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The 'Zurich Intensive Programme' is a group therapeutic treatment option for sexual and violent offenders with a high habitual risk disposition deep-seated in the personality. It is conducted in the largest of the Swiss penal institutions and is in this form a unique option in Switzerland for preventing recidivism. The 'Zurich Intensive Programme' is part of the interdisciplinary overall strategy, with maximum focus on the prevention of offences, of Law Enforcement in the Zurich PPD model, which structurally integrates forensic psychiatry and psychotherapy. The fundamental methodical and conceptional aspects of integrative, specifically offence-orientated and group therapeutic treatment approaches of the 'Zurich Intensive Programme' were described in an earlier article. Systematic integration of methods as the basis of the concept and conceptional aspects such as, for example, interdisciplinarity, selective setting variation, offence and resource orientation as well as the orientation of the treatment to a differentiated goal matrix were explained. In this study the 'Zurich Intensive Programme' specific therapeutic concept for the prevention of offences will be presented and explained with examples. Throughout the course of treatment a rigid phase model of the therapeutic process has been rejected in favour of a multi-dimensional viewpoint. The necessity for the interaction of obligatory offence-oriented and complementary personality-focussing treatment elements for the treatment of clients described as having a high to very high structural risk disposition is substantiated and presented. The therapeutic curriculum is flexible with regard to the timing and the type of presentation of the topic contents, without relinquishing clear therapeutic basic conditions. The continuous flexible co-ordination of interventions and short-term therapeutic objectives takes place on the basis of transparent and professional team-work. The treatment concept of the 'Zurich Intensive Programme' integrates five therapeutic focuses, which are continually worked on during the course of the process: 1) Clarification/diagnosis: Starting with a structured initial diagnosis, a prognosis with regular standardised risk assessments is carried out during the process. 2) Group cohesion/relationship pattern: The relationship structure between the individual group participants, the members of the treatment team and the relationship pattern between clients and therapists are continually reconsidered. 3) Offence orientation: The systematically offence-oriented therapeutic work pursues the aims of offence reconstruction, the handling of cognitive distortions, fantasy control, the promotion of empathy, offence coping and creating with the purpose of an individual plan for the prevention of relapse. 4) Controlled testing: Behaviour to prevent offence is practised in a specific way and tested under various intra- and extramural environmental conditions. 5) Aftercare/risk assessment: Structured and demanding aftercare is planned at an early stage and includes regular standardised risk checks. Even if the concept of the 'Zurich Intensive Programme' is oriented towards achieving the highest measure of risk reduction and prepares the ground for long-term risk management processes, relapses of clients who have undergone therapy cannot be completely excluded. However, there neither is a sociopolitical consensus nor is it legally practicable to apply to all clients at high risk of relapse lifelong preventive detention, especially when they are in principle approachable by therapy. For this reason, there is at present no recognisable alternative to professionally developed, intensive offence-preventive options for offenders who are in relevant danger of relapse and requiring treatment.

schweizer archiv für neurologie und psychiatrie

Das Zürcher «Ambulante Intensiv-Programm» (AIP) zur Behandlung von Sexual- und Gewaltstraftätern. Teil 2: Spezifisch deliktpräventive und therapeutische Konzeptionen