{"title":"Behavioural Experiments in Cognitive Therapy for Posttraumatic Stress Disorder: Why, When, and How?","authors":"Hannah Murray, Sharif El-Leithy","doi":"10.1159/000511921","DOIUrl":"https://doi.org/10.1159/000511921","url":null,"abstract":"<p><p>Behavioural experiments are an integral component of cognitive therapy (CT) for posttraumatic stress disorder (PTSD), but they can be overlooked due to practical constraints and therapist concerns. Here we describe why behavioural experiments are an important part of CT, where they fit into different elements of treatment for PTSD, how to design and implement effective experiments including coping with unexpected outcomes, and how to incorporate behavioural experiments when therapy is delivered remotely. Clinical case examples are used to illustrate a range of idiosyncratic and creative behavioural experiments.</p>","PeriodicalId":49386,"journal":{"name":"Verhaltenstherapie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000511921","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39264530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Front & Back Matter","authors":"","doi":"10.1159/000515800","DOIUrl":"https://doi.org/10.1159/000515800","url":null,"abstract":"","PeriodicalId":49386,"journal":{"name":"Verhaltenstherapie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86473463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mitteilungen der Verbände / Information by Behavior Therapy Associations","authors":"S. Hofmann, M. Hengartner, Daniela Mier","doi":"10.1159/000514017","DOIUrl":"https://doi.org/10.1159/000514017","url":null,"abstract":"Die Deutsche Gesellschaft für Verhaltenstherapie DGVT e. V. lädt vom 4.–6. März 2021 zum 31. Kongress für Klinische Psychologie, Psychotherapie und Beratung zum Thema „BRAVE NEW PSYCHO THERAPY“ ein. Coronabedingt findet der Kongress online statt, was seiner Vielfalt an Veranstaltungsformen jedoch nicht abträglich ist. In zahlreichen Work-shops, Symposien und Diskussionsrunden können sich die Teilnehmer*innen aktiv beteiligen und sich von Diskussionen inspirieren lassen. Der DGVT-Kongress wartet auch 2021 mit einigen Highlights auf Sie. Wir eröffnen den Onlinekongress mit einem Beitrag von Stefan G. Hofmann zum Thema „Process-based therapy“. Weitere Hauptvorträge werden gehalten von: Hanna Christiansen „Kinder von Eltern mit psychischen Erkrankungen“, Michael Hengartner „Kritische Auseinandersetzung mit der neurobiogenetischen Depressionsforschung“, Daniela Mier „Funktionelle Bildgebung sozialer Wahrnehmung bei Schizophrenie – Neue Impulse für die Psychotherapie“, Andreas Zick „Rechtsextremismus und gruppenbezogene Menschen-feindlichkeit“. Ausführliche und aktuelle Informationen zum 31. Kongress für Klinische Psychologie, Psychotherapie und Beratung finden Sie auf unserer Homepage unter: www. dgvt-kongress.de","PeriodicalId":49386,"journal":{"name":"Verhaltenstherapie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84552194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
VerhaltenstherapiePub Date : 2021-03-01DOI: 10.1159/isbn.978-3-318-06921-1
U. Stangier
{"title":"Verhaltensexperimente","authors":"U. Stangier","doi":"10.1159/isbn.978-3-318-06921-1","DOIUrl":"https://doi.org/10.1159/isbn.978-3-318-06921-1","url":null,"abstract":"Verhaltensexperimente sind eine der wirkungsvollsten Interventionsmethoden in der kognitiven Therapie. Zentrales Prinzip ist die Kombination von Erfahrungs- und Einsichtslernen: Es geht darum, Überzeugungen in realen Situationen zu überprüfen, um anschließend die erwarteten und beobachteten Auswirkungen in der Therapie zu reflektieren. Der Band liefert einen Leitfaden zur Planung und Durchführung von Verhaltensexperimenten und schließt damit eine Lücke im deutschsprachigen Raum.\u0000Der Band schildert das praktische Vorgehen in der Therapie und gibt Anregungen, wie Verhaltensexperimente in den Behandlungsprozess eingebettet werden können. Von besonderer Bedeutung ist die Vorbereitung von Verhaltensexperimenten. Sie dient nicht nur der Motivierung, sondern soll auch helfen, möglichen Verzerrungen durch ungünstige Verarbeitungsweisen und Sicherheitsverhalten vorzubeugen, um eine möglichst unverfälschte Sichtweise der Erfahrung zu ermöglichen. Das Buch stellt Verhaltensexperimente anhand exemplarischer Fallvignetten für eine Vielzahl von Störungen und Problembereichen vor, unter anderem für Grübeln, Angst vor Ablehnung, negatives Selbstwertgefühl, Hoffnungslosigkeit, Angst vor Peinlichkeit, Kontrollverlusterleben, Fehlinterpretation von Körpersymptomen, exzessives Kontrollstreben, negative Zukunftserwartungen, Wiedererleben bei Traumatisierung, eingebildete Hässlichkeit, paranoides Denken und maladaptive positive Affekte.","PeriodicalId":49386,"journal":{"name":"Verhaltenstherapie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81706740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Standardized Patients in Clinical Psychology: From Research to Practice","authors":"F. Kühne, Ulrike Maass, Florian Weck","doi":"10.1159/000510049","DOIUrl":"https://doi.org/10.1159/000510049","url":null,"abstract":"Background: Within the pending reform of the German