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PubMed1977

[Individual psychotherapy. Institutional psychotherapy. Individual approach].

In the psychiatric management of patients where the author works the following factors are given careful consideration: a) source of referral, b) previous information about the illness, c) the content of the first session, d) obstacles for further treatment and e) theoretical basis for the psychotherapy sessions. Bellak and Small outlines are followed to structure brief and emergency psychotherapy at the author's institution.

Humans↗
PubMed1997

[Body-centered psychotherapy IKP: holistic psychotherapy of anxiety disorders].

After describing the difference between body therapies and body-centered psychotherapies, the methods of body-centered psychotherapy IKP are treated in this article. In order to explain the reduction of panic by motor activity, neurophysiological hypothesis are also discussed. Assuming that symptoms of panic are no "psycho"-pathological symptoms but multidimensional pathological phenomenon, the therapeutic approach has to be holistic and multirelational. Activating resources of the six different life dimensions also belongs to the holistic IKP approach. This way of holistic-multirelational thinking is demonstrated along two case studies.

Anxiety Disorders↗
PubMed2007

Childhood depression: a place for psychotherapy. An outcome study comparing individual psychodynamic psychotherapy and family therapy.

BACKGROUND: Although considered clinically effective, there is little systematic research confirming the use of Individual Psychodynamic Psychotherapy or Family Therapy as treatments for depression in children and young adolescents. AIMS: A clinical trial assessed the effectiveness of these two forms of psychotherapy in treating moderate and severe depression in this age group. METHODS: A randomised control trial was conducted with 72 patients aged 9-15 years allocated to one of two treatment groups. RESULTS: Significant reductions in disorder rates were seen for both Individual Therapy and Family Therapy. A total of 74.3% of cases were no longer clinically depressed following Individual Therapy and 75.7% of cases were no longer clinically depressed following Family Therapy. This included cases of Dysthymia and "Double Depression" (co-existing Major Depressive Disorder and Dysthymia). There was also an overall reduction in co-morbid conditions across the study. The changes in both treatment groups were persistent and there was ongoing improvement. At follow up six months after treatment had ended, 100% of cases in the Individual Therapy group, and 81% of cases in the Family Therapy group were no longer clinically depressed. CONCLUSIONS: This study provides evidence supporting the use of focused forms of both Individual Psychodynamic Therapy and Family Therapy for moderate to severe depression in children and young adolescents.

Adolescent↗
PubMed1998

Was ist eine erfolgreiche Psychotherapie? Was ist erfolgreich in der Psychotherapie?

What Is Successful Treatment? What Is Success in Therapy? - Observations on Psychotherapy ResearchThe author raises the following questions: What are the criteria for the evaluation of successful psychotherapeutic treatment? Which are the suitable research methods for the assessment of psychotherapeutic success? He proposes a research paradigm based on multiple criteria and multiple methods. Psychotherapeutic treatment success must be assessed on different levels: aetiology of disease, disease as nosologic category (e. g. depression), symptomatology, consequences (psychic, physical, social, economical) of disease. He further develops a research logic that is multimethodical: Results from different research methods must be aggregated on the basis of convergent findings. The three 'key research methods' in psychotherapy research are: single-case studies, controlled trials, naturalistic catamnestic research. Statements about any psychotherapeutic method or intervention strategy are only valid when results from these different study types converge. It may be a very severe bias when findings from only one study type (e. g. controlled trials) are generalised as a final verdict on certain psychotherapeutic methods.

Journal Article↗
PubMed1986

[Support psychotherapy or support in psychotherapy : a necessary reflection on the work in sector psychiatry.].

This article deals with the notion of supportive psychotherapy. This overall approach is often discredited even if, in the mental health network, it is widely used. Therefore, it appears important to analyze this approach and to define the idea of support in psychotherapy; this article reviews secondly when it is opportune to offer such an approach, what are the techniques related to this approach and finally, what are the results we can hope for? This article wants to initiate a reflexion while integrating some readings on the matter and using a clinical experience evolved from a practice in sector psychiatry.

