Einsatzmöglichkeiten von Peerbegleitung in der psychiatrischen Versorgung

Models of peer support in psychiatric care

Zusammenfassung

In der Psychiatrie findet seit einiger Zeit ein Wandel hin zu einer verstärkt recovery-orientierten Versorgung statt. Recovery (Genesung) umfasst einen subjekt- oder personenorientierten, ganzheitlichen Ansatz im Umgang mit einer Erkrankung. Die Arbeit von Peerbegleiterinnen und -begleitern als Form der Unterstützung durch andere Betroffene (Peersupport) leistet in der Psychiatrie diesbezüglich einen wichtigen Beitrag. Mit ihren eigenen Genesungs- oder Krisenerfahrungen können sie Patienten und Angehörigen neben ihrem Wissen auch Hoffnung auf Genesung vermitteln.

Der vorliegende Beitrag gibt einen Überblick über die Einsatzmöglichkeiten der Peerbegleitung, die Evidenz solcher Interventionen sowie den aktuellen Stand der Implementierung in unterschiedlichen psychiatrischen Kontexten. Es werden ausgewählte, aktuelle Publikationen vorgestellt. Zudem wird aus der Hamburger Praxis der EX-IN-Ausbildung zur Genesungsbegleitung, dem Trialog zwischen Betroffenen, Angehörigen und Professionellen und der Psychoseseminare berichtet sowie Praxisbeispiele und Erfahrungen aus verschiedenen Feldern der Versorgung werden gegeben.

Genesungsbegleitung kann in verschiedenen Bereichen der psychiatrischen Versorgung erfolgreich eingesetzt werden, z. B. in der ambulanten Einzelbegleitung, in Gruppenangeboten, Krisenintervention sowie zur Verringerung von Zwangsmaßnahmen.

Obwohl sich Genesungsbegleitung in vielen verschiedenen Kontexten als erfolgreich gezeigt hat, wird vielfach auch von Schwierigkeiten bei der Implementierung in der psychiatrischen Praxis berichtet. Diese können nur mit einer Veränderung im gesamten System und in der Arbeit mit allen Teammitgliedern überwunden werden.

Abstract

In the past decades, psychiatric care has changed from the traditional medical model to a more person-centered and recovery-focused approach. In this process, peer support workers are essential, because with their lived experience of crisis and recovery they are able to spread hope.

This article gives an overview of the recent literature describing the current change model of peer support, reporting the evidence of peer support, as well as the current stage of implementation of peer support in different psychiatric contexts.

An overview of the current state of research, selected by the authors, based on repeated systematic literature searches in peer support research projects, is given. Additionally, some examples of user involvement from the Hamburg EX-IN Curriculum, trialogs between sufferers, relatives and professionals, as well as the so-called psychosis seminars are described in more detail.

Peer support has shown promising results in one-to-one and group settings, case management, crisis interventions, and the reduction of coercive measures.

Although there are promising results of peer support in various clinical contexts, multiple challenges in the implementation of peer support are reported. They need to be overcome by the inclusion of all staff members in the change process of the system in order to further develop user-oriented and recovery-oriented psychiatric care.

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Correspondence to Dr. phil. Candelaria Mahlke.

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Interessenkonflikt

C. Mahlke, G. Schulz, G. Sielaff, R. Nixdorf und T. Bock geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Mahlke, C., Schulz, G., Sielaff, G. et al. Einsatzmöglichkeiten von Peerbegleitung in der psychiatrischen Versorgung. Bundesgesundheitsbl 62, 214–221 (2019). https://doi.org/10.1007/s00103-018-2875-z

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Schlüsselwörter

  • Peerbegleitung
  • Psychiatrische Versorgung
  • Wirkmodelle
  • Recovery
  • Implementierung

Keywords

  • Peer support
  • Psychiatric care
  • Change models
  • Recovery
  • Implementation