Verelendung psychotherapeutischer Rahmenbedingungen

Relationships of dependence in psychotherapeutic training, its high training costs and the taboo against discussing money and power, result in therapists being unable to adequately deal with their counter-transference with the particularly rich and powerful and vice versa with poor patients. In this article characteristic types of counter-transference and its associated entanglements are discussed. Psychotherapy does not take place beyond social developments nor is it able to compensate for their consequences especially in poor, badly educated and disintegrated patients. The author states that psychotherapy cannot be a substitute for a failed social, family, migration or educational policy.     

Neurobiologische Grundlagen psychotherapeutischer Verfahren

In the last few years the investigation of the neurobiological basis of psychotherapeutic treatments has gained importance. Therapy-associated functional changes have been studied in a number of different psychiatric diseases. It has been shown that diseases with a central role of emotions (e.g. depression, anxiety disorders, borderline personality disorder) often demonstrate dysfunctions in brain areas that are linked to emotional regulation. Psychotherapeutic interventions can lead to a kind of normalization of brain responses in these areas (e.g. amygdala, ventromedial prefrontal cortex, anterior cingulate cortex, orbitofrontal cortex). In addition, therapy-associated transformations were also demonstrated in areas which are related to attention processes and visual perception. Other studies have aimed at finding neurobiological parameters that can be used to predict a therapeutic outcome or to choose between various therapeutic strategies. For instance, in depression, the amygdala and the anterior cingulate cortex are assumed to play a major role. Altogether, knowledge on the neurobiological basis of psychotherapeutic procedures is limited. A comparatively small number of studies and several methodological problems (e.g. small sample sizes, insufficient control groups, variability of methods used) make it difficult to propose reliable statements.     

Entwicklungstendenzen psychotherapeutischer Praxis und Forschung

This review presents an analysis of articles in the journal “Psychotherapeut” during the years 2000 and 2001 with the focus on new efforts in the field of psychotherapeutic practice and research. The main topics of the journal are the presentation of new therapeutic approaches, some of them integrating different theoretical orientations, and the emphasis on the therapeutic relationship as a specific contribution to the process and the results of psychotherapy. In addition, this article presents a survey of the various subjects in psychotherapeutic research including a) the application and testing of new questionnaires to measure the effectiveness and the process of psychotherapy and b) research in the epidemiology of selected forms of stress, their consequences and lasting effects.     

Existenz psychotherapeutischer Praxen nach wie vor bedroht

Ohne Zusammenfassung     

Die Bindungstheorie als Basis psychotherapeutischer Interventionen in der Terminalphase

Recent attachment research has shown that every person develops, already in early childhood, special attachment strategies activated in cases whenever the person cannot cope on his own with dangers. These strategies are classified into four categories: “secure”, “insecure-avoidant”, “insecure-ambivalent/enmasked” and “disoriented/disorganized” attachment patterns. The death of a next person represents a situation of a unique and final separation causing psychical disturbances for the patient himself and his relatives. It is, therefore, an especially effective trigger for the activation of the attachment system. This article aims on relating attachment theory to an attachment-oriented therapy, that would open, particularly in the field of palliative medicine, possibilities of application which have been neglected. Case studies illustrate how these insights may be applied during the psychotheraputic care for patients and their relatives. As dying patients generally are brought by their family to the clinic, physicians have a particularly favourable situation to observe the attachment patterns in the family and integrate these informations into their treatment strategy: for example in case of “avoidant” attachment patterns, to bring cautiously the denied emotions into the communication and to support hopes for the fulfilment of needs for affection and protection; or in case of so-called “ambivalent/entangled” attachment patterns to help to disentangle too close relationships; or in case of “disorganized” attachment patterns to support emotional regulation and help to clear the relationships. It is obvious that this approach based on attachment theory and offering alleviations during the process of dying, is not only on a palliative board relevant, but may be applied with success in the medical care of dying patients and their relatives.     

Kontextanalytische Supervision in der psychoanalytischen Ausbildung

Clinical practice with supervision is that area of psychoanalytic education, in which psychotherapeutic competence is learned, developed and imparted. From the results of the current research about education and supervision, the tasks and aims of supervision are derived. Based on that a context-analytical concept of supervision is evolved. In context-analytical supervision a researching attitude is adopted by which the interactional evaluation of the patient/supervisee is captured and understood for to follow this in psychotherapeutic/supervisory acting and intervening. Finally the potential of context-analysis as a method of qualitative research is pointed out.     

Supervision in der psychotherapeutischen Ausbildung in Deutschland

One of the functions of supervision in psychotherapy training is quality assurance. In order to fulfill this function the quality of supervision itself needs to be high and needs to be controlled. Thus in a large survey of psychotherapy training in Germany questions related to the quality of supervision were included in the survey. Answers to those questions from different samples (trainees, alumni, trainers, training institutes, expert organizations) were compiled. Quantitative and qualitative methods were used. Satisfaction and usefulness ratings with individual and group supervision were high to very high. Supervision amount, group size and frequency were rated as adequate. Criticism pertained to the lack of systematic evaluation, insufficient qualification of the supervisors and lacking integration of supervision into the whole training. As supervision is a very important part of psychotherapy training measures for quality assurance and improvement are necessary.     

Zur Anerkennung psychotherapeutischer Verfahren als Verfahren im Rahmen der Krankenversorgung durch die gesetzlichen Krankenkassen

Ohne Zusammenfassung     

Die Ausbildung der mathematischen Zeichensprache und ihr Einfluss auf die Entwicklung der mathematischen Problemstellung

Ohne ZusammenfassungStark gekürzte Fassung.