Psychotherapie Psychosomatik Medizinische Psychologie最新文献

Almost everyone owns things that would be difficult to throw away - for instance a favorite picture, a keepsake from childhood or an item of daily use that has been valued over the years. In individuals suffering from pathological hoarding, the gathering of items reaches a pathological extent. This article presents typical symptoms of this mental disorder, maintaining factors and a psychotherapeutic treatment.

Recalled Parental Rearing Behavior is an important factor of socialization and vulnerability. Based on two representative surveys, Recalled Parental Rearing Behavior of fathers and mothers is compared between the eastern and the western German states from the perspectives of men and women in the years of 1994 and 2020. Participants, aged between 14 and 92 years, filled out the standardized Recalled Parental Questionnaire in 1994 (N=2948) and 2020 (N=2503). Results were compared by ANOVA according to time point, East-West-differences, sex and age. According to hypotheses, paternal and maternal rearing behavior was recalled in Germany as less punishing and warmer in 2020 compared to 1994. Parental rearing behavior of fathers and mothers was consistently reported less punishing and warmer in the eastern compared to the western states. Parental overprotection was more strongly recalled in 1994 in the western than the eastern states. As in the case of recalled warmth assessments in both regions converged over time. As in previous surveys, sons recalled their parents in east and west more punishing and less warm than daughters; daughters recalled their mothers only marginally warmer than sons. Older participants recalled parental rearing behavior consistently more negatively than younger ones. In the second survey assessments of the older cohorts were consistently more positive than in the previous survey with comparable age cohorts. Findings are discussed with regard to the impact of sociocultural characteristics on recalled parental rearing behavior under the aspects of cohort and age (e. g., convergence of sociocultural differences in East and West, gender roles, recall effects). On the background of robust associations with mental disorders, positive recollections of parental rearing behavior can be considered an important mental resource, reflecting multiple sociocultural influences and trends.

Specialized therapeutic residential communities for individuals with eating disorders have become increasingly common in Germany. These facilities provide intensive care for clients whose disorder is too severe to be managed with outpatient psychotherapy alone. The study explores which residents are treated in these settings, which measures are carried out there and how the result is to be assessed from the perspective of the professionals.All residential communities affiliated with the German Federal Association for Eating Disorders (Bundesfachverband Essstörungen e.V. BFE) were invited to participate in the study. Seventeen residential community providers contributed data, which consisted of questionnaires completed by health professionals to collect key information about clients discharged over a one-year period.Data from 101 clients was analyzed. The majority of clients had been diagnosed with anorexia nervosa (78%), followed by bulimia nervosa (18%). Many clients had been hospitalized multiple times in the past. The mean age was 21 years (SD: 3.7), with 16 residents being minors at admission. The average length of stay was 17 months. Among clients with anorexia nervosa, the mean Body Mass Index (BMI) increased from 17.5 kg/m² at admission to 19.4 kg/m² at discharge. According to the evaluations by the staff, 73% of the clients with bulimia nervosa no longer had any binge eating episodes at the time they were discharged. Other disorder-specific symptoms also notably improved in both groups. Facilities commonly provided psychotherapeutic and socio-pedagogical interventions in individual and group formats, along with family therapy and crisis management as needed. Professionals rated the services as generally helpful for most residents.Specialized residential communities for individuals with eating disorders play a critical role in supporting recovery, particularly during the transition between inpatient and outpatient care.

Emotional experience and emotion regulation are one of the focal points of gerontological research. However, the clinical significance of these issues in older people has been little investigated.

Methods: In the present study, a clinical group of elderly patients (>60 years of age) was assessed with the Emotion Experience and Regulation (EER) questionnaire and compared with a middle-aged clinical sample (40-60 years) and a healthy sample of older subjects (>60 years).

Results: The results confirm that clinically conspicuous older people hardly differ from younger patients in passive-negative emotions, but do differ in active-negative emotions, which are similarly low in older patients as in healthy older people. Older patients are less successful at maximising positive emotions.

