Psychoanalytische Therapie

A statement of the professional umbrella society DGPT is presented that was formulated in cooperation with the various professional societies and with the German Society of Psychosomatic Medicine and Psychotherapy and the Society of Child and Adolescent Therapy. The statement is a reaction to the public claim for effective evidence of psychotherapy and takes the opportunity for a comprehensive presentation of this field. In the introduction Alf Gerlach, as chairman of the umbrella society at the time of the formulation of this statement and now executive chairman responsible for coordinating research, describes the history of the development of the statement.There were two particular moments prompting this statement. On the one hand the Scientific Advisory Board for Psychotherapy as an advisory committee based on the law of psychotherapy, has presented demands for effective evidence that are incompatible with psychoanalysis. Thus, the recognition of psychoanalysis as a treatment method for illnesses was put in doubt. On the other hand, a suggestion was put forward to the Board to recognize psychodynamic psychotherapy as an independent entity. This questioned the unity of the psychotherapeutic field.The statement was passed onto the Scientific Advisory Board last autumn. It is intended for a professional audience and includes answers to important issues of this field. It will have an important role to play in future discussions about professional politics. For this reason, we have decided to begin the present issue of our journal with this statement and thus to open a wide discussion forum.

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Deutsche Gesellschaft für Psychoanalyse, Psychotherapie, Psychosomatik und Tiefenpsychologie e.V. (DGPT)In Verbindung mit:Deutsche Gesellschaft für Analytische Psychologie (DGAP)Deutsche Gesellschaft für Individualpsychologie (DGIP)Deutsche Gesellschaft für Psychotherapeutische Medizin (DGPM)Deutsche Psychoanalytische Gesellschaft (DPG)Deutsche Psychoanalytische Vereinigung (DPV)Vereinigung Analytischer Kinder- und Jugendlichen-Psychotherapeuten (VAKJP)Redaktion: Stephan Hau und Marianne Leuzinger-Bohleber

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How Does Neurobiological Research Influence Psychoanalytic Treatments?—Clinical Observations and Reflections From a Study on the Interface of Clinical Psychoanalysis and Neuroscience

One of the counterarguments against empirical research in psychoanalysis is that research negatively influences the treatment situation. In this paper, the impact of a neurobiological study on psychoanalytically oriented treatments is presented from three different perspectives: patients' views, a study group of participating psychoanalysts and a clinical case example. Twenty chronically depressed patients, 20 healthy controls and 16 psychoanalysts participated in the project on research. Results show a clear influence of the neurobiological study on the course of treatments. Patients consistently reported that study participation had a positive impact on their treatment experiences. However, study participation was conflictual for the psychoanalysts and forced them to carefully reflect on their unconscious and conscious involvement to establish a psychoanalytic stance independent from empirical research.     

National Trends in Implementing Wraparound: Results of the State Wraparound Survey, 2013

The wraparound process aims to provide an effective practice-level approach to coordinating care for youths with complex behavioral health needs, and reformed system structures to support such integration of care. The current study provides an update to two prior surveys of state children’s mental health directors, completed in 1998 and 2007, on the extent of wraparound implementation in the United States and implementation supports that have been employed. Results from 2013 found that 100 % of states reported having some type of wraparound program that conformed to the definition and yielded an estimate of 75,000 children and families served via wraparound in that year. States reported a continued increase in use of wraparound standards; however, fewer states reported collection of fidelity data, and availability of internal resources for training and coaching. Over three-quarters of states reported availability of parent to parent peer support, and 46 % of states are supporting wraparound implementation by blending or braiding funding across child-serving systems. Results also revealed that 61 % of states had a centralized oversight entity for wraparound, an important finding given that such “statewideness” was also associated with more youth served, greater accountability, use of standards, and other implementation supports.     

