[Patient-centered group therapy--an indirect form of managing gerontopsychiatric patients]

Indirect care for gerontopsychiatric patients by means of patient-centered group discussions under the heading "How to deal with Difficult Patients" is presented as a succession of case reports concerning the progress and course of the first year of a team counselling project in a home for aged persons. The theoretical results outline the framework of such patient-centred group discussions with the following cornerstones: Specialist training or continuing education, supervision, sociopsychiatric counselling and advising the institution; these topics are dealt with in detail. Our model of group discussions is subdivided into the following patient-centred developmental stages: Initiation, acceptance of the psychiatric line of thought, increasing specialist competence. Our paper supplies pointers with regard to the demands made on the discussion leaders, together with hints as to which factors connected with the individual cornerstones and developmental stages should be given special attention. It became evident that these group discussions help to impart more knowledge to the individual partners of the team and hence promote a greater amount of understanding of the psychological patterns of linkups in the development of each patient, thus enabling the medical staff to respond better and more adequately to the psychological needs of the individual patient. As the feeling grows in each individual that he can now cope better with the demands his profession makes on him, a feeling of satisfaction also grows among the team members and there is less job fluctuation.(ABSTRACT TRUNCATED AT 250 WORDS)