The effects of psychotherapies: a study on patients' perception of results in an Italian public setting.

Enquiries centred on the perspective of users of psychiatric treatments and their families, has become an increasingly widespread method to improve the quality of treatments administered by health services. In this study, in particular, we examine the users' perception of the quality and variability of the effects of psychotherapies, the difficulties met, and the perceived help factors. The sample consists of 216 users of psychotherapy and 223 patients in psychiatric treatment with psychological support. They are outpatients, managed by the public health service. The questionnaires included closed ended, open-ended questions and scales that were previously tested on a sample of patients. The questionnaire for patients was anonymous and administered by researchers external to the medical staff. Irrespective of the diagnosis or of a concurrent pharmacological therapy, a high percentage of patients (75%), in both groups, feel improved. Improvement consist of the decrease of symptoms, a sense of feeling better, but also feeling grown up, more mature, having higher self-esteem and feeling more adequate in interpersonal relationships. This last type of result is significantly more frequent in the group of patients in psychotherapy. Besides these patients are faced with more difficulties and play more active a role while they are in treatment. The main difference between patients in psychotherapy and those in psychiatric management with psychological support is not indeed the identification of different perceived therapeutic factors, but rather the different evaluation of their relative importance. On the whole, the study seems to show that the effects of real psychotherapies include, beside an improvement of symptoms, the achievement of goals of personal growth and maturity, self-satisfaction and an increase in self-esteem, all in accordance with a conception of health as well-being and self-satisfaction rather than as absence of illness.

[Psychotherapies in psychosocial centers in Lombardia: a point of view of psychiatrists and psychologists]. / Le psicoterapie nei centri psicosociali della Lombardia: il punto di vista di psichiatri e psicologi.

OBJECTIVE: The purpose of this study is the systematic analysis of operators' points of view about psychotherapies concretely performed in the Public Psychiatric Public Services and inside the global operating mode of the assistance. SETTING: The study has involved 26 CPS selected randomly in Lombardia. The sample has been built with 73 psychiatrists and 42 psychologists. MAIN OUTCOME MEASURES: All the therapeutists involved in this research have been submitted to a question-form querying socio-anagraphic data, professional training, orientations, operating modes in their CPS, rules and objectives of their psycotherapies, observations and evaluations about psychoterapic treatments and their effects. RESULTS AND CONCLUSIONS: Psychiatrists and psycologists working in CPS, mostly the younger ones (less than 45 years old), followed a personal training in over the 70% of the cases. The prevalent orientation is the psycoanalityc one in both the categories. The most part of therapeutists deems that there has been an evolution in their way of conceiving psychiatry inside the public service. The lines at these evolutions have been mentioned explicitly in the article. Psychiatrists and psycologists, even with some concrete differences; seems to have mostly homogeneous points of view: psychiatrists have a more flexible vision of which practices can be considered as a psychotherapy, whereas psycologists are more rigorously linked to theoric reference models and to rules learnt during their training. They are both slightly favourable to the use of psychotherapies in their services, even if, as a matter of fact, they are used by just a few patients. No contrast between psycotherapy and psycopharmacology has been detected from operators' answers. These practices seem to be both considered useful and integrable.