The forensic psychiatric treatment of psychotic reactions
The development of forensic psychiatric treatment depends on social and scientific influences. Legal aspects and changes in the population of detainees held by the Governments' Pleasure cause an emphasis on the security of society and the limitsetting in the TBR-institutions.
There is an increase in personality disorders concerning psychotic behaviour. The last three years these numbers are stabilized, which means a constant population of about 40% of (pre)psychotic disturbances. The treatment of psychopaths needs the pressure of a very closed system of environmental and therapeutic measures. (Pre)psychotic delinquents need more room because of their fear of annihillation. On the other hand they tend to autism and hospitalization, so that also the treatment personnel has to induce some activation and secured room for personal activities.
Limitsetting has three ways as main categories, namely isolation, medication and the steady companionship. These are also three degrees of measures forced upon the patients. Limitsetting is the main condition of treatment of these patients. It gives the structure and incentives to the treatment environment for developing relationships between patients and personnel on a base of reciprocity.