Die Therapeutenvariable

Background

The objective of this study was to investigate the therapeutic attitude as a self-contained dimension of the therapeutic process.

Patients and methods

The psychotherapists’ beliefs and attitudes in therapeutic matters are measured according to the Therapeutic Attitude Scales (TASC) of the Therapeutic Attitude Questionnaire (ThAt) and were applied to investigate the therapist variable. The investigation concentrated on the therapist’s belief in the curative value of a number of ingredients of psychotherapy, on the therapist’s individual style of conducting psychotherapy and on basic assumptions about the nature of psychotherapy and the nature of the human mind. A total of 451 psychotherapists (81 psychodynamic psychotherapists, 208 psychoanalytic psychotherapists and 162 behaviour therapists) were investigated.

Results

There were highly significant differences between the three groups of therapists, a finding which is in line with the basic theory. Adaptation and insight of the assumed curative factors as well as supportiveness and neutrality of the technique factors, differentiate the groups highly significantly. The multivariate analysis underlines the importance of adaptation and insight to differentiate between all groups.

Conclusion

The results by and large confirm the general assumptions held on the differences between the groups. Thus the ThAt appears to be a valid instrument to grasp more subtle features of the therapist variable that may influence the outcome of psychotherapy.     

Ambulante Psychotherapie der Substanzstörungen

Background

The revision of the psychotherapy guidelines in 2011 broadened the options for treating substance use disorders (SUD) in outpatient psychotherapy (OP).

Aim

The aims of this study were to answer the following questions: how frequently are SUDs treated in OP? What opinions do psychotherapists (PT) hold concerning the new treatment possibilities?

Material and methods

In this study the frequency of OP for patients with SUD, e.g. harmful use and abuse of as well as dependence on psychotropic substances according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and the International Statistical Classification of Diseases and Related Health Problems (ICD-10), by private practice PTs as well as their attitude towards the treatment of patients with these diagnoses were investigated. Private practice PTs in five states in East Germany were asked to participate in a postal survey.

Results

Of the 1,382 PTs contacted, 229 (16.6 %) participated in the study. Of the respondents 94.3 % had treated at least one patient with SUD (4-week prevalence including nicotine dependence). These rates ranged from 3.1 % to 26.6 % depending on the substance and diagnosis (SUD as primary reason for treatment). The highest rates of strong affirmation for OP of approximately 20?% were found for disorders related to alcohol, tobacco and medication.

Conclusion

Most PTs treated at least one patient with SUD in OP. However, this particular type of treatment offer should be further extended. Information about the options of treating SUD in OP should be further disseminated and conducting such treatment should be supported by (e.g.) therapist training.     

Station?re Psychotherapie und Medien

Background

According to several studies the application of different media in inpatient psychotherapy and psychiatry has proven to be a useful and effective addition to conventional methods of intervention. This study is the first to catalogue the current spread of media in inpatient treatment as well as the evaluations of media-supported interventions by therapists and patients.

Sample and method

In a representative survey conducted in all psychiatric and psychosomatic clinics in North-Rhine/Westphalia (response: 40 psychologists/doctors and 289 patients from 39 clinics) media equipment, usage of media in different areas, evaluation of and satisfaction with the media usage were measured by a questionnaire which was constructed especially for this purpose.

Results

A widespread usage and acceptance of media could only be found in some areas. The study identified large differences in equipment standards and media usage depending on the type of media, the area of usage and the specific clinic.

Conclusion

Recommendations for the further development and optimization of media usage in inpatient psychotherapy are derived from the results of this study.     

Mangelnde Eignung bei angehenden Psychotherapeuten

Background

Psychotherapy research has shown that some therapists have systematically more negative outcomes than their colleagues. Many attempts have been made to answer the question of whether these unsuccessful therapists have specific features but as yet no consensus has been reached. Particularly in the field of psychotherapy training this issue has rarely been discussed.

Aims

This study focused on the following questions: how many trainees are incompetent, what characteristics do they have and how to deal with them? How are trainees selected?

Material and methods

In a research expertise on psychotherapy training for the German Ministry of Health, directors of training institutions were interviewed and 129 responses were analyzed using, for example content analysis.

Results

A total of 4–5?% of trainees were judged as being not sufficiently competent to become a psychotherapist. Relevant criteria were mainly the lack of personal and interpersonal competencies.

Conclusions

Future psychotherapy training should focus more and earlier on recognizing and intervening regarding incompetence in the given areas.     

