Checkliste zur Bewertung der wissenschaftlichen Qualität kontrollierter psychotherapeutischer Interventionsstudien (CPI)

Ohne Zusammenfassung     

Leitlinie für die Begutachtung von Schmerzen

The present guidelines for expert testimony have been elaborated for the first time in 2004 by medico-legal representatives from several German professional academic societies (neurology, orthopedic surgery, psychiatry, psychosomatic medicine, psychotherapy). Their aim is to standardize the course and the content of expert testimony in subjects, who complain about chronic pain as the leading symptom for seeking pension or other compensation. In 2006, the guidelines have been revised and completed by adding detailed data about classification and prognosis of chronic pain, about causality questions, and about estimation of functional impairment in different legal areas.     

Fibromyalgie und Leistungseinschränkung

Interdisciplinary guidelines allowed for new quality standards in pain appraisal. Simultaneously, the scientific notion of fibromyalgia changed from a subjectively overvalued malaise to a central disturbance of coping with stress, which is neurobiologically determined. Therefore, in this article a psychosomatics-based guide is given for the socio-medical appraisal of fibromyalgia with reference to the new International Classification for Functioning and Disability (ICF) of the World Health Organization (WHO). As illustration a case study is presented.     

The role of therapist support on effectiveness of an internet-based modular self-help intervention for adjustment disorder: a randomized controlled trial

Background: Adjustment disorder is among the most often diagnosed mental health disorders. Still, there is a lack of specific interventions available for adjustment disorder.

Objectives: The aim of this study was to test if an internet-based self-help intervention for adjustment disorder could be effective without therapist involvement.

Design: A parallel group randomized controlled trial design was used to test the effectiveness of the Brief Adjustment Disorder Intervention (BADI) – an internet-based intervention for adjustment disorder.

Methods: In total 1077 participants were randomized into two conditions: BADI intervention and BADI intervention with therapist support. The main outcome measures were symptoms of adjustment disorder and well-being.

Results: Pre-intervention to post-intervention adjustment disorder effect size for the BADI intervention group was d?=?0.64, and for the BADI with therapist support group the effect size was d?=?0.53.

Conclusions: The present study supported the effectiveness of the BADI intervention. Our findings also indicated that adding therapist support to the standard BADI intervention did not significantly improve the outcomes.     

Manualisierte psycho- dynamisch-interaktionelle Gruppentherapie

20–40% of the patients in general practices, as well as in different departments in hospitals, suffer from somatoform diseases. 70% of these patients have pain as their main complaint. The present treatment manual is the first disease-specific, psychodynamically oriented group-treatment for these patients. Compared to other psychodynamic treatment settings this therapy is a short and cost-effective approach to treat these patients. It is based on a so-called psychodynamic-interactional group psychotherapy and focuses on disease-specific parts of the problem, as well as on psychic and interpersonal problems resulting from adverse childhood experiences. Over a period of six months 7 to 9 patients are treated in 40 group therapy sessions. Two weekly meetings are held during the first four months and one weekly session is held during the last two months. The concept contains psycho-educational elements, the discussion and formulation of individual treatment goals as well as work with a psychodynamic and relationship- oriented treatment focus. The efficacy of this concept is planned to be evaluated in a randomised, controlled clinical trial, including two treatment conditions and one control condition. One of the two treatment conditions is, beneath the concept already discussed, a cognitive behavioural group therapy.     

Now and Then

I describe my development as a psychoanalyst from my dream of psychoanalysis as a revolutionary movement battling against ignorance and fixed beliefs to finding in Freud's theoretical framework a reliable, scientific base from which I could pursue my own thinking. I trace the evolution of my thinking through my experiences on the training and at my first post-training job in an antenatal department. I give an account of the culmination of my analytic development in my work at Brent Adolescent Centre where my husband, Moe Laufer, and I developed our theory of developmental breakdown in adolescence. Here we pioneered work and research with adolescents in analysis and at the walk-in center.