English Abstract↗
PubMed1988

[The Berlin psychotherapy study (decision on indications and the therapeutic reality in various fields of psychotherapy practice].

This article presents concepts, problems, and approaches used in a completed observational study carried out by 47 therapists in analytical/psychotherapeutic private practices and institutions. The diagnostic situation (of 739 patients) and the initial phase of therapy (involving 381 patients) were studied with the help of a comprehensive system of documentation. What is documented here is the patient perspective on the one hand and the perspective of the therapists on the other with regard to numerous self-evaluations and evaluations by others, evaluations that throw light on the diagnostic-therapeutic process from different observational levels. Most of the scales used were developed in the study group. Given the complex structure of the data, new methods of storing and evaluating data had to be found. In addition to the description of the therapeutic reality of a large city, the main goal of the study was to examine the patient-therapist relationship and the prognostic elements it contains since these elements influence the indication for psychotherapy and the possibility of its successful realization and thus have the character of predictors for the course of psychotherapy. A number of other results of the study are presented in the succeeding contributions to this issue.

Berlin↗
PubMed2003

[2-stage group psychotherapy with integrated autogenic training within the scope of a general integrated psychotherapy concept].

Group-therapy and autogenic training in combination show mutual potentiation. Our results have proved the hypothesis to be true and we have also been able to explain it by an analysis of the neurophysiological and psychological findings concerning both methods. Our "model" has proved to be very economical in time and can be easily applied. It needs basic psychotherapeutical education but no special additive schooling. It is particularly well employed in rehabilitation patients, elderly patients and geronto-rehabilitation patients. As numbers of such patients are steadily increasing, it could soon become highly important, and in the technically dominated medicine of today, the particularly communicative component that we postulate in integrated psychotherapy could also grow in importance. By combining the two methods, it is not method that is at the centre of our endeavours but the patient.

Adaptation, Psychological↗
PubMed1990

Individual psychotherapy as an adjunct to group psychotherapy.

This paper describes a form of combined psychotherapy in which the individual sessions are used as an adjunct to group therapy. Each group member is seen regularly in individual sessions to focus primarily on the member's ongoing group work. The individual sessions are scheduled on a rotating basis. Typically, each group member is seen in an individual session once every four weeks. Additional individual sessions are available only when immediate attention is appropriate and necessary. The group is viewed as the primary therapeutic component. A cost-effective therapeutic approach that uses both individual and group methods, this modality lends itself well to a clinic and to a private practice setting.

Adult↗
PubMed1993

Psychotherapy and bulimia nervosa. Longer-term effects of interpersonal psychotherapy, behavior therapy, and cognitive behavior therapy.

OBJECTIVE: To determine whether cognitive behavior therapy (CBT) for bulimia nervosa has a specific therapeutic effect and determine whether a simplified behavioral treatment (BT) of CBT is as effective as the full treatment. DESIGN: Randomized controlled trial involving three psychological treatments. Two planned comparisons, CBT with interpersonal psychotherapy (IPT), and CBT with BT. Closed 12-month follow-up period. Independent assessors. SETTING: Secondary referral center. PATIENTS: Seventy-five consecutively referred patients with bulimia nervosa. Patients with concurrent anorexia nervosa were excluded. INTERVENTIONS: Cognitive behavior therapy, IPT, BT conducted on an individual outpatient basis. There were nineteen sessions over 18 weeks. Six experienced therapists administered all three treatments. There was no concurrent treatment. MAIN OUTCOME MEASURE: Frequency of binge eating and purging. RESULTS: High rate (48%) of attrition and withdrawal among the patients who received BT. Over follow-up, few patients undergoing BT met criteria for a good outcome (cessation of all forms of binge eating and purging). Patients in the CBT and IPT treatments made equivalent, substantial, and lasting changes across all areas of symptoms, although there were clear temporal differences in the pattern of response, with IPT taking longer to achieve its effects. CONCLUSIONS: Bulimia nervosa may be treated successfully without focusing directly on the patient's eating habits and attitudes to shape and weight. Cognitive behavior therapy and IPT achieved equivalent effects through the operation of apparently different mediating mechanisms. A further comparison of CBT and IPT is warranted. The behavioral version of CBT was markedly less effective than the full treatment.

