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This presentation by Prof. Dr. Luc Ciompi at the IX Symposium on "Early Intervention in Psychiatry" explores the Soteria model as a transformative approach in managing schizophrenia. Focusing on historical roots, basic concepts, and practical realizations, it highlights therapeutic results, including long-term recovery and reduced chronicity rates. Key principles emphasize lowering emotional tension and creating supportive environments. The discussion encompasses treatment phases, outcomes, and unanswered questions surrounding the Soteria method, providing insights into systemic improvements in psychiatric care.
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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 • Historical roots • Basic concepts • Practical realisation • Therapeutic results • Hypotheses and open questions 4
Long-term outcome • Full recovery 20-30 % • Minor residuals 30-40 % • Severe chronicity 30-35 % 7
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
Basic principle: • Do everything which lowers the emotional tension! • Avoid everything which increases it!
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
Four phases of treatment • Calming down (soft room) • Reinsertion into everyday reality • Reinsertion into external reality • Post-care
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
Soteria has neuroleptica-like effects – but without undesirable side-effects!
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
Further information • www.ciompi.com
