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Background
Quality control in psychotherapy is a pivotal goal in clinical practice and research and requires to define and measure good practice. The Behavior Therapy Competency Checklist (BTCC) allows (a) good clinical practice in behavior therapy to be defined, (b) measurement of the quality and (c) support for training of therapists.Methods
In this study 182 tape recordings of routine treatment sessions of 14 behavior therapists were evaluated by 4 independent observers using the BTCC.Results
The most frequent therapeutic interventions were homework assignments (71.4%) and modification of cognitions (41.6%). Macro-behavioral analysis (19.5%), or problem solving (19.5%) were rare interventions. The average BTCC quality score for all interventions was 3.4 on a scale from 1 (insufficient) to 7 (very good).Conclusions
The BTCC allows an analysis of problems of therapists and can help to improve therapist education, supervision or intervision. It is also possible to use the scale as self-rating after a single session in order to control one’s own treatment behavior. A patient version allows a contrast between therapist and patient perspectives on the treatment process. 相似文献4.
Dr. med. Dipl.-Psych. Karin Maria Kernhof Alexander Obbarius Johannes Kaufhold Wolfgang Merkle Ralph Grabhorn 《Psychotherapeut》2013,58(2):152-158
Background
Countertransference is seen as an instrument of research into a patient’s unconscious and is therapeutically useful in furthering psychodynamic work. For inpatient psychodynamic psychotherapy, where patients are treated by a team of psychotherapists, countertransference is much more complex and makes consideration and integration of different countertransference feelings necessary. Using the first German translation of the countertransference questionnaire (CTQ, Zittel Conclin and Westen, the countertransference questionnaire, 2005) an attempt was made to identify differences in countertransference phenomena in a team of psychotherapists and to show the impact countertransference has on therapy outcome.Materials and methods
A total of t multiprofessional teams of psychotherapists (15 physicians, 5 psychologists and 9 body and art therapy psychotherapists) took part in the study and completed the CTQ for 137 patients (100 female, 37 male) at the beginning and at the end of inpatient psychotherapy. In addition, the patients completed two questionnaires, the Symptom Check List Revised 90-R (SCL-90) for the severity of symptoms and the Assessment of DSM-IV Personality Disorders Questionnaire (ADP-IV) for personality disorders.Results
Body and art therapy psychotherapists expressed more positive, protective and involved countertransference feelings whereas psychotherapists for single and group therapy expressed more aggressive and hopeless feelings. Countertransference has an impact on therapy outcome and feelings of a lack of interest, aggression and resignation at the beginning of therapy can point to a poor outcome. Patients with personality disorders activate more negative countertransference reactions than patients without personality disorders but at the same time they may also evoke parent-like feelings of protection.Conclusions
Using the CTQ it is possible to differentiate countertransference phenomena in a team of psychotherapists treating inpatients with psychodynamic psychotherapy. The timely perception and integration of countertransference feelings has a positive influence on the therapeutic process and therapy outcome. 相似文献5.
Dr. Elena Partschefeld Dipl.-Psych. Bernhard Strauß Michael Geyer Swetlana Philipp 《Psychotherapeut》2013,58(5):438-445
Background
The development of therapeutic skills is an essential therapist-related variable that deserves special attention in the context of the currently increasingly discussed topic of therapeutic failures and discontinuation of therapy.Aim
The study investigated whether the use of simulated patients (SP) in the training of psychotherapists can lead to an increase in therapeutic skills.Material and methods
The use of SP (16 teaching units) was tested in a pre-post comparison with 29 training participants for child and adolescent therapy and analyzed from three perspectives: from the perspective of the SP, the training of participants and rater.Results
The work with SP in psychotherapy training leads to a significant increase in therapeutic skills; however, it requires further research to see if this teaching method is more effective than other approaches to teaching, whether it contributes to long-term changes in therapeutic skills and to what extent the results can be transferred to other therapeutic contexts (except exploration). 相似文献6.
Dipl.-Psych. Sophie Kaczmarek Kai Passmann Ruben Cappel Veronika Hillebrand Andrea Schleu Bernhard Strau? 《Psychotherapeut》2012,57(5):402-409
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. 相似文献7.
Background
The high prevalence of cancer and the considerable psychological comorbidity is a challenge for psychotherapists. There are, however, relatively few patients in outpatient psychotherapy. Aim of the study was to survey outpatient psychotherapists concerning this issue and their attitudes towards the treatment of cancer patients.Methods
All outpatient psychotherapists of an East-German city were surveyed using semi-structured interviews.Methods
There are various reasons for the relatively rare visits of cancer patients in psychotherapeutic practices: For instance the subjective lack of specific competence, the fear of many psychotherapists to treat physically ill people, insufficient fitting of the relatively inflexible organization structure of psychotherapeutic settings with the vicissitudes of life among physically ill people, e.g. long waiting periods until the begin of treatment, furthermore the psychotherapeutic training focuses on psychosomatic and not so much on somatopsychic perspectives. A further problem is the widespread attitude about psychic causation of cancer, which is contradictory to scientific evidence.Conclusions
Psychotherapists who want to treat cancer patients need specific and in-depth training in psychooncology. 相似文献8.
