Auswirkungen der Etablierung des psychiatrischen Behandlungskonzepts „Weddinger Modell“ auf mechanische Zwangsmaßnahmen

Czernin, Klara; Bermpohl, Felix; Heinz, Andreas; Wullschleger, Alexandre; Mahler, Lieselotte

doi:10.1055/a-1116-0720

Cited by 21 publications

(16 citation statements)

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“…Interventions were especially helpful if they were combined with each other, incorporated organizational changes and were endorsed by the management of the clinic. Therefore, several complex interventions consisting of different measures were developed in the past few years, e.g., internationally Six Core Strategies (11) and Safewards (12,13) and in Germany Weddinger Modell (14). While the Six Core Strategies (11) include top-down-elements focusing on the organization of a psychiatric ward or clinic, Safewards emphasizes the communication among patients and staff on a specific ward (12).…”

Section: Introductionmentioning

confidence: 99%

“…While the Six Core Strategies (11) include top-down-elements focusing on the organization of a psychiatric ward or clinic, Safewards emphasizes the communication among patients and staff on a specific ward (12). The Weddinger Modell, developed in 2010 in Berlin, Germany, is an innovative model of psychiatric care focusing on recovery, participation, supported decision-making and the prevention of coercive measures on psychiatric wards (14).…”

Section: Introductionmentioning

confidence: 99%

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Implementation of Guidelines on Prevention of Coercion and Violence (PreVCo) in Psychiatry: Study Protocol of a Randomized Controlled Trial (RCT)

et al. 2020

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Implementation of Guidelines on Prevention of Coercion and Violence (PreVCo) in Psychiatry: Study Protocol of a Randomized Controlled Trial (RCT)

et al. 2020

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“…To date, one other controlled study investigating the effects of post-coercion review did not show a significant reduction of PTSD symptoms [17]. Based on the previous clinical experiences made within the context of a recovery orientation of inpatient care (Weddinger Model), a standardized guideline for the conduction of a post-coercion reflecting review session was developed [13,18]. A first observational study indicated a good acceptance of the intervention by patients and staff members [13,14].…”

Section: Introductionmentioning

confidence: 99%

Effect of standardized post-coercion review session on symptoms of PTSD: results from a randomized controlled trial

Wullschleger

Vandamme

Mielau

et al. 2020

Eur Arch Psychiatry Clin Neurosci

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Objective Post-coercion review is increasingly regarded as a mean to reduce the negative consequences of coercive interventions, including the development of posttraumatic symptoms. However, the efficacy of this intervention in preventing posttraumatic symptoms or PTSD has not been sufficiently studied. The objective of this study is to examine the influence of a single, standardized post-coercion review session on the development or exacerbation of PTSD symptoms in patients with psychotic disorders. Methods In a multi-center, two-armed, randomized controlled trial, patients who experienced coercive interventions during current hospitalization were either randomized to standard treatment or an intervention group receiving a guideline-based, standardized reflecting review session. Factorial MANCOVA and subsequent ANCOVAs investigated the effects of the post-coercion reflecting review session on post-traumatic symptoms as measured by the subscales of the Impact of Events Scale-Revised (IES-R). Similarly, the effect of the intervention on the intensity of the peritraumatic reactions measured by the Peritraumatic Distress Inventory (PDI) was analyzed by conducting a factorial ANCOVA. Results N = 82 patients were included in an intention-to-treat analysis. MANCOVA and post hoc ANCOVAs revealed a significant main effect of the intervention for the IES-R subscales intrusion and hyperarousal, when controlling for levels of peritraumatic distress, whereby intervention group participants presented lower respective mean scores. There was no significant difference regarding the intensity of the peritraumatic reaction. Conclusion Standardized post-coercion review contributes to a reduction of the burden of PTSD symptoms in patients with psychotic disorders experiencing coercive interventions in acute settings and shall be recommended as a measure of trauma-informed care. The trial was registered at ClinicalTrials.gov (ID NCT03512925) on 01/30/2018 (retrospectively registered).

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“…5,22 h). Im Prä-Post-Vergleich zeigte sich außerdem, dass nach Einführung des Weddinger Modells die Anzahl der Fixierungen signifikant gesenkt werden konnte[7]. Anhand derselben Stichprobe konnte in einer weiteren Studie dargelegt werden, dass sich bei beschriebener Reduktion der mechanischen Zwangsmaßnahmen auch die Zwangsmedikation signifikant reduziert werden konnte[8].…”

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Das Weddinger Modell

Mahler¹,

Oster²,

Vandamme³

2021

Nervenheilkunde

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ZUSAMMENFASSUNGCharakteristisch für Psychosen ist eine Vielzahl an Symptomen, die sich in Veränderungen und Unsicherheiten der Wahrnehmung, der Identität und insbesondere der Beziehung zur Außenwelt manifestieren. Besondere Relevanz in der Behandlung von Menschen mit Psychosen haben der Aufbau stabiler und vertrauensvoller therapeutischer Beziehungen, auch um Eskalationen vorzubeugen und Zwangsmaßnahmen zu vermeiden. Starre Stationsstrukturen und -regeln lassen allerdings wenig Raum und Flexibilität für die individuellen Bedürfnisse und Erklärungsmodelle von Menschen in (psychotischen) Krisen. Vor diesem Hintergrund und aus den praktischen Erfahrungen heraus, wurde 2010 in der Psychiatrischen Universitätsklinik der Charité im St. Hedwig Krankenhaus (PUK-SHK) ein neues Recovery-orientiertes Behandlungskonzept, das Weddinger Modell, entwickelt und implementiert. Nach 10 Jahren Arbeit mit dem Weddinger Modell gibt es neben den guten praktischen Erfahrungen zahlreiche wissenschaftliche Befunde, die dessen Wirksamkeit hinsichtlich Beziehungsförderung und Zwangsvermeidung auf verschiedenen Dimensionen belegen. Dieser Artikel gibt einen Überblick über die Kernelemente des Weddinger Modells sowie die wissenschaftlichen Befunde. Diese werden im Hinblick auf die spezifischen Erfordernisse in der Behandlung von Menschen in psychotischen Krisen dargestellt und in den Verlauf einer psychiatrischen Behandlung eingeordnet. Die praktische Relevanz der Forschungsergebnisse und die flexible und ressourcensparende Umsetzbarkeit des Weddinger Modells im (akut-)psychiatrischen Setting werden diskutiert.

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Auswirkungen der Etablierung des psychiatrischen Behandlungskonzepts „Weddinger Modell“ auf mechanische Zwangsmaßnahmen

Cited by 21 publications

References 16 publications

Implementation of Guidelines on Prevention of Coercion and Violence (PreVCo) in Psychiatry: Study Protocol of a Randomized Controlled Trial (RCT)

Implementation of Guidelines on Prevention of Coercion and Violence (PreVCo) in Psychiatry: Study Protocol of a Randomized Controlled Trial (RCT)

Effect of standardized post-coercion review session on symptoms of PTSD: results from a randomized controlled trial

Das Weddinger Modell

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