law of psychotherapy training, education in clinical psychology and the examination of psychotherapeutic competencies are established as more practice oriented. Students will acquire and demonstrate therapeutic skills through interactions with standardized patients (SPs). The aim of the current paper is to enhance evidence-based implementation of these new methods of education and examination by presenting the current evidence regarding the use of SPs and by pointing out areas for further research. Results: Results of recent studies demonstrate that SPs are able to present mental disorders authentically. Prerequisites are, among others, the selection of suitable SPs, detailed role scripts, specific training, feedback, and corrective training. Although some research questions, including the comparative effectiveness of SPs, remain unanswered, practice implications for using SPs in education, examination, and research can be drawn. These implications are illustrated schematically. Conclusions: The use of SPs has large potential for education in clinical psychology and for research on psychotherapy training. With a view to encouraging the widespread use of SPs, we provide exemplary materials (e.g., role script) within the online supplements (for all online suppl. material, see www.karger.com/doi/10.1159/000510049).","PeriodicalId":49386,"journal":{"name":"Verhaltenstherapie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85632121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Wilhelm, W. Rief, A. Haberkamp, P. von Blanckenburg, J. Glombiewski
{"title":"Master’s Graduates as State-Licensed Psychotherapists, Both a Challenge and an Opportunity: Practical University Teaching Concepts in Clinical Psychology","authors":"M. Wilhelm, W. Rief, A. Haberkamp, P. von Blanckenburg, J. Glombiewski","doi":"10.1159/000508273","DOIUrl":"https://doi.org/10.1159/000508273","url":null,"abstract":"Psychotherapeutic training in Germany is about to be changed soon: master’s graduates in clinical psychology will be able to become state-licensed psychotherapists. It is therefore mandatory to teach basic psychotherapeutic skills at the universities. This article presents examples of application-oriented courses in clinical psychology, which have been tried and tested at the Philipps University of Marburg for years. During the practical exercises “Interventions in practice 1 and 2“, students gain initial experiences with psychotherapeutic techniques on personally relevant problems. In the case seminar, the students apply their acquired skills to treat an actual outpatient case, while translating basic psychological knowledge into an individualized treatment plan. The seminar “Different approaches to psychotherapy in practice“ offers the opportunity to explore 6 different patients coming from a variety of treatment settings. The courses are evaluated regularly. An overview of cumulated evaluations shows a high degree of student satisfaction with the course concepts. The described courses meet several requirements of the new licensing regulations, especially regarding job-qualifying and self-reflection. Necessary adjustments and additional requirements are discussed, and possible solutions are presented accordingly. If the licensing regulations are implemented as demanded, receiving a state license after the master’s degree seems justified.","PeriodicalId":49386,"journal":{"name":"Verhaltenstherapie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80196537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"30 Jahre Zeitschrift Verhaltenstherapie: Die Verhaltenstherapie als Motor der Professionalisierung der Psychotherapie","authors":"W. Rief, S. Hofmann","doi":"10.1159/000514718","DOIUrl":"https://doi.org/10.1159/000514718","url":null,"abstract":"","PeriodicalId":49386,"journal":{"name":"Verhaltenstherapie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91241277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
U. Voderholzer, Ina Beintner, Bernhard Backes, Elisa Esguerra, Johannes Baltasar Hessler-Kaufmann
{"title":"Implementing Videoconference CBT for Depression in Routine Outpatient Care: Outcome, Working Alliance, and Influence of Patients’ Technology Commitment","authors":"U. Voderholzer, Ina Beintner, Bernhard Backes, Elisa Esguerra, Johannes Baltasar Hessler-Kaufmann","doi":"10.1159/000513643","DOIUrl":"https://doi.org/10.1159/000513643","url":null,"abstract":"Background: While videoconference cognitive behavioral therapy (V-CBT) has shown promising results in controlled studies, data from routine care are rare. We examined (1) changes in depressive symptoms and life satisfaction during V-CBT in German routine outpatient care for patients with depressive disorders, (2) the quality of the established working alliance, and (3) the influence of working alliance and the patients’ technology commitment on outcomes. Patients and Methods: Patients with primary diagnoses of depressive disorders were treated with V-CBT and concurrent internet-guided self-help via the MindDoc program, which operates within the regulations of the German health care system. The patients completed the 9-item Patient