The use of treatment contracts in short-term psychiatric care

Two different treatment contracts, one with and one without active patient cooperation were compared during two 4-month periods on a short-term psychiatric ward. Attitudes and symptoms were measured at admission after 5 days and at discharge by an independent rater and by self-ratings. The length of stay was similar during the two periods. Patients with cooperation contracts showed a significantly larger reduction of anxiety compared with the others. Patients benefitting most from a cooperation contract were those with socio-psychological treatment contract objectives and those treated in a basic activation group. It is concluded that treatment contracts with an active patient cooperation on a short-term psychiatric ward are useful especially for patients not primarily suitable for specific psychotherapy or specific psychopharmacological treatment.