Conclusion: In therapy, a special focus should be placed on reducing passive-negative and generating positive emotions.

Self-reflection is considered a central component in the training of clinical psychologists and requires accurate self-assessment of psychotherapeutic competencies. However, previous research suggests that self-assessment of psychotherapeutic skills is prone to biases. The aim of this study was to assess the ability of master's students to evaluate their own competencies and to identify person-specific and situational factors predicting self-assessment.The study was conducted as part of the communication skills practicum in the master's program in Clinical Psychology and Psychotherapy at the University of Mannheim. At the end of the practicum, students conducted an anamnesis interview with simulated patients. Subsequently, 39 master's students assessed their own psychotherapeutic competencies in the anamnesis interview using the Cognitive Therapy Scale. Additionally, a trained expert evaluated the competencies to compare self-assessments with external evaluations. Therapeutic self-efficacy was recorded before the practicum as a person-specific factor predicting self-assessment. The difficulty of the simulated interview was coded to determine situational factors.On average, the agreement between self-assessment and external evaluation of competencies was low (ICC=0.25). Overall, students underestimated their psychotherapeutic competencies, particularly when their performance was above average. However, when their performance was below average, they tended to overestimate their competencies. Especially higher therapeutic self-efficacy predicted more positive self-assessment scores. Higher self-efficacy was also associated with an overestimation of one's own competencies.The results of the study indicate that self-assessment of psychotherapeutic competencies by master's students is subject to systematic biases. Initial findings also suggest that person-specific factors are better predictors of the distortion of self-assessment than situational factors.To ensure beneficial self-reflection, master's students should be trained in the reliable assessment of their own psychotherapeutic competencies.

To promote the competence of psychotherapists in the long term, it is necessary to adapt the content of the training programs to the specific needs of those involved in therapy. The present study explores which therapeutic competence psychotherapy trainees and patients consider relevant. In addition, it examines the extent to which the understanding of competence aligns within therapist-patient pairs and the role this alignment plays in the therapeutic alliance.Psychotherapy trainees (N=58) and their patients (N=51) were asked two open-ended questions about important therapeutic competences and relevant aspects of a good therapeutic relationship. The answers were assigned to the competence categories of the contextual model by Anderson and Hill and the Facilitative Interpersonal Skills (FIS) by Anderson using a structuring content analysis. In addition, the relationship between the alignment in the answers of therapist-patient pairs and the therapeutic alliance (Working Alliance Inventory - Short Revised) was examined.While relational competence was mentioned most frequently, cultural competence was missing in all responses. Some of the aspects mentioned could not be assigned to any competence field of the contextual model. Regarding a good therapeutic relationship, warmth, acceptance and understanding and alliance bond capacity were particularly emphasized. The alignment in the answers of the therapist-patient pairs was high on average. However, alignment and the therapeutic alliance did not show any significant correlation.The perspectives of the respondents were represented to varying degrees by the theoretical models. The importance of therapists' and patients' competence understanding for therapy needs to be further investigated. The results of the present study are consistent with previous research that shows relationship skills to be a central aspect of psychotherapy. For areas of competence that were missing from the respondents' answers, awareness should be raised specifically within training and further education.

The 2020 reform of the German Psychotherapist Act emphasizes competency acquisition in university education. The measurement of competence is therefore of central importance. It remains unclear to what extent Facilitative Interpersonal Skills (FIS) can be used in this context and how additional competence domains can be addressed. The aim of this study is to introduce an assessment procedure for psychotherapeutic competencies as defined by the new licensing regulations.In an online study, 60 students responded to six newly generated video case vignettes covering competence domains relevant to professional practice and licensure. Responses were audio-recorded and assessed using the FIS and a newly developed domain-specific competence scale (FI-KOMP).FIS and FI-KOMP correlated vignette-specific. Interpersonally challenging situations were more difficult to address than less challenging ones. The FIS scale demonstrated good psychometric properties when applied to the new vignettes. The results for FI-KOMP suggest that a domain-specific competence assessment appears to be reasonable. Final grades and sociodemographic data did not predict either of the two scales.The procedure appears suitable for individualizing competence acquisition in university training and may provide a more comprehensive measure of competence. The FIS scale seems to be an appropriate instrument across all newly developed vignettes. The results for FI-KOMP suggest that specific scenarios capture behavioral competencies. A domain-specific competence assessment appears reasonable.The study presents a competence assessment procedure, highlighting challenges and potential for promoting individualized training plans in the master's program. Further research on selection criteria for admissions is encouraged.

