It was in 1922 that the Psychiatry Clinic of the Faculty of Medicine of the István Tisza University of Debrecen opened its gates to patients and students under the leadership of Professor László Benedek. With its name changed to Neurology and Psychiatry Clinic, the institution worked as a single structural unit to provide university-level psychiatric and neurological care between 1923 and 1996. Since 1996 the Psychiatry Clinic has been the sole provider of healing and teaching tasks.
2. Main areas of care and medical specialties
At present, the Psychiatry Clinic primarily uses (group and individual) psychotherapy tools in healing. The main objective of patient care is to restore psychic functions to the fullest extent possible.
The regional psychiatric care of outpatients takes place at our specialty consultation clinic (mood disorders, panic disorders, gerontopsychiatry, addictology, and psychotherapy). Our clinic provides professional consultations for all other clinics.
3. Types of medical care and services
Our clinic uses an appointment system for treatment, which is usually preceded by a motivational interview.
The operation of the inpatient section is separate from that of the day care section. In addition to a cognitive behavior therapy and schema therapy group, the inpatient section also houses relaxation, mindfulness, anxiolysis, problem-solving, and a narrative/fairy tales group as well as animal-assisted therapy. There are physical education classes and creative activities daily. In the day-care hospital patients can attend diverse socio-therapy activities with psychotherapy in the focus.
A patient is treated for a minimum of four weeks, which may be further extended. As a result of treatment, the patients who take part in the program are able to achieve considerable changes in their way of thinking, they report on changes in their relationships, their communication skills and stress management abilities improve, which creates opportunities for the patients to function better in their original living space, return to their work, or find a new job.
Treatment takes place in a group-focused psychotherapeutic system with a cognitive approach. In this process our main tool is psychotherapeutic work (which can be supplemented with medication if necessary). According to the cognitive psychotherapy approach, in the background of symptoms (anxiety, obsessions, sleep disorders, bad mood, repeated relationship or workplace conflicts, self-esteem issues, or sometimes physical problems) there are typical patterns of thinking and behavior.
Our system focuses on the group, with work being primarily done in groups.
- Large groups – where patients and members of the staff discuss and (verbally) represent the processes, problems occurring in a community or anything else that they would like to discuss together.
- Cognitive group – in this type of group we study and practice the recognition of negative distortions of thinking and we search for and incorporate alternative thoughts and effective solutions to problems, as a result of which the individual’s communication skills and stress-management abilities improve, leading to considerable changes in their relationships.
- Schema therapy – according to the schema therapy model, our erroneous basic concepts and way of thinking that developed in childhood pervade our thinking and emotions in the present and prevent us from solving emerging problems in an adaptive (practical, sensible) way. Therapy helps in recognizing these principles of operation and hence in shaping them.
- Narrative/Fairy tale group – dramatization of a traditional tale from world literature takes place in this type of group work. Acting the tale out and processing and receiving it together creates a special atmosphere. As the tale unfolds, it becomes possible to symbolically gain insights into universal human fates, the turning points in them, while recognizing our own challenges and solutions, too.
- Experience-based group – this type of group work is based on own sensorimotor experience where the stimulus provides effects (e.g. scents, images, own movement, moving the partner, listening to music, touching, etc.) that can be experienced and observed „here and now”. Individual experience is followed by group work and discussion. Through the concrete, real experiences we gain access to long-forgotten memories and less developed thoughts.
- Relaxation – is a tool that can be used to manage stress, physical and mental fatigue. Its function is simply to reduce the load on the nervous system (the preponderance of the response of the sympathetic nervous system). If we can calm down the continuous activity of our body and mind, we can use them more efficiently later on.
- Tension-regulating training – this type of group work focuses on understanding our emotions, impulses, and inner drives or, for that matter, forces that slow us down or hold us back. As a starting point, this group work uses individuals’ own stories, previous life situations, which are then discussed by the group using understanding and analytical attention so that any difficult-to-bear emotions can reveal our personalities, provide a better understanding of our decisions, solutions, and our impasses.
- Mindfulness – practicing awareness that arises through paying attention, on purpose, to the present moment and its happenings in a non-judgmental way. This allows us to examine our feelings and thoughts without being swept away by them. This exercise helps us manage our past worries, conflicts as well as our anxiety over the future.
- Animal-assisted therapy – involves a (trained) dog in a therapeutic context and a trainer. It improves emotional, social and cognitive functions, and helps nonverbal communication and empathy. It has an anxiety- and stress-reducing effect and improves self-confidence.
4. Data related to patient care
The department of psychotherapy has 22 rehabilitation rooms, while the day hospital can provide care for 11 regular patients. Care is provided by medical psychiatrists, psychologists, nurses, and psychotherapy assistants.
5. Device-assisted diagnostics; intervention
CANTAB (Cambridge Neuropsychological Test Automated Battery): A computer-based cognitive assessment system suitable for measuring cognitive (partial) functions.
rTMS (repetitive Transcranial Magnetic Stimulation): a non-invasive procedure which involves therapeutic use of a magnet to target and stimulate certain areas of the brain (the cerebral cortex) primarily to treat mood problems (refractory major depression).