Anforderungen an Behandlungsteams und Klienten in der stationären Behandlung psychisch gestörter Straftäter

Demands on management teams and clients in inpatient treatment of mentally ill offenders in imprisonment under Criminal Code Art. 59 para. 3 exemplified by the forensic psychiatry department of Zürich prison system Modern forensic inpatient measures as applied in the forensic-psychiatric department (FPA) of Pöschwies prison institute offers and individually tailored therapy combining three interrelated approaches: 1. offence-oriented individual or group therapy; 2. personality-centred individual or group therapy; 3. personality-centred and offence-oriented environmental therapy. Forensic management teams should offer a highly professional therapy concept based on binding principles, in an atmosphere of security at all relevant levels and in a comprehensive, reliable and verifiable manner. The necessary 10 principles were presented and defined with respect to their relevance (uniformity, diversity, openness, transparency, information flow, independence, therapeutic optimism, respect, professional welfare and treatment by motive-oriented forming of relationships, a common idea of the client). With respect to the indications and contraindications for inpatient treatment of mentally disturbed offenders in prison, the chief issue is not diagnoses or the expressed or recognisable will of the offender. Rather, in each individual case specific questions arise regarding dangerosity, the type and extent of the mental disturbances or syndromes related thereto and the prospects for treatment, defined as emotional, social and cognitive influenceability or mental permeability. In the expert assessment of a treatment indication for an inpatient forensic measure the issue is the extent of the client’s alienation from basic psychological needs and motives. What is involved is at least a rudimentary access to his own affects, cognitions, attitudes, schemes, a positive “irritability” regarding disturbed perception, interpretation and behaviour models. What is needed is at least the first signs of a group ability, meaning a genuine possibility of contact with others, i.e. interactions which do not appear to be exclusively marked by tactical and manipulative considerations. In addition the client needs a minimum of coping ability and skill for criticalconstructive feedback. Relevant positive and negative criteria were proposed. Finally, the problem of misplacements in forensic-inpatient treatment settings or the concept of untreatability from the viewpoint of the treatment team, and of the client to be treated, were critically discussed.