[Treatment Quality or Hotel Quality - What Determines more Rehab Satisfaction and Subjective Treatment Success in Psychosomatic Rehabilitation?]
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.
[Eating Disorder-Related Symptom Reduction, Suicidal/Self-Injurious Behavior, Emotional Dysregulation and Interpersonal Difficulties in an Eating Disorder-Specific Treatment - A Clinical Study]
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
[Organised abuse in the GDR - A Secondary Analysis of the Victims' Perspective]
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.
[Gender-Specific Effects using the Example of Health Services Research - To what Extent are Analyses of Dichotomous Gender Still up to Date?]
[Young Adult Cancer Patients (AYA): Preferences for Outpatient Psychosocial Care and Gender-Specific Differences - Results from the AYA-LE study]
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.
[Global Change in Psychotherapy: Influences of Current Social Change on Mental Health and Therapy]
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.
[Patients with Diabetes Mellitus and Comorbid Mental Disorders - Is there a Psychotherapeutic Undertreatment? - Results of the DiMPS Study]
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.
[Psychometric evaluation of the German version of the Questionnaire of Cognitive and Affective Empathy (QCAE)]
Empathy as a central element of social cognition plays a decisive role in various psychosocial areas and interpersonal dynamics, especially within the context of psychotherapy. Despite the controversy surrounding a standardized definition, empathy is generally regarded as a multidimensional concept that encompasses both cognitive and affective dimensions. This differentiation between cognitive and affective facets is addressed by a widely used and internationally well-established self-report measure of empathy, the Questionnaire of Cognitive and Affective Empathy (QCAE). This study focuses on evaluating the psychometric properties of the German version of the QCAE. In a convenience sample (N=1300), the postulated confirmatory five-factor model showed an adequate fit to the underlying structure. The subscales of the QCAE exhibited satisfactory internal consistency and convergent validity with other instruments measuring empathy. Despite certain methodological limitations, our findings suggest that the German version of the QCAE is suitable as a reliable and valid instrument for measuring empathy. Further studies in population-representative samples and clinical populations are required before a clear recommendation regarding its utilization can be provided.
[Information and Counseling needs Regarding Parenthood Decisions: Are Existing Services Sufficient and what Role does Depression Play?]
Support needs in parenting decisions and the associated desire for information and counseling services are insufficiently researched, especially in relation to groups of people with mental health burdens. The aim of this study was to assess information and counseling needs in parenting decisions. In addition, we investigated whether more severe depressive symptomatology is associated with increased needs.
[Utilization of Psychosocial Support for Young Adults with Suicidal Thoughts and Behaviors]
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.
[Experiences of Psychologists and Sport Therapists Conducting Open and Closed Therapy Groups]
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.
[Patient-Centredness in Psychosomatic Medicine and Psychotherapy - Always Considered, but only Partially Implemented?]
[Digital Interventions in Psychotherapy]
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.
[Explaining Transtheoretical Therapist Training using Alliance-Focused Training as an Example]
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.
[Indication and Prevalence of Inpatient Psychosomatic-Psychotherapeutic Rehabilitation in Patients in Outpatient Psychotherapy Data from a Study on the Epidemiology of Care]
Outpatient psychotherapy is qualitatively and quantitatively an important treatment option for patients with psychological disorders. Additionally, there is the option of inpatient care, including psychosomatic rehabilitation units. There is a lack of data on the cooperation between the ambulatory and the inpatient sector, and on which patients in outpatient psychotherapy have already been in psychosoamtic rehabilitation or should be admitted.
Patients With Chronic Pain: The Aspect Of Negative Body Image
Negative body image is an increasingly important factor in chronic pain disorders; particularly because the two conditions mutually influence each other. Our study examines body-image-related attitudes and comorbid psychic symptoms in patients with chronic pain disorders.
[New Normative Values for the German Short Version of the Resilience Scale (RS-13)]
In a representative survey conducted in Germany, normative values for the German short version of the RS-13 resilience scale were updated and compared with the data from a previous representative survey conducted in 2001.
[Symptom perception and coping in patients with primary biliary cholangitis: a qualitative study in the context of SOMA.LIV]
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.
[Psychodiagnostics in Psychosocial Centers for Refugees]
Accurate psychodiagnostics is crucial for diagnosing and ensuring quality treatment for individuals with mental health disorders. However, there is limited understanding of psychodiagnostic practices within Psychosocial Centers (PSZ) when dealing with refugees, particularly in the presence of language and cultural barriers and resource constraints. This study aims to evaluate the current status and potential pathways for enhancing culturally sensitive diagnostics in this context.
