Psychotherapie für Straftäter

The legal and administrative framework for psychotherapy of offenders in prisons and secure forensic hospitals is outlined. Established treatment programs for offenders are presented including different variations of standardized cognitive behavioral approaches, e. g. relapse prevention programs (RP), dialectic behavioral therapy (DBT), transference-focused psychotherapy (TFP), and mentalization-based treatment (MBT). The foci of the individual programs as well as their integrative tendencies are described. In psychodynamic therapies cognitive processes are taken into consideration and, vice versa, cognitive-behavioral therapists discover the significance of the therapeutic relationship.     

Die Bindungstheorie und ihre Relevanz für die Psychotherapie

Zusammenfassung W?hrend im ersten Teil der übersicht über die Relevanz der Bindungstheorie Grundlagen und Methoden der Bindungsforschung skizziert wurden, werden nun die m?glichen Implikationen der Theorie für die Psychotherapie und Psychosomatik er?rtert. überlegungen zur allgemeinen klinischen Relevanz und zum Verh?ltnis der Bindungstheorie zur Psychoanalyse bilden die Basis für die Darstellung konkreter Anwendungen von Ergebnissen der Bindungsforschung in der therapeutischen Praxis. Es folgen zusammenfassende Darstellungen von Untersuchungen, die sich mit der Bedeutung von Bindungscharakteristika für die Entwicklung psychosomatischer St?rungen und die Krankheits- bzw. Stre?verarbeitung befassen sowie von Studien, in denen Bindungscharakteristika psychischen St?rungen zugeordnet wurden. Schlie?lich wird die Bedeutung der Theorie für die Psychotherapie und die Psychotherapieforschung dargestellt.      

Die Bindungstheorie und ihre Relevanz für die Psychotherapie

Ten years ago, two reviews of clinical attachment research were published in this journal (Schmidt and Strauß 1996; Strauß and Schmidt 1997) dealing with the question whether this theory might be of relevance for psychotherapy. Since that time, numerous theoretical and empirical papers related to this issue have been published, thus, justifying an update. The prediction that attachment theory would gain importance within psychotherapy and psychosomatics has been clearly confirmed. Elements of attachment theory have been incorporated into non-specific and specific psychotherapeutic approaches. Recently, also including neurobiological evidence, clinical attachment research continues to deal with the question whether clinical diagnoses or constructs can be differentiated on the basis of attachment characteristics. Related to this question, problems in assessing attachment characteristics are still of relevance. Within psychotherapy research, attachment-related characteristics are primarily investigated in relation to a) their value to predict treatment outcome, b) their significance for the psychotherapeutic process and c) their change during treatment.     

Die Bindungstheorie und ihre Relevanz für die Psychotherapie

Zusammenfassung Die ursprünglich von John Bowlby entwickelte Bindungstheorie gewinnt zunehmend an Relevanz im Bereich der Psychotherapie(forschung). Diese übersicht beginnt mit einer Kl?rung der zentralen Begriffe und Annahmen dieser Theorie und fa?t einige Befunde zur Entwicklung und den Korrelaten von Bindung zusammen, die vornehmlich aus entwicklungspsychologischen Untersuchungen stammen. übertragen auf Erwachsene, bedürfen die Konzepte der Bindungstheorie einer Revision, die in dieser Arbeit skizziert wird. Schlie?lich werden auf dieser Basis einige heute übliche Methoden zur Erfassung von Bindungsstilen und Bindungsverhalten im Erwachsenenalter dargestellt, die bei Untersuchungen im klinischen Feld (Inhalt des 2. Teils der übersichtsarbeit) eine wichtige Rolle spielen.      

Dokumentation auf einer Station für psychosomatische Medizin und Psychotherapie

The documentation system for a psychosomatic-psychotherapeutic ward must integrate and process medical and psychotherapeutic treatment in a way that allows, over and above transparence and completeness, the constructive use of the collected information. But how to describe the increasingly complex picture of the patient during a stay on the ward, and how to utilize it effectively for his treatment? The search for satisfying answers has led the Department of Psychosomatics and Psychotherapy of the Clinic of the University of Münster to develop a new documentation system that will meet such demands. The system is innovative in visualizing and using the progression of the different therapeutic offers, in addition to introducing a “synopsis” of the dysfunctional relationship patterns and the individual psychodynamic background, which permits a swift overview of a patient’s treatment during his whole stay. This allows optimization of the multimodal treatment concept.     

