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

1. 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

2. Plan of lecture • Historical roots • Basic concepts • Practical realisation • Therapeutic results • Hypotheses and open questions 4

3. Historical roots

4. 3

7. 6

8. Long-term outcome • Full recovery 20-30 % • Minor residuals 30-40 % • Severe chronicity 30-35 % 7

9. 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 7

10. 2. Basic concepts

11. Basic principle: • Do everything which lowers the emotional tension! • Avoid everything which increases it!

12. 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 10

13. 3. Practical realisation

29. Four phases of treatment • Calming down (soft room) • Reinsertion into everyday reality • Reinsertion into external reality • Post-care

30. 4. Results

34. 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

38. Soteria has neuroleptica-like effects – but without undesirable side-effects!

39. 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 40

40. Further information • www.ciompi.com

41. ¡ Muchas gracias por su atenciòn !