[Aspects of Utilization of Psychotherapy in Germany in Times of the GDR and Later]
Objective The aim of the study was to examine real differences in the use of psychotherapy in the New Federal States during the GDR era and today. In addition, differences according to the willingness seeking psychotherapy as well as barriers in opinions and contact to the mentally ill between people from the New Federal States, the Old Federal States and people who moved from the New Federal States to the Old Federal States (internal migrants) should be recorded, taking into account generational effects (experience of the Cold War - birth before / after January 1, 1980). Methods To investigate these questions, the data from a representative survey in the New Federal States of N=2729 people as well as the data from a second online based survey of people from the New and Old Federal States as well as internal migrants with a total of N=4789 participants were evaluated.Results There was a prevalence of 1% for the use of psychotherapy during the GDR era. Overall, the prevalence of therapy experiences among people who experienced the GDR and were born before January 1 in 1980 was almost 13%. They also reported greater willingness seeking help for mental suffering since the end of the Cold War. The prevalence among younger people was about 12%. In the second survey, there were significant differences, among the older respondents. East Germans today and even during the GDR era were less willing to seek psychotherapy for mental suffering, they also have less contact to mentally ill people. Differences according to desires for distance from mentally ill people, self stigmatization in the presence of a mental illness and discrimination against mentally ill people emerged between East Germans, West Germans and internal migrants depending on generational affiliation.Discussion Barriers that prevent the use of psychotherapy should be taken into account on a generational and socialization specific basis. Socialization as a relevant factor might explain a lack of willingness to utilize psychotherapy amongst people that experienced the GDR era and still live in the new Federal States.
[Measuring and training of therapeutic competencies]
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.
[Learning Evidence-Based Practice - Multi-Perspective Competence Development using the Example of Generalised Anxiety Disorder]
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.
[Partnership Status And Prevalence Of Mental Disorders In Women And Men With Cancer]
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.
[How to Support People with Hearing Impairment beyond Hearing aid Provision - A Systematic Review on Self-Management Interventions]
People with hearing handicap have to use a whole range of strategies to cope with everyday challenges - they have to self-manage their hearing impairment. While the support of self-management is well established in foreign language audiological rehabilitation programs, there are no recommendations in Germany yet. Therefore, the aim of this systematic review is first to give an overview of existing self-management interventions for people with hearing handicap and then to suggest possible applications in the German care system.
[Learning from Mistakes? - A Randomized Controlled Trial on the Acquisition of Knowledge about Clinical Communication Skills Using Positive vs. Mixed Therapy Models]
This study compares two types of therapeutic model videos: an ideal model and a model that shows mistakes. The idea is that the conscious perception of mistakes is more likely to help build a comprehensive understanding of clinical communication skills than an ideal model.
[The DZPG Academy - Network for strengthening mental health in Germany]
[Oncological Disease and Pregnancy Denial: Psychological Support and Interdisciplinary Collaboration]
In the following casuistry, a denied advanced pregnancy was discovered during the diagnosis of an oncological disease. Faced with a life-threatening condition, the patient urged late termination of the pregnancy and was introduced to psychological counselling in order to find a viable and ethically justifiable solution. Strategies for crisis intervention and supportive approaches in the patient's care as well as interdisciplinary collaboration are presented and discussed.
[ORPHYS - Treatment Manual for a Short-Term Psychodynamic Psychotherapy in Patients with Serious Physical Illness]
The diagnosis of a life-threatening illness may lead to a breakdown of psychological processing patterns and a reactualization of existential conflicts. The sudden loss of continuity, physical integrity and social roles can overwhelm patients' ability to cope psychologically. Psychosocial and medical care is likely compromised if patients suffer from affective disorders or symptoms of existential distress. Psychodynamic treatments may strengthen the experience of closeness and connectedness in order to cope with losses and enable farewell processes. ORPHYS describes a short-term psychodynamic psychotherapy (12-24 sessions) that aims to address the existential distress of seriously physically ill patients by taking into account relational conflicts at the end of life. The combination of supportive and expressive treatment techniques that focus on patients' subjective experience and illness situation may enable patients to integrate painful affective states and to explore their relationship and coping patterns. ORPHYS can thus facilitate a shared mourning process, in which the intense desire for connectedness at the end of life and the reality of dying can be reconciled.
[Open Debates Versus Discourse Vulnerability: A Plea for more Courage in the University Culture of Debate]
[Embodiment - Connecting Body and Mind]
Body and mind are often considered as separate entities, also in medicine. However, new neuroscientific research indicates that body and mind are much more connected than previously thought. This scientific contribution will look at the importance of "embodiment" for medicine.