The working alliance in a randomized controlled trial comparing online with face-to-face cognitive-behavioral therapy for depression

Background: Although numerous efficacy studies in recent years have found internet-based interventions for depression to be effective, there has been scant consideration of therapeutic process factors in the online setting. In face-to face therapy, the quality of the working alliance explains variance in treatment outcome. However, little is yet known about the impact of the working alliance in internet-based interventions, particularly as compared with face-to-face therapy. Methods: This study explored the working alliance between client and therapist in the middle and at the end of a cognitive-behavioral intervention for depression. The participants were randomized to an internet-based treatment group (n = 25) or face-to-face group (n = 28). Both groups received the same cognitive behavioral therapy over an 8-week timeframe. Participants completed the Beck Depression Inventory (BDI) post-treatment and the Working Alliance Inventory at mid- and post- treatment. Therapists completed the therapist version of the Working Alliance Inventory at post-treatment. Results: With the exception of therapists' ratings of the tasks subscale, which were significantly higher in the online group, the two groups' ratings of the working alliance did not differ significantly. Further, significant correlations were found between clients' ratings of the working alliance and therapy outcome at post-treatment in the online group and at both mid- and post-treatment in the face-to-face group. Correlation analysis revealed that the working alliance ratings did not significantly predict the BDI residual gain score in either group. Conclusions: Contrary to what might have been expected, the working alliance in the online group was comparable to that in the face-to-face group. However, the results showed no significant relations between the BDI residual gain score and the working alliance ratings in either group

The impact of positive psychological interventions on well-being in healthy elderly people

This systematic review aims to evaluate the impact of Positive Psychological Interventions (PPIs) on well-being in healthy older adults. Systematic review of PPIs obtained from three electronic databases (PsycINFO, Scopus, and Web of Science) was undertaken. Inclusion criteria were: that they were positive psychology intervention, included measurement of well-being, participants were aged over 60 years, and the studies were in English. The Cochrane Collaboration Guidelines dimensions of quality control, randomization, comparability, follow-up rate, dropout, blinding assessors are used to rate the quality of studies by two reviewers independently. The RE-AIM (Reach, Efficacy, Adoption, Implementation, and Maintenance) for evaluation of PPIs effectiveness was also applied. The final review included eight articles, each describing a positive psychological intervention study. The reminiscence interventions were the most prevalent type of PPIs to promote and maintain well-being in later life. Only two studies were rated as high quality, four were of moderate-quality and two were of low-quality. Overall results indicated that efficacy criteria (89%), reach criteria (85%), adoption criteria (73%), implementation criteria (67%), and maintenance criteria (4%) across a variety of RE-AIM dimensions. Directions for future positive psychological research related to RE-AIM, and implications for decision-making, are described

E-Mental Health und klinisch-therapeutische Intervention für Ältere

Ältere Menschen haben sich sowohl im wirtschaftlichen als auch im wissenschaftlichen Bereich als interessante Zielgruppe für technische Unterstützung zur Förderung der physischen und psychischen Gesundheit entwickelt. Selbstbestimmtes Leben und Wohnen, aber auch verbesserter Zugang zu Informationen und Unterstützungsangeboten im Internet stehen dabei im Vordergrund. Der Bereich Informationsvermittlung im Internet wird anhand von Beispielen zu Informations- und Entlastungsangeboten für Angehörige von Alzheimer Patienten vorgestellt. Weiters werden Beratungs- und Therapieangebote im Internet diskutiert, die vor allem für Personen mit PTBS und komplizierter Trauer entwickelt wurden. Darüber hinaus werden im Internet weitere Interventionsformen, wie computergestützte Selbsthilfeprogramme für eine ganze Reihe psychischer Störungen angeboten. Abschließend wird auf das so genannte Butler-System eingegangen, das älteren Menschen die Möglichkeit bietet virtuelle Welten zu besuchen, die darauf abzielen depressive oder ängstliche Stimmung zu verbessern. Vor- und Nachteile dieser internetbasierten Angebote sowie Fragen der Wirksamkeit und Akzeptanz werden abschließend aus einer psychologischen Perspektive diskutiert

Life-review interventions as psychotherapeutic techniques in psychotraumatology

BACKGROUND: Life-review interventions (LRI) are psychotherapeutic techniques originally derived from gerontology, which can be distinguished from other biographical and reminiscing techniques. They have been systematically implemented and investigated not only in elderly clients with depression, cognitive decline, in oncology units and in hospices but also in adolescents with various mental problems. LRI are mainly based on the elaboration of the autobiographical memory as well as on personal identity consolidation. This bears the potential for the systematic introduction, use, and evaluation of LRI within the field of psychotraumatology. METHOD: This article gives a general overview and outlines a structured LRI by means of a case example of a World War II-traumatised patient. Other applications and implementations of LRI in psychotraumatology and other related areas are presented. RESULT: So far, only uncontrolled or controlled LRI case studies have been investigated with traumatized samples. CONCLUSION: The importance of further randomized controlled studies is emphasized