Familienfunktionalität und Therapieerfolg

Background

Even though it is a treatment standard of child psychotherapy to involve the parents, hardly any research has been carried out about the impact of family functioning on treatment outcome. Aims of the present study were to investigate the change in and the prognostic power of family functioning on treatment outcome of short-term psychodynamic psychotherapy in children and adolescents.

Patients and methods

The sample consisted of 54 children and adolescents undergoing outpatient short-term psychodynamic psychotherapy. To assess family functioning, their parents were asked to complete the Family Assessment Measure (FAM).

Results

Patients from families with high levels of functioning in task accomplishment, communication and affective expression were more often treated successfully. Improvement in levels of functioning in role performance, emotionality and control were only found in the group of successfully treated patients.

Conclusion

Family functioning is a decisive factor in the differential indication of psychotherapeutic treatment in children and adolescents.     

Lachen, um nicht zu weinen …

In this article the prevalent concepts on crying will first be described, especially concepts on occasions and various functions of crying. Subsequently, some very preliminary results of an ongoing study are presented including assumptions about the reasons why crying is mostly experienced as being difficult and aversive and is therefore often suppressed or controlled by laughter. Examples from diagnostic interviews will illustrate the interplay of laughter or smiling and crying. At the end a hypothesis on the basic function of crying and on the connection between crying and laughter will be presented.     

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.     

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.     

Internet als Ratgeber bei psychischen Problemen

Communication serves as an integral part of every psychotherapeutic treatment. Consequently, in the last decade modern information and communication technologies in the therapeutic context gained in importance. How important are Internet-based therapeutic information and intervention sources for potential patients and how are they appraised when already known or used? In the course of a representative study the health-related Internet use behavior of 2,411 Germans was examined. There was a focus on the usage of health-related websites and counseling services in the past and (potentially) in the future. More than one third (37.3%) of the German population and almost two thirds (63.5%) of German Internet users search for medical information on Internet. However, physicians, psychologists, pharmacists, family members and friends have a greater impact on health behavior than the Internet. Of German Internet users 54.1% are not informed about the possibilities of psychosocial online counseling. Nevertheless, they would maybe use the Internet in the future. The 2.2% who already used Internet in case of psychosocial problems are content with the service. In fact new media have not yet found their way into psychotherapy and counseling as much as in our daily lives. With regard to manifest mental disorders, Germans would prefer the conventional psychotherapeutic milieu to media-assisted kinds of treatment.     

„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.     

Sinnorientierte Interventionen in der Psychoonkologie

Patients with advanced cancer often suffer from existential distress. Although a variety of effective psychotherapeutic interventions for the treatment of psychological distress in cancer patients are available, concerns such as hope and meaning of life are only occasionally at the center of therapeutic attention. During recent years growing efforts have been made to develop and evaluate meaning-based interventions for cancer patients, particularly in the Anglo-American research literature. Meaning-based interventions are often realized as group therapy approaches to reduce emotional and spiritual distress and to promote hope, courage and control, to mobilize internal resources and to discuss future goals despite a noticeable limited life expectancy. Further aims include strengthening a patient??s self-esteem and sense of dignity, to appreciate strengths and past achievements, to reduce feelings of isolation, to strengthen the relationship with the partner and family members and to improve communication with the professional healthcare team.