Health Questionnaire (PHQ-9) for depressive symptoms, an item on life satisfaction before and after treatment, the Working Alliance Inventory (WAI), and the Technology Commitment questionnaire for beliefs about handling technology. Results: Fifty-nine patients (71.2% female) with a mean age of 44.46 years (SD = 12.86) were included in the analyses. Longitudinal multilevel mixed models revealed improvements in depressive symptoms (Cohen’s d = 1.27) and life satisfaction (d = 0.80). The working alliance was good and showed a positive association with outcome, while technology commitment did not. Conclusion: V-CBT seems effective in reducing depressive symptoms, increasing life satisfaction, and establishing a good working alliance in routine care.","PeriodicalId":49386,"journal":{"name":"Verhaltenstherapie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81665860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Geeignete Messzeitpunkte in der Psychotherapieevaluation: Ein Vorschlag","authors":"E. Geissner, Petra Maria Ivert, M. Schmitt","doi":"10.1159/000513949","DOIUrl":"https://doi.org/10.1159/000513949","url":null,"abstract":"Untersucht man Therapieverläufe nicht nur zwischen unmittelbarem Beginn und Beendigung, können Fortschritte bereits zwischen Anmeldung und Beginn, noch ohne Intervention, aufgezeigt werden. Diese t<sub>0</sub>-t<sub>1</sub>-Veränderungen werden anhand eigener Befunde diskutiert: Ist der Vergleich Beginn (t<sub>1</sub>) – Ende der Therapie (t<sub>2</sub>) bzw. Katamnese (t<sub>3</sub>) sinnvoll, oder erfordert die angemessene Erfolgsbeurteilung nicht gerade Anmeldezeitpunkt t<sub>0</sub>? Wir plädieren für t<sub>0</sub>. (1) Anmeldung (t<sub>0</sub>) impliziert eine ausgeprägte, realistische Symptomschilderung, (2) positive Erwartungen zur erfolgreichen Behandlung verbessern Messwerte zu t<sub>1</sub> (Aufnahme), (3) Aufnahmezeitpunkt t<sub>1</sub> ist durch Sicherheitssignale der Klinik/der Behandler beeinflusst, Patientenratings – z.B. bei Angst – sind geringer (Kontextfaktoren), (4) Regression zur Mitte relativiert die Aussagekraft eines Einzelmesszeitpunkts: Hohe Messwerte dort fallen zu einem zweiten Zeitpunkt geringer aus. Um dies zu kontrollieren, müssen zu t<sub>0</sub> (in geringem Abstand) 2 Messungen durchgeführt werden, nämlich t<sub>01</sub> und t<sub>02</sub>. In der Praxis dient das Intervall t<sub>02</sub>–t<sub>2</sub> zur geeigneten Erfolgsbeurteilung, aber auch t<sub>02</sub>–t<sub>3</sub> sollte, wenn möglich, Auswertungsroutine sein. Einzelfallbeurteilungen erfordern die Berücksichtigung kritischer Differenzen, um messfehlerbereinigte Unterschiede zu sichern (Beispielerläuterung). Die Möglichkeit erweiterter Auswertung mittels Ausschluß nichtpathologischer Werte, der vereinfachten Auswertung mittels Cutoff-Bestimmung und einige Praxishinweise komplettieren die Arbeit. Unspezifische t<sub>0</sub>–t<sub>1</sub>-Veränderungen bedeuten keine Relativierung der Ergebnisse aktiver Intervention (t<sub>1</sub>–t<sub>2</sub>), sind vielmehr Bestandteil der Gesamttherapie.","PeriodicalId":49386,"journal":{"name":"Verhaltenstherapie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73646503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prediction of Therapeutic Outcome in a Naturalistic Setting Using Pretreatment Psychological Distress Indicators","authors":"Kaline Mütze, M. Witthöft, Anne-Kathrin Bräscher","doi":"10.1159/000510272","DOIUrl":"https://doi.org/10.1159/000510272","url":null,"abstract":"Background: Outcome predictions allow to improve psychotherapy and to increase economic benefit. The efficient translation into practice requires simple prediction methods. The present study evaluates the prediction of treatment outcome based on initial distress level. Methods: Routine data of a university psychotherapy outpatient clinic were used (N = 3,145, Mage = 35.8, 67% female). Low versus high distress patients (classified by overall psychological distress, symptomatology, and previous treatment) were compared on total reduction in psychopathology, (early) response, remission, and premature treatment discontinuation using t tests and logistic regressions. Response and remission were assessed via relative (percentage improvement) and absolute measures (Reliable Change Index; RCI). Results: Distress level was inversely related to percentage improvement (OR = 0.62) and remission (OR = 0.34). It was positively related to total reduction in psychopathology (d = 0.63), RCI response (OR = 2.37), and treatment discontinuation (OR = 2.15). Early response and treatment discontinuation partially mediated the relationship between distress level and treatment outcome. Conclusions: Treatment success tends to be lower when initial distress is high, but this finding appears contingent on the operationalization of treatment outcome. The presented classification approach is easy to implement in practice and may be useful in order to counter an excessive workload in psychotherapy trainees.","PeriodicalId":49386,"journal":{"name":"Verhaltenstherapie","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80233958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}