Hausaufgaben in der Psychotherapie

Homework assignments represent a standard intervention in psychotherapy. Homework provides the unique opportunity to emphasize patients’ responsibility for therapeutic change and to intensify the therapeutic process. Despite these high potentials systematic homework assignment is still rare in practice. Psychotherapy research has just recently focused its attention on homework as an effective therapeutic method. Meanwhile the positive effects of homework use on therapeutic outcome have been demonstrated but little is known about therapeutic strategies to enhance these effects. The present article highlights the functions of homework within the therapeutic process and discusses its theoretical mechanisms of action. The article concludes with suggestions from both an empirical and practical point of view to further assist practitioners’ use of homework assignments.     

Körperbeschwerden bei niedergelassenen Psychologischen Psychotherapeuten

From June until August 2004 we asked 488 freely practising psychological psychotherapists in selected German federal states for the frequency of somatic complaints using the short version of the Gießener Beschwerdebogen (GBB-)24. It turned out that the psychotherapists suffered most from exhaustion and pain. Their somatic complaints were remarkably less influenced by sociodemographic characteristics like age, gender and location of practising (East/West). In comparison to the overall population the psychotherapists in total reported quantitatively the same frequencies of somatic complaints. Qualitatively the psychotherapists reported less problems concerning gastric and heart complaints but more problems concerning exhaustion than the overall population. Compared with a sample of saxonian general practitioners, the psychotherapists suffered from slightly less somatic complaints.     

Innerdeutsche Migration und psychisches Befinden

In a representative study German migrants within Germany were assigned to two different groups depending on their answers to the following two questions (?Where did you mainly grow up – Eastern Germany or Western Germany?“ and ?Where do you live now?“). The migrants (54 West-East and 68 East-West migrants) were compared with non-migrants (1,136 Western and 294 Eastern Germans) concerning different variables of their psychic condition. Migrants suffered from higher stress, less bodily well-being and more somatic symptoms than non-migrants. Probands migrating from Western to Eastern Germany reported the lowest levels of quality of life.     

Dissoziative Störungen (Konversionsstörungen)

The ICD-10 diagnostic category of dissociative disorders encompasses very different clinical pictures. The so called dissociative disorders of consciousness are characterized by functional disturbances to the psychic domains of consciousness, identity, autobiographic memory and experience of self and the world. The core features of conversion disorders are functional alterations in the sensorimotor systems. The phenomenological heterogeneity is reflected by prevalence rates ranging from very rare to 30% in clinical populations. Traumatic experiences play a crucial role in the etiology and pathogenesis of these disorders. High rates of comorbid disorders, a tendency to a chronic course and a somatic illness concept in patients with conversion disorders complicate the psychotherapeutic approach. Depending on the therapeutic goals, both psychodynamic and cognitive-behavioral treatment forms are suitable.     

Onlineberatung für Betroffene von Essstörungen und deren Angehörige

An independent online consulting service for persons with eating disorders and their relatives (www.ab-server.de) exists in Germany since 1998, which was developed by physicians and psychologists. This study aims to comprehend the individual use of the online consulting for affected persons and their relatives. In order to do this, two online questionnaires were developed for these two groups. The questionnaires were sent digitally in two phases to those people who had posted an e-mail to the online consulting service from January 1999 to November 2003 and from January 2004 to July 2006 (phase 1: n=2,760; phase 2: n=1,419). A total of 493 data sets of affected persons and 127 of relatives were included in the analysis. The online consulting service is of great importance especially to establish the user’s first contact with professional help. The main reported effects were an improved understanding of the disease and the motivation to seek further professional help. This specific setting of internet-based intervention fulfils the function of a signpost within the German supply system.     

A Level of Care Instrument for Children's Systems of Care: Construction, Reliability and Validity

The Child and Adolescent Level of Care System/Child and Adolescent Service Intensity Instrument (CALOCUS/ CASII) is designed to help determine the intensity of services needed for a child served in a mental health system of care. The instrument contains eight dimensions that are rated following a comprehensive clinical evaluation. The dimensions are risk of harm, functionality, co-morbidity (psychiatric, substance abuse, development disability and medical), environmental stressors, environmental supports, the child's resiliency, and the child and family's willingness to engage in treatment. An algorithm connects the ratings to a level of care recommendation. The instrument specifies six levels of care defined flexibly enough to consider whatever services are available. The results of psychometric testing using raters with a broad range of clinical experience and training from four different systems of care around the country are presented. The testing demonstrates excellent reliability when rating vignettes. Using children and adolescents in live system of care clinical settings, the CALOCUS/CASII demonstrates reasonable validity when compared with the Child Global Assessment Scale, and the Child and Adolescent Functional Assessment Scale.     

Psychologische Mess- und Testverfahren

The use of psychological assessment methods is flawed by incorrect assumptions of their capacity. Some of these assumptions are discussed. It is argued that psychological tests are necessary to expand the database for expert reports about the impact of mental disorders on work and different levels of functioning. Tests help to protect psychological assessments against errors and chance bias. With respect to levels of functioning, examples of German tests and questionnaires are given. Test-based information requires objective validation methods and should not be subordinated to an intuitive assessment strategy.     

Die Sachverständigenexpertise im Spannungsfeld zwischen Justiz und Psychiatrie am Beispiel des Hangbegriffes des § 66 StGB (Sicherungsverwahrung)

Using the example of psychiatric expert opinions in trials leading to preventive detention, we analysed how far the corresponding orders by the courts were suited to guide the psychiatric experts and restrict them to their area of expertise. Furthermore we concentrated on the question, what reasons were given for preventive detention on both psychiatric and judicial side and how psychiatric arguments were adopted by the judges. Our results show clearly, that placing an order with the psychiatric expert as well as adopting the psychiatric arguments for preventive detention occur mainly in a stereotypic way. Psychiatric and judicial arguments for preventive detention refer both to previous delinquency. Aspects concerning the offenders personality appear to be secondary, although they play a major role in the decision for preventive detention. The article shows the controversy associated with forensic-psychiatric expertise in the courtroom and the need for communication and clarification between psychiatry and law.     

Measuring well-being: A comparison of subjective well-being and PERMA

We compared Seligman’s PERMA model of well-being with Diener’s model of subjective well-being (SWB) to determine if the newer PERMA captured a type of well-being unique from the older SWB. Participants were 517 adults who completed self-report measures of SWB, PERMA, and VIA character strengths. Results from four analytic techniques suggest the factor underlying PERMA is capturing the same type of well-being as SWB. Confirmatory factor analysis yielded a latent correlation of r = 0.98 between SWB and PERMA. Exploratory structural equation modeling found two highly related factors (r = 0.85) that did not map onto PERMA and SWB. SWB and PERMA factors showed similar relationships with 24 character strengths (average correlation difference = 0.02). Latent profile analyses yielded subgroups of people who merely scored high, low, or mid-range on well-being indicators. Our findings suggest that while lower-order indicators SWB and PERMA have unique features, they converge onto a single well-being factor.