Susanne Prüß Sven Speerforck Johannes Bahlmann Harald J. Freyberger Georg Schomerus 《Psychotherapeut》2014,59(4):275-282
Background
In the last decades much has been found out about the stigmatization of persons with mental illnesses. Recently, a potential stigmatization of psychologists, psychiatrists and psychotherapy has been debated.Aim
The question should be answered whether there is any scientific evidence for stigmatization of psychologists, psychiatrists and psychotherapy by using the conceptualization of stigma as brought forward by Link and Phelan (Ann Rev Sociol 2001; 27:363–385).Material and methods
For the systematic literature search in 2013 a databank search was carried out in Web of Science using the search terms stigma or discrimination or stereotypes or prejudice AND psychiatrist or psychotherapist or psychotherapy or mental health professional. A total of 2013 publications were identified which were systematically arranged according to the title and abstract with respect to the relevance for the question whether psychotherapy or associated professional groups are stigmatized. Only four of the articles were considered to be relevant. After advice from experts six further relevant articles could be found which did not appear in the databank search.Results
The review found evidence for both positive and negative stereotypes but not for other components of the stigmatization process.Conclusion
At present there is no evidence for a stigma related to psychotherapy or to the professions of psychotherapists and psychiatrists. 相似文献9.
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. 相似文献10.
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. 相似文献11.
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. 相似文献12.
Dr. Astrid Sonntag Heide Glaesmer Sven Barnow Elmar Brähler Jörg M. Fegert Steffen Fliegel Harald J. Freyberger Lutz Goldbeck Steffi Kohl Judith Lebiger-Vogel Marianne Leuzinger-Bohleber Felicitas Michels-Lucht Nina Spröber Ulrike Willutzki Bernhard Strauß 《Psychotherapeut》2009,54(6):427-436
Background
A survey was performed to assess the current situation in education and to identify critical issues 10 years after the inception of the German law regulating the education of psychological psychotherapists and child and adolescent psychotherapists. The study reports the results of a nationwide survey of German psychological psychotherapists and child and adolescent psychotherapists currently in training. The aim of the survey was to evaluate the individual sections of training, desired alterations and structural and financial conditions.Methods
All trainees were contacted via the training institutes and the umbrella organizations. A total of 3,223 trainees participated and answered questions mainly using an online questionnaire.Results
Most respondents practiced their training part-time and in most cases the trainees thought that the training would last longer than initially expected. The practical training was rated most poorly, whereas practical education and individual supervision were rated as most useful. The survey revealed deficits concerning the evaluation of the quality of several components of the training.Conclusions
From the perspective of the trainees there is a necessity to modify the financial conditions of the training. This result has been considered in the recommendations of a research expertise on psychotherapy training and should stimulate further research. 相似文献13.
Background
Starting from Klaus Grawe’s draft of a general psychotherapy, the patient’s resources and resource-activating interventions have received increasing attention in empirical research.Objective
The effectiveness of standardized writing instructions for the activation of patients’ resources before participating in internet chat aftercare groups for psychosomatic patients was examined.Method
In a randomized controlled trial writing instruction for the activation of patients’ resources was given in 52 out of 102 internet chat aftercare sessions. The effects of this minimal intervention on the patients’ activity and the number of positive emotion words expressed during the chat session were examined. Additionally, the effects on patients’ self-esteem, attachment, orientation, control and well-being after the group sessions were assessed.Results
Patients reported higher levels of self-esteem, orientation, control and well-being after chat sessions with a resource-activating intervention. No differences between intervention and control groups were detected on the text-based variables activity and number of positive emotion words.Conclusions
Standardized minimal interventions for the activation of patients’ resources seem to be promising for enhancing the effectiveness of therapeutic Internet chat groups. 相似文献14.
Background
Well-being and its correlates have rarely been investigated in psychotherapists. Results from research on other occupational groups have shown that subjective and work-related well-being are both associated with performance and motivation as well as with mental and physical health. Therefore, personal and job-related resources of practicing psychotherapists were investigated in this study in order to assess their associations with well-being.Method
A total of 771 psychotherapists filled in an online questionnaire including questions concerning well-being (WHO-Five Well-being Index, WBI-5), burnout (Maslach Burnout Inventory, MBI), and personal (Psychological Capital Questionnaire, PCQ) as well as job-related (Dutch Questionnaire on Work Experience, VBBA) resources.Outcomes
Of the participants 45?% reported that they were suffering from high emotional exhaustion. Over 30?% reported a reduced subjective well-being, while more extensive professional experience was associated with better well-being. Psychotherapists reported optimism and hope to be the most important personal resources, whereas opportunities for personal and professional development were the most important job-related resources.Conclusions
The study identified personal and job-related resources which may be relevant for different aspects of well-being in psychotherapists. 相似文献15.
