Von anderen Patienten lernen: Konsequenzen neuer Entwicklungen im Internet für webbasierte, psychotherapeutische Angebote

Zusammenfassung: Internetbasierte Technologien werden heute in praktisch allen Phasen der psychosozialen Versorgung eingesetzt. Bestehende psychotherapeutische Angebote konzentrieren sich dabei auf die Implementierung traditioneller Ansätze ins Internet. Selbsthilfeprogramme werden ins Netz gestellt, Einzeltherapien finden via E-Mail statt und Gruppen treffen sich in virtuellen Chaträumen. Betrachtet man die Veränderung des Webs in den letzten beiden Jahren, wird deutlich, dass das massive Wachstum und die Beliebtheit dieses Mediums v.a. auf Webplattformen zurückzuführen ist, auf denen kollaborativ Inhalte und Wissen entwickelt sowie Erfahrungen mit anderen Nutzern ausgetauscht werden können. Dieser Beitrag beschäftigt sich mit dieser Entwicklung und zeigt anhand einer Beispielanwendung, wie kollaborative Elemente in ein psychotherapeutisches Angebot integriert werden könne

Four Versions of Transtheoretical Stances, and the Bernese View

A brief characterization of transtheoretical stances to which existing approaches can be allocated is followed by a description of the "Bernese view", that is, what Klaus Grawe and his colleagues, including the authors of this article have developed: the origins, a model of the multiple constraint satisfaction construction of therapist action, a discussion of psychotherapy integration, the crucial role of supervisors in an integrative multiple constraint satisfaction approach, and a discussion of when and how trainees should be introduced to a transtheoretical stance

Depression and identity : Are self-constructions negative or conflictual?

Negative self-views have proved to be a consistent marker of vulnerability for depression. However, recent research has shown that a particular kind of cognitive conflict, implicative dilemma, is highly prevalent in depression. In this study, the relevance of these conflicts is assessed as compared to the cognitive model of depression of a negative view of the self. In so doing, 161 patients with major depression and 110 controls were assessed to explore negative self-construing (self-ideal discrepancy) and conflicts (implicative dilemmas), as well as severity of symptoms. Results showed specificity for the clinical group indicating a pattern of mixed positive and negative self-descriptions with a high rate of conflict. Regression analysis lent support to the conflict hypothesis in relation to clinically relevant indicators such as symptom severity, global functioning. However, self-ideal discrepancy was a stronger predictor of group membership. The findings showed the relevance of cognitive conflicts to compliment the well-consolidated theory of negative self-views. Clinical implications for designing interventions are discussed.Peer reviewedFinal Published versio

Confronting Patients: Therapists' Model of a Responsiveness Based Approach

Confrontation represents a way of challenging patients in psychotherapy to stimulate change. Confrontation draws attention to discrepancies, for example between elements in a patient’s functioning. The present study was designed to construct a conceptual model of confrontation used by therapists when trying to address two main questions: what are the risks and opportunities of confrontation and how can these effects be influenced? Fifteen therapists from the Psychotherapy Outpatient Clinic of the University of Bern in Switzerland participated in semi-standardized interviews, which were analyzed using qualitative content analysis and thematic analysis. Several main themes merged into a dynamic, sequential model: groundwork required before a confrontation, shaping the confrontation, the (immediate) effects, and management of negative consequences. Therapists assume that a confrontation may induce insight and can strengthen the therapeutic relationship either directly or indirectly through the repair of a rupture in the alliance

Konflikte als Thema in der Verhaltenstherapie

Zusammenfassung: Der vorliegende Betrag gibt einen Überblick über die Geschichte der verhaltenstherapeutischen Beschäftigung mit Konflikten, gefolgt von einer Darstellung plananalytischer und konsistenztheoretischer Konfliktkonzepte. Möglichkeiten einer modernen, integrativ-orientierten Verhaltenstherapie zum Umgang mit Konflikten werden skizziert

Tailoring Guidance in Internet-Based Interventions With Motive-Oriented Therapeutic Relationship.

Guidance is commonly used in Internet interventions. However, there is little work on how guidance can be optimally implemented in guided self-help approaches. Despite some general models on guidance, there is no theoretical framework as how to optimally individualize the guidance to the participants needs. The Motive-Oriented Therapeutic Relationship (MOTR) approach is based on the Plan Analyses (Caspar, 1995, 2022) and allows the therapist to provide answers that fulfil the participant’s needs in a way that is acceptable for the participants and is useful for the therapeutic goals. We argue that MOTR can be applied to guidance in Internet interventions and that it can improve adherence and outcome through different processes that help the participant navigate through different difficulties encounter during the completion of an internet intervention

Erratum to: Motive-Oriented Psychotherapeutic Relationship Facing a Patient Presenting with Narcissistic Personality Disorder: A Case Study

Motive-oriented therapeutic relationship (MOTHER), a prescriptive concept based on an integrative form of case formulation, the Plan Analysis (PA) method (Caspar, in: Eells (ed.), Handbook of psychotherapy case formulations, 2007), has shown to be of particular relevance for the treatment of patients presenting with personality disorders, in particular contributing to better therapeutic outcome and to a more constructive development of the therapeutic alliance over time (Kramer et al., J Nerv Ment Dis 199:244-250, 2011). Several therapy models refer to MOTHER as intervention principle with regard to borderline and Narcissistic Personality Disorder (NPD) (Sachse et al., Clarification-oriented psychotherapy of narcissistic personality disorder, 2011; Caspar and Berger, in: Dulz et al. (eds.), Handbuch der Borderline-Störungen, 2011). The present case study discusses the case of Mark, a 40-year-old patient presenting with NPD, along with anxious, depressive and anger problems. This patient underwent a seven-session long pre-therapy process, based on psychiatric and psychotherapeutic principles complemented with PA and MOTHER, in preparation for further treatment. MOTHER will be illustrated with patient-therapist verbatim from session 4 and the links between MOTHER and confrontation techniques will be discussed in the context of process-outcome hypotheses, in particular the effect of MOTHER on symptom reduction

Das deutsche IMI

Das Impact Message Inventory (IMI) von Don Kiesler ist ein interpersonaler Fragebogen, der zur Beurteilung zwischenmenschlicher Eigenschaften durch Zweitpersonen eingesetzt wird. Ein besonderes Merkmal: Die beurteilende Person beschreibt die Wirkung der beurteilten Person auf sich. Das IMI wird mit seiner Einbettung in den Interpersonalen Ansatz und seiner Entwicklung über mehrere Stufen der Verbesserung eingeführt. Es folgt eine Darstellung der Übersetzung und Evaluation der deutschen Version, anschließend wird der Zugang zum Fragebogen und zum Auswertungsschlüssel erklärt