Intervallbehandlung statt disziplinarischer Entlassung

Background

Conduct disorder is a frequent mental health problem in children and adolescents characterized by high functional impairment and a poor prognosis. Different types of interventions have been established but only few have proven effective. Relevant effect sizes could only be shown for family centred interventions. Inpatient treatment is not the first line treatment even though children, adolescents and their families often present with a query for inpatient admission when outpatient resources are at their limits.

Aim

The effectiveness of a newly developed interval treatment for adolescents with conduct disorder, which focuses on motivation of the adolescent, involvement of the family in the therapy and the avoidance of disciplinary discharge, was evaluated.

Material and methods

A total of 19 adolescents aged between 16 and 18 years with conduct disorder was treated and assessed within the new interval treatment. The key symptoms of conduct disorder, sociodemographic data, psychosocial functioning (children global assessment of functioning scale, CGAS) as well as the severity of impairment of behavior (health of the nation outcome scales for children and adolescents, HoNOSCA) were recorded before treatment (T1). After completion of treatment (T2) the frequency of participation in the three possible treatment intervals, as well as psychosocial functioning and severity of impairment of behavior were documented.

Results

Interval treatment leads to a reduction of disciplinary discharges. Engagement in and motivation for treatment was enhanced. At the end of treatment a significant effect on psychosocial functioning, behavior and severity of symptoms could be shown for interval treatment.

Conclusion

Inpatient interval treatment for adolescents with conduct disorder is an innovative and effective concept, when outpatient treatment has reached its limits.     

Emotional Contagion and its Relevance to Individual Behavior and Organizational Processes: A Position Paper

Purpose

Emotions and emotional contagion are being increasingly recognized as crucial variables influencing individual behavior and organizational functioning. This position paper serves the function as a ready reckoner by reviewing and consolidating existing literature in the field of emotional contagion. The review is categorized into three broad headings: (a) individual, (b) interpersonal, and (c) contextual factors, based on their relationship with emotional contagion.

Design/Methodology/Approach

The article focuses on analyzing and critiquing studies of emotional contagion conducted in several streams such as psychological processes, personality, organizational behavior, marketing, and consumer behavior. A conceptual framework of emotional contagion is presented, supplemented with research propositions.

Findings

The phenomenon of emotional contagion in workplace and its effects on personal and group outcomes has emerged as a critical area of research. It has been firmly established in literature that spread of emotions, if not properly managed, is bound to influence work effectiveness.

Implications

Importance of understanding the effects of transfer of emotions, for both academicians and practicing managers is one of the critical take-aways of this article. Suitable interventions are the need of the hour in order to ensure proper management of emotions.

Originality/Value

The contribution of the article is expected to be fourfold, in terms of: (a) presenting a structured and comprehensive review of literature on emotional contagion, (b) identifying gaps in the existing literature, (c) proposing a conceptual framework, and (d) developing propositions for future research.     

Ambulante psychotherapeutische Versorgung depressiver Patienten

Background

The effectiveness of psychotherapeutic interventions in treating depressive disorders has been shown in manifold ways. However, information is missing from the point of view of psychotherapists concerning diagnostic and therapeutic procedures, their experienced difficulties and barriers, their self-assessment of their competence in the handling of depressive patients and the satisfaction with the cooperation in routine care.

Method

A cross-sectional survey of cognitive-behavioral (n=61) and psychodynamic psychotherapists (n=78) was carried out.

Results

The concordance of clinical diagnoses with diagnoses using the formal ICD-10 criteria was very low. Both groups feel themselves specifically responsible for early detection and differential diagnosis. They neither differ with regard to the frequency of cooperation contacts to other service providers nor with regard to their satisfaction with them or the experienced barriers in the care for depressed patients.

Conclusion

A good psychotherapeutic care exists with options for improvement concerning diagnostic procedures and a stronger connection network.     

Wenn Psychotherapie schadet …

Background

The examination of the negative and harmful effects of psychotherapy has recently moved into the focus of psychotherapy research. The investigation described in the following article specifically analyzes for the first time the contents of complaints by psychotherapy patients and presents a practical category system for classification of the negative effects of psychotherapeutic treatment.

Samples and method

A total of 67 cases of complaints submitted to the Ethics Association (reg. co). Ethics in Psychotherapy during the time period from 18.02.2008 to 27.12.2010 were analyzed with respect to the content in the sense of an inductive categorization and quantitative evaluation.

