Klinik Schwedenstein
Specialized Clinic for Psychosomatic Medicine
The Klinik Schwedenstein offers a specialized treatment concept based on the methods of Dialectical Behavior Therapy (DBT) by M. Linehan.
Admission Process
Section titled “Admission Process”Patients typically come for an outpatient preliminary interview at the clinic after telephone pre-registration and cost approval from the funding agency (health insurance or pension insurance carrier) for inpatient rehabilitation.
The preliminary interview serves:
- A first meeting
- Diagnostics and motivation assessment
- Making fundamental agreements
By arrangement with the referring practitioner, a telephone preliminary interview may also be sufficient.
Diagnostic Phase
Section titled “Diagnostic Phase”The first 14 days of treatment serve for diagnostics, motivation building, and somatic and psychopharmacological assessment. If suitable and desired by the patient, admission to the 12-week DBT module follows (e.g., via a waiting list).
In coordination with referring practitioners, direct transfers from acute facilities are arranged as a meaningful treatment chain.
Entry Criteria
Section titled “Entry Criteria”Patients must meet the following criteria, among others:
- No current medication, drug, or alcohol dependence or gambling addiction
- At least 2 weeks of abstinence and/or completed detoxification
- No significant propensity for violence
- No significant pending criminal proceedings
- No highly acute suicidality
- Self-motivated therapy engagement
- Capacity for agreements
Basic Assumptions of DBT
Section titled “Basic Assumptions of DBT”- Patients are truly doing their best.
- Patients want to change.
- Patients must invest considerable effort and motivation to change.
- Patients may not have caused all their difficulties themselves, but they must nevertheless solve them on their own.
- The life of a suicidal borderline patient is unbearable in its current form.
- Patients must learn new behavioral patterns in all relevant areas of life.
- Patients cannot fail in therapy.
- Therapists treating borderline patients need support.
Treatment Goals
Section titled “Treatment Goals”The central goal of treatment according to the DBT concept is improving the quality of life and everyday functioning of patients. Various sub-goals must be achieved for this:
- Development of an understandable and plausible explanatory model for the emergence and chronification of the complex symptomatology
- Reduction of suicidal impulses and thoughts as well as self-harming behaviors (e.g., self-injury, risky behavior, lack of self-care)
- Optimization and possible reduction of symptom-dampening medications, especially those with addiction potential
- Reduction of the need for continuous and acute medical treatments
- Improvement of the capacity for enjoyment and relaxation
- Improvement of physical resilience and psychological performance
- Regaining of work/training capacity and planning for occupational reintegration
- Improved coping with stress and demands
- Treatment of accompanying and consequential psychological problems (depression, sleep disorders, anxiety, compulsions, addiction disorders)
- Changing problematic attitudes and thought patterns
- Reducing existential insecurity and anxiety
- Regaining positive body awareness
- Improving the perception and expression of one’s own needs
- Promoting social competencies
- Developing new strategies for dealing with problems and stressors of everyday life
Foundations of Inpatient Treatment
Section titled “Foundations of Inpatient Treatment”- Patients commit to not attempting suicide during the entire course of therapy.
- Patients will work on reducing suicidal and parasuicidal thoughts and behaviors.
- Patients will work on reducing behavioral patterns that hinder or make therapy impossible.
- Patients will work on reducing behavioral patterns that led to inpatient admission.
- Patients will work on reducing behavioral patterns that impair their quality of life.
The patient’s motivation to actively participate in this concept is decisive for the course of treatment.
Therapeutic Offerings
Section titled “Therapeutic Offerings”On Ward 1b of the Klinik Schwedenstein, a specialized DBT program is offered. Currently, 13 places are available for the 12-week therapy module.
Weekly Therapy Schedule
Section titled “Weekly Therapy Schedule”| Therapy | Frequency | Duration |
|---|---|---|
| DBT Group | 2x weekly | 90 min |
| Basic Group | 2x weekly | 50 min |
| Body/Creative Therapy | 2x weekly | 50 min |
| Individual Therapy (Therapist) | 1x weekly | 45 min |
| Individual Therapy (Primary Nurse) | 1x weekly | 15 min |
| Guided Imagery | 2x weekly | 30 min |
| Organization Group | 1x weekly | 30 min |
| Progressive Muscle Relaxation | 1x weekly | 30 min |
| Qi Gong | 1x weekly | 30 min |
| Morning Exercise | 3x weekly | - |
Additional Offerings
Section titled “Additional Offerings”- Social work
- Activity log
- Work capacity testing
- Food diary
- Feedback round from the eating ward
- Physiotherapy
Treatment Duration
Section titled “Treatment Duration”The duration of treatment depends on the type and severity of borderline symptomatology and the approval of the cost carrier. Treatment can be fractionated in intervals.
The inpatient therapy duration should be 12 weeks.
The DBT therapy components can be continued on an outpatient basis.
Prognosis
Section titled “Prognosis”A favorable prognosis is a fundamental prerequisite for carrying out rehabilitation treatment. The prospects for improvement in borderline personality disorders (BPD) are favorable when intensive therapy is begun early enough.
However, significant improvements can also be achieved in chronic cases. The development of sustained therapy motivation and a viable working relationship between patients and psychotherapists is decisive for this.
The Team
Section titled “The Team”The therapeutic team includes specially trained:
- Physicians
- Psychologists
- Therapeutic nurses
- Creative therapists
- A social worker
The borderline ward can accommodate up to 13 patients. For conceptual reasons, the stay will generally take place in a double room for the entire treatment period.
Facilities
Section titled “Facilities”- Group therapy and common room with refrigerator and kitchenette
- Separate therapy rooms for body and movement therapy, art therapy, mandala painting, guided imagery, and aromatherapy
- Bath department
- Sports hall, swimming pool, sauna, and fitness room (shared use by arrangement)
Contact
Section titled “Contact”Klinik Schwedenstein Specialized Clinic for Psychosomatic Medicine Obersteinaer Weg 01896 Pulsnitz
Phone: (035955) 47-0 Fax: (035955) 47-635
Website: www.klinik-schwedenstein.de Email: [email protected]
Contact Persons
Section titled “Contact Persons”The following contact persons are available for questions:
- Lead Psychologist: Phone hours Tuesdays 9:00-9:30 AM and Thursdays 1:00-1:45 PM
- Ward Therapist: Phone hours Wednesdays 9:00-9:30 AM
- Ward Physician: Phone hours Wednesdays 10:00-10:30 AM
Specializations
Section titled “Specializations”- Borderline personality disorder
- Psychosomatic conditions
- Depression
- Anxiety disorders
- Eating disorders