Behandlung von Epilepsie bei Menschen mit Intelligenzminderung

People with intellectual disability frequently suffer from epilepsy. Management of epilepsy in this population is particularly challenging because of the different ways of communicating, cognitive impairment, changes in behavior which can be disruptive, the severity of the epilepsy syndrome, the seizure types, and the seizure frequency. Treatment of epilepsy is complicated due to the interaction of the intellectual disability and the behavior as well as behavioral changes caused by the antiepileptic drugs or the change of seizure types or frequency. This article provides the reader with a guidance for managing epilepsy in this particular population and raises important open questions.     

Die vielen Gesichter der primär progredienten Aphasie

psychopraxis. neuropraxis - Primär Progrediente Aphasien (PPA) präsentieren sich initial in Form von Defiziten in der Sprache und im Sprechen. Meist betrifft dies...     

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.     

Beleuchtung von anwendungen der logistik in werken von Rudolf Carnap

Ohne Zusammenfassung     

Der Einsatz von Hausaufgaben in der Psychotherapie

Homework is not only an essential part of cognitive-behavioral treatment but is also used in a variety of other therapy approaches. Its positive relation to therapy outcome has been proved. In consequence, patients’ compliance with homework assignments is an important therapeutic goal. In the last years, numerous papers focused on recommendations for enhancing acceptance and completion of homework assignments. The present article provides an overview about existing recommendations. Proposals are summarized and opposed to empirical studies on single homework procedures and their influence on homework compliance. Due to a lack of empirical data, the effectiveness of most recommendations could not yet be proved. General problems in homework study design and possible directions of further research addressing homework use are discussed.     

Goethes und Schopenhauers Stellung in der Geschichte der Lehre von den Gesichtsempfindungen

Ohne Zusammenfassung     

Kombination von Settings und Verfahren in der Psychotherapie

Literature research and own clinical experiences confirm the significance of a combined use of settings and methods in the area of inpatient and outpatient psychotherapy. For inpatient treatment, the combined use of methods, such as individual psychotherapy, group therapy, creative therapies, and sport, are an essential part of the treatment. In outpatient treatment, the regulations of the German insurance do not permit such combinations. Nevertheless, they occur and are often proactively initiated by the patients. The various combined use of psychotherapy and psychotropics is very well studied, but also the combination of settings, i.e. supplementary inpatient treatment, day treatment, and outpatient treatment have to be considered. While administering their therapies, psychotherapists should keep in mind possibly concurrently ongoing treatments as well as former therapies and their effects on the patients. With the exception of combinations with psychotropic treatment, there exist almost no empirical data in this important field.     

Zur Bedeutung von Gruppenleitern in der gruppenpsychotherapeutischen Weiterbildung

Training in group therapy is fundamentally based on self-experience in groups. The importance of the model character of the group leader's role has hardly been subject to empirical research in spite of its highly qualified and specialized requirements. In order to ensure process quality in group therapy training, the effects of the leader's model on the reported learning effects of 413 members in 35 short-term Process (self-awareness) and so-called Special Interest (thematically focused) groups of the American Group Psychotherapy Association (AGPA) were investigated. The first two sessions out of four were investigated by process questionnaires focusing on self-experience, experience of the group atmosphere and subjective impressions of the group leaders' performances. These process variables were later correlated with the overall learning impression after all four sessions. It turned out that particularly those group leaders' styles and attitudes had a strong positive correlation with favourable learning effects, that were decisive and charismatic instead of vague and that group leaders who were experienced by group members as predominantly indecisive, vague and less charismatic were in spite of the fact of being seen as competent and skillful produced weak learning effects. Results are discussed in the light of the need of neophyte group therapists to identify with a leader model promising to provide authority and sovereignity even prior to competence and empathy given the anticipatory fear regarding possible critical group dynamics in future therapy groups.