Results

From the available patient complaints a reliable category system could be elucidated. The violation of therapeutic base variables and violations of sexual limitations were the most common cause of complaints against male therapists whereas for female therapists accusations of violation of medical confidentiality and documentation duty were significantly higher.

Conclusions

The results of this study allow formulation of research recommendations for extended investigation of the negative effects of psychotherapy and reveal options for the development of a targeted risk management.     

Beziehungsökologische Therapie bei Panikstörung

Background

In 2000/2001 the authors presented the theory and practice of the ecological approach to the psychotherapy of panic disorders. The aim of the present study was to investigate the psychotherapeutic effectiveness of its application, supplemented by cognitive behavioural elements. According to the ecological approach, panic disorder arises whenever external changes in the living conditions enforce changes in professional or interpersonal relationships, which had been previously postponed and/or avoided out of fear of their consequences.

Methods

A total of 24 therapies consisting of 11–20 sessions were examined. Patients were examined 5 times from the beginning of the therapy until at least 1 year after cessation. Standardized questionnaires for the diagnosis and severity of the panic syndrome were used including the Panic and Agoraphobia Scale (PAS), the Hamilton Anxiety Scale (HAMA), the Symptom Checklist (SCL) 90-R and a relationship questionnaire.

Results

In the subjects’ self-evaluation 67% had recovered or showed only mild symptoms 1 year after therapy compared to 75% in the evaluation by the therapists. Effect sizes before and after therapy varied between 0.78 and 2.73 and all were significant. In addition, we developed a questionnaire on relationships, according to the ecological hypothesis. This showed that more than 80% of the subjects experienced essential changes in their relationships prior to the onset of the panic disorder requiring further developmental changes, which could be mastered with increasing success in the course of therapy.

Conclusions

Compared to other studies the combination of ecological and cognitive-behavioural approaches in this study resulted in impressive symptom and therapy reduction in less than 20 sessions.     

A Test of Two Positive Psychology Interventions to Increase Employee Well-Being

Purpose

Despite an abundance of organizational research on how contextual and individual difference factors impact well-being, little research has examined whether individuals themselves can take an active role in enhancing their own well-being. The current study assessed the effectiveness of two simple, self-guided workplace interventions (“gratitude” and “social connectedness”) in impacting well-being.

Design/Methodology/Approach

Sixty-seven university employees participated in one of the two self-guided interventions for 2 weeks and completed self-report measures prior to the intervention, immediately following the intervention, and one-month post-intervention. Growth curve modeling was used to examine the effects of each intervention.

Findings

Partially supporting hypotheses, the gratitude intervention resulted in significant increases in positive affective well-being and self-reported gratitude but not did significantly impact negative affective well-being or self-reported social connectedness. The social connectedness exercise did not significantly impact any of those four outcomes. However, both interventions related to a reduction in workplace absence due to illness.

Implications

The study suggests that self-guided, positive psychology interventions (particularly gratitude) hold potential for enhancing employee well-being. Because the interventions are short, simple, and self-guided, there is little in the way of costs or drawbacks for organizations. Thus, these types of interventions seem like a potentially useful component of workplace wellness initiatives.

Originality/Value

This study is one of the few to examine whether self-guided, positive psychology interventions can enhance well-being. Moreover, this is the first study to examine a social connectedness workplace intervention and the first to demonstrate effects on illness-related absence.     

Individuelle Therapiezielerreichung nach Gruppentherapie „SAVE“

Background

Adolescents with attention deficit hyperactivity disorder (ADHD) are severely impaired in routine daily activities in the same way as adults. Therapy programs focus on improving everyday behavior. Goal attainment scaling (GAS) has already proven to be a suitable instrument for assessing treatment success with adult ADHD patients.

Material and methods

Goal attainment scaling was used in addition to standardized self-evaluation of core symptoms of ADHD in 49 adolescents aged 12-18 years old with a mean age of 14.14 years (standard deviation SD±1.59 years) with ADHD to operationalize treatment success of the cognitive behavior group therapy program SAVE. Behavior-oriented aims and criteria for target achievement were set. To examine treatment success changes were assessed at different time points (10 weeks before treatment, process evaluation during treatment and after treatment).

Results

The adolescents in this study were able to define relevant goals together with the therapists. They focused on goals concerning organization of everyday life, attention, distraction and power of endurance. Goals were reached from the beginning of the study to post-evaluation, even before SAVE started, with great effects (d?=?1.85). Adolescents evaluated changes in symptoms during the course of the SAVE program in general (d?=?0.47) and attention deficits (d?=?0.45) as having significant effects. The reduction in symptoms (attention) was only moderately correlated with the target achievement.

