PSYCHOTHERAPIE PSYCHOSOMATIK MEDIZINISCHE PSYCHOLOGIE

[Organised abuse in the GDR - A Secondary Analysis of the Victims' Perspective]
Laue P and Strauß B
Organiszed abuse (OA) is a form of long-lasting, mostly sexualized violence against children, youth, or women by networked perpetrators for financial and power-related enrichment. Individual reports and historical analyses imply this violence could have taken place in the German Democratic Republic (GDR). This study is the first to shed light on OA in the GDR from the perspective of those affected.
[Making aging positive - can we learn from Japan's centenarian society?]
Mehnert-Theuerkauf A
[Experiences of Psychologists and Sport Therapists Conducting Open and Closed Therapy Groups]
Südmeier M, Gissendanner S, Lorenz K and Muschalla B
Few studies compare differences between open and closed therapy groups. Different characteristics of both formats, which have been theoretically and practically substantiated to date, are presumably responsible for different therapeutically relevant effects. The present analysis documents and analyzes therapists' experiences with both open and closed group formats and provides information relevant to the selection of group format. To this end, psychologists and sport therapists in a department for behavioral orthopedic rehabilitation were asked in open, guided interviews about their experiences during a changeover from closed to open groups. Their responses were analyzed using qualitative content analysis. Characteristics of open and closed groups identified in the literature were largely confirmed, but differences not yet identified in the literature were also discovered. These relate to everyday therapeutic practice and therapist motivation. Additionally, similarities and differences between sport and psychotherapy groups are highlighted. In sum, closed groups are characterized by high group cohesion and deeper relationships in the course of therapy. Closed group sessions can build on each other and are structured. Open groups have a consistent level of energy and stronger dynamics over time and offer a wide range of contact opportunities. Different patient roles in group therapy must be kept in mind in both formats. Both group forms have characteristics that can be used for different therapeutic goals and indications and are therefore justified in a therapeutic context. These empirical findings suggest that therapists can strategically choose a specific group form for the support of specific types of patients or for reaching specific therapy goals.
[Global Change in Psychotherapy: Influences of Current Social Change on Mental Health and Therapy]
Kleinschmitt A, Mohrmüller M and Beelmann A
Global change affects both individual life situations and social coexistence in a variety of ways. However, the effects of social events on mental illness and psychotherapy are only recorded and included in psychotherapy research in individual areas. The aim of this study is to explore current problems and concerns of patients in Germany on the basis of practical experience reports, to collect possible social causes and to bundle considerations for therapeutic treatment. To this end, psychotherapists (n=10) and psychotherapy patients (n=12) were interviewed in qualitative interviews and these were analyzed using grounded theory. After evaluating the collected perspectives, five main effects of current social events and the consequences of globalization were identified. From the perspectives of psychotherapists and patients, these include increasing anxiety about the future, decreasing social inclusion, increased questions about goals and identity as a concern for psychotherapy, increased psychological stress as a result of political divide and an increased demand for diversity-sensitive psychotherapy. In addition to expanding the scope of action, therapeutic approaches primarily include providing contact, guidance, orientation, emotional support and bonding experiences. The inclusion of knowledge from psychotherapists and patients as well as findings from social science can be helpful for identifying current problems and developing new therapeutic approaches or bundling, linking, and effectively using existing ones.
[Eating Disorder-Related Symptom Reduction, Suicidal/Self-Injurious Behavior, Emotional Dysregulation and Interpersonal Difficulties in an Eating Disorder-Specific Treatment - A Clinical Study]
Dippold B, Dreyße K and Kröger C
This study exploratively investigated a possible relationship between suicidal/self-injurious behavior and the change in self-reported eating disorder symptoms as well as emotional dysregulation and interpersonal difficulties during eating disorder-specific treatment. For this purpose, the symptom index of the Eating Disorder Inventory-2 (EDI-SI) and the scale for the assessment of impulsivity and emotional dysregulation of borderline personality disorder (IES-27) with its subscales suicidal and self-injurious behavior (SVV/SEV), emotional dysregulation (EmotDys) and interpersonal difficulties (BezSchw) were collected from 167 female patients at a psychosomatic clinic. The participants were divided into four groups depending on the occurrence of SVV/SEV before the start and/or end of treatment. A one-way multivariate analysis of variance (MANOVA) with repeated measures showed an interaction of time and SVV/SEV group with regard to EDI-SI, EmotDys and BezSchw. The effect sizes of the pre-post comparison of the EDI-SI were very different in the groups divided according to the occurrence of SVV/SEV (0.27
[Symptom perception and coping in patients with primary biliary cholangitis: a qualitative study in the context of SOMA.LIV]
Hasenbank N, Buck L, Maehder K, Hartl J, Löwe B, Schramm C and Toussaint A
Patients with primary biliary cholangitis (PBC) suffer from a variety of physical complaints such as fatigue, itching or joint pain. Since little is known about the experience of symptoms and the corresponding coping strategies in this patient group, a qualitative study was conducted in which 15 patients with PBC were interviewed. The patients reported being burdened by numerous physical complaints, some of which require extensive coping and adaptation processes. By means of thematic analysis, two overarching themes could be generated from the data material: "Accepting limitations and shifting boundaries" describes the patients' challenge of redefining their own stress limits and adapting demands and expectations to their own capabilities. "Maintaining normality and reorienting" describes the tension between the desire to maintain normality and the challenge of integrating the symptoms as perceptible signs of their illness into their own self-image. The results illustrate the central role of physical symptoms in the everyday lives of many patients with PBC, the complexity of the experience of symptoms and the challenges of dealing with these symptoms. They also emphasize the supportive and mediating function of healthcare practitioners in individual symptom management.
