Die Therapeutenvariable

Background

The objective of this study was to investigate the therapeutic attitude as a self-contained dimension of the therapeutic process.

Patients and methods

The psychotherapists’ beliefs and attitudes in therapeutic matters are measured according to the Therapeutic Attitude Scales (TASC) of the Therapeutic Attitude Questionnaire (ThAt) and were applied to investigate the therapist variable. The investigation concentrated on the therapist’s belief in the curative value of a number of ingredients of psychotherapy, on the therapist’s individual style of conducting psychotherapy and on basic assumptions about the nature of psychotherapy and the nature of the human mind. A total of 451 psychotherapists (81 psychodynamic psychotherapists, 208 psychoanalytic psychotherapists and 162 behaviour therapists) were investigated.

Results

There were highly significant differences between the three groups of therapists, a finding which is in line with the basic theory. Adaptation and insight of the assumed curative factors as well as supportiveness and neutrality of the technique factors, differentiate the groups highly significantly. The multivariate analysis underlines the importance of adaptation and insight to differentiate between all groups.

Conclusion

The results by and large confirm the general assumptions held on the differences between the groups. Thus the ThAt appears to be a valid instrument to grasp more subtle features of the therapist variable that may influence the outcome of psychotherapy.     

Psychoonkologie

Changes in the spectrum of illnesses have led to a predominance of chronic diseases, including oncological disorders, that are connected with substantial mental health problems. The needs of people with cancer are increasingly attracting the attention of psychosocial and psychosomatic disciplines as far as patient-oriented health care research and counselling practice are concerned. Psychosocial work in oncology appears to be becoming increasingly professionalized. Theories of the psychosocial origin of cancer are gradually losing ground in the scientific community, giving way to a rational attitude towards oncological diseases that counters the stigma of cancer. At the same time, the demand for psycho-oncological services is becoming more important if we take into account the high rate of psychiatric co-morbidity and the fact that these patients are poorly diagnosed and inadequately treated. This is all the more regrettable in that a broad range of evidence-based interventions are available which are gradually being implemented in the guidelines of rehabilitation facilities and oncological centres of excellence. The transfer of knowledge in the everyday care of cancer patients, however, has yet not been accomplished.     

Erfahrungsorientiertes Lernen in der Psychotherapie

Background

Based on principles of experiential learning, psychophysical exposure (PPE) on a tightrope course offers a promising intervention in the treatment of patients with mental disorders. A PPE program conducted on a hospital tightrope course is presented as an adjunct in inpatient psychotherapy.

Methods

The acceptance and effectiveness of the PPE were evaluated in a prospective controlled naturalistic study. A total of 155 patients, who were exposed at least once during their inpatient therapy, were compared with 92 control patients, who did not participate in the tightrope course. The main outcome criteria were self-reported depressive symptoms, state anxiety, locus of control, self-efficacy, and trait anxiety.

Results

The PPE was highly accepted by the participants. Patients who attended the tightrope courses showed greater improvement in the outcome criteria than patients who received inpatient treatment as usual. Particularly better effects were found on the personality variables.

Conclusions

Psychophysical exposure can successfully and effectively be integrated into a psychosomatic inpatient treatment program. Methodological limitations of the study, especially threats to internal validity, are discussed.     

Die „Seelenkulturrevolution“

In this paper the work of the author as a psychoanalytic training therapist and supervisor at a counselling centre in a Chinese metropolis will be described. In the first part her experiences with adults of the age cohort 25–35 years will be described, the second generation after the Cultural Revolution. Special attention is devoted to biographically relevant life stages such as childhood, education and marriage in a transient society between a system of traditional Confucian values and that of the new capitalism. The second part of the paper focuses on culture-specific characteristics of a collectivist society from a psychoanalytic perspective, such as setting limits, saving face, empathy, transference and sexuality.     

Kombination von Settings und Verfahren in der Psychotherapie

Literature research and own clinical experiences confirm the significance of a combined use of settings and methods in the area of inpatient and outpatient psychotherapy. For inpatient treatment, the combined use of methods, such as individual psychotherapy, group therapy, creative therapies, and sport, are an essential part of the treatment. In outpatient treatment, the regulations of the German insurance do not permit such combinations. Nevertheless, they occur and are often proactively initiated by the patients. The various combined use of psychotherapy and psychotropics is very well studied, but also the combination of settings, i.e. supplementary inpatient treatment, day treatment, and outpatient treatment have to be considered. While administering their therapies, psychotherapists should keep in mind possibly concurrently ongoing treatments as well as former therapies and their effects on the patients. With the exception of combinations with psychotropic treatment, there exist almost no empirical data in this important field.     

Extraversion and neuroticism: Investigation of resting electrodermal activity

In 1967 Eysenck published his biological account of extraversion and neuroticism. In the same year Claridge identified several problems with this theory. More recently Robinson has detailed a promising modification to Eysenck's theory which addresses many of the issues raised by Claridge. Drawing on Robinson's theory it was hypothesised that differences in resting electrodermal activity (EDA) would contrast extraverted‐neurotics (low arousal) and introverted‐neurotics (high arousal). The Eysenck Personality Questionnaire (EPQ) was used to identify four extreme groups of female participants: extraverted‐stable (n = 16), extraverted‐neurotic (n = 15), introverted‐stable (n = 8) and introverted‐neurotic (n = 16). EDA measures of skin conductance level (SCL) and non‐specific skin conductance response (NS‐SCR) were collected during two rest periods. Planned contrasts between the extraverted‐neurotic and introverted‐neurotic groups provided support for Robinson's theory on SCL but not NS‐SCR. It was argued that the results for NS‐SCR frequency could be accommodated by Robinson's theory if NS‐SCR was conceptualised as a measure of cortical reactivity to unspecified stimuli rather than as a measure of tonic arousal.     

When being a girl matters less: Accessibility of gender‐related self‐knowledge in single‐sex and coeducational classes and its impact on students' physics‐related self‐concept of ability

Background . Establishing or preserving single‐sex schooling has been widely discussed as a way of bringing more girls into the natural sciences. Aims . We test the assumption that the beneficial effects of single‐sex education on girls' self‐concept of ability in masculine subjects such as physics are due to the lower accessibility of gender‐related self‐knowledge in single‐sex classes. Sample . N = 401 eighth‐graders (mean age 14.0 years) from coeducational comprehensive schools. Methods . Random assignment of students to single‐sex vs. coeducational physics classes throughout the eighth grade. At the end of the year, students' physics‐related self‐concept of ability was measured using a questionnaire. In a subsample of N = 134 students, the accessibility of gender‐related self‐knowledge during physics classes was assessed by measuring latencies and endorsement of sex‐typed trait adjectives. Results . Girls from single‐sex physics classes reported a better physics‐related self‐concept of ability than girls from coeducational classes, while boys' self‐concept of ability did not vary according to class composition. For both boys and girls, gender‐related self‐knowledge was less accessible in single‐sex classes than in mixed‐sex classes. To the extent that girls' feminine self‐knowledge was relatively less accessible than their masculine self‐knowledge, their physics‐related self‐concept of ability improved at the end of the school year. Conclusions . By revealing the importance of the differential accessibility of gender‐related self‐knowledge in single‐ and mixed‐sex settings, our study clarifies why single‐sex schooling helps adolescents to gain a better self‐concept of ability in school subjects that are considered inappropriate for their own sex.