Centres de Thérapies Brèves (CTB) à Genève: la crise dans les centres de crise?

Abstract

Summary Brief therapy centres in Geneva: a crisis in the crisis centres? Created at Geneva in 1980, brief therapy centres are outpatient units providing psychiatric care based on a psychodynamic crisis intervention model. Their initial purpose was to offer an alternative to hospitalisation to patients who habitually are not major consumers of hospital care. In 2001 they were assigned a new institutional role: to widen their care offering and lighten the burden on hospitals by taking in, among others, patients with much more severe psychopathologies. We conducted a retrospective pilot study including the 449 patients treated at the Servette sector 3 brief therapy centre during 2006, to improve our understanding of how practice had really evolved at these centres in response to the changes institutional therapy had undergone in the last two decades. In general we noted among these patients a high rate of psychiatric antecedents with a time to admission seldomly below 24 h. We found a high rate of referrals by psychiatric emergency departments at the expense of indications from general practitioners and psychiatrists, while the diagnosis of mood disorder (76% with 72.4% depressive disorders) was significantly represented. We also observed several significant differences between the patient group receiving crisis-type care and the group receiving only nights of support. The retrospective study we conducted showed us that the new institutional role is only partly fulfilled and raises the question of a gap between theory and practice that is widening with the passage of time.