Diagnostik in der Verhaltenstherapie

After an introduction, a short historical review of the development of behaviour therapy and the importance of categorical classification of mental disorders is given. We present different assessment approaches that are important in behaviour therapy. They comprise anamnesis, categorical classification, somatic differential diagnosis, psychometric methods, ratings scales, and diaries. As the core assessment strategy in cognitive behaviour therapy, functional behavioural analysis is introduced in detail, in which methods of horizontal analysis of behaviour (SORKC model proposed by Kanfer) and the vertical analysis of behaviour are explained. The importance of computer-based assessment and specific approaches of assessment within behaviour therapy for children and adolescents are presented. By way of conclusion, the prospects of possible new developments of assessment in behaviour therapy are outlined.     

Pathologisch autodestruktives Verhalten und Verhaltenstherapie

The literature on pathological self-destructive behaviour (apart from psychotic, substance-induced or brain disorders) and behaviour therapy is reviewed. An introduction on definition, classification, current typological approaches, occurrence, pathogenesis, and psychopathology is given. From a behavioural theoretic perspective, functional aspects of self-destructive behaviour are emphasised. Basic treatment problems are outlined. They particularly concern covert self-destructive behaviour (artificial disease, Munchhausen-syndrome) that is typically met in a medical hospital setting. Recommendations from the literature are resumed. Most of the relevant publications are psychoanalytically based. Case reports on self-destructive patients predominate even in behaviour therapy publications. These are briefly reviewed. So far, the most elaborate approach is considered to be M. Linehan's Dialectic-Behavioral-Therapy which has been developed for the treatment of borderline personality disorders. A considerable overlap between overtly self-destructive patients and borderline patients underlines the usefulness of this approach. Nonetheless, a further development of behavioural therapeutic methods with regard to different types of self-destructive behaviour is considered to be indicated.     

Indikationsstellung zur Verhaltenstherapie

Behavioral therapy is a recognized guideline-conform procedure based on the principles of learning theory. The principle is that behavior that has been learnt can also be forgotten again, which was applied very early on to the example of anxieties. Furthermore, cognition and emotions as well as attention-based procedures play an important role in the behavioral therapeutic treatment of mental illnesses. The advantages compared to other guideline procedures are the rapid and universal applicability, the contemporary relevance and the transparency of the application as well as the wide variety of methods. Additionally, the methods are very evident and can be selectively or differentially implemented for a multitude of mental illnesses. This article summarizes the most important illnesses from the perspective of the application of behavioral therapeutic methods. Aspects of differential indications are discussed in relation to specific illnesses and personality characteristics.     

Kognitive Verhaltenstherapie bei schizophrenen Psychosen

Cognitive behavioral therapy (CBT) can be regarded as an established intervention for the treatment of patients with schizophrenia. Based on randomized clinical trials and meta-analyses, which found evidence for the efficacy of CBT, almost all evidence-based treatment guidelines recommend CBT for routine treatment. This paper demonstrates that in psychoses CBT is a disorder-specific adaptation of general principles of CBT for the treatment of patients suffering from schizophrenia. The CBT procedure draws on cognitive models of symptoms for the identification of treatment targets and focuses on everyday problems of patients by implementing a self-management approach. Fostering motivation and the application of behavioral and cognitive treatment strategies characterize this approach. If the patients live in a family, other family members should be involved in order to improve crisis management and problem solving within the family. A major challenge for the future is to improve the availability of CBT under the German conditions of routine mental health care.     

Ambulante manualisierte Verhaltenstherapie bei Anorexia nervosa

Anorexia nervosa is a serious illness leading to high morbidity and mortality. Its treatment poses a particular challenge to psychotherapists offering outpatient treatment. Often therapists follow or work according to a treatment manual. Supervision in the treatment of anorexia nervosa patients intends to promote quality assurance as well as to foster therapists’ mental hygiene. It offers the opportunity to collect plenty of practical experiences. Some of these will be presented here to provide suggestions and support to therapists working with anorexia nervosa patients. Certain treatment modules of cognitive-behavioral therapy (CBT) such as motivation, eating behavior, case formulation and relapse prevention will be considered. Regarding the therapist-patient relationship ambivalent relation shaping and motivational interviewing will be targeted.     

Aktuelle Entwicklungen in der Psychotherapieausbildung und der Ausbildungsforschung

In the journal Psychotherapeut, issues of psychotherapy training have been repeatedly published during recent years, especially related to discussions about a reform of the current training system. This reform now seems to have been initiated. Besides a historical sketch of the training-related discourse of recent years and a proposal for defining core fields of competence of psychotherapists, this paper summarizes current trends in training research, which seem to be gaining importance within psychotherapy research.     

Psychosomatische und psychotherapeutische Probleme in der Frauenheilkunde und Geburtshilfe

Ohne Zusammenfassung     

Leugnen der Tat und Tatbearbeitung in der prognostischen Begutachtung

The perpetrator’s examination of his own criminal actions seems to be very important for the risk assessment by the German criminal justice and psychological and psychiatric experts. At the same time other risk factors like general dissociality, the structure of the future neighbourhood, the patterns of social bindings, and personal core competencies seem to be more important for the prevention of criminal recidivism. Anyway the analysis of one’s own criminal offence may enlighten the individual attitudes and behavioral problems and thus may become an important domain of cognitive restructuring. If a convict still denies his deed this not necessarily makes a parole impossible. Denial may indicate a general hostility against the law, but in other cases it is caused by overwhelming shame and indicates positive bindings to social norms.     

Heidegger und der Tod

Ohne Zusammenfassung