Plädoyer für eine Direktausbildung zum Psychotherapeuten

The undisputed necessity of a reform of the Psychotherapist Act could open up the chance to reconsider the training of psychological psychotherapists and to completely renew the structure from the ground up. This article proposes that psychotherapy training should be designed based on the profession itself. Starting from the question of what a good psychotherapist needs to have learnt, a study curriculum is drafted which is structured towards this professional target from the very beginning. This direct training imparts psychotherapeutic competence based on a broad psychological, medical and social scientific education, encourages targeted social competences and enables clinical experience in advance. The training terminates after six years with a state examination and qualification for the profession of psychotherapist. Subsequently, qualified psychotherapists undertake a four-year in-house advanced professional education to an adult or pediatric and adolescent psychotherapist. After completing half of the study period, i.e. after three years, students decide on one of the scientifically recognized courses and subsequently the study course is partly procedure-related and mostly interprocedural. The study incorporates a practical year which accompanies the last four semesters as a half day practical training. Universities which want to offer this study course must be qualified to award doctorates and have a psychotherapy research walk-in clinic. They must also cooperate with recognized training partners who participate in the course of the study and professionally structure the four-year in-house advanced professional education.     

„Ist eine Allgemeine Psychotherapie notwendig, sinnvoll und machbar”?

Ohne Zusammenfassung     

Die Verantwortung der Psychoanalyse für die Psychotherapie

Whether psychoanalysis can take over the responsibility for psychotherapy when it is not operating as a part of psychoanalysis but on its own is a question which has currently become significant again. The present paper gives an affirmative answer, but under certain limiting conditions only. Psychoanalysis can take responsibility for psychotherapy. It can base this on the fact that the definition of “depth psychological psychotherapy” binds psychotherapy—as it is usually called—to psychoanalysis. How this is possible in practice is determined during the training. The training at the Michael-Balint-Institute in Hamburg is presented which partly occurs jointly and partly separately, in this way representing the reality of the two separate fields linked to each other and yet independent. The common ground is constituted by the basic principles of psychoanalysis. As an example of this common ground, the seminar on the technique of diagnosis and treatment, which is part of the early curriculum, is discussed in detail. Later on in the training, the two curricula separate more and more, each taking over its own responsibility. Not only questions of the contents but also formal aspects have to be considered. There are good reasons for establishing an independent Institute for Psychotherapy which runs the necessary arrangements together with the Institute for Psychoanalysis, from which it derives, and also remains close to the latter. Finally, it is pointed out that all of this is only possible when respecting each other’s work. Independent psychotherapy is not less valuable than psychoanalysis, but simply something else.     

Psychotherapie chronischer Erschöpfungszustände

Chronic fatigue is common. Since fatigue has little specificity, it can be the consequence of many different somatic diseases and psychiatric disorders. Therapy needs to be individually tailored with regard to the underlying or assumed causes. When objective and established causes cannot be identified or cannot adequately explain the symptoms experienced, the diagnosis of chronic fatigue syndrome (CFS) is possible. But what is CFS? Is it a valid diagnosis? How can the chronic fatigue patient be treated? Based on an integrative understanding, a psychobiological etiological and psychotherapeutical model of chronic fatigue will be developed and described.     

Qualitätsmanagement für Psychoanalytiker

The article discusses current problems with the quality of psychotherapeutical services. Based on professional quality-management models (ISO 9.000, EFQM) a concept of quality management and accreditation for psychoanalysts is proposed.     

Unerwünschte und schädliche Wirkungen von Psychotherapie

Unwanted effects or even damage due to psychotherapy are largely neglected issues within psychotherapy research as compared to other fields. On the other hand, it is reasonable to assume that unwanted effects of a treatment which intends to influence patients into a positive direction are very likely. The rate of negative effects of psychotherapy (the deterioration effect according to Bergin) is consistently estimated to be 10% of all cases and shows this same rate in a variety of studies. This review highlights side effects of psychotherapy both on the part of the patients and of the therapists. It reports unwanted effects related to different psychotherapeutic methods, i.e. psychoanalysis, cognitive behaviour therapy, client-centered psychotherapy and – beyond these basic orientations – group psychotherapy. The paper also reports on negative effects of psychotherapy on an untreated partner. Finally, some proposals are given on how negative effects of psychotherapy could be diminished. The authors especially highlight the possibilities of changing the therapist, the treatment technique, or the theoretical treatment approach as a way to reduce negative effects.     

Mindestanforderungen für Schuldfähigkeitsgutachten*

Ohne Zusammenfassung Wegen der besonderen Bedeutung für die Bemühungen um die Qualit?tssicherung in den forensischen Disziplinen wird der folgende Artikel, entstanden aus einer interdisziplin?ren Diskussion am BGH, hier nochmals den Fachkollegen zur Kenntnis gegeben. H. Sa? * bereits 2005 erschienen in NStZ 25:57–62     

Psychotherapie und soziale Unterstützung

Relations between social support as an informal helping system on one hand and psychological intervention on the other are outlined. Starting from an overview of approaches to define and conceptualize social support, common aspects of informal and professional help are derived. These are then illustrated by two intervention contexts which mark the transition between support and psychological intervention. Furthermore, effects of the individuals’ support network on utilization, maintenance, and outcome of psychotherapy are summarized. Finally, interventions to optimize the individual support situation are discussed.