Psychotherapeutenausbildung aus Sicht der Absolventen

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.     

Deuten aus der Perspektive der strukturalen Psychoanalyse Lacans

“Beware of understanding!” Lacan’s structural analysis: theory and practice of interpretation. This paper investigates the relationship of understanding and countertransference analysis in the process of analytical interpretation. Here self-image of the analyst is crucial concerning the direction of the analysis. As field and function of speech are pivotal, they will be briefly sketched to clarify the structural-analytic starting point of the following arguments. The basis of the ideas is a definition of the unconscious as what is not conscious available. Should the analyst see himself as the “knowing” one, as his patient also assumes, a false assurance will result and the analysis will lead nowhere. This is typical of a “forced” transference analysis in the here and now. The alternative is a strategy of hints, whose premise is, that we do not know. This assumption makes it unnecessary to rely on countertransference analysis. Instead, the spoken word and its contradictions are in the focus. This analytical attitude makes listening to the “subject of the unconscious” possible by means of the analyst and his hints.     

Die Psychotherapeutenausbildung aus Sicht der Teilnehmer

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.     

Erste Erfahrungen mit der operativen Fallanalyse aus der Sicht des Revisionsrichters

Criminal investigative case analysis is a method for identifying the perpetrator of a crime based on an analysis of the nature of the offence and the manner in which it was committed. Various aspects of the criminal’s personality makeup are determined from the choices before, during and after the crime. In German criminal procedural law it is a new investigative tool in preliminary proceedings to give the prosecutor extensive assistance to the police to profile unknown criminal subjects or offenders and to supply more evidence. The Federal High Court has decided that police officers who use this method are not expert witnesses whose evidence can be challenged in the main proceedings by the state attorney.     

Ambulante Psychotherapie in Deutschland aus Sicht der Patienten

This study analyzed the provision of outpatient psychotherapy services in Germany in typical practice settings. In a representative survey (from June 2008 to September 2009) 1,212 subjects who received outpatient psychotherapy during the past 6 years were questioned about their experiences with outpatient psychotherapy via telephone interviews. Socio-economic data, reasons for seeking treatment, access paths, financial resources and psychosocial support data were collected. Therapeutic settings and modalities and concomitant medication treatment are described. The findings illustrate the problem of multiple psychiatric morbidity in the clinical practice and confirm the urgent need for patient access to professional psychotherapeutic services. Improving access to these services requires close cooperation between care providers.     

Ambulante Psychotherapie in Deutschland aus Sicht der Patienten

This study analyzed the provision of outpatient psychotherapy services in Germany in standard practice settings. A total of 1,212 subjects who received or were still receiving outpatient psychotherapy during the past 6 years provided information about their experiences via a telephone survey. Outpatient psychotherapy was sought for many different conditions and was rated as highly effective. The improvement rates for all complaints were higher than 50%, except for obesity (37%) and sexual dysfunctions (44%). Patient ratings of worsening were less than 8% throughout. Treatment had very positive results not only for target symptoms but also for other aspects of patients?? lives. Almost 90% of those questioned stated that they were satisfied with their therapist. High agreement ratings were reported specifically with respect to positive therapeutic relationship, stable working alliance, experience of autonomy during therapy and therapists?? competency and ethical conduct. Patients gave their psychotherapists excellent evaluations and were highly satisfied with the changes achieved through treatment.     

Behandlungskrisen ambulanter Psychotherapien aus der Sicht einer Krisenstation

The purpose of the following study is to identify characteristics of the clinical treatment of patients who came into a crisis during an out-patient psychotherapy and were admitted to a crisis intervention ward. Most of the patients particularly reacted to a disruption of the treatment process as a result of conflicts in their relationship with their therapists. By means of a psychodynamic short diagnostics these conflicts were elucidated although they were often hidden and had to be traced back to their origins in the therapeutic relationship. Moreover, the authors describe their therapeutic focus on the conflict-solution-oriented short-term psychotherapy of the disruption of the therapeutic bond between patient and therapist which leads to a fixation of the setting. The in-patient crisis intervention aims at preparing the patients to continue the out-patient psychotherapy.     

Versorgungsforschung im psychosozialen Feld aus dem Blickwinkel der gesetzlichen Krankenversicherung

Since 2000 the statutory health insurance funds in collaboration with the Federal Ministry of Research have promoted health services research. In 2008 the statutory pension fund and the private health insurers joined this collaboration. This multidisciplinary program aims at the completion of the basic medical research and of the clinical research by research activities focusing on the actual health care under everyday conditions. This research that has been known in the USA since more than 50 years as ?health services research“ can be of growing importance for psychosocial care and psychotherapy if the systematic and early participation of decision makers, payers and providers can be further improved. From the perspective of the statutory health insurance, beside the quality of care also the effectiveness under everyday conditions, the efficiency and acceptance of treatment, of psychosocial support, and of complex care programs are top-ranking in the research agenda of health services research in the field of psychosocial care and psychotherapy.     

Zum Stand der forensischen und forensisch-psychiatrischen Nachsorge in der Bundesrepublik Deutschland (Daten aus der sog. Pfingstabfrage 2013)

In 2007 forensic aftercare was integrated into the German Penal Code as part of legal supervision. Since then a large and growing number of patients have been supervised by forensic psychiatric aftercare units throughout Germany. Due to the federal system in Germany the system of forensic aftercare has developed differently in the 16 federal states. The number of patients looked after varies widely and the implementation of several legal norms also differs from state to state. This article gives an overview of the situation of forensic aftercare in the different German federal states and presents some specific characteristics of the development.