Conclusion

The GAS method has been proven to be a practical instrument to assess treatment success for adolescents with ADHD. Further studies in a controlled design should focus on assessment of the influence of GAS as an intervention method.     

Elternschaft, Krebs und Kindersorgen

Background

The diagnosis of parental cancer may destabilize the whole family, parents and children as well. The Hamburg children of somatically ill parents (COSIP) intervention supports parental skills and adaptation of children to the situation. There is currently no evidence for criteria to determine which family members should be involved in the COSIP intervention, predominantly the parents (parent setting), the children (child setting) or both (family setting).

Aim of the study

Data from a multicentre study were analyzed with respect to the predominant intervention settings, the correlation between setting and aims of intervention as well as variables that predict the involvement of children in the intervention.

Material and methods

A total of 203 documented cases were analyzed. Different variables that had been documented by the therapists were included in a regression analysis model in order to identify predictive variables.

Results

In 142 cases the intervention was carried out in a specific intervention setting. In 57?% of the cases children were involved (32?% family setting and 25?% child setting). A systematic relationship between the reported intervention aims and the intervention setting was not detected. The most powerful predictor was the existence of emotional problems of children as reported by the child itself.

Conclusions

Decision-making on intervention settings should therefore take the assessment of emotional symptoms of children by the means of age-appropriate self-reporting tools into consideration. Further investigations are needed to reveal variables concerning needs, motivation and capabilities of the family members as well as institutional conditions.     

Bindungsrepräsentation bei stationär behandelten chronisch-depressiven Patientinnen

Background

Studies on the association between attachment and chronic depression are scarce.

Aim

This study was carried out to investigate attachment representations in chronically depressed female inpatients.

Material and methods

A total of 20 female inpatients with major depression were assessed with the adult attachment interview. Attachment representations were assessed following the method of Main et al. Furthermore, a dimensional evaluation of attachment representations according to Waters was compiled and related to symptom severity.

Results

The analysis of attachment resulted in a distribution of 5?% securely attached patients, 30?% with insecure-avoidant attachment, 15?% insecure-preoccupied attachment and 50?% disorganised attachment representation. For the dimensional approach along the secure-insecure dimension, attachment security was correlated with global assessment of functioning (GAF) and reflective functioning and insecurity was correlated with unresolved loss. For the dimension avoidance-preoccupation a relationship was found between avoidance and GAF.

Conclusion

In comparison to non-clinical samples the results demonstrate a high proportion of insecure and disorganised attachment in this sample of severely depressed female inpatients with high chronicity (mean course of illness 11.7?±?7.6 years) and high symptom load (Beck depression inventory BDI =?36.6?±?8.7 points). This result underlines the importance of psychotherapeutic interventions for depressed patients with unresolved loss experiences.     

The Mediating Role of Discrete Emotions in the Relationship Between Injustice and Counterproductive Work Behaviors: A Study in Pakistan

Purpose

Our study explores the mediating role of discrete emotions in the relationships between employee perceptions of distributive and procedural injustice, regarding an annual salary raise, and counterproductive work behaviors (CWBs).

Design/Methodology/Approach

Survey data were provided by 508 individuals from telecom and IT companies in Pakistan. Confirmatory factor analysis, structural equation modeling, and bootstrapping were used to test our hypothesized model.

Findings

We found a good fit between the data and our tested model. As predicted, anger (and not sadness) was positively related to aggressive CWBs (abuse against others and production deviance) and fully mediated the relationship between perceived distributive injustice and these CWBs. Against predictions, however, neither sadness nor anger was significantly related to employee withdrawal.

Implications

Our findings provide organizations with an insight into the emotional consequences of unfair HR policies, and the potential implications for CWBs. Such knowledge may help employers to develop training and counseling interventions that support the effective management of emotions at work. Our findings are particularly salient for national and multinational organizations in Pakistan.

Originality/Value

This is one of the first studies to provide empirical support for the relationships between in/justice, discrete emotions and CWBs in a non-Western (Pakistani) context. Our study also provides new evidence for the differential effects of outward/inward emotions on aggressive/passive CWBs.     

Role Definition as a Moderator of the Relationship Between Safety Climate and Organizational Citizenship Behavior Among Hospital Nurses

Purpose

This field study investigated the moderating influence of role definitions on the association between safety climate and employees’ organizational citizenship behavior (OCB).

