270631_CD_ROM_3_Fallvignetten_fin_AKs.ppt

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Vignette 1

One morning ....

Today Peter got up a little earlier than usual. Somehow getting out of bed was easier than normal too. Sure, Peter needed a shower and two cups of coffee after getting up. That was always the case for Peter. But he slept extremely well that night and felt especially alert today. He noticed that he got dressed faster today and was ready to leave the house.

Peter knew that today would be a good day. Today was the day he could finally pick up the three records at his friend Bruno's house. When he last met him, Bruno said he didn't need them any more. That was very convenient for Peter because he was especially interested in older albums, in particular in collecting music from the early 1970s.

As he left the apartment, he also exchanged a few words with the neighbor, something he usually avoided. He was interested in hearing how she was. Peter simply felt good that day.

He sat down on his bike and set off. In front of the large intersection, a man approached the crosswalk and walked across the street without looking. Peter caught sight of the man early. He was able to brake immediately and avoid him without any problem.

Without attaching much importance to this incident, Peter continued to Bruno's house. As planned, he picked up the records and returned home at noon with a satisfied feeling.

Today was simply a good day.

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 2

Later the same day ....

After returning home, first Peter listened to all the records he picked up from Bruno's. Then he had the idea of re-arranging his record collection again. He had already collected a few dozen over the last few years. He began to take them all out from the shelf and to sort them by the year they were produced.

Peter had to concentrate fairly hard, since he had planned on ordering the records sequentially. This was actually not so difficult, but it took time. After about a quarter of an hour, Peter noticed that his thoughts were wandering more and more. He looked out the window increasingly often and needed more and more time to sort a record. After a half an hour, he was quite tired. He stood up and went to the kitchen to drink something.

After a short break, Peter went back to "work". He could concentrate better again now because he definitely wanted to finish today and looked forward to the result.

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 3

And last Friday at work ....

Pater thought about the previous Friday. He had been in the workplace where he normally works part-time. There he experienced a situation similar to when he was sorting the records. Peter remembered that he almost fell asleep while doing a job his boss gave him.

He had to sort out components the entire afternoon. The longer the work went on, the more boring it seemed. Maybe one reason he couldn't concentrate then well for longer periods of time was that the work no longer seemed meaningful to him and he couldn't get enthusiastic about it.

That was of course not the case with the records. He was happy that he had devoted some time again to his record collection. At any rate, last Friday he had to take more and more breaks. Yet finally he managed to finish the job by the end of his shift, which gave not only him but also his boss great satisfaction.

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 4

Rendezvous at a café ....

Peter has a date with Manuela tonight. The two became acquainted at the house of his buddy Bruno. They want to meet in town at the Café Adonis at 7 PM. Peter had to think the whole day about the appointment. He likes Manuela. On the one hand, he's really looking forward to meeting her. On the other hand, he's a bit nervous and can't make up his mind about what to wear. He finally sets off for the Café Adonis.

Peter is there a bit early. But, to his surprise, Manuela is already waiting at a small table. Peter greets Manuela and joins her.

Both order a café au lait. Now Peter is really nervous and doesn't know what to say. This shakes his self-confidence. Yet

Manuela starts telling him about her day, about work, her family, and her last vacation. She talks like a waterfall. Peter tries carefully to listen. As he does, he notices that Manuela looks at him directly in the eyes again and again.

While he listens, Peter thinks about what these looks by

Manuela mean and what she wants to say with them: Is

Manuela happy to talk to him? As she continues to speak, Peter observes Manuela more closely: her posture, her motions, and above all her facial expression. But Peter is still not sure whether Manuela's face is expressing pleasure. Maybe she‘s expressing annoyance because he's hardly talking. Or maybe she's disgusted by his belly, which has gotten a bit larger recently?

After a half hour, Manuela says goodbye with a warm handshake. On the way back home, Peter reflects for a long time, whether he should call Manuela again or not ...

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 5

A day to forget!

Peter has no plans today. He doesn't have to go to work and has no appointments. It takes a bit longer to get out of bed today than usual.

It's already noon. Peter decides to do something sensible and to take care of the groceries. As he climbs down the stairs

Peter doesn't like taking the elevator

 he sees the new neighbor who moved in below him. But what is her name again? Peter can't recall her name even though they have already introduced each other. The young woman greets him by name, but he walks quickly by with a short nod and thinks: "Man, that was embarrassing." In front of the house, he looks for her name on the doorbell: Julia Schmitt.

When Peter arrives at the supermarket, he notices that he has no idea what supplies he needs at home. He forgot to make a shopping list again. He leaves the supermarket empty-handed.

Since he's in town now, he wants to call up his buddy Daniel or maybe his acquaintance Manuela to meet. Although he's called up Daniel many times, try as he might, he can't remember his number, which he never wrote down. "Something with 365, but that doesn't help much. What a pain in the neck!" he thinks and goes back home.

