In the field of perinatal psychiatry mother-and-child treatment is effective, social risk factors have a significant influence on the success of the treatment.

BackgroundWith all the legislative changes (patients’ rights law, decisions of the German constitutional court on forces medication) taking place at the moment, Advance Care Planning and medical treatment agreement are becoming particularly topical.At the Clinics of Upper Bavaria representatives of the clinics, the organised relatives and those affected developed the pilot project «medical treatment agreement» in a trialogical process.Aimto test and enhance the processes associated with the medical treatment agreementto identify and define the target group of patientsto reduce coercive actions, compulsory hospizalisation and to promote voluntary treatmentMethodsThe pilot project has been designed as a learning project. The model project is supervised by a trialogical steering committee.The result and quality control within the pilot project will be performed by means of qualitative evaluation.Resultsa practical example of a trialogical (psychiatric acute care hospital, relatives and those affected) implementation of the pilot project “medical treatment agreement”experience based treatment recommendations to support the implementation of the medical treatment agreement in a psychiatric acute care hospitala systematic overview of the project’s phases and structuresDiscussion/conclusionAdvance Care Planning and the medical treatment agreement promote participative decision making as well as mutual confidence building, which is an important process of shared decision making in psychiatric treatment. Using the experience gained from the trialogical pilot project, we will establish the medical treatment agreement in all kbo clinics.