Indikation zur strukturbezogenen Psychotherapie

The distinction of conflict processing and structure promoting psychotherapeutic approaches in the psychodynamic field is now common knowledge and has now been incorporated into the guideline comments. The differentiation of treatment presupposes theoretical knowledge of the dynamics of conflict and structure and corresponding thorough initial diagnostics. Based on these foundations an appropriate focus of therapy can be agreed with the patient and the therapy target can be set. This focussed working towards a joint target is especially important for psychodynamic psychotherapeutic treatment, which is of limited duration. The actively accompanying therapeutic process differs from older assumptions that positive developments on the foundation of a therapeutic relationship occur quasi automatically but possibly need a long time. Aspects of the treatment technique and the therapeutic attitude, estimation of the therapeutic development and typical age-related modifications in adolescents and older persons are discussed.     

Psychodynamische Gruppenpsychotherapie

Scientific evidence on the criteria for indications for (psychodynamic) group treatment is still rare, although relatively high drop-out rates are reported for this setting. The majority of the criteria to exclude or to include a person into groups are based upon clinical experience. Instruments to select patients for group treatment and materials to prepare patients for a group therapy are briefly described. An attempt is made to review findings on the differential indications for psychodynamic group treatment. These findings indicate that, besides person-related characteristics, the compatibility between a psychodynamic treatment model and the expectations of a potential group member seems to be an important indicative criterion. Finally it is concluded that information about group therapy in general and motivation for the special form of group therapy intended is crucial for a good outcome.     

Gruppenpsychotherapie

Group therapy treatments represent a most suited treatment option for a broad spectrum of psychological disturbances in the field of psychosomatic, psychiatric and somatic diseases. For some distortions and problems group therapy is the preferential treatment: personality disorders, substance abuses, eating disorders, psychiatric and chronic somatic diseases. The broad indicational options of the group setting are widely unknown, but they certainly need careful preparations and indicational decisions.     

Indikation zur ambulanten Nachsorge (Curriculum Hannover) in der Psychosomatischen Rehabilitation

Outpatient psychosomatic aftercare (Curriculum Hannover) was introduced nationwide in 2000 by the pension scheme. The effectiveness and efficacy of outpatient psychosomatic aftercare has been widely researched. This publication presents an indication-model based on four levels (capacity, participation, activity and impairment) whereas empirical results and clinical experience concerning participation in psychosomatic outpatient aftercare following an in-patient rehabilitation are considered in accordance with the international classification of functioning, disability and health.     

Behandlungsmotivation und Indikation von Psychotherapie

Concepts and results of research into treatment motivation under psychotherapy are discussed with regard to the question whether decisions for indications on the basis of the motivational characteristics of patients are reasonable. Established concepts and broader theories of treatment motivation as well as diagnostic tools for the assessment are presented. Subsequently, empirical results for the effects of motivational factors on the maintenance and success of psychotherapy are briefly sketched. Approaches aimed at the enhancement of treatment motivation before and during psychotherapeutic processes are then illustrated. Finally, it is emphasized that, in turn, features of individual therapeutic processes may provide a basis for the indication of motivational enhancement interventions, thus supporting the notion of a dynamic nature of treatment motivation.     

Volkmar Tschuschke (Hrsg.) ?Praxis der Gruppenpsychotherapie

Ohne Zusammenfassung     

Indikation zu Psychoanalyse und analytischer Psychotherapie

Based on the diagnostic process in the initial interview, which is an intersubjective encounter, the various developmental steps for establishment of the indications for psychoanalysis are presented. Freud and his followers, who were initially oriented to the psychiatric diagnosis, were later oriented to the criteria of approachability, analysability and in particular on the aptitude for psychoanalysis. The criterion of aptitude was not only elaborated from the perspective of Ego psychology but was also relevant for all high frequency non-terminated psychoanalyses which followed the basic psychoanalytical principles of “afocality”. This has so far characterized the standard procedure of all psychoanalytic schools. Due to the experiences of psychoanalysts with early disturbed, structurally Ego-disturbed neuroses and personality disorders, the extent of lability of the mental structure and by turning to countertransference analysis, the person of the psychoanalyst become more important for the assessment of the indications. In Germany the integration of psychotherapy, which is financially supported by healthcare insurance, ultimately leads to differential indication assessments between high frequency psychoanalysis or analytical psychotherapy, modified psychoanalytical psychotherapy and less frequent psychodynamic procedures.