Integrating an Institutional Psychiatric Open Light Treatment: Network and Pathways for Therapeutic Change in Adolescence.

Introduction The increasing psychiatric diseases in adolescence and the earlier age of symptom onset requires new treatment strategies, based on a better inter-institutional interaction. The latter evolution of psychodynamic approach leads to flexible and effective new therapeutic pathways for teens with serious emotional and behavior disorders. Objectives Observing clinical outcome in the global care-net work with adolescents, analyzing the specific therapeutic approach of the team, the emotional reliability and the capacity of working together of the various professionals involved and the value of a common language and a common emotional context, involving different institutions related to the care process. Methods Longitudinal case reports, lasting from one to three years. Day Center and Therapeutic Community with psychodynamically oriented programs, assessing emotional, behavioral, medical, educational, social and leisure needs; individualized planning; individual and group therapy; psychiatric care; environment involvement. Inpatient Psychiatric Unit with psychodynamic integrated approach, where each intervention (pharmacotherapies, medical examinations, psychological interviews, milieu therapy, etc) came from the same key to understanding. Results Working in alliance and by same therapeutic methods, it’s possible integrate patients needs fragments, so responding to their holding and care request. It represents an organization function for their personality structure; an affordable and integrated ‘container” (W.R. Bion; 1988), in perspective of continuum of care for young patients and their family. Conclusions Therapeutic relationship may represents cornerstone for psychological transformations or changes so profound. Social, medical and psychotherapeutic aspects were incorporated into this model,so that patients are not passivated, thanks to the care network.