Psychodynamische Kurzzeittherapie mit erlebnisaktivierenden Interventionen

This short-term therapy model with experiential interventions is based on the basic assumptions of psychodynamic psychotherapy. The focus of treatment is the current psychosocial situation, in which dysfunctional emotional patterns are elicited by specific triggers. These emotional patterns are evidence of anconscious intrapsychic conflict, which has biographically relevant precursors. This conflict and the associated dysfunctional relationships are explored in a supportive therapeutic relationship, formulated in cooperation with the patient and then made accessible in an experience-activating process in the present. The effect is, in addition to the reduction of clinical symptoms, the improvement in managing relationships and improved social competence. The transference is noticed, but it is only addressed if it has a lasting compromising effect on the therapeutic relationship. This therapy model is especially suitable for psychotherapy with time limits of 25–40 hours.     

Psychosoziale Interventionen bei Patientinnen mit Brustkrebs

Breast cancer patients are subject not only to physical strain but also to substantial psychological and social stress as well as major threats and challenges.The paper presented gives an overview of the research status on psychosocial interventions to support patients in their coping endeavours.Psychosocial basic care of women with breast cancer is performed by the physicians treating oncologically and includes information fitting patients' information needs,and responding to their emotional stress.Evaluated training and educational programs are available for physicians to enhance their psychosocial competence.Psychosocial basic care is completed by psychoeducational interventions.In 20–30% of women with breast cancer, there is a need for a special psychotherapeutic treatment.Especially, supportive and cognitive-behavioral therapies in an individual or a group setting contribute to a reduction of anxiety and depression. Even anticipated side-effects of somatic treatments can be diminished by psychotherapy. Research in the field supports that there is a need for broad integration of psychosocial interventions into disease management programs for women suffering from breast cancer.     

Klinisch-psychologische Intervention im Internet

Background

Currently a multitude of Internet-based intervention (IBI) programs exist for various disorders. These programs generally have the potential to reach a wide spectrum of the low threshold population and encourage them to play a more active role in managing individual healthcare. How effective are disorder and problem-specific IBI programs? This review aims to give a systematic overview of controlled evaluation studies available to date and contrast them with the state of research in 2003 (Ott 2003).

Method

References were analyzed in three steps: 1. Research in pertinent international scientific databases using specified keywords (result: more than 1,000 publications since 2003). 2. Selection: exclusion of publications which did not contain empirical evidence of effectiveness (with control group design) (result: 89 studies published between 2003 and 2009 as opposed to 30 up to 2003). 3. Systemization: classification of the analyzed studies based on two dimensions (type of syndrome, function of intervention).

Results

In most of the studies on hand (91.0%) the effectiveness of IBI could be confirmed. Among the methods used cognitive behavioral methods (cognitive, behavioral therapy, CBT) were used almost exclusively. In nearly three quarters of all studies (71.9%), IBI procedures were used for treatment. The remaining studies were on prevention (19.1%) and rehabilitation (9.0%).

Conclusion

Evaluation studies of IBIs are now available, particularly for anxiety disorders, depression, posttraumatic stress disorder, eating disorders including adiposity, substance-related and behavioral medical disorders, psychological problems related to physical illnesses, compulsive gambling and burnout. For each type of disorder, exemplary programs are described. Subsequently the methodical limitations of several of the studies are pointed out.     

Spezifische psychoanalytische Interventionen

It is held that specific ingredients are responsible for the effectiveness of various psychotherapies and it is supposed that for this reason particular therapeutic approaches are more efficient than others. First, this article presents Bruce E. Wampold’s research on psychotherapeutic efficacy, which gives evidence that psychotherapies efficiency is due to general, not to specific factors. It is shown that in the end the common factors like alliance, compliance, empathy and the fact, that therapists generally make best use of their personality, are interpersonal factors. The impact of these empirical results on psychotherapy, on theory and practice is described in the light of two metatheories, the “medical modell”and the “contextual model”. The author delineates some consequences, for instance that in psychotherapeutic practice the diagnosis-based indication for therapy has to be replaced by fitting-indication. Regarding outcome research, the randomized goldstandard research design has to be replaced by a fitting indication concerning therapist /patient and patient/paticular treatment. Further it is shown that although specific ingredients in a strict sense are not active, therapists have to realize that they are nessessary even if active only as a component of the healing context. How specific ingredients might be realized within a healing context is shown with regard to the adaptive approach to psychoanalysis.     

Psychologisch-psychotherapeutische Interventionen bei onkologischen Erkrankungen

Psychooncological interventions reduce significantly anxiety, desperation, depression, and stress in cancer patients, and can often help to improve quality of life and to eliminate communicational problems which occur in the social environment as a consequence of the disease.Hardly any research regarding the complex connections in the brain between the emotional experience, the endocrine and the immunological systems has been done, but the few available investigations are promising. In the absence of methodologically sound studies, the question still remains unanswered if adjuvant psychological or psychotherapeutic interventions contribute to a better survival or not.Up to now there exist just as many studies supporting this hypothesis as refutations.     

Sinnorientierte Interventionen in der Psychoonkologie

Patients with advanced cancer often suffer from existential distress. Although a variety of effective psychotherapeutic interventions for the treatment of psychological distress in cancer patients are available, concerns such as hope and meaning of life are only occasionally at the center of therapeutic attention. During recent years growing efforts have been made to develop and evaluate meaning-based interventions for cancer patients, particularly in the Anglo-American research literature. Meaning-based interventions are often realized as group therapy approaches to reduce emotional and spiritual distress and to promote hope, courage and control, to mobilize internal resources and to discuss future goals despite a noticeable limited life expectancy. Further aims include strengthening a patient??s self-esteem and sense of dignity, to appreciate strengths and past achievements, to reduce feelings of isolation, to strengthen the relationship with the partner and family members and to improve communication with the professional healthcare team.     

