Psychotherapieforschung - Ist «Dodo Bird» en vogue?

Das «Dodo-Bird-Verdikt», Ende der achtziger Jahre Resultat einer Metaanalyse, stellte fest, dass sich die etablierten Psychotherapieschulen in ihrer Wirksamkeit statistisch nicht bedeutsam unterscheiden. Der Begriff hat seinen Ursprung in «Alice im Wunderland», wo ein Dodo den Vorschlag macht, ein Rennen zu veranstalten, bei dem am Ende alle gewinnen, weil es kein Ziel gibt und auch die Zeit nicht gemessen wird. – Ist die These unter Akteuren der Psychotherapie en vogue? Ein Kommentar

How therapists' interpersonal behaviour is perceived by their patients and close others: A longitudinal and cross-situational study

Due to their predictive abilities, therapist interpersonal behaviour is of great relevance for psychotherapy. However, there is a lack of knowledge about its stability inside but also outside of the therapy room within and between therapists. The current study investigates interpersonal behaviour of trainee therapists (N = 20) as perceived by four patients each suffering from generalized anxiety disorder and three closely related persons of every therapist (close others). Investigating repeated measures, four patients per therapist completed the Impact Message Inventory (IMI; Kiesler, 1987) three times over the course of their cognitive behavioural therapy. Furthermore, the IMI was completed by three close others at one assessment time. Therapist interpersonal behaviour was perceived as more friendly and less submissive when evaluated by close others compared to patients. Using a multilevel approach, our results indicate that therapists' interpersonal behaviour was perceived considerably stable across patients and over the course of treatment, and there is considerable uniformity of the IMI evaluations in respect to the particular subscales within and between therapists. Our results highlight the potential similarities of observer-based habitual therapists' interpersonal behaviour inside and outside of the therapy room. Keywords: impact message inventory; perceptions of therapists; therapists' effects; therapists' interpersonal behaviour; therapy researc

Basale Wirkmodelle in der Psychotherapie

Der Beitrag gibt einen Überblick über verschiedene Ansätze, wie die Wirkungsweise von Psychotherapie erklärt werden kann. Basierend auf dem biopsychosozialen Rahmenmodell postuliert die evidenzbasierte Praxis einen Rahmen des professionellen psychotherapeutischen Handelns. Grundsätzlich haben alle an der Therapie beteiligten Personen aktive Mitwirkung. Allgemeine Wirkfaktoren wie beispielsweise die Bereitschaft der Patient*innen zur Veränderung, die Qualität der gemeinsamen Arbeitsallianz oder die Auseinandersetzung der Therapeut*innen mit systematischem Feedback werden dabei als übergeordnete störungs- und therapieschulenübergreifende Wirkkomponenten verstanden. = The article gives an overview of different approaches about the understanding of how psychotherapy works. Based on the biopsychosocial model, the evidence-based practice approach postulates a framework for professional psychotherapeutic actions. As a basic assumption, all persons involved in the therapy have an active participation and therefore provide variability in process and outcomes. Common curative factors, such as the willingness and preparedness of the patients for change, the collaborative quality of the working alliance and the therapist’s involvement with systematic feedback are proposed to transcend the gaps between research and practice

How resilient are former CBT patients with generalized anxiety disorder in times of COVID-19? A follow-up study considering post-treatment depressive symptoms

Background: Research suggested that preexisting mental disorders, particularly generalized anxiety disorder (GAD), might increase the already elevated risk of responding to the COVID-19 pandemic with mental health impairments. The present follow-up study investigated the course of GAD symptoms during the pandemic in former outpatients (N = 86) of two randomized controlled trials who were treated with cognitive behavioral therapy (CBT) up to eight years ago. Methods: GAD symptomatology was examined as the probability for a “well month”, that is, a month with no or minimal symptoms, as assessed by the Longitudinal Interval Follow-Up Evaluation (LIFE), taking the periods pre-pandemic, early pandemic, lockdown, and post-lockdown into account, and considering depressive symptoms post-treatment as its predictor. Results: Generalized linear mixed models revealed lower odds ratios for a “well month” during the early pandemic period and higher odds ratios post-lockdown compared with pre-pandemic. Post-treatment depressive symptoms proved to be a significant predictor since pandemic onset. Strategies learned in CBT were analyzed for their applicability and helpfulness in coping with worries during the pandemic. Six particularly helpful strategies were identified by participants. Limitations: Although attrition was comparably low with no indication of an association between missingness and primary outcomes, bias cannot be ruled out. Conclusions: The findings provide preliminary support for the resilience of former CBT patients with GAD during COVID-19, for the long-term relevance of CBT strategies, and for post-treatment depressive symptoms as risk factors for exacerbation of GAD symptoms since the onset of the COVID-19 pandemic

Leveraging The Potential Of Personality Traits For Digital Health Interventions : A Literature Review On Digital Markers For Conscientiousness And Neurotism

Digital health interventions (DHIs) are designed to help individuals manage their disease, such as asthma, diabetes, or major depression. While there is a broad body of literature on how to design evidence- based DHIs with respect to behavioral theories, behavior change techniques or various design features, targeting personality traits has been neglected so far in DHI designs, although there is evidence of their impact on health. In particular, conscientiousness, which is related to therapy adherence, and neuroticism, which impacts long-term health of chronic patients, are two personality traits with an impact on health. Sensing these traits via digital markers from online and smartphone data sources and providing corresponding personality change interventions, i.e. to increase conscientiousness and to reduce neuroticism, may be an important active and generic ingredient for various DHIs. As a first step towards this novel class of personality change DHIs, we conducted a systematic literature review on relevant digital markers related to conscientiousness and neuroticism. Overall, 344 articles were reviewed and 21 were selected for further analysis. We found various digital markers for conscientiousness and neuroticism and discuss them with respect to future work, i.e. the design and evaluation of personality change DHIs

Centrality of Buddhist Religiosity Scale: Adaptation and Validation of the Centrality of Religiosity Scale in a Buddhist Sample in Vietnam

This paper describes an adaptation of the Centrality of Religiosity Scale to the Buddhist religious tradition (CBRS) and a validation in Vietnam. The sample included data from 421 Vietnamese Buddhists (300 females, 121 males), aged 17 to 71 years (M=35.03, SD=13.09). The results provided evidence for good psychometric properties of the short, intermediate, and long version: CBRS-5, CBRS-10, and CBRS-15 respectively. Specifically, exploratory and confirmatory factor analyses supported the measure’s original five-factor structure: intellect, ideology, public practice, private practice, and religious experience. Furthermore, the Centrality of Buddhist Religiosity has proven to be a stable psychological construct across the three versions of CBRS and was associated strongly with the Gordon Allport’s notion of the intrinsic religious orientation. The results also suggested that the Stefan Huber’s centrality of religiosity model can capture the Buddhist religiosity and that the CBRS can be used to measure the five theoretical defined core dimensions of religiosity in Buddhism

The Process-Outcome Mindfulness Effects in Trainees (PrOMET) study: protocol of a pragmatic randomized controlled trial

Background: Mindfulness has its origins in an Eastern Buddhist tradition that is over 2500 years old and can be defined as a specific form of attention that is non-judgmental, purposeful, and focused on the present moment. It has been well established in cognitive-behavior therapy in the last decades, while it has been investigated in manualized group settings such as mindfulness-based stress reduction and mindfulness-based cognitive therapy. However, there is scarce research evidence on the effects of mindfulness as a treatment element in individual therapy. Consequently, the demand to investigate mindfulness under effectiveness conditions in trainee therapists has been highlighted. Methods/Design: To fill in this research gap, we designed the PrOMET Study. In our study, we will investigate the effects of brief, audiotape-presented, session-introducing interventions with mindfulness elements conducted by trainee therapists and their patients at the beginning of individual therapy sessions in a prospective, randomized, controlled design under naturalistic conditions with a total of 30 trainee therapists and 150 patients with depression and anxiety disorders in a large outpatient training center. We hypothesize that the primary outcomes of the session-introducing intervention with mindfulness elements will be positive effects on therapeutic alliance (Working Alliance Inventory) and general clinical symptomatology (Brief Symptom Checklist) in contrast to the session-introducing progressive muscle relaxation and treatment-as-usual control conditions. Treatment duration is 25 therapy sessions. Therapeutic alliance will be assessed on a session-to-session basis. Clinical symptomatology will be assessed at baseline, session 5, 15 and 25. We will conduct multilevel modeling to address the nested data structure. The secondary outcome measures include depression, anxiety, interpersonal functioning, mindful awareness, and mindfulness during the sessions. Discussion: The study results could provide important practical implications because they could inform ideas on how to improve the clinical training of psychotherapists that could be implemented very easily; this is because there is no need for complex infrastructures or additional time concerning these brief session-introducing interventions with mindfulness elements that are directly implemented in the treatment sessions. Trial registration: From ClinicalTrials.gov, Identifier: NCT02270073 (registered October 6, 2014

The Effects of Health Care Chatbot Personas With Different Social Roles on the Client-Chatbot Bond and Usage Intentions: Development of a Design Codebook and Web-Based Study

Background The working alliance refers to an important relationship quality between health professionals and clients that robustly links to treatment success. Recent research shows that clients can develop an affective bond with chatbots. However, few research studies have investigated whether this perceived relationship is affected by the social roles of differing closeness a chatbot can impersonate and by allowing users to choose the social role of a chatbot. Objective This study aimed at understanding how the social role of a chatbot can be expressed using a set of interpersonal closeness cues and examining how these social roles affect clients’ experiences and the development of an affective bond with the chatbot, depending on clients’ characteristics (ie, age and gender) and whether they can freely choose a chatbot’s social role. Methods Informed by the social role theory and the social response theory, we developed a design codebook for chatbots with different social roles along an interpersonal closeness continuum. Based on this codebook, we manipulated a fictitious health care chatbot to impersonate one of four distinct social roles common in health care settings—institution, expert, peer, and dialogical self—and examined effects on perceived affective bond and usage intentions in a web-based lab study. The study included a total of 251 participants, whose mean age was 41.15 (SD 13.87) years; 57.0% (143/251) of the participants were female. Participants were either randomly assigned to one of the chatbot conditions (no choice: n=202, 80.5%) or could freely choose to interact with one of these chatbot personas (free choice: n=49, 19.5%). Separate multivariate analyses of variance were performed to analyze differences (1) between the chatbot personas within the no-choice group and (2) between the no-choice and the free-choice groups. Results While the main effect of the chatbot persona on affective bond and usage intentions was insignificant (P=.87), we found differences based on participants’ demographic profiles: main effects for gender (P=.04, ηp2=0.115) and age (P<.001, ηp2=0.192) and a significant interaction effect of persona and age (P=.01, ηp2=0.102). Participants younger than 40 years reported higher scores for affective bond and usage intentions for the interpersonally more distant expert and institution chatbots; participants 40 years or older reported higher outcomes for the closer peer and dialogical-self chatbots. The option to freely choose a persona significantly benefited perceptions of the peer chatbot further (eg, free-choice group affective bond: mean 5.28, SD 0.89; no-choice group affective bond: mean 4.54, SD 1.10; P=.003, ηp2=0.117). Conclusions Manipulating a chatbot’s social role is a possible avenue for health care chatbot designers to tailor clients’ chatbot experiences using user-specific demographic factors and to improve clients’ perceptions and behavioral intentions toward the chatbot. Our results also emphasize the benefits of letting clients freely choose between chatbots

Personality change through a digital-coaching intervention: Using measurement invariance testing to distinguish between trait domain, facet, and nuance change

Recent intervention research has shown that personality traits can be modified through psychological interventions. However, it is unclear whether reported effects represent changes in the trait domain or only some facets or items. Using data ( N = 552) from a recent intervention trial, the present study examined the effects of a digital-coaching intervention on self- and observer-reported personality facets and items. We focused on participants who wanted to decrease in Negative Emotionality, increase in Conscientiousness or increase in Extraversion. We used measurement invariance testing to examine which level of the trait domain hierarchy changed during the intervention. For the self-reports, we found some heterogeneity in the effects on all three trait domains, but most notably Extraversion and Conscientiousness. Specifically, participants reported to increase strongly on sociability (Extraversion), and moderately on productiveness and organization (Conscientiousness), but not on the other facets of these trait domains. Observers generally reported small but non-significant changes, with no scalar invariance violations except for Extraversion. Overall, this suggests considerable heterogeneity in intervention-related personality change that can be overlooked if only focusing on the trait domain level. We discuss the relevance of measurement invariance testing and measurement approaches for personality development and intervention research

Personality change through a digital-coaching intervention: Using measurement invariance testing to distinguish between trait domain, facet, and nuance change

Recent intervention research has shown that personality traits can be modified through psychological interventions. However, it is unclear whether reported effects represent changes in the trait domain or only some facets or items. Using data ( N = 552) from a recent intervention trial, the present study examined the effects of a digital-coaching intervention on self- and observer-reported personality facets and items. We focused on participants who wanted to decrease in Negative Emotionality, increase in Conscientiousness or increase in Extraversion. We used measurement invariance testing to examine which level of the trait domain hierarchy changed during the intervention. For the self-reports, we found some heterogeneity in the effects on all three trait domains, but most notably Extraversion and Conscientiousness. Specifically, participants reported to increase strongly on sociability (Extraversion), and moderately on productiveness and organization (Conscientiousness), but not on the other facets of these trait domains. Observers generally reported small but non-significant changes, with no scalar invariance violations except for Extraversion. Overall, this suggests considerable heterogeneity in intervention-related personality change that can be overlooked if only focusing on the trait domain level. We discuss the relevance of measurement invariance testing and measurement approaches for personality development and intervention research