Design/Methodology

Data were obtained from 94 hospital nurse dyads. Focal nurses and their peers completed paper surveys. All predictor measures were self-reported; whereas the OCB ratings were provided by nurses’ peers.

Findings

Nurses’ perceptions of job requirements regarding OCB (i.e., OCB-specific role definitions) moderated the relationship between psychological safety climate and peer-rated OCB. The correlation between psychological safety climate and OCB was significant when nurses’ role definitions were narrow but non-existent when role definitions were broad.

Implications

This study links managerial commitment to safety to nurses’ pro-social behavior and identifies an important boundary condition.

Originality-Value

The link between safety climate and safety compliance has been firmly established. We investigated a less well-researched association between safety and OCB and proposed a theoretical foundation for this positive association.     

Systemic Family Therapy Competences in Child and Adolescent Mental Health Care

This article is based on a doctoral research project aiming to identify a comprehensive and detailed outline of the systemic therapist competences in child and adolescent mental health care in Norway. Because of the growing demands to offer specialized services within child and adolescent mental health care, I intended the identified competences to target the psychosocial difficulties that are categorized as associated abnormal psychosocial situations (axis 5) in the multiaxial diagnostic system (WHO, Multiaxial classification of child and adolescent psychiatric disorders. The ICD-10 classification of mental and behavioural disorders in children and adolescents. Cambridge University Press, Cambridge, 1996). The project is based on twelve qualitative in-depth interviews with six experienced systemic family therapists, and fieldwork observations of the therapists (participants) in practice. The qualitative methodology is based on Grounded Theory and five overarching categories were identified through the analysis: (1): the importance of ethical and contextual awareness in systemic therapy; (2) the systemic therapist’s stance; (3) therapeutic processes; (4) therapeutic practices; and (5) session-specific features. Challenges, such as limiting the systemic approach to five overarching competences, are discussed alongside this strengths and limitations of the study. The detailed outline of systemic therapist competences is intended to offer a framework for delivering flexible, yet specialized systemic therapy in the context of child and adolescent mental health care. This research may therefore facilitate a “bridge-building process” between mental health’s biomedical focus and postmodern systemic ideas.     

Generational Differences in Work-Related Attitudes: A Meta-analysis

Purpose

Differences among generations on a wide variety of outcomes are of increasing interest to organizations, practitioners, and researchers alike. The goal of this study was to quantitatively assess the research on generational differences in work-related attitudes and to provide guidance for future research and practice.

Design/Methodology/Approach

We conducted a meta-analysis of generational differences on three work-related criteria: job satisfaction, organizational commitment, and intent to turnover. Our review of published and unpublished research found 20 studies allowing for 18 generational pairwise comparisons across four generations (Traditionals, Baby Boomers, Generation Xers, and Millennials) on these outcomes using 19,961 total subjects.

Findings

Corrected mean differences for job satisfaction ranged from .02 to .25, for organizational commitment they ranged from ?.22 to .46, and for intent to turnover the range was ?.62 to .05. The pattern of results indicates that the relationships between generational membership and work-related outcomes are moderate to small, essentially zero in many cases.

Implications

The findings suggest that meaningful differences among generations probably do not exist on the work-related variables we examined and that the differences that appear to exist are likely attributable to factors other than generational membership. Given these results, targeted organizational interventions addressing generational differences may not be effective.

Originality/Value

This is the first known quantitative review of research on generational differences in the workplace.     

„Rocken statt Ritzen“

Background

Non-suicidal self-injury (NSSI) starts in adolescence and decreases during young adulthood. Despite a high prevalence among adolescents only a few therapeutic interventions directly addressing adolescents exist.

Aim

By connecting music therapy with elements from behavioral therapy an attempt was made to create a therapeutic program which is attractive to adolescents.

Material and methods

A pilot trial of the program “Stop cutting - rock!” was conducted with 12 adolescent females with a mean age of 15.15 years (standard deviation SD ±1.34). The study aimed to compare the frequency of NSSI throughout the treatment phase as well as a pre-post comparison of depression scores.

Results

The results showed a trend towards a decreasing frequency of NSSI. Depression scores decreased significantly between the assessment before therapy and at a 3-month follow-up after the end of the therapy.

Conclusion

The positive feedback concerning music therapeutic elements points to the attractiveness of the approach. By integrating multimodal therapeutic strategies it seems possible to create an individually tailored intervention for adolescents with NSSI.