its relationship with treatment outcome were investigated.Results: Mean motivation to change improved significantly over the course of treatment from the contemplation stage [2nd stage, mean ANSOCQ sum score 47.26 (SD 17.60)] at admission to the action stage [4th stage, mean ANSOCQ sum score 77.64 (SD 18.97)] at the end of HoT (p < 0.001) and remained stable during the follow-up period. At each assessment, higher motivation to change was significantly correlated with lower ED-specific cognitive illness severity (Spearman ρs: −0.53 to −0.77, all p < 0.05). Only pretreatment motivation to change significantly predicted ED-specific cognitive illness severity after the first inpatient treatment phase when taking prior illness severity into account.Conclusions: Motivation to change is an important aspect of treatment success in adolescent AN, especially in the early phase of treatment. In addition, home treatment contributed significantly to a higher motivation. Further longitudinal research into how motivation to change in adolescent patients with AN is related to outcome in this often severe and enduring disease and into targeted therapeutic strategies and interventions that reliably enhance the motivation to change in adolescent patients with AN seems promising.

Treatment of an 11-year-old Obsessive-compulsive Ritualizer and Tiqueur Girl with in vivo Exposure and Response Prevention

1983 ◽  
Vol 11 (1) ◽  
pp. 75-81 ◽  
Author(s):  
P. Zikis
Keyword(s):  
Traumatic Event ◽  
Specific Treatment ◽  
Sudden Onset ◽  
Home Treatment ◽  
Response Prevention ◽  
Exposure And Response Prevention ◽  
Obsessive Compulsive ◽  
Primary Problem

A case is described of an 11-year-old schoolgirl with both obsessive-compulsive rituals and tics of sudden onset following a traumatic event at the age of five. Treatment consisted of exposure in vivo and response prevention directed mainly towards her obsessive-compulsive rituals as they were considered the primary problem. Following the initial therapist–patient out-patient session and home treatment with her mother, the obsessive-compulsive rituals disappeared and the tics decreased. Three weeks later the tics disappeared without specific treatment and the patient has maintained her improvement at follow-up, 52 weeks later. The actual therapist–patient time was about an hour.

scholarly journals Intensive Home Treatment for adolescents in psychiatric crisis

2019 ◽  
Author(s):  
Jet Muskens ◽  
Pierre C.M. Herpers ◽  
Caroline Hilderink ◽  
Patricia A.M. van Deurzen ◽  
Jan K. Buitelaar ◽  
...  
Keyword(s):  
Mental Health Problems ◽  
Treatment Time ◽  
Primary Diagnosis ◽  
Home Treatment ◽  
Control Group ◽  
Long Term Effects ◽  
New Model ◽  
Combined Application

Abstract Adolescents with acute psychiatric disorders are typically treated with long-term clinical admission. However, long term admission may be associated with a variety of negative outcomes. This pilot study presents a new model of care, that is, the combined application of intensive home treatment and the possibility of short term stay at a psychiatric high & intensive care. Methods In total 112 referred adolescents with mixed diagnoses participated in this longitudinal observational design. Clinical outcome was measured by the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) which measures the severity of multiple mental health problems. The HoNOSCA was clinician-rated at intake, after two months and after four months at discharge. Change in HoNOSCA total score was analysed with paired t-tests. Outcome moderators were gender, age, primary diagnosis, clinical admission, home treatment-time, medication and additional therapies. Follow up data were completed for 62 patients after two months and for 53 after four months. Results Participants aged between 11 and 18 years (M = 14.8 years, SD = 0.3; 52% female). Mean HoNOSCA total score at intake was 18.8 (SD = 5.2), after two months 13.0 (SD = 5.0); after four months resulting in a score of 9.3 (SD = 5.2). None of the moderators tested showed a significant effect on HoNOSCA scores. However, a control group could not be used because of the severe psychopathology and high risk for suicidality and the lack of an effective treatment intervention for a comparable study group. Conclusion With a symptom decrease of over 50% within four months as measured by the HoNOSCA, including less risk for hospitalization, this new model appears promising and of clinical relevance. Nevertheless, further research regarding stability of treatment outcome is warranted and evaluation of long-term effects of this model in follow-up studies is needed.

Sign in / Sign up

Export Citation Format

Share Document