[A patient switches wards: significance for the therapeutic process in inpatient psychotherapy]

The therapeutic process is influenced significantly from the outside conditions of the therapy setting. Changes in the setting in an ongoing therapy process are a special aspect. The Mannheim psychosomatic clinic has four conceptually different wards. This structure makes it possible to change settings during current therapy by moving patients from one ward to another within the clinic. With three case examples the significance of the move for the therapeutic process is described. The possibility of trial actions and gains in insight is compared with the danger of fixating pathological conflict solutions. Special attention is paid to aspects of power-powerlessness and coping with separation wishes and separation anxieties. Moving a patient to a different ward during an ongoing therapy process contains in a special way the possibility for development but also the danger of disintegration.