Die Bindungstheorie als Basis psychotherapeutischer Interventionen in der Terminalphase

Recent attachment research has shown that every person develops, already in early childhood, special attachment strategies activated in cases whenever the person cannot cope on his own with dangers. These strategies are classified into four categories: “secure”, “insecure-avoidant”, “insecure-ambivalent/enmasked” and “disoriented/disorganized” attachment patterns. The death of a next person represents a situation of a unique and final separation causing psychical disturbances for the patient himself and his relatives. It is, therefore, an especially effective trigger for the activation of the attachment system. This article aims on relating attachment theory to an attachment-oriented therapy, that would open, particularly in the field of palliative medicine, possibilities of application which have been neglected. Case studies illustrate how these insights may be applied during the psychotheraputic care for patients and their relatives. As dying patients generally are brought by their family to the clinic, physicians have a particularly favourable situation to observe the attachment patterns in the family and integrate these informations into their treatment strategy: for example in case of “avoidant” attachment patterns, to bring cautiously the denied emotions into the communication and to support hopes for the fulfilment of needs for affection and protection; or in case of so-called “ambivalent/entangled” attachment patterns to help to disentangle too close relationships; or in case of “disorganized” attachment patterns to support emotional regulation and help to clear the relationships. It is obvious that this approach based on attachment theory and offering alleviations during the process of dying, is not only on a palliative board relevant, but may be applied with success in the medical care of dying patients and their relatives.     

Psychoanalyse mit Traumatisierten

Extreme and complex traumatisation represents a severe problem in today’s world. There is a need to develop treatment approaches that are efficient for traumatised persons who often live under very difficult circumstances. There are moreover certain societal conditions that are important for the treatment and rehabilitation of the traumatised patient. The paper will discuss how psychoanalytic therapy may be helpful for severely traumatised patients and what are the mechanisms of change in the therapeutic process. A focus is on how traumatic experiences are actualised in the transference and brings the analyst in a situation where enactments inevitably occur. It will be demonstrated how these processes may lead to symbolisation of these traumatic experiences. What are the therapeutic and societal preconditions for treating traumatised patients?     

Psychotherapie mit Migranten

After an introduction and presentation of the influence of immigration on psychological health, the present overview focuses on several models of psychological development in immigration. Cross-cultural psychodynamics and culturally conditioned transference in ethnically mixed cultural psychotherapy settings are explored. The effectiveness of Western therapy methods based on Christian – Jewish values is discussed with regard to the therapy of patients from different ethnic backgrounds, i. e. so-called traditional societies. In Western cultures, proximity in object relations is based on autonomy whereas in traditional societies proximity is based on relatedness. Knowledge of specific cultural issues are considered to be an important instrument in cross-cultural therapies. Joining, activation of ethnic resources, and culture-sensitive interventions are considered to be helpful psychotherapeutic interventions. Specialized therapy settings, e.g. integration of ethnic therapists in established institutions, mono-cultural ethnic settings and collaborative projects are described. Last but not least, the authors point out the necessity of cross-cultural therapeutic competence because of an expanding cultural heterogeneity of society.     

Umgang mit dem Trauma

Die Posttraumatische Belastungsst?rung (PTBS, engl.: posttraumatic stress disorder, PTSD) wird klinisch charakterisiert durch die Symptomtrias „Wiedererinnern“ (so genannte intrusive Symptomatik, engl.: re-experiencing), „Vermeidung und Bet?ubung“ (engl.: avoidance and numbing) und „vegetative übererregbarkeit“ (engl.: increased arousal). Diese St?rung stellt insofern eine Ausnahme des ph?nomenologisch-beschreibenden, diagnostischen Ansatzes der modernen psychiatrischen Diagnosesysteme dar, als sie einen eindeutigen ?tiologischen Bezug nimmt – n?mlich auf ein erlebtes Trauma. Im Folgenden sollen spezielle Aspekte der PTBS zur geschichtlichen Entwicklung der Erfassung des St?rungsbildes sowie betreffend Diagnose, Risiko-und Resilienzfaktoren, Neurobiologie und Therapie dargestellt werden.     

Sozial-emotionales Lernen mit FAUSTLOS

Maltreatment, sexual and emotional abuse and neglect during childhood contribute to the development of psychic and somatic disorders. Therefore interventions against violence are necessary to support psychological health. The development of social-emotional competences became an elementary part of psychosocial prevention programs. Children with good capacities in problem solving are less at risk to show violent behaviour in difficult emotional conflicts, because they don’t tend to stabilize and compensate their self esteem in these situations. Relevant core dimensions concerning psychological development can be taught systematically in social- emotional learning lessons. Teachers in kindergardens and schools are presenting the series of lessons. A growing number of studies in this field show good effects. In Germany FAUSTLOS has been developed as an evaluated and systematically constructed tool for preventing aggressive behaviour in children visiting kindergardens and elementary schools. During these programs 28 lessons are presented in kindergardens and 51 lessons in elementary schools. Follow-up studies with FAUSTLOS show significant changes in emotional competences and prosocial developments in children.     

Parsing mit inkonsistenten Grammatiken

A novel approach to the parsing of natural language based on weighted constraints is presented. Wellformedness conditions are exclusively expressed by means of constraints and no generative rule component is available. In general, constraints can be violated and contradictory requirements of a grammar are tolerated. Additional representational levels allow the integration of different linguistic perspectives into a coherent model, thus contributing jointly to the computation of the most plausible structural interpretation. A number of solution procedures is available for such a parsing problem. Their properties are discussed with respect to possible analogies to human language processing, focussing on robustness against deviating utterances and external temporal pressure.