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Minerva Psichiatrica 2007 December;48(4):431-41

Copyright © 2007 EDIZIONI MINERVA MEDICA

language: Italian

Setting-up a therapeutic environment for psychotherapy of the adolescent and his/her family in a local public Health Department

Finicelli C.

Psicologo, Psicoterapeuta Responsabile Struttura Semplice ASL Provincia di Milano n° 1

In light of orientations expressed in the literature, the goal of this study was to review ways to optimise the overall impact of psychotherapy treatments offered adolescents and their parents in a local public department of the Local Health Unit of the Province of Milan No. 1. A literature review was conducted on parallel psychotherapy interventions for adolescents and families and the interactions between the patient-therapist dyad and the institutional context where the treatment is provided. The prevailing orientations identified in the literature were then compared to the multi-level approach actually experimented at the Operatio-nal Unit of Clinical Psychology of the Local Health Unit from 2000 to 2005. The systematic and on-going organisation of coordination activities, both within and outside the department, with the various institutions working with adolescents and their parents, seemed to favour interaction in the user-therapist dyad, search for theoretical-practical convergences among the therapists working with families, and monitoring of the psychotherapy process.
Multilevel synergic interventions in public health services (involving individuals, their families and institutions) appeared to obtain better results through parallel interventions with adolescents and parents in variously severe clinical situations. By contrast, fragmented, discontinuous institutional interventions produced less satisfactory results, even in patients initially featuring less severe signs of disorder. Furthermore, in the specific departments the need emerged to adopt tools and methods to assess processes and outcomes in managing “the context that treats patients.”