Arriving at the locked front door, he realizes to his horror that he hasn't got a key. "Did I leave the keys hanging in my apartment door?" he asks himself. "No problem, I'll just ring at my new neighbor's. But what is her name?

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 6

A telephone call for Daniel

In the evening, Peter's roommate Daniel comes home.

Peter: "Hey, somebody wanted to talk to you on the telephone today..."

Daniel: "Who was it? What did he want?"

Peter: "It was a woman. I can't remember her name, ..., something about your job I think..., you should call her back".

Daniel: "Do you have the number?"

Peter: "Hmm, no. I thought you knew it."

Daniel: "How am I supposed to know who I should call, let alone how and why?!"

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 7

Yesterday at the Italian restaurant ...

Yesterday Peter was eating with Daniel at an Italian restaurant:

"Good evening, what can I bring you?" the waiter asked.

Daniel looked at the menu and ordered: "For me a tomato juice with pepper, then a small garden salad with French sauce, and a "Pizza Quattro Stagioni", without artichokes if possible. And a cola with lemon, please.

Peter immediately made his order: "And for me a soup, then the risotto with mushrooms and before that an orange juice,

...hmm, no. I'd rather have the spaghetti with seafood and a half liter of still mineral water."

The waiter brings their order to the kitchen. "..."

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 8

The forgotten doctor's appointment

It was on the day Peter picked up the new records at his friend

Bruno's house. That evening he watched a football match on TV.

It was one of the games that interested Peter because his home team was playing.

In the break, he listened in passing to an interview with a player on his way to the kitchen. This player had to be treated briefly by a paramedic with a cooling spray because of a foul.

It suddenly occurred to Peter: paramedic…cooling spray…injury

 doctor!! He should have had a doctor's appointment that day!

Peter had an appointment note somewhere, he knew that, but he didn't hang it up anywhere he could see it and the appointment slipped his mind.

The next day he called the doctor, excused himself for missing the appointment, and made a new one. Peter reflected that he had forgotten the doctor's appointment because he had planned on meeting Bruno that day. The prospect of the new records helped him not to forget the arrangement with Bruno. As opposed to the doctor's appointment, he looked forward to meeting Bruno.

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 9

Art opening

With Daniel, Peter visits the opening of an exhibition of pictures made by a former patient of the clinic. The artist's name is

Domenica. She had always been a talented painter and worked in the clinic's workshop during her stay there. She met Peter there. Now Domenica is a well-known artist and has exhibitions in several galleries.

The opening is attended by many people. There is a small refreshment bar. Peter and Daniel stand somewhat to the side.

When Daniel becomes engaged in conversation with someone,

Peter decides to look at the pictures on display a bit more closely. Domenica paints large-format pictures of at least 2

2 meters. Most of the paintings realistically depict street scenes with various persons. Domenica often uses bright colors.

As Peter stands in front of one of these pictures, he finds it hard to nail down what it's about. He sees many details on the picture, such as people walking on a city street, a carriage being pursued by a dog, children playing on a sidewalk, and women looking out of windows and observing the action below. In the top left sits the sun enthroned in glaring yellow. Peter notices he's having trouble orienting himself in the picture, making his

"own picture" of the picture, mentally reconciling all the details.

He begins to make assumptions about what Domenica must have been thinking when she was painting.

Suddenly Peter notices an older man next to him. The old man asks him amicably: "Can you explain to me what this picture is about?"

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 10

Back at Café Adonis

It's a rainy day. Peter decides to go to the Café Adonis to drink a coffee and read the paper.

After reading the paper for fifteen minutes or so, he suddenly hears a familiar voice. It's Manuela, who is accompanied by a male and female friend, both of whom he doesn't know. She greets Peter amicably. Manuela and her friends sit at the table next to Peter and immediately start a conversation. As they do so, Manuela glances several times at Peter and smiles.

Peter hasn't seen Manuela since their date. He would very much like to talk to her. But she seems to be in deep conversation with her friends. Manuela is sitting on the same side of her table as

Peter is. Her friends are sitting close together on the opposite side. Peter wonders whether they might be a couple.

Now Peter can't concentrate on his newspaper anymore. He listens to the conversation at the next table. He can't help it.

Peter tries to hide this by acting as if he's reading the paper.

Manuela and her friends appear to be well-acquainted. They talk about school, holidays, and about the art exhibition of the former patient of the clinic, the opening of which Peter recently attended.

Now Peter is truly nervous and wonders whether he should get involved in the conversation and how.

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 11

One film

 two summaries

Yesterday, Peter went to the movies again. He returned home and, visibly impressed, told his roommate Daniel about it:

"It was a great movie!"

