@misc{PhilippKristonLanioetal.2019, author = {Philipp, Rebecca and Kriston, Levente and Lanio, Jana and K{\"u}hne, Franziska and H{\"a}rter, Martin and Moritz, Steffen and Meister, Ramona}, title = {Effectiveness of metacognitive interventions for mental disorders in adults-A systematic review and meta-analysis (METACOG)}, series = {Clinical psychology \& psychotherapy}, volume = {26}, journal = {Clinical psychology \& psychotherapy}, number = {2}, publisher = {Wiley}, address = {Hoboken}, issn = {1063-3995}, doi = {10.1002/cpp.2345}, pages = {227 -- 240}, year = {2019}, abstract = {We evaluated the effectiveness and acceptability of metacognitive interventions for mental disorders. We searched electronic databases and included randomized and nonrandomized controlled trials comparing metacognitive interventions with other treatments in adults with mental disorders. Primary effectiveness and acceptability outcomes were symptom severity and dropout, respectively. We performed random-effects meta-analyses. We identified Metacognitive Training (MCTrain), Metacognitive Therapy (MCTherap), and Metacognition Reflection and Insight Therapy (MERIT). We included 49 trials with 2,609 patients. In patients with schizophrenia, MCTrain was more effective than a psychological treatment (cognitive remediation, SMD = -0.39). It bordered significance when compared with standard or other psychological treatments. In a post hoc analysis, across all studies, the pooled effect was significant (SMD = -0.31). MCTrain was more effective than standard treatment in patients with obsessive-compulsive disorder (SMD = -0.40). MCTherap was more effective than a waitlist in patients with depression (SMD = -2.80), posttraumatic stress disorder (SMD = -2.36), and psychological treatments (cognitive-behavioural) in patients with anxiety (SMD = -0.46). In patients with depression, MCTherap was not superior to psychological treatment (cognitive-behavioural). For MERIT, the database was too small to allow solid conclusions. Acceptability of metacognitive interventions among patients was high on average. Methodological quality was mostly unclear or moderate. Metacognitive interventions are likely to be effective in alleviating symptom severity in mental disorders. Although their add-on value against existing psychological interventions awaits to be established, potential advantages are their low threshold and economy.}, language = {en} } @misc{DomhardtGessleinvonRezorietal.2019, author = {Domhardt, Matthias and Gesslein, Helene and von Rezori, Roman Enzio and Baumeister, Harald}, title = {Internet- and mobile-based interventions for anxiety disorders}, series = {Depreddion and anxiety}, volume = {36}, journal = {Depreddion and anxiety}, number = {3}, publisher = {Wiley}, address = {Hoboken}, issn = {1091-4269}, doi = {10.1002/da.22860}, pages = {213 -- 224}, year = {2019}, abstract = {BackgroundAlthough the efficacy of Internet- and mobile-based interventions (IMIs) for anxiety is established, little is known about the intervention components responsible for therapeutic change. We conducted the first comprehensive meta-analytic review of intervention components of IMIs for adult anxiety disorders. MethodsRandomized controlled trials (RCTs) comparing IMIs for anxiety disorders to active online control groups, or IMIs to dismantled variations of the same intervention ( specific components) were identified by a systematic literature search in six databases. Outcomes were validated observer-rated or self-report measures for anxiety symptom severity and treatment adherence (number of completed modules and completer rate). This meta-analytic review is registered with PROSPERO (CRD42017068268). ResultsWe extracted the data of 34 RCTs (with 3,724 participants) and rated the risk of bias independently by two reviewers. Random-effects meta-analyses were performed on 19 comparisons of intervention components (i.a., different psychotherapeutic orientations, disorder-specific vs. transdiagnostic approaches, guidance factors). IMIs had a large effect when compared to active online controls on symptom severity (standardized mean difference [SMD] of -1.67 [95\% CI: -2.93, -0.42]; P=0.009). Thereby, guided IMIs were superior to unguided interventions on symptom severity (SMD of -0.39 [95\% CI: -0.59, -0.18]; P=0.0002) and adherence (SMD of 0.38 [95\% CI: 0.10, 0.66]; P=0.007). ConclusionsOverall, the results of this meta-analysis lend further support to the efficacy of IMIs for anxiety, pointing to their potential to augment service supplies. Still, future research is needed to determine which ingredients are essential, as this meta-analytic review found no evidence for incremental effects of several single intervention components apart from guidance.}, language = {en} } @article{KuehneLackiMuseetal.2019, author = {K{\"u}hne, Franziska and Lacki, Fiona Janina and Muse, Kate and Weck, Florian}, title = {Strengthening competence of therapists-in-training in the treatment of health anxiety (hypochondriasis)}, series = {Clinical psychology \& psychotherapy : an international journal of theory and practice}, volume = {26}, journal = {Clinical psychology \& psychotherapy : an international journal of theory and practice}, number = {3}, publisher = {Wiley}, address = {Hoboken}, issn = {1063-3995}, doi = {10.1002/cpp.2353}, pages = {319 -- 327}, year = {2019}, abstract = {Although the observation and assessment of psychotherapeutic competences are central to training, supervision, patient care, quality control, and life-long practice, structured instruments are used only occasionally. In the current study, an observation-based tool for the Assessment of Core CBT Skills (ACCS) was translated into German and adapted, and its psychometric properties were pilot