[Training and Continuing Education in Psychotherapeutic Skills: State of Research and new Developments]
Lutz W, Bommer J and Strauß B
[The Effect of Therapists' Interpersonal Skills on Therapeutic Alliance]
Schwartz B, Rubel JA, Lutz W and Schöttke H
Therapists' interpersonal skills play a significant role in outcome differences between therapists. Similarly, the strength of the therapeutic alliance is influenced by therapist characteristics. Therefore, the aim of this study was to capture therapist differences in the alliance and to examine the effect of therapists' interpersonal skills on the therapeutic alliance.
[Explaining Transtheoretical Therapist Training using Alliance-Focused Training as an Example]
Babl A
Although most psychotherapists adopt an integrative and process-oriented approach, transtheoretical approaches to psychotherapy training are rare. To better prepare future therapists for the complexities of clinical practice, such an approach is needed. A promising way forward is to consider principles of change that cut across different schools of therapy. The principle of the therapeutic alliance is where different therapy schools agree most. Therefore, an alliance-focused training is presented below, where therapists learn to recognize ruptures in the therapeutic alliance and respond to them with resolution strategies. Current teaching methods like role-playing and supervision have their limitations, as they can only be applied post hoc and to a small number of cases. A new approach could be an online training that integrates principles of change, such as the alliance and markers for interventions, utilizes proven methods of deliberate practice and expert training, and makes use of the potential of technology.
[Learning Evidence-Based Practice - Multi-Perspective Competence Development using the Example of Generalised Anxiety Disorder]
Flückiger C, Munder T and Schürmann-Vengels J
Within the framework of the evidence-based practice model of the American Psychological Association (APA, 2006), psychotherapeutic core competences are mostly formulated transdiagnostically and transtheoretically, but do not exclude the systematic consideration of symptom-specific aspects. This article provides an exemplary case study of a person suffering from a generalized anxiety disorder to illustrate how evidence-based practice can be implemented. Multi-perspective competence development can be stimulated in training through the following therapeutic areas: (1) through broad assessment and psychodiagnostics, (2) through joint development of an individual explanatory model, (3) through inclusion of symptom-specific models, (4) through broad consideration of stringent interventions, (5) through application of various treatment modalities, (6) through patient-centred treatment implementation. The article concludes with a list of study examples of how psychotherapeutic competence development can be researched within the framework of the evidence-based practice model.
[Measuring and training of therapeutic competencies]
Gumz A
This article provides an overview of our research concepts on therapeutic competencies with regard to three main questions. The first research question deals with therapists' competencies to succesfully handle transference and countertransference in the cotext of Alliance Ruptures. Research on the Alliance-Focused Training and on subjective countertransference is presented. The second research question deals with therapists' general interpersonal skills. The research approaches outlined here concern the construct of Facilitative Interpersonal Skills (FIS) and the measurement of these skills using the FIS-task. In further studies on this topic, we are focusing on the question of which therapist characteristics are associated with higher interpersonal skills and which linguistic and phonetic features characterise therapist responses that are rated as interpersonally competent. Another study concerns the tendency of therapists to overestimate their interpersonal skills (self-assessment bias). The third main research question deals with the competence to apply therapeutic techniques and to create helpful change processes. An instrument to assess verbal techniques (Psychodynamic Intervention List) and research approaches focusing on the description and the assessment of mediators of change are presented.
[Competence-Orientated and Transtheoretical? Ideas and Barriers for Psychotherapeutic Training]
von Blanckenburg P, Wilhelm M and Rief W
The education and training of psychotherapists is usually based on a procedure-specific theoretical orientation. However, this can have disadvantages as it hinders the utilisation of the possibilities and experiences offered by the overall field of psychotherapy. It could therefore be useful to combine different theoretical approaches and to orientate psychotherapeutic education and training in a transtheoretical and cross-procedural way.
