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Biomedical subjects

H Kächele

Publications and source records attributed to H Kächele.

15 recordsLinked to original sources

[Psychotherapy research and therapeutic management].

The history of psychotherapy research has been closely allied with the development of clinical practice, as this review demonstrates. Empirical psychotherapy research aims at the scientific evaluation of existing practice and at the discovery of new fields of application. The early phases of psychotherapy research were concerned with scientific justification and societal legitimation. These questions changed with the extension of possible indications, the growing differentiation of treatment procedures and the progressive implementation of psychotherapy within the health-care system. The early issue "does psychotherapy work at all?" has been replaced by the questions "to whom is psychotherapy helpful?" and "how does psychotherapy work?". As an established part of the health-care system, psychotherapy is now faced with the same urgent problems as other medical specialties: therapeutic goals and economic conditions have to be brought in balance. Thus the perspectives of psychotherapy research have to encompass the individual patient as well as the system of care. These demands create new questions which enlarge the approaches of traditional psychotherapy research; new structural and logistic methodologies are asked for. We conclude by referring to a multicenter study on the psychodynamic treatment of eating disorders that has been initiated by the Center for Psychotherapy Research in Stuttgart as a prototype form of the new look in psychotherapy research.

Anorexia Nervosa

[Phases in the rehabilitation of male and female bone marrow transplant patients].

Teamwork is essential when investigating the long-term adoption of such medical intervention that are highly demanding on patients, physicians and nursing staff. Bone marrow transplantation represent such an intervention for a series of well defined hematological diseases. The contribution demonstrates the multiple perspective approach of the Ulm team. A case report illustrates the multiplicity of clinical issues. The state of research allows the sketching of a process model on rehabilitation.

Adaptation, Psychological

Defense mechanisms in patients with bone marrow transplantation: a retrospective study.

The impact of defense processes on coping with threatening life diseases has been shown in many studies. Systematic studies focusing on defense mechanisms in these conditions are still rare, however. We report here on the results of a retrospective study on patients after bone marrow transplantation. Thirty four transcripts of patients interviewed at various time spans from treatment were analyzed for the presence or absence of an inventory of defense mechanisms. Cluster-analytic analysis revealed 2 clinically meaningful factors, described in detail.

Adaptation, Psychological

[The personality of the psychotherapist and its contribution to the treatment process].

The therapist's activity is a highly personalized form of medical action. However, it is still unclear to which extent the personality of the therapist or his acquired technical skill bear the responsibility for his contribution to the treatment process. The present state of process-outcome research contributes a host of results which may stimulate further clinical considerations. Especially the distinction of private features and personalized handling of the therapeutic process is relevant. The importance of self analysis or training therapy in this respect is controversial; the discrepancy between results of formal research and prevailing clinical notions is breathtaking.

Adaptation, Psychological

[Research in psychoanalytic therapy 1930-1990].

The author provides a survey of three phases of psychoanalytic therapy research, each one is being characterized by its most important representatives and their contributions. The first phase (1930-1970) sought in essence to justify, i.e. to prove, that analytical therapies are useful. The second phase (1960-1980) was dedicated to a deeper understanding of the relationship between the course of therapy and its results. The third phase, finally, can be identified as a thorough and detailed inquiry into the analytical process.

History, 20th Century

[How long does psychotherapy last?].

In West Germany, the sickness insurance companies pay for a psychotherapy treatment course for a certain length of time may or may not be sufficient for achieving a successful treatment result. We made a statistical analysis of a large sample of patients (n = 1,689) treated in the outpatient department of a psychotherapeutic hospital of the University of Ulm. It was found that the longer the treatment period covered by the study, the lower the proportion of successfully completed courses. These results are discussed with reference to the long-term treatment ("dose")/effect relationship.

Follow-Up Studies

[Change in the central relationship conflict by short-term therapy].

Luborskys method of the Core Conflictual Relationship Theme is introduced as a reliable tool for studying structural aspects of transference. The change of the components of the CCRT induced by a short term psychotherapy is described and discussed in terms of its clinical significance.

Adult

[Changes in vocabulary in a psychoanalytic process].

This paper at first deals with some aspects of the relationship between psychoanalysis and linguistics. Freuds theory of parapraxis is interpreted in terms of Bühlers model of speech, whereby the entire verbal output of a speaker can be understood as an act of symptomatic behavior. The investigation of the vocabulary of nouns of a patient suffering from anxiety neurosis illustrates the fertility of this model. The frequency dispersion of all nouns taken from a specific sample of the patient's and analyst's speaking shows the stability of statistical properties of speech behavior. Following, the role of content-analytic techniques for the specific demands of research in pstchotherapy is discussed. A large part of content-analytic measures is rather far removed from the clinical description of the psychotherapeutic process, thus diminishing the validating relevance of these studies for psychoanalytic concepts. The final chapter describes the process of a psychoanalytic treatment by means of the content-analytic technique. The changes of the patient's verbal content show highly specific correlation to the clinical ratings of psychoanalytic concepts like transference and anxiety. As an initial study, these results are qualified to stimulate the development of content-analytic categories for research in psychotherapy.

Adult

[Music therapy single case process research--development and organization of a research field].

Music therapy yet to be discovered as a target of psychotherapy research. A first step consists in creating adequate samples of significant musical dialogues. Video-recording is an essential requirement for establishing such data. To test the clinical view that the emotional content of the musical dialogue in music therapy reflects the basic relationship issues of a patient was the objective of this study. By using ratings of significant musical dialogue sequences with the instrument of semantic differential comparing groups with varying clinical expertise (music therapists, psychoanalyts, lay persons) the results demonstrate that there is considerable stability of the judgments; however, systematic differences exists among the three groups of raters.

Adult