Daniel asked what he liked so much about it. Peter answered:

"Well, I can't recall the plot of the movie quite so well anymore. I was simply entranced by the images, which is what made it hard for me to concentrate on the main theme of the film. I can't find the words for it. Anyhow it was a good movie. I really liked the whole story with that actress, what's her name...? And the scenes...man, you have to see it for yourself."

Daniel watched the film himself the next day and, equally impressed, told his girlfriend about it:

"Wow, I found this film very moving. This majestic landscape imagery at the beginning, the warm colors of the evening sky in the otherwise so dry desert... I could even smell the sharp aroma of the cactus flowers. The main character was a woman on an adventure tour who, by a twist of fate, meets a new life partner. But the film also shows that conflicts also arise between the couple because of cultural differences. This makes the relationship difficult, and the two initially part ways. But they reunite again happily in the end. So the movie first made me feel somewhat sad, but in the end it gave me feelings of confidence and hope. At any rate, I left the movie theater with a satisfied feeling and a smile on my face.

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 12

Planning the trip to the cinema

Peter's trip to the movie theater actually came about quite spontaneously. He went into town again, strolled around without a definite goal, and saw the poster for the movie outside the theater. Since he had enough money on him and the poster looked interesting, he spontaneously decided to watch it without giving it much thought. This is not typical of him.

The last time Peter went to the movies, he had no idea what he wanted to do. He was sitting around the house and suddenly had the idea of going to the movies again. At first he wasn't really sure of which movie we wanted to watch. We was already aware of several possibilities. He could look in the newspaper, in the Internet, or ask Daniel whether he could recommend a movie. Or he could go to the train station and look at the posters or even take a look directly at a couple movie theaters he knew to see what was playing. Peter thought that it would be best and fastest to grab a newspaper at the store downstairs and look for a movie that way.

Peter didn't really know the city that well yet. To get to the movie theater, he first had to look at the city map, just like when he rode to Bruno's house to get the records. Once again, there were several possible ways to get to the movie theater. This time he chose the bus. But it only went as far as the train station. He would have to transfer to the tram there and ride another 5 minutes or so. He found the movie theater without much difficulty and was even there a bit early. Peter had another good day, he thought to himself. He was a bit proud of himself because everything went so smoothly. For this reason, he was also able to enjoy the film fully.

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 13

By bike to Café Adonis

Peter is meeting Daniel and Bruno at 5 PM at the Café Adonis.

Listening to music at home, he notices at about 4:45 that time is getting short. He doesn't want to be late and decides to go by bike to save some time.

Peter is an experienced cyclist. But today he's wearing bellbottom jeans like they wore in the 1970s. They look cool, and he wants to show Bruno that he's also wearing them. Now Peter is afraid that the jeans he borrowed will get caught up in the bike chain and could get ruined. So he concentrates more on keeping his feet on the outside of the pedals as much as possible than on the traffic. That's also the reason why he almost overlooks an elderly lady walking over a crosswalk. He also rides by a red light without noticing it. After almost plowing straight into the edge of a sidewalk, he finally arrives at the Café Adonis. "What a hell ride!" he thinks.

At the Café Adonis, he initially sees neither Bruno nor Daniel.

While Peter is looking for an empty table, Daniel calls to him, who is sitting with Bruno in the far corner because no other tables were free. Peter joins them. He is still out of breath a bit and tell them about his scary ride. Danial snaps: "Dude, if you can't ride a bike, you shouldn't bother!" Peter laughs awkwardly.

The three friends talk for about an hour. Then Daniel calls the waiter and asks for the bill. Only then does Peter notice that the whole time he had forgotten to order a coffee for himself. That annoys him, because Peter loves the coffee there.

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 14

Recently at the bar

Peter went recently to the bar around the corner from his apartment. Again, he simply wanted to read the newspaper in peace. But already on the way there he noticed that he wouldn't be able to tolerate too many people around him today. As he enters the bar, his first intention is to walk directly to the table where he normally sits and reads his paper. That is, in the corner, on the edge of the room where the two benches are. However, he notices that the table is already taken and that the bar is especially full today.

One small table is still free in the middle of the room. Peter takes a seat and orders a coffee. Then he stands up again to get a newspaper. Peter flips through the first few pages of the paper and notices that he hasn't really looked at the title page yet.

Somehow he feels distracted by the conversations of the other people around him. The waiters are also running back and forth between the kitchen and the room, which is also distracting.

Quite a lot of noise is coming from the kitchen today, too.

After a while, a table becomes available in a back corner. Peter moves to the other table with his coffee. The noises there are less distracting. Now he can concentrate on the newspaper better, and now he reads the local section, which is always the most interesting to him.