[Body-Focused Repetitive Behavior Disorders: Classification, Diagnosis and Treatment]
Moritz S, Jelinek L, Schmotz S and Hoyer L
Body-focused repetitive behaviors (BFRBs) such as trichotillomania and skin picking are disorders at the interface of psychiatry/psychology, dermatology and dentistry. The disorders can be both either a consequence or a cause of severe somatic disorders. If BFRBs remain undetected and untreated, they tend to become chronic with at times serious somatic complications. There is currently no approved medication for BFRBs. Cognitive-behavioral therapy, especially habit reversal training, is the method of choice. The self-help technique decoupling is also effective for a subgroup of patients. In addition to behavioral change, therapy should also address precipitating factors such as poor stress and emotion regulation strategies and sensory triggers.
[Young Adult Cancer Patients (AYA): Preferences for Outpatient Psychosocial Care and Gender-Specific Differences - Results from the AYA-LE study]
Görres C, Leuteritz K, Sender A and Geue K
To investigate the importance of individual topics in outpatient care services and the preferences for their design from the perspective of young adults with cancer (AYA="adolescents and young adults") in Germany.
[Utilization of Psychosocial Support for Young Adults with Suicidal Thoughts and Behaviors]
Weiss M, Hildebrand A and Stemmler M
The study explores the utilization of psychosocial support by young adults facing suicidal ideation or impulses, considering a comprehensive spectrum of psychosocial services. The study sheds light on help utilization and gaps in service use among different groups. The data is derived from the baseline assessment of the research project "Outcome Evaluation [U25]". The sample includes 888 young adults who reported suicidal thoughts and behaviors. Among the participants, 55% accessed at least one psychosocial service. Medical/psychotherapy services were the most utilized (54%), followed by professional counseling (34%) and non-professional self-help services (22%). Gender differences were observed, with males using help less frequently than females and individuals with diverse gender identities. Participants in relationships were less likely to seek help than singles. A migrant background showed no consistent impact on service utilization. Psychological distress and suicide literacy were associated with increased service utilization. Regression analysis revealed that gender and relationship status remained predictors of service utilization even when considering mental distress, suicidal thoughts and behaviors, and suicide literacy.
[Patients with Diabetes Mellitus and Comorbid Mental Disorders - Is there a Psychotherapeutic Undertreatment? - Results of the DiMPS Study]
Röhrig B, Petrak F, Bartel A, Hagena V, Dieris-Hirche J, Meier JM and Herpertz S
Diabetes mellitus is associated with an increased likelihood of mental disorders, especially depression. Despite a frequently postulated underprovision, the actual need for psychotherapeutic treatment in this patient group has hardly been investigated. The aim of this study is to analyze the care situation of diabetes patients with mental comorbidities in Germany.
[Treatment Quality or Hotel Quality - What Determines more Rehab Satisfaction and Subjective Treatment Success in Psychosomatic Rehabilitation?]
Schmidt J, Nübling R, Kaiser U, Kupferschmitt AA and Köllner V
Rehab satisfaction and treatment success are firmly anchored in the German Pension Insurance's quality assurance program as quality criteria for medical rehab. In the field of psychosomatic rehab, there are hardly any studies in which the relative importance of treatment- and hotel-related characteristics for the prediction of these criteria has been investigated.
[Gender-Specific Effects using the Example of Health Services Research - To what Extent are Analyses of Dichotomous Gender Still up to Date?]
Flückiger C
[Patient-Centredness in Psychosomatic Medicine and Psychotherapy - Always Considered, but only Partially Implemented?]
Karger A and Dinger U
[Digital Interventions in Psychotherapy]
Berger T, Bielinski L and Philipp Klein J
During the last 20 years, many digital interventions in psychotherapy have been developed and tested for a wide range of clinical problems. Digital interventions expand the range of treatment options and reach people who are unable or unwilling to take part in traditional psychotherapy. This article sheds light on various forms of digital interventions, such as unguided and guided self-help interventions, blended treatments, and video-based therapy, the practical use of Digital Health Applications (DiGA) in Germany, and the current state of research in digital interventions.
[Partnership Status And Prevalence Of Mental Disorders In Women And Men With Cancer]
Köditz AK, Mehnert-Theuerkauf A and Ernst J
Patients facing the diagnosis of cancer are confronted with high stress levels, which increase the risk of developing a mental disorder. Being in a relationship moderates patients' mental health and can have a risk-reducing effect. We aim to describe the influence of partnership status on the 4-week-prevalence of mental disorders in cancer patients and how it varies by gender.