Affektive Interaktion zwischen Patienten und Therapeuten

Zusammenfassung Eine positive therapeutische Beziehung wird therapieschulenübergreifend als wichtige Voraussetzung für den Therapieerfolg angesehen. Meist wird jedoch in Studien lediglich die schriftliche Patienteneinschätzung erfasst. Nonverbale Aspekte der Interaktion zwischen Patienten und Therapeuten werden kaum untersucht. Aus einer Studie zur Vorhersage des Erfolgs stationärer Fokaltherapie werden affektive Interaktionsprozesse im Erstinterview exemplarisch zwischen einer erfolgreichen und einer nicht erfolgreichen Behandlung mit mikroanalytischen Verfahren (facial action coding system, FACS) verglichen. In der nicht erfolgreichen Therapie waren die mimischen Affektäußerungen reziprok; Therapeutin und Patientin zeigten ähnliche vorherrschende (sog. Leit-)Affekte. Erfolgreicher waren die Behandlungen, wenn die Therapeuten komplementäre Affektmuster zeigten. Implikationen für Behandlungstechnik, Supervision und Weiterbildung werden diskutiert.     

Psychoanalytische Therapie

A statement of the professional umbrella society DGPT is presented that was formulated in cooperation with the various professional societies and with the German Society of Psychosomatic Medicine and Psychotherapy and the Society of Child and Adolescent Therapy. The statement is a reaction to the public claim for effective evidence of psychotherapy and takes the opportunity for a comprehensive presentation of this field. In the introduction Alf Gerlach, as chairman of the umbrella society at the time of the formulation of this statement and now executive chairman responsible for coordinating research, describes the history of the development of the statement.There were two particular moments prompting this statement. On the one hand the Scientific Advisory Board for Psychotherapy as an advisory committee based on the law of psychotherapy, has presented demands for effective evidence that are incompatible with psychoanalysis. Thus, the recognition of psychoanalysis as a treatment method for illnesses was put in doubt. On the other hand, a suggestion was put forward to the Board to recognize psychodynamic psychotherapy as an independent entity. This questioned the unity of the psychotherapeutic field.The statement was passed onto the Scientific Advisory Board last autumn. It is intended for a professional audience and includes answers to important issues of this field. It will have an important role to play in future discussions about professional politics. For this reason, we have decided to begin the present issue of our journal with this statement and thus to open a wide discussion forum.

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Deutsche Gesellschaft für Psychoanalyse, Psychotherapie, Psychosomatik und Tiefenpsychologie e.V. (DGPT)In Verbindung mit:Deutsche Gesellschaft für Analytische Psychologie (DGAP)Deutsche Gesellschaft für Individualpsychologie (DGIP)Deutsche Gesellschaft für Psychotherapeutische Medizin (DGPM)Deutsche Psychoanalytische Gesellschaft (DPG)Deutsche Psychoanalytische Vereinigung (DPV)Vereinigung Analytischer Kinder- und Jugendlichen-Psychotherapeuten (VAKJP)Redaktion: Stephan Hau und Marianne Leuzinger-Bohleber

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Die Geschichte der „Stellungnahme zur psychoanalytischen Therapie“

Ohne Zusammenfassung

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Beziehungsmuster und Beziehungskonflikte

Zusammenfassung  Die Veränderung pathogenetisch bedeutsamer Beziehungsmuster gilt als wesentliches psychotherapeutisches Behandlungsziel. Um zielgerichtete Veränderungen von Beziehungsstrukturen zu erreichen, bedarf es sowohl einer Diagnostik und Beschreibung solcher Beziehungsmuster, einer darauf zielenden Behandlungstechnik als auch einer Verlaufskontrolle und Evaluation der angestrebten Veränderungen. Nach einem Überblick über verschiedene Methoden zur Erfassung von Beziehungsmustern wird die Methode des Zentralen-Beziehungskonflikt-Themas (ZBKT) von Luborsky näher beschrieben; ausgewählte Ergebnisse der ZBKT-Forschung werden dargestellt und die Methode kritisch bewertet.

Introducing ethics and engineering: the case of Delft University of Technology

This article focuses mainly on (1) the policy of Delft University of Technology since 1992 as regards the university-wide introduction of a compulsory course on ethics and engineering, and (2) the ideal structure of such a course, including the educational goals of the course. Dr. G. J. Scheurwater is Senior policy-advisor to the Board of Delft University of Technology. Prof. S. J. Doorman is Chairman of the Advisory Committee on Ethics of Delft University of Technology.     

The ‘redefinition of death’ debate: Western concepts and western bioethics

Biomedicine is a global enterprise constructed upon the belief in the universality of scientific truths. However, despite huge scientific advances over recent decades it has not been able to formulate a specific and universal definition of death: In fact, in its attempt to redefine death, the concept of death appears to have become immersed in ever increasing vagueness and ambiguity. Even more worrisome is that bioethics, in the form of principlism, is also endeavouring to become a global enterprise by claiming neutrality. It appears that the discourse within both disciplines have similarly manipulated the boundaries of death to include the “dying”. This paper argues that the redefinition of death debate in biomedicine reveals a concept of personhood which is profoundly western in origin and which is in accordance to the concept adhered to within principlism. Biomedicine and bioethics do not appear to acknowledge the limitations of their own world view and hence lack an understanding of their applicability and appropriateness in diverse social and cultural contexts; a situation which adds credence to claims as to the hegemonic and imperialistic nature of all such global enterprises. Ms. Jones is an intensive care clinical nursing specialist. Dr. Kessel is a public health physician and medical ethicist.     

Fehldiagnose Aufmerksamkeitsdefizit- und Hyperaktivit?tssyndrom?

Although it is assumed both by healthcare professionals as well as by public opinion that attention deficit hyperactivity disorder (ADHD) is widely overdiagnosed, so far there is little empirical evidence to support this presumption. However, the presented study shows clear evidence for an overdiagnosis of ADHD. Furthermore, the data demonstrate that based on identical symptoms, boys more often receive a diagnosis for ADHD than girls. A false ADHD diagnosis also correlates with a recommendation for medical and psychotherapeutic treatment. One explanation for misdiagnosis is the fact that therapists in the course of diagnosis, as with other everyday decision-making processes, are influenced by heuristics. The most common heuristics that can lead to misdiagnosis are the representativeness heuristic and the availability heuristic. Such mistakes could be avoided by clearly following diagnostic criteria and the use of structural interviews.     

Linderung depressiver Symptomatik

Standard interventions, such as antidepressive medication or psychotherapy, show only medium effect sizes in the reduction of depressive symptomatology. In addition, medication has problematic and not well accepted side-effects therefore it seems reasonable to look for alternative, cost-effective, easily available treatments which show no side-effects. A large number of studies have demonstrated similar neurophysiological effects of sport as antidepressants or psychotherapies but the crucial question remains unanswered: does sport show antidepressive effects by alleviating depressive symptomatology? Some randomized, controlled studies and all available recent meta-analysis addressing this question are reviewed. This review concludes that randomized control trials including sport activities have similar positive effect sizes as psychotherapy or antidepressant studies. The pre-post effects are in the medium to high range. Such a conclusion is jeopardized by a limited number of methodolically sound studies. It is too early to make evidence-based recommendations about the antidepressive effect of sport. Currently, it can only be speculated about moderators and mechanisms mediating outcome.