Psychiatria pre prax 4/2021

Transformations of addiction treatment – therapy without power (powerlessness)

In-patient programs for addicted people in the Czech Republic evolved from the original apolinar model. Each treatment facility has adapted this model differently, but the programs have some common features – a high degree of program structuring, a high level of control of patients, a hierarchical therapeutic community with a strong staff role, sanction systems, fixed program offer, high level of limitations in contact with the original environment. Many of these elements do not correspond to the possibilities and needs of actual patients, current civilization values and do not allow to create such a therapeutic environment and a relationship in which the patient could openly offer his problems and where his competence would grow. The choice of therapeutic attitude to the patient and specific therapeutic approaches is largely a matter of ethical choice.

Keywords: addiction treatment, Apolinar model, Jaroslav Skala