After a half hour, Peter decides to go home. He wants to pay for his coffee and notices that the bar is even more crowded in the meantime. Many people are standing at the bar now as well.

Peter finds it difficult to find the waiter responsible for his table so he can signal him. To make things worse, many of the guests are wearing bright shirts like the waiters. 20 minutes pass before

Peter can finally pay. "Man, that was exhausting!" he thinks as he makes his way home.

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 15

A busy day at work

This morning at work, Peter got an assignment from his boss.

He had to polish and paint the wooden toys that had just been completed. Peter was already familiar with this task, and he found working with wood fun. He found it very easy last time. He always polished and then painted each piece one at a time.

Then he would start with the next piece.

Peter noticed that it was not quite as easy this time. He started first with polishing until the coffee break. Then he continued with polishing. His boss told him he should complete at least 10 pieces by lunchtime.

But to do this, he would have to stop polishing and switch to painting. He found that difficult. He was so absorbed in the first task that he could hardly manage to stop polishing and pick up the paintbrush. Peter then needed some time to get used to the new work step of painting. When he finished painting, he again found it difficult to go back to polishing the wooden toys.

After a while though, he suddenly found a very good way to switch back and forth between the two tasks flexibly. By the end of the day, he could even have a chat with nearby coworkers while working without having to interrupt his work. So Peter finished his work on schedule and returned home after closing time with a good feeling.

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 16

A truly successful day?

Today is an important day for Peter. This morning is the semiannual performance review with his boss at work, and this afternoon he has the opportunity to meet Manuela again.

At 9 AM, Peter waits at the workshop for the interview. His buddy Bruno is just in front of him in line. When Bruno returns to the workshop, Peter asks him how it went. Bruno is in low spirits and answer quietly: "The boss said I fulfilled the performance requirements, but only barely. I'm just not that good. My abilities are unfortunately pretty limited!" Bruno returns to his workstation.

When Peter sits before his boss, the latter says with a very loud and commanding voice: "You fulfilled the performance requirement, but just barely. You've made some progress since last time and you're trying. But that is not enough by far. I require more from you. You'll have to make more of an effort!" Walking out the door, Peter thought that the boss was in a worse mood today than usual. And the way he treats his workers at a secure workplace is not good. Peter, on the other hand, is satisfied with his work. He noticed himself that many things are easier now than they were at the beginning. "The main thing is that I passed." and "What an arrogant boss!" are his thoughts.

Manuela is already waiting at the Café Adonis. Again, Peter doesn't say much, and Manuela‘s words flow like a waterfall.

Peter is not as nervous today, and he thinks to himself that there must be something good about him for the beautiful Manuela to want to see him of all people. After all, she could have any man.

Peter stretches his back so that his belly doesn't stick out as much, and inhales deeply. He's proud of himself and smiles at

Manuela, who smiles back at him.

When they say goodbye, Manuela asks him whether he knows why she likes to be with him? Peter shrugs his shoulders sheepishly. Manuela responds: "Because you are such a good listener!"

On the way home, Peter cheerfully whistles one of his favorite melodies.

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

Vignette 17

This time everything went well!

Peter is in a good mood today. He's made a plan with friends to go to a nightclub again. It's an oldies nightclub that plays the kind of good old music Peter likes so much. Entrance is free for employees of the workshop where Peter works.

Peter rides the bus to the nightclub. It's Friday evening, and the bus is as full as usual. Peter doesn't feel comfortable. He senses an increase in stress. He quickly considers whether he should get off at the next stop. But he decides to stay. After all, he definitely wants to go to the nightclub. His friends are waiting there. Peter breathes deeply several times, tries to stop his straining thoughts, quietly repeats calming things to himself such as "I'll be there soon. I can do this!" and looks at the floor or out the window in order to escape the looks of the other passengers.

Finally, Peter is standing in front of the nightclub entrance. Some people are already waiting to get in. When Peter's turn is up, the doorman, a big, muscular man in uniform, asks him whether he has a work ID card with him. Otherwise he will have to buy a ticket. Peter gets nervous. He's afraid that he forgot the ID card and looks in all his pockets for it. He feels less afraid when he realizes that the doorman must know him from the last time he was there. Now Peter is really annoyed!

But he stays calm and thinks to himself that the doorman certainly can't recall every customer's face. He's only doing his job. Peter stretches briefly, exhales loudly, and counts backwards from 10. Then he looks for his ID card again. "There it is!" Peter exclaims. Now he can enter.

In the nightclub, Bruno and Daniel are already waiting. Manuela is there, too. Peter is really happy today. He and his friends have a lot to talk about and dance the whole night. Peter will have a good memory of this night for a long time to come...

V. Roder, D. Müller: INT - Integrated Neurocognitive Therapy for Schizophrenia Patients. © Springer-Verlag Berlin Heidelberg 2013

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