Practical training formats for the acquisition of psychotherapeutic competencies and skills are currently being developed and tested for their effectiveness. The DYNAMIC curriculum aims to promote the development of psychodynamic intervention skills over the course of therapeutic training, the overall curriculum consists of 8 practical training seminars in 4 years. The study reported here focuses on self-reported, subjectively perceived longitudinal development of general dynamic intervention skills. For the investigation of this research question, 82 current postgraduate trainees in psychodynamic psychotherapy were recruited and attended practical training seminars. The study period was 2 years, during this time participants attended 1-4 seminars. They reported on their perceived general dynamic intervention skills before and after each seminar. The results show that there is a significant subjective competence increase during the first few seminars, which decreases over the course of the curriculum. At the same time, the average level of subjectively experienced competence increased over the two years studied. Limitations exist due to the self-report scale that was used and the lack of a control group. Despite these limitations, the findings indicate a positive effect of practical training seminars on subjectively perceived general psychodynamic competence development.

Clinical micro-skills, such as empathic communication, are essential in every therapeutic session, regardless of theoretical orientation or patient diagnosis. These skills should be fostered from the outset of clinical training. This study explores various facets of clinical micro-skills and their development throughout training.The sample included 59 future therapists, comprising master's students and psychotherapists at early and advanced stages of training. Clinical micro-skills were assessed using the Clinical Micro-Skill Training Scale (CMST) by two independent raters, based on reaction videos to scripted patient statements. Skill facets and their progression were analyzed using an Aligned Rank Transform (ART) ANOVA followed by post-hoc tests.The ART ANOVA revealed significant main effects for skill facets (F(2,11)=42.58, p<0,001, ηp²=0,43) and training level (F(2,56)=7,18, p=0,002, ηp²=0,20). Communicative skills were the most developed across all training levels, while interpersonal skills were the least developed. Marked inter-individual differences were observed: some participants excelled across all skill facets, others in only one or two, and some struggled in all three. Differences between training levels were most pronounced in interpersonal skills.The significant differences in clinical micro-skill facets suggest that therapeutic competence should be measured in a differentiated way rather than as a global value. Future research should longitudinally explore how personal strengths and weaknesses can be systematically addressed.

The construct of therapeutic competence should enable measurement of therapist effectiveness, though this poses challenges. This study aimed to investigate the increase in students' competence in clinical communication skills through objective assessment, and to reflect on learning experiences with competence assessment.Communication techniques were taught over three seminar sessions, each using standardized 20-minute role plays. Between the second and third sessions, the participants received structured or unstructured video supervision. Competence was evaluated by two independent rater groups using an adapted Cognitive Therapy Rating Scale (CTRS).The videos of 82 students were analyzed. Interrater reliability was low in the first group of raters (ICC3,1=0.48) and non-existent in the second group (ICC3,1=0.00). A small main effect of assessment time point was observed, indicating a slight, non-significant increase in clinical communication skills from the first to the third session. Neither the effect of supervision nor the interaction effect was significance.Due to the chosen application of the CTRS, a standardized and objective assessment of therapeutic interviewing skills was not feasible, requiring cautious interpretation of the results regarding clinical communication skills. The fit of the measurement instrument, the standardization of the assessed situation and the lack of experience of the raters probably had affected interrater reliability negatively. These aspects can also be a challenge in the newly introduced parcours examination for the licence to practise psychotherapy and must be taken into account when planning and classifying the evaluation.