Psychoanalytische Ressourcen im Internet

Ohne Zusammenfassung     

Psychoanalytische Intervalltherapie

The history of focal therapy clearly reveals it to be closely linked with short-term therapy. This fact can often lead us to take a rather limited view of the focal therapeutic approach, since in reality it can also be a useful concept for long-term treatment. Experiences with therapy performed on an interval basis show that development happens in stages and that a new step forward – a “quantum leap in development”– can only be achieved when the time is right. This step frequently requires that the patient have their own experiences, undergo their own suffering and develop an Ego-dystonic reaction towards their characteristic behavioral conditions which can often only be achieved outside the therapeutic environment. In this context, it becomes even more significant that we understand and take into consideration the “self-analytical function of the Ego”. If these preconditions are met, then it may even be possible to achieve profound structural changes in a longer-term therapeutic process, assuming that this therapy is performed in focal stages rather than continuously.     

Psychoanalytische Aspekte des Umzugs von West nach Ost im vereinten Deutschland

After the reunion of East and West Germany many people of the former GDR had to deal with cultural shocks and adjustment difficulties of different types in the new cultural environment, which could be characterized as becoming intimate with post-modern western culture in a process of identity development. On the other hand people who move from West Germany to East Germany still are confronted with the heritage of harassment in public and private life over more than two generations. Some of these persons, especially those who were victims of early traumata in their childhood during the rigid and authoritarian social world after World War II in West Germany, are subject to re-traumatization under these circumstances. Two case vignettes illustrate these phenomena. The childhood traumata of these patients, their coping in West Germany, and the process of pathological regression after the removal to East Germany are described and analyzed.     

Psychoanalytische Kompetenzen

The author presents a project trying to gain as transparent as possible criteria for a competent psychoanalytic practice. The project is oriented at David Tuckett’s (2005) proposal of tracing the implicit knowledge of psychoanalytic experts on quality and of making it explicit. Thirty written comments by experienced training analysts on candidate‘s case reports are utilized. A qualitative content analysis leads to the formulation and explanation of ten psychoanalytic competences. They are framed by a model that conceptualizes psychoanalytic practice by three steps: (1) perceiving unconscious material in a participant–observational frame, (2) reflecting it in a conceptual frame and (3) interpreting it in an interventional frame. The competences of the first frame involve the abilities of evenly suspended attention and abstinence, of working with the countertransference and with psychoanalytic interaction and intersubjectivity, the ability to establish an as helpful experienced relationship, the ability to tolerate and to handle anxiety, tensions and conflicts, and the ability to give psychic space and developmental freedom to the patient. The conceptual frame comprehends the ability to establish, form and end a psychoanalytic process, the ability to utilize theoretical concepts and that of selfreflection. The last but not least ability is related to interpretation in the interventional frame. It is not possible in this survey to characterise the competences in a more detailed way nor to add the indispensable vignettes in order to anchor the competences in practice. Some most interesting questions on plurality and competence in psychoanalytic work are raised.     

Psychoanalytische Therapie

A statement of the professional umbrella society DGPT is presented that was formulated in cooperation with the various professional societies and with the German Society of Psychosomatic Medicine and Psychotherapy and the Society of Child and Adolescent Therapy. The statement is a reaction to the public claim for effective evidence of psychotherapy and takes the opportunity for a comprehensive presentation of this field. In the introduction Alf Gerlach, as chairman of the umbrella society at the time of the formulation of this statement and now executive chairman responsible for coordinating research, describes the history of the development of the statement.There were two particular moments prompting this statement. On the one hand the Scientific Advisory Board for Psychotherapy as an advisory committee based on the law of psychotherapy, has presented demands for effective evidence that are incompatible with psychoanalysis. Thus, the recognition of psychoanalysis as a treatment method for illnesses was put in doubt. On the other hand, a suggestion was put forward to the Board to recognize psychodynamic psychotherapy as an independent entity. This questioned the unity of the psychotherapeutic field.The statement was passed onto the Scientific Advisory Board last autumn. It is intended for a professional audience and includes answers to important issues of this field. It will have an important role to play in future discussions about professional politics. For this reason, we have decided to begin the present issue of our journal with this statement and thus to open a wide discussion forum.

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Deutsche Gesellschaft für Psychoanalyse, Psychotherapie, Psychosomatik und Tiefenpsychologie e.V. (DGPT)In Verbindung mit:Deutsche Gesellschaft für Analytische Psychologie (DGAP)Deutsche Gesellschaft für Individualpsychologie (DGIP)Deutsche Gesellschaft für Psychotherapeutische Medizin (DGPM)Deutsche Psychoanalytische Gesellschaft (DPG)Deutsche Psychoanalytische Vereinigung (DPV)Vereinigung Analytischer Kinder- und Jugendlichen-Psychotherapeuten (VAKJP)Redaktion: Stephan Hau und Marianne Leuzinger-Bohleber

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Berufspolitik im Internet

Ohne Zusammenfassung     

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.     

Psychoanalytische Psychotherapie mit niedriger Sitzungsfrequenz

Compared to Freud??s use of six sessions a week, the frequency of therapy has now decreased to a maximum of three or four sessions. The current field of applied psychoanalysis using only one or two sessions a week is of much higher relevance for the worldwide supply of the population with psychotherapy. Not only frequency and duration have decreased over the years but also the sum of applied sessions per patient. This is especially the case in psychodynamic short term psychotherapy. With the change in frequency a change in therapy technique took place resulting in a more active and attentive therapist, an interactive pattern with more dialogue and an avoidance of regressive movements of the patient. The crucial role concerning the work with transference and resistance was maintained in tendency but the specific techniques also underwent modifications. The empirical state of psychodynamic psychotherapy is better than it used to be but further studies are urgently needed.