evaluated. Competence of therapists-in-training was assessed in a random sample of n = 30 videos on cognitive behavioural therapy including patients diagnosed with hypochondriasis. Two of three raters independently assessed the competences demonstrated in the entire, active treatment sessions (n = 60). In our sample, internal consistency was excellent, and interrater reliability was good. Convergent validity (Cognitive Therapy Scale) and discriminant validity (Helping Alliance Questionnaire) were within the expected ranges. The ACCS total score did not significantly predict the reduction of symptoms of hypochondriasis, and a one-factorial structure of the instrument was found. By providing multiple opportunities for feedback, self-reflection, and supervision, the ACCS may complement current tools for the assessment of psychotherapeutic competences and importantly support competence-based training and supervision.}, language = {en} } @article{KuehneMeisterMaassetal.2019, author = {K{\"u}hne, Franziska and Meister, Ramona and Maass, Ulrike and Paunov, Tatjana and Weck, Florian}, title = {How reliable are therapeutic competence ratings?}, series = {Cognitive therapy and research}, volume = {44}, journal = {Cognitive therapy and research}, number = {2}, publisher = {Springer}, address = {New York}, issn = {0147-5916}, doi = {10.1007/s10608-019-10056-5}, pages = {241 -- 257}, year = {2019}, abstract = {Assessments of psychotherapeutic competencies play a crucial role in research and training. However, research on the reliability and validity of such assessments is sparse. This study aimed to provide an overview of the current evidence and to provide an average interrater reliability (IRR) of psychotherapeutic competence ratings. A systematic review was conducted, and 20 studies reported in 32 publications were collected. These 20 studies were included in a narrative synthesis, and 20 coefficients were entered into the meta-analysis. Most primary studies referred to cognitive-behavioral therapies and the treatment of depression, used the Cognitive Therapy Scale, based ratings on videos, and trained the raters. Our meta-analysis revealed a pooled ICC of 0.82, but at the same time severe heterogeneity. The evidence map highlighted a variety of variables related to competence assessments. Further aspects influencing the reliability of competence ratings and regarding the considerable heterogeneity are discussed in detail throughout the manuscript.}, language = {en} } @phdthesis{Perlich2019, author = {Perlich, Anja}, title = {Digital collaborative documentation in mental healthcare}, doi = {10.25932/publishup-44029}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-440292}, school = {Universit{\"a}t Potsdam}, pages = {x, 135}, year = {2019}, abstract = {With the growth of information technology, patient attitudes are shifting - away from passively receiving care towards actively taking responsibility for their well- being. Handling doctor-patient relationships collaboratively and providing patients access to their health information are crucial steps in empowering patients. In mental healthcare, the implicit consensus amongst practitioners has been that sharing medical records with patients may have an unpredictable, harmful impact on clinical practice. In order to involve patients more actively in mental healthcare processes, Tele-Board MED (TBM) allows for digital collaborative documentation in therapist-patient sessions. The TBM software system offers a whiteboard-inspired graphical user interface that allows therapist and patient to jointly take notes during the treatment session. Furthermore, it provides features to automatically reuse the digital treatment session notes for the creation of treatment session summaries and clinical case reports. This thesis presents the development of the TBM system and evaluates its effects on 1) the fulfillment of the therapist's duties of clinical case documentation, 2) patient engagement in care processes, and 3) the therapist-patient relationship. Following the design research methodology, TBM was developed and tested in multiple evaluation studies in the domains of cognitive behavioral psychotherapy and addiction care. The results show that therapists are likely to use TBM with patients if they have a technology-friendly attitude and when its use suits the treatment context. Support in carrying out documentation duties as well as fulfilling legal requirements contributes to therapist acceptance. Furthermore, therapists value TBM as a tool to provide a discussion framework and quick access to worksheets during treatment sessions. Therapists express skepticism, however, regarding technology use in patient sessions and towards complete record transparency in general. Patients expect TBM to improve the communication with their therapist and to offer a better recall of discussed topics when taking a copy of their notes home after the session. Patients are doubtful regarding a possible distraction of the therapist and usage in situations when relationship-building is crucial. When applied in a clinical environment, collaborative note-taking with TBM encourages patient engagement and a team feeling between therapist and patient. Furthermore, it increases the patient's acceptance of their diagnosis, which in turn is an important predictor for therapy success. In summary, TBM has a high potential to deliver more than documentation support and record transparency for patients, but also to contribute to a collaborative doctor-patient relationship. This thesis provides design implications for the development of digital collaborative documentation systems in (mental) healthcare as well as recommendations for a successful implementation in clinical practice.}, language = {en} }