TY - JOUR A1 - Kühne, Franziska A1 - Meister, Ramona A1 - Maass, Ulrike A1 - Paunov, Tatjana A1 - Weck, Florian T1 - How reliable are therapeutic competence ratings? BT - results of a systematic review and meta-analysis JF - Cognitive therapy and research N2 - 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. KW - competency KW - therapist competence KW - adherence KW - psychotherapy KW - assessment Y1 - 2019 U6 - https://doi.org/10.1007/s10608-019-10056-5 SN - 0147-5916 SN - 1573-2819 VL - 44 IS - 2 SP - 241 EP - 257 PB - Springer CY - New York ER - TY - JOUR A1 - Wagner, Birgit A1 - Rosenberg, Nicole A1 - Hofmann, Laura A1 - Maaß, Ulrike T1 - Web-based bereavement care BT - a systematic review and meta-analysis JF - Frontiers in psychiatry N2 - Background: Web-based interventions have been introduced as novel and effective treatments for mental disorders and, in recent years, specifically for the bereaved. However, a systematic summary of the effectiveness of online interventions for people experiencing bereavement is still missing. Objective: A systematic literature search was conducted by four reviewers who reviewed and meta-analytically summarized the evidence for web-based interventions for bereaved people. Methods: Systematic searches (PubMed, Web of Science, PsycInfo, PsycArticles, Medline, and CINAHL) resulted in seven randomized controlled trials (N= 1,257) that addressed adults having experienced bereavement using internet-based interventions. We used random effects models to summarize treatment effects for between-group comparisons (treatmentvs.control at post) and stability over time (postvs.follow-up). Results: All web-based interventions were based on cognitive behavioral therapy (CBT). In comparison with control groups, the interventions showed moderate (g= .54) to large effects (g= .86) for symptoms of grief and posttraumatic stress disorder (PTSD), respectively. The effect for depression was small (g= .44). All effects were stable over time. A higher number of treatment sessions achieved higher effects for grief symptoms and more individual feedback increased effects for depression. Other moderators (i.e.dropout rate, time since loss, exposure) did not significantly reduce moderate degrees of heterogeneity between the studies. Limitations: The number of includable studies was low in this review resulting to lower power for moderator analyses in particular. Conclusions: Overall, the results of web-based bereavement interventions are promising, and its low-threshold approach might reduce barriers to bereavement care. Nonetheless, future research should further examine potential moderators and specific treatment components (e.g.exposure, feedback) and compare interventions with active controls. KW - grief KW - bereavement KW - depression KW - post-traumatic stress disorder KW - internet KW - e-health KW - intervention KW - psychotherapy Y1 - 2020 U6 - https://doi.org/10.3389/fpsyt.2020.00525 SN - 1664-0640 VL - 11 PB - Frontiers Media CY - Lausanne ER - TY - JOUR A1 - Maaß, Ulrike A1 - Kühne, Franziska A1 - Maas, Jana A1 - Unverdross, Maria A1 - Weck, Florian T1 - Psychological interventions for health anxiety and somatic symptoms BT - a systematic review and meta-analysis JF - Zeitschrift für Psychologie = Journal of psychology N2 - This study examined the effectiveness of psychological interventions for severe health anxiety (SHA) regarding somatic symptoms (SS) and health anxiety (HA). The databases Web of Science, EBSCO, and CENTRAL were searched on May 15, 2019, May 16, 2019, and August 5, 2019, respectively. Eighteen randomized controlled trials (N = 2,050) met the inclusion criteria (i.e., hypochondriasis, illness anxiety disorder or somatic symptom disorder with elevated HA being assessed with validated interviews: use of standardized outcome measures). Two reviewers independently evaluated the studies' risk of bias using the Revised Cochrane Risk-of-Bias Tool for randomized trials (RoB-2) tool. Overall, