Telephone-Administered Cognitive Behavioral Therapy for Body Dysmorphic Disorder: Case Series

Cognitive behavioral therapy is an effective treatment for body dysmorphic disorder (BDD), but many patients do not receive appropriate treatment due to several treatment barriers and psychosocial care structures. Low-threshold interventions, including those from the field of e-mental health, could improve access to psychotherapy. In addition to internet-administered therapy, telephone-administered therapy may reduce treatment barriers, especially during the COVID-19 pandemic. This article presents four case reports of the same treatment (12 weeks of telephone-administered cognitive behavioral therapy accompanied by a workbook) applied to patients with body dysmorphic disorder during the summer of 2020. Three patients who completed the treatment had clinically relevant reductions in body dysmorphic and depressive symptoms and improved insight. One patient did not complete the telephone-administered therapy because her symptoms worsened, and she needed a more intensive form of treatment. These findings encourage future studies on the efficacy and effectiveness of telephone-administered treatment for BDD and its role in stepped-care models

Prevalence of symptoms of body dysmorphic disorder (BDD) and associated features in Swiss military recruits: a self-report survey

Background Body dysmorphic disorder (BDD), defined as the obsessive idea that some aspect of one’s own body or appearance is severely flawed/deformed, is relatively common in the general population and has been shown to have strong associations with mood and anxiety disorders and substance abuse disorders. Furthermore, a previous study on symptoms of BDD among people in the military showed that muscles are an important area of preoccupation. Hence, this study aimed to 1. assess the prevalence of BDD symptoms in Swiss military recruits, 2. specify the areas of preoccupation, and 3. analyze associated features (depression and alcohol/drug abuse). Method A total of 126 Swiss male military recruits (age: M = 20.12, SD = 1.09, range: 18–24) were examined using self-report measurements to assess symptoms of BDD, depression, alcohol/drug abuse. Results The results showed that symptoms of BDD were relatively common (9.5% reached the cutoff value for probable BDD, 84% reported some symptoms), with the muscles as the most common area of preoccupation. A positive correlation (r = .38, p < .001) between depressive symptoms and symptoms of BDD was found, thus no correlation between alcohol/drug abuse and symptoms of BDD. Conclusion The results indicate a need to develop and implement measures for prevention (e.g. raising awareness among the military) and intervention in this specific population

Supervision in pädagogischen Kontexten. Ein Vergleich von Supervision in der Sozialen Arbeit und in der Schule

Pädagogische Kontexte sind von einer Vielzahl an Konflikten geprägt. Supervision stellt eine Möglichkeit dar, diese Konflikte zu lösen und kann nachweislich dazu beitragen zu entlasten sowie Kooperation und Handlungssicherheit zu fördern. In verschiedenen pädagogischen Kontexten (z.B. Soziale Arbeit und Schule) ist Supervision unterschiedlich stark etabliert. Diese Studie untersucht und vergleicht Häufigkeit, Rahmenbedingungen, Anliegen und den wahrgenommenen Nutzen von Supervision in Sozialer Arbeit und Schule, indem 376 Supervisorinnen und Supervisoren, die in pädagogischen Kontexten supervidieren, befragt wurden. Die Ergebnisse zeigen Unterschiede in allen Bereichen zwischen Sozialer Arbeit und Schule, aus denen sich Implikationen für Praxis, Forschung und Weiterbildung ableiten lassen

Psychosocial Burden and Strains of Pedagogues - Using the Job Demands-Resources Theory to Predict Burnout, Job Satisfaction, General State of Health, and Life Satisfaction

The current study examines the Job Demands-Resources theory among pedagogical professionals. A total of 466 pedagogues (n = 227 teachers; n = 239 social workers) completed the Copenhagen Psychosocial Questionnaire online. After testing the questionnaire structure using confirmatory factor analysis, a JD-R-based prediction model to predict effects of strains on the outcome constructs of burnout, job satisfaction, general state of health, and life satisfaction was estimated. The results confirm the questionnaire structure (RMSEA= 0.038; CFI = 0.94) as well as the fit of the prediction model (RMSEA = 0.039; CFI = 0.93). The outcome constructs could be predicted by emotional demands, work–privacy conflict, role conflicts, influence at work, scope for decision making, and opportunities for development (0.41 ≤ R² ≤ 0.57). Especially for life satisfaction, a moderator analysis proved the differences between teachers and social workers in the structure of the prediction model. For teachers, quantitative demands and work–privacy conflict are predictive, and for social workers, role conflicts and burnout are predictive. The study offers starting points for job-related measures of prevention and intervention

Innovative moments in low-intensity, telephone-based cognitive-behavioral therapy for depression.

BACKGROUND Innovative moments (IMs), defined as moments in psychotherapy when patients' problematic patterns change toward more elaborated and adaptive patterns, have been shown to be associated with a clinical change in patients with depression. Thus, far IMs have been studied in face-to-face settings but not in telephone-based cognitive-behavioral therapy (t-CBT). This study investigates whether IMs occur in t-CBT and examines the association between IMs and symptom improvement, and reconceptualization and symptom improvement. METHODS The therapy transcripts of n = 10 patients with mild to moderate depression (range: 7-11 sessions, in total 94 sessions) undergoing t-CBT were qualitatively and quantitatively analyzed. Symptom severity (Patient Health Questionnaire-9) and IMs (levels and proportions) were assessed for each therapy session. Hierarchical linear models were used to test the prediction models. RESULTS The rating of IMs was shown to be feasible and reliable using the Innovative Moments Coding System (IMCS) (84.04% agreement in words coded), which is indicative of the applicability of the concept of IMs in t-CBT. Only reconceptualization IMs were shown to have a predictive value for treatment success (R2 = 0.05, p = 0.01). DISCUSSION The results should be interpreted with caution due to the exploratory nature of this study. Due to the telephone setting, it was necessary to adapt the IMCS. Nonetheless, the extent of IMs identified in the low-intensity t-CBT investigated was comparable to IMs in face-to-face therapy. Further studies are needed to clarify the association between IMs and treatment success as a change process, especially for low-intensity treatments

Innovative moments in low-intensity, telephone-based cognitive-behavioral therapy for depression

BackgroundInnovative moments (IMs), defined as moments in psychotherapy when patients’ problematic patterns change toward more elaborated and adaptive patterns, have been shown to be associated with a clinical change in patients with depression. Thus, far IMs have been studied in face-to-face settings but not in telephone-based cognitive-behavioral therapy (t-CBT). This study investigates whether IMs occur in t-CBT and examines the association between IMs and symptom improvement, and reconceptualization and symptom improvement.MethodsThe therapy transcripts of n = 10 patients with mild to moderate depression (range: 7–11 sessions, in total 94 sessions) undergoing t-CBT were qualitatively and quantitatively analyzed. Symptom severity (Patient Health Questionnaire-9) and IMs (levels and proportions) were assessed for each therapy session. Hierarchical linear models were used to test the prediction models.ResultsThe rating of IMs was shown to be feasible and reliable using the Innovative Moments Coding System (IMCS) (84.04% agreement in words coded), which is indicative of the applicability of the concept of IMs in t-CBT. Only reconceptualization IMs were shown to have a predictive value for treatment success (R$^{2}$ = 0.05, p = 0.01).DiscussionThe results should be interpreted with caution due to the exploratory nature of this study. Due to the telephone setting, it was necessary to adapt the IMCS. Nonetheless, the extent of IMs identified in the low-intensity t-CBT investigated was comparable to IMs in face-to-face therapy. Further studies are needed to clarify the association between IMs and treatment success as a change process, especially for low-intensity treatments

Comparing stress, areas of stress and coping-strategies between distance-learning and on-campus students – A mixed-methods approach

In recent years, the increase in stress experienced by students, and the related health problems have become a key challenge for health psychologists. The aim of this cross-sectional survey study was to compare stress, areas of stress and coping-strategies of 246 distance-learning (81.7% female; 33.62 years, SD = 9.30) and 254 on-campus students (82.3% female; 24.23 years, SD = 3.99). One-way analyses of variance showed no significant differences in perceived stress and stress symptoms between the student groups. Stress-inducing areas were revealed by qualitative content analysis. Chi-square tests showed that on-campus students significantly more often reported study- and performance-related areas, whereas conflicts between work and private life were more present among distance-learning students. Results also indicated that on-campus students significantly more often cope with stress by means of social support. These findings may help tailoring stress-management interventions for different student groups

Psychosocial hazards of trainee teachers - characteristics, manifestations, outcomes

Diese Studie beschreibt im Rahmen einer quantitativen Erhebung die Merkmale und Ausprägungen von psychosozialen Belastungen im zweiten Teil der Lehrerausbildung und stellt Zusammenhänge zu Folgen her. Die Erhebung der Daten erfolgte online mit dem Copenhagen Psychosocial Questionnaire (COPSOQ). 342 Referendarinnen und Referendare nahmen an der Befragung teil. Die Datensätze wurden mit denen von Lehrkräften [...] sowie von sonstigen Berufen aus der COPSOQ-Datenbank [...] verglichen. Die Ergebnisse zeigen, dass Befunde der Lehrerbelastungsforschung bezüglich der starken Ausprägung von emotionalen Belastungen und Folgen bestätigt werden können. Allerdings zeigten sich durchschnittlich negativere Werte als bei den Vergleichsstichproben in den Bereichen der Folgen (Burnout, Gedanken an Berufsaufgabe und kognitive Stresssymptome), jedoch positivere Werte in den wahrgenommenen Entwicklungsmöglichkeiten sowie der Bedeutung der Arbeit und der Verbundenheit mit dem Arbeitsplatz. Zum Schutz individueller, aber auch systemischer Ressourcen sollten die spezifischen multidimensionalen Bedingungen im Referendariat genau untersucht und entsprechende multimodale Präventions- und Interventionsmaßnahmen entwickelt und evaluiert werden. (DIPF/Orig.)The present study describes the characteristics and manifestations of psychosocial hazards of trainee teachers and shows interrelations to resulting strains within a cross-sectional design. The data was gathered through an online-questionnaire by means of the Copenhagen Psychosocial Questionnaire (COPSOQ). The sample consists of 342 German women and men in their second phase of teacher training and was compared to teachers [...] and to two groups of other professions [...] from the COPSOQ-database. Results confirm findings focussing on teachers\u27 health. But they show that psychosocial hazards and the resulting strains are worse for the teacher trainees especially in the strains (burnout, thoughts on giving up, and cognitive stress-symptoms) than for the reference groups. But there were also some structural advantages, like a larger influence on work, greater possibilities for development, the meaning of work and the commitment to the workplace. Among others, emotional demands, work-privacy-conflict and the meaning of work were identified as predicators for increasing strains and worse outcomes. To protect and to preserve individual but also systemic resources there is a need for action in the investigation of possible causes as well as on the level of prevention and intervention. (DIPF/Orig.

Acceptance of E-Mental Health Services for Different Application Purposes Among Psychotherapists in Clinical Training in Germany and Switzerland: Secondary Analysis of a Cross-Sectional Survey

Background: Despite solid evidence supporting the efficacy of electronic mental health (EMH) services, their acceptance among psychotherapists is limited and uptake rates remain low. However, the acceptance of different EMH services has yet barely been examined in future generations of psychotherapists in a differentiated manner. The aims of this study were (1) to elaborate the intention to use various EMH services for different application purposes and (2) to determine predictors of EMH service acceptance among psychotherapists in clinical training (PiT). Materials and Methods: Our paper is based on a secondary data analysis of a cross-sectional survey. Respondents were recruited via recognized educational institutions for psychotherapy within Germany and the German-speaking part of Switzerland between June and July of 2020. The survey contained items on the intention to use different EMH services (i.e., guided and unguided programs, virtual reality, psychotherapy by telephone and videoconference) for various application purposes (i.e., prevention, treatment addition, treatment substitute, aftercare). Potential predictors of EMH service acceptance (e.g., barriers and advantages) were examined based on an extension of the Unified Theory of Acceptance and Use of Technology (UTAUT). Results: Most of the n = 216 respondents were female (88.4%) and located in Germany (72.2%). General acceptance of EMH was moderate (M = 3.4, SD = 1.12, range 1–5), while acceptance of psychotherapy via videoconference was highest (M = 3.7, SD = 1.15) and acceptance of unguided programs was lowest (M = 2.55, SD = 1.14). There was an interaction effect of EMH service and application purpose (η2 = 0.21). Barriers and advantages both had a uniform influence on EMH service acceptance (Pr > 0.999), while impersonality, legal concerns, concerns about therapeutic alliance, simplified information provision, simplified contact maintenance, time flexibility, and geographic flexibility were significant predictors (all p 0.999). Conclusions: The intention to use different EMH services varied between application purposes among PiT. To increase acceptance of EMH services and reduce misconceptions, we identified predictors that should be addressed in future acceptance-facilitating interventions when educating PiT