Citation

Walby FA, Ness E. Tidsskr. Nor. Laegeforen. 2009; 129(9): 885-887.

Vernacular Title

Psykiatrisk behandling av selvskading pa legevakt.

Affiliation

Psykiatrisk legevakt Psykiatrisk divisjon Oslo universitetssykehus, Ulleval og Nasjonalt senter for selvmordsforskning og -forebygging Universitetet i Oslo og Psykiatrisk avdeling Diakonhjemmet Sykehus.

Copyright

(Copyright © 2009, Norske Laegeforening)

DOI

10.4045/tidsskr.08.0417

PMID

19415091

Abstract

BACKGROUND: Patients who harm themselves are often considered difficult to treat. There are no evidence-based approaches available for the emergency setting. General practitioners should nevertheless be able to offer interventions directed towards emotional needs in self-harm patients. In this article we suggest how to intervene in such situations. MATERIAL AND METHOD: Based on experience from Oslo psychiatric out-of-hours service and with elements from Dialectic Behavioural Therapy, we present a five-step model for treatment of these patients in an out-of-hours service within the primary health care services. RESULTS: The aim of this model is to bring the patient out of the acute crisis and to arrange for further treatment. Assessment, validation or confirmation, problem-solving, avoiding unnecessary hospitalisation, and focus on continuing established treatment, are important elements in the proposed intervention. This can all be carried out in 60 - 90 min. INTERPRETATION: The model may be suitable for training general practitioners to meet and care for patients with self-harm behaviour in the out-hours-services. We have positive experience with the intervention, but systematic research is necessary to assess the effect of the model.

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