Adolescent↗
PubMed2006

Outpatient psychotherapy for borderline personality disorder: randomized trial of schema-focused therapy vs transference-focused psychotherapy.

CONTEXT: Borderline personality disorder is a severe and chronic psychiatric condition, prevalent throughout health care settings. Only limited effects of current treatments have been documented. OBJECTIVE: To compare the effectiveness of schema-focused therapy (SFT) and psychodynamically based transference-focused psychotherapy (TFP) in patients with borderline personality disorder. DESIGN: A multicenter, randomized, 2-group design. SETTING: Four general community mental health centers. PARTICIPANTS: Eighty-eight patients with a Borderline Personality Disorder Severity Index, fourth version, score greater than a predetermined cutoff score. INTERVENTION: Three years of either SFT or TFP with sessions twice a week. MAIN OUTCOME MEASURES: Borderline Personality Disorder Severity Index, fourth version, score; quality of life; general psychopathologic dysfunction; and measures of SFT/TFP personality concepts. Patient assessments were made before randomization and then every 3 months for 3 years. RESULTS: Data on 44 SFT patients and 42 TFP patients were available. The sociodemographic and clinical characteristics of the groups were similar at baseline. Survival analyses revealed a higher dropout risk for TFP patients than for SFT patients (P = .01). Using an intention-to-treat approach, statistically and clinically significant improvements were found for both treatments on all measures after 1-, 2-, and 3-year treatment periods. After 3 years of treatment, survival analyses demonstrated that significantly more SFT patients recovered (relative risk = 2.18; P = .04) or showed reliable clinical improvement (relative risk = 2.33; P = .009) on the Borderline Personality Disorder Severity Index, fourth version. Robust analysis of covariance (ANCOVA) showed that they also improved more in general psychopathologic dysfunction and measures of SFT/TFP personality concepts (P<.001). Finally, SFT patients showed greater increases in quality of life than TFP patients (robust ANCOVAs, P=.03 and P<.001). CONCLUSIONS: Three years of SFT or TFP proved to be effective in reducing borderline personality disorder-specific and general psychopathologic dysfunction and measures of SFT/TFP concepts and in improving quality of life; SFT is more effective than TFP for all measures.

Ambulatory Care↗
PubMed2001

[What is science-based psychotherapy? On the discussion of guidelines for psychotherapy research].

The scientific nature of psychotherapy can be defined by two partially interrelated criteria: validity of the theory underlying a therapy and efficacy or effectiveness of a therapy. To enhance the scientific basis of a psychotherapeutic approach, research is needed on therapeutic objectives, principles, and processes, measuring methods, process-outcome relationships, and efficacy and effectiveness of therapies. Determination of efficacy requires randomized clinical trials (RCT). The scientific basis must be seen as the continuous development of a psychotherapeutic approach. In contrast, the question of whether a psychotherapeutic approach is well established is dichotomous. In addition to scientific criteria, those deriving from mental health policy and economics are also important. This paper presents various approaches to ascertaining efficacy. According to the criteria of the American Psychological Association Task Force, to be "well-established," treatments for specific disorders must be shown efficacious in at least two independent randomized clinical trials. Although comparability is limited, we propose that psychotherapeutic research be conceptualized into phases, as in pharmacotherapeutic research.

Evidence-Based Medicine↗
PubMed1984

Short-term residential psychotherapy: psychotherapy in a nutshell.

Psychotherapy in a psychotherapeutic community often is characterized by absence of time limits and by long duration. In this article an account is given of the adaptions that are necessary when short-term treatment is carried out in such a residential setting. Implications for focus, therapy program, and treatment style are presented.

