An important effect of managed care is keeping partially decompensated patients out of the hospital, for this is the single most decisive factor in cutting the costs of psychiatric services.
It is proposed that discharging sicker patients from inpatient units and denying admission to poorly compensated patients poses new challenges to their outpatient therapists.
This calls for new, refined psychotherapeutic skills, especially around the development of a therapeutic alliance.
Patient communications in the form of metaphors may help the clinician understand the patient's conflicts while avoiding excessive anxiety that might accompany more direct communications.
Recognizing the meaning of the metaphor and working with it can keep the patient from regressing and assist in the formation ofa therapeutic alliance.
This statement is examined in a number of clinical examples.
The similarities and differences between metaphors and dreams, symptoms, and the transference are discussed.
Mots-clés Pascal : Soin intégré, Trouble psychiatrique, Traitement, Service santé, Qualité service, Santé mentale, Etats Unis, Amérique du Nord, Amérique, Homme
Mots-clés Pascal anglais : Managed care, Mental disorder, Treatment, Health service, Service quality, Mental health, United States, North America, America, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0375465
Code Inist : 002B18H05B. Création : 22/03/2000.