Suchttherapie bei abhängigen Ärzten

Background

International studies indicate an increased incidence of substance abuse disorders among physicians. This article investigates specific variables in the work field and describes existing treatment programs.

Patients and methods

In a cross-sectional study 107 physicians with and 468 without substance abuse disorders were compared. Two highly developed treatment programs in Germany and Canada are described.

Results

The high work-load associated with the medical work environment leads to reduced performance and social isolation. Treatment programs for addicted physicians work with the concept of ?help before restriction“. The abstinence rate of the 5-year Canadian program is over 90%.

Conclusions

As a form of prevention, medical students should be systematically informed about work-related stress in the medical profession. Structured treatment programs should be implemented nationwide. The expert team ?Risk of addiction in physicians“ of the German Addiction Foundation, whose members are authors of this article, may be a small step in this direction.     

Patientenziele in der Psychotherapie

Zusammenfassung  Im vorliegenden Artikel wird ein Überblick zum Stand der Forschung zu Patientenzielen in der Psychotherapie gegeben. Auf vier Aspekte wird dabei besonders eingegangen: (1) auf grundlagenwissenschaftliche Modelle und Befunde zu Lebenszielen, (2) auf allgemeine Lebensziele von Patienten und deren Zusammenhang zu ihrem psychopathologischen Zustand, (3) auf explizite Therapieziele und (4) auf zielbezogene therapeutische Interventionen. Durch diesen Überblick soll zum einen deutlich gemacht werden, wie grundlagenwissenschaftliche Forschung zu persönlichen Zielen klinische Forschung beeinflusst und bereichert hat. Zum anderen werden die therapeutischen Implikationen der Zielforschung herausgearbeitet.

Systemische Therapie bei Störungen des Erwachsenenalters

Background

Systemic therapy is a scientifically acknowledged form of psychotherapy in the US and many European countries, but not yet in Germany.

Method

All randomized (or parallelized) controlled trials (RCT) evaluating systemic couples/family/individual therapy with adult index patients published in English, German or Spanish up to the end of 2004 were identified via data base searches and cross-references in other meta-analyses and reviews. A meta-analysis of the identified RCT was performed.

Results

28 RCT (43 publications) evaluating systemic therapy with adult index patients suffering from clinical disorders (ICD-10) were identified. Systemic therapy is efficacious with regard to substance disorders, mental/social factors interacting with somatic disorders, schizophrenia, depression and eating disorders. The results are stable across follow-up periods of up to 5 years.

Conclusion

According to the criteria of the German Scientific Advisory Board Psychotherapy (Wissenschaftlicher Beirat Psychotherapie) there seems to be good evidence for the efficacy of systemic therapy in at least four fields of application of adult psychotherapy.     

Topografie der Jugenddelinquenz

The article shows that the registered juvenile delinquency has decreased in recent years. Serious violent crime partially exists, but this is only a small part of the overall juvenile delinquency. Forms of appearance of these violent crimes are outlined. With the help of a dark field study it is illustrated that there is a great variety of delinquency among young people. There are young people showing mostly law-abiding behavior, infrequent offenders and a group with a significant burden of crimes.     

Effects of a Brief Parenting Intervention In Shelters For Mothers And Their Children Experiencing Homelessness

This study was designed to examine the effectiveness of an evidence-based parenting program—Triple P Positive Parenting Program—in shelter settings for families experiencing homelessness. The intervention has not previously been evaluated in a shelter setting, where there is a critical need for evidence-based parenting programs. Using a within-group pre- and post-intervention with 3-month follow-up design, 39 mothers residing in a shelter with a child ages 2–6 years participated. Results of this preliminary study showed positive effects of Triple P Discussion Groups. There were significant improvements in mother-reported parenting practices and child behavior across time, but no change in child maltreatment risk as measured by the Brief Child Abuse Potential Inventory. Mothers rated satisfaction with the program high immediately after the group and again three weeks later. Results showed Triple P Discussion Groups are acceptable and have some positive effects for this vulnerable population in need of parenting support. We discuss implications of findings, limitations of the study (including a 33% attrition rate), and recommendations for further study.