Gidi Rubinstein 《Journal of Contemporary Psychotherapy》1997,27(2):105-118
The integration of different theoretical schools in the practice of psychotherapy is a widespread phenomenon, and eclectic therapists make a large part of the subject pool in studies regarding therapeutic approaches. This eclectic trend has its own ideology, and empirical evidence for its efficacy is being investigated. Taking this into account, it seems desirable to study the professional tolerance of therapists toward approaches different from their own. This professional tolerance is investigated in the present study of Israeli psychotherapists holding different theoretical approaches. The vast majority of the subjects chose the psychoanalytic-psychodynamic approach as their preferred theoretical orientation. The therapists' own orientations influenced their selection of the mode of therapy from which they felt most distant (DTM). Thus, most of the psychodynamic therapists chose aversive conditioning and most of the behavioral-cognitive therapists chose classical psychoanalysis (i.e., on the couch) as their DTMs. The readiness of the opponents of classical psychoanalysis to cooperate with an orthodox analyst was significantly higher than the readiness of the opponents of aversive conditioning to cooperate with a therapist identified with this mode of therapy. It is suggested that DTM selection is determined by its extremeness and the orientation of the therapist. The DTM selected determines in turn the therapists' tolerance. 相似文献
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Diego Romaioli 《Psychological studies》2012,57(2):195-202
The aim of this work is to provide therapists with a conceptual outline to help them utilize theoretical and methodological perspectives from different psychotherapy models. More specifically, we will start with three basic assumptions from the social constructionist paradigm, particularly effective in bringing together different perspectives in therapy and providing therapists with useful criteria for selecting among them. The assumptions are as follows: (1) the psychological world of the individual is constructed within relational processes, mainly through dialogue; (2) in general, discourse can be classified as either generative or degenerative; and (3) individuals construct their life narratives based also on a common-sense that can derive from psychological theories developed within specific cultural traditions. These assumptions derive mainly from Gergen??s relational perspective (2009) and lead us to foresee a set of implications for clinical practice, where therapist and client are seen as ??multi-beings??, consequently endowed with multiple views, not one. 相似文献
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Background
Despite changes in the regulations concerning outpatient psychotherapy in Germany, relatively few patients with substance use disorders receive this type of treatment.Objectives
The results of a recent study among stimulant users are taken as an example to illustrate the psychotherapeutic needs of patients with substance use disorders.Materials and methods
A total of 392 individuals with active use of amphetamine and/or methamphetamine were included using a broad range of recruitment strategies. In a mixed methods approach, qualitative as well as quantitative data were gathered regarding the history of substance use, the motives for use, and traumatic experiences during childhood.Results
Psychological distress was a frequent motive even at the initiation of stimulant use. About two thirds of the participants (65.1?%) reported at least one form of childhood trauma (sexual, physical or emotional abuse, emotional or physical neglect).Conclusion
The findings suggest a high need for psychotherapy among patients with substance use disorders. It seems important to further improve the information as well as the training of psychotherapists to work with these clients. 相似文献18.
Dr. Heide Glaesmer Astrid Sonntag Sven Barnow Elmar Brähler Jörg M. Fegert Steffen Fliegel Harald J. Freyberger Lutz Goldbeck Steffi Kohl Judith Lebiger-Vogel Marianne Leuzinger-Bohleber Felicitas Michels-Lucht Ulrike Willutzki Nina Spröber Bernhard Strauß 《Psychotherapeut》2009,54(6):437-444
Background
A survey was performed to assess the current situation in education and to identify critical issues 10 years after the inception of the psychotherapy act in Germany.Methods
In August 2008 all non-medical psychotherapists who had graduated since 2002 according the psychotherapy act were invited to take part in the survey and a total of 863 persons participated. The answers from 666 could be evaluated corresponding to a participation rate of 20%.Results
A total of 57.6% of the graduates had completed a full-time training and approximately 50% of the graduates had completed the training within the allotted time. In the majority of cases evaluation occurred only for the theoretical courses. During the practical work (PT I) 36.8% of the graduates did not receive any salary or remuneration, 82% had their own field of activity and of these 38% treated patients without the presence of qualified tutor.Conclusions
The training often lasts longer than intended, the financial situation in the PT I is exceptionally critical and in clear contrast to the field of activity in this section of training. Further detailed results will be presented and discussed. 相似文献19.
Background
Communication is part and parcel of every interaction. This raises the question of the role of modern media in mental health care. The aim of this explorative study was to investigate the use of modern media in the clinical practice.Material and methodology
In an Internet survey 234 psychotherapists from Nordrhein-Westfalen (NRW) were surveyed about the extent to which they integrate new media in the practice and their opinion about this integration. For this purpose a questionnaire was developed based on the questionnaire of Wangberg et al. (2007).Results
Most of the psychotherapists already use e-mails as well as mobile communication to contact their patients. The main reason for choosing this modern way of communication is the possibility to simplify the management of formal issues. Psychotherapists were indifferent about the idea of web-based counseling.Conclusion
Forms of digital media are used as an addition to conventional ways of therapeutic communication but face-to-face interaction cannot be replaced completely which is also indicated by the fact that professionals still highly value personal contact. 相似文献20.