Hospitals, Psychiatric↗
PubMed1987

Assessing the effects of psychotherapy. III. Reliability and validity of 'change after psychotherapy'.

Ratings of 'Change after Psychotherapy' (CHAP) in a group of psychologists and a group of psychology students are found to have generally acceptable or high reliability and concordant validity. Factor analyses of the change scales yield basically a common factor, splitting at a higher level into an outer, behavioral, and an inner, intrapsychic change factor, the former indicated by the 'symptoms' and 'adaptive capacity' scales and the latter by the 'self-insight' and 'basic conflict' scales. Factor analyses also support the construct validity of the 'extra-therapeutic conditions' scale. This indicates that summing the change scales will yield a measure of nonspecific change, like global change ratings, whereas the adjusted sum will measure more specifically psychotherapeutic change. A scalogram analysis of the change scales reveals a cumulative pattern that is open to theoretically opposed interpretations about the process relations between inner and outer change.

Humans↗
PubMed1990

Toward a clinical model of psychotherapy for depression, I: Systematic comparison of three psychotherapies.

In a two-part series, the author explores the current status of psychotherapy for depression. In part I, three predominant approaches to the psychological treatment of depressive disorders today--psychodynamic, cognitive, and interpersonal--are described and contrasted schematically. They are depicted as conceptually different but potentially complementary with regard to 1) basic characteristics, including theoretical orientation, major strategies, goals, and mechanisms of change, and 2) respective advantages and limitations. This clinical comparison forms the foundation of an integrative and selective model for the treatment of depression.

Cognitive Behavioral Therapy↗
PubMed1986

The Nottingham experiential day in psychotherapy: a new approach to teaching psychotherapy to medical students.

A prime objective in teaching psychotherapy to medical students is to convey a practical understanding of what happens and a sense of the pleasure and responsibility of working with another person to improve the quality of their relationships. In Nottingham an experiential day was developed during the psychiatry clerkship; the teaching is by doing rather than describing, while spontaneity and individual expression are encouraged; the experience is valued by most and forgotten by none; it would be improved by a second experiential day or by a weekly forum for discussion of the personal and patient-care issues raised.

Education, Medical, Undergraduate↗
PubMed1976

Psychotherapy sabotage revisited: the better half of individual psychotherapy.

This study examined the amount of actual client self-disclosure emitted and the pattern of its occurrence within and across individual therapy sessions. An earlier finding showed that many clients avoided self-disclosure until the session's closing minutes early in therapy. These data revealed that in the middle stages of short-term therapy for a university population (N = 26) clients continue to engage in the highest proportion of self-disclosure during the latter half of the therapy hour. The position that there are ways in which psychotherapy sabotage can be reduced was discussed.

Adult↗
PubMed1995

[Diagnosis in psychotherapy. Results of a survey of diagnostic practices of psychotherapy trained psychologists].

In a representative survey concerning the current status and future perspectives of psychological assessment procedures, psychologists trained as psychotherapists were investigated with respect to their diagnostic activity within the framework of psychotherapy. The analysis aimed both at providing insights into the practice of test application among psychotherapeutically active psychologists and at determining the extent to which their diagnostic activity is influenced by the existing debiting procedures with health insurance companies. The results did not indicate any differences in the relevant aspects of the investigation between psychotherapists who did and those who did not debit health insurance companies.

Germany↗
PubMed1995

[Psychotherapy research and child psychotherapy practice].

Psychotherapy research results are viewed under the aspect of relevance and irrelevance for psychotherapeutic practice. The difficulties to develop effective research designs for children, and adolescents are described, and possible research perspectives are developed for this complex domain. Especially the amount of variables in combination with developmental stages of children, and adolescents creates extreme difficulties to develop research designs to give an answer to the question, which therapeutic approach is better than others in the near future. Some conclusions from research results are made for psychotherapeutic practice.

Adolescent↗