Audiovisual influences on the perception of visual apparent motion: exploring the effect of a single sound

Previous research has shown that irrelevant sounds can facilitate the perception of visual apparent motion. Here the effectiveness of a single sound to facilitate motion perception was investigated in three experiments. Observers were presented with two discrete lights temporally separated by stimulus onset asynchronies from 0 to 350 ms. After each trial, observers classified their impression of the stimuli using a categorisation system. A short sound presented temporally (and spatially) midway between the lights facilitated the impression of motion relative to baseline (lights without sound), whereas a sound presented either before the first or after the second light or simultaneously with the lights did not affect motion impression. The facilitation effect also occurred with sound presented far from the visual display, as well as with continuous-sound that was started with the first light and terminated with the second light. No facilitation of visual motion perception occurred if the sound was part of a tone sequence that allowed for intramodal perceptual grouping of the auditory stimuli prior to the critical audiovisual stimuli. Taken together, the findings are consistent with a low-level audiovisual integration approach in which the perceptual system merges temporally proximate sound and light stimuli, thereby provoking the impression of a single multimodal moving object.     

Effectiveness of the Wraparound Process for Children with Emotional and Behavioral Disorders: A Meta-Analysis

Wraparound is a team-based service planning and coordination process intended to improve outcomes for children and youth with serious emotional and behavioral disorders and support them in their homes, schools, and communities. Given the substantial resources devoted to implementing wraparound, a meta-analysis of outcome studies was conducted to better understand current empirical support for this process. A literature search identified seven studies between 1986 and 2008 that documented the effects of youth receiving wraparound compared to control groups. Mean treatment effects across outcome domains ranged from medium for youth living situation (0.44) to small for mental health outcomes (0.31), overall youth functioning (0.25), school functioning (0.27), and juvenile justice-related outcomes (0.21). The overall mean effect size across studies was 0.33. Interpretation of results was complicated by the lack of consistent documentation of implementation fidelity across studies and conditions, variations in target population and intended outcomes, and methodological concerns. The authors conclude that, though the published wraparound research base is expanding and findings are largely positive, it continues to be in a preliminary state of development. However, there are insufficient data to support calls for wraparound’s acceptance or dismissal based on the strength of existing studies.     

Cross-modal training induces changes in spatial representations early in the auditory processing pathway

In the ventriloquism aftereffect, brief exposure to a consistent spatial disparity between auditory and visual stimuli leads to a subsequent shift in subjective sound localization toward the positions of the visual stimuli. Such rapid adaptive changes probably play an important role in maintaining the coherence of spatial representations across the various sensory systems. In the research reported here, we used event-related potentials (ERPs) to identify the stage in the auditory processing stream that is modulated by audiovisual discrepancy training. Both before and after exposure to synchronous audiovisual stimuli that had a constant spatial disparity of 15°, participants reported the perceived location of brief auditory stimuli that were presented from central and lateral locations. In conjunction with a sound localization shift in the direction of the visual stimuli (the behavioral ventriloquism aftereffect), auditory ERPs as early as 100 ms poststimulus (N100) were systematically modulated by the disparity training. These results suggest that cross-modal learning was mediated by a relatively early stage in the auditory cortical processing stream.     

Intervening in the Lives of Youth with Complex Behavioral Health Challenges and Their Families: The Role of the Wraparound Process

Wraparound is an individualized, team-based service planning and care coordination process intended to improve outcomes for youth with complex behavioral health challenges and their families. In recent years, several factors have led wraparound to become an increasingly visible component of service systems for youth, including its alignment with the youth and family movements, clear role within the systems of care and public health frameworks, and expansion of the research base. In this paper, we provide a review of the place of the wraparound process in behavioral health, including a discussion of the opportunities it presents to the field, needs for further development and research, and recommendations for federal actions that have the potential to improve the model’s positive contribution to child and family well-being.     

Nurturing behavioral repertoires within a nonsupportive environment

Recent articles have expressed concern over the increasing retreat to mentalism among behaviorists. The problem has been described elsewhere as a shift in verbal behavior resulting from the contingencies imposed by mentalistic verbal communities. Previous solutions have focused on strengthening our behavioral graduate programs to make the graduates' verbal repertoires more resistant to change. We suggest it is useful to analyze the problem in terms of inappropriate audience control and offer an approach by which behaviorists may assemble audiences to maintain their behavioral verbal repertoires within mentalistic verbal communities.