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.     

Assessing and predicting supervisors' evaluations of psychotherapists – an empirical study

Objective: The aim of this study was to analyze the dimensions used by supervisors to evaluate trainee therapists and to detect how supervisors' assessments are influenced by features of the case and of the therapist.

Method: Data from 226 patients with diverse mental and social disorders who had been treated by 22 trainee therapists under the supervision of 12 supervisors were analyzed by factor- and regression analyses. Supervision was implemented as part of a psychotherapy training program. After treatment, each supervisor was asked to evaluate the trainee by using a list of 38 items proposed by Kanfer, Reinecker and Schmelzer (1996 Kanfer, FH, Reinecker, H and Schmelzer, D. 1996. Selbstmanagement-Therapie, Berlin: Springer.  [Google Scholar]). Case characteristics and therapists' features were assessed by questionnaires and checklists and related to the supervisors' evaluations.

Results: The statistical analyses indicated that supervisors could not easily integrate the multitude of relevant aspects into a differentiated schema of evaluation. A two-factor model best fitted the data. The two factors focus on specific aspects of therapeutic behavior. The evaluations were mainly related to the experience of the trainee therapist and to therapy outcome. For trainee therapists with more experience, the standards of comparison were set higher resulting in less positive evaluations.

Discussion: The results are discussed with reference to a process-oriented view of supervision and therapist evaluation. It was concluded that supervisors of behavior therapy seem to weight therapist-related and case-related information differently. However, the way supervisors integrate these types of information into evaluations of trainee therapists still remains rather vague.     

Literatur in Examensarbeiten

After the Second World War up to the 1980s Harald Schultz-Hencke’s so-called German neopsychoanalysis was an important theoretical reference for psychoanalysts in the German Psychoanalytical Society (DPG). Simultaneously, however, references were increasingly being made to quintessential psychoanalytical sources which of course had an impact on the psychoanalytical training. The references in final papers of a DPG psychoanalytical institute from 1971–2008 were compared to the references in clinical papers of the International Journal of Psychoanalysis. It can be shown that the influence of German neopsychoanalysis in the final theses of the psychoanalytical institute in question has diminished since the 1990s and has become irrelevant in the twenty-first century.     

Suche nach der Ursache des chronischen Ersch?pfungssyndroms

The etiology of chronic fatigue syndrome is subject to a longstanding controversy between scientists, healthcare providers, patients and self-help groups. The reasons for this, sometime heated, dispute are most likely not only due to the diversity and complexity of scientific facts alone but can also be seen as the consequences of the desired legitimation or dreaded delegitimation of the syndrome by the respective etiological model. The mechanisms of these processes will be described one the basis of the current discussion regarding the role of xenotropic murine leukemia virus-related virus in chronic fatigue syndrome.     

Seelische Gesundheitsvorsorge f��r Kinder krebskranker Eltern

Children of cancer patients are increasingly being paid attention to as target group for family-based mental health prevention concepts in psychosocial oncology. Based on the long-term experiences with the concept Children of Somatically Ill Parents (COSIP) for child-centred medical family counselling, which was developed at the counselling service COSIP at the Hamburg University Medical Centre, a specialized manual was developed for the context of psychosocial care in oncology, which is currently being tested in a multi-center approach. In this article the theoretical framework and the practical steps of this manualized concept in caring for families with a parent having cancer are summarized. Characteristic elements are the flexible handling of the three system levels parents, family and child in the counselling setting as well as focussing on previously defined intervention goals which are expected to strengthen the coping resources in the family and the children. Perspectives for clinical practice and research are discussed.     

„Die Umwelt macht mich krank“

Fears and physical complaints are frequently attributed to the environment. In the form of environmental illness or environmental syndromes they can often reach clinical relevance, even if no causal relationship between subjective stimuli and symptoms can even if be found. The role of psychotherapy is controversial, especially because patients fear for the legitimacy of their complaints and preferably seek somatic or alternative forms of treatment. In addition, there is limited evidence for the effectiveness of psychotherapy. In view of the high degree of suffering, especially as anticipatory anxiety, avoidance behavior, social retreat and distrust, and comorbidity with mental illness, psychotherapy can frequently enable patients to reach more self-efficacy, trust, a wider range of activities and thus a better quality of life.