[Promoting Self-Care Instead of Resistance Orientation: Therapeutic or Side Effect in Regard to Work?]

In rehabilitation medicine an important goal is to restore the ability to work by improving resistance to stress. We observed the development of resistance orientation on one hand and the tendency of self-care, stress avoidance, and regeneration orientation on the other, in the course of a 5 week psychosomatic inpatient rehabilitation. A convenience sample of 121 inpatients of a psychosomatic rehabilitation unit filled in the ReRe-Scale (Resistance-Regeneration-Scale) at the beginning and end of a 5 week inpatient treatment. Also patients rated their ability to work before discharge from the hospital. There was a decline in resistance orientation and a clear increase in regeneration orientation. Regeneration orientation, in contrast to resistance orientation, was associated with a greater ability to work. The reduction in resistance and increase in regeneration orientation was unexpected and could be seen as an unwanted effect of inpatient rehabilitation. When taking into account the disposition to go back to work, promotion of regeneration seems to be the better way. This raises questions in respect to treatment strategies for stress tolerance, and occupational rehabilitation but also for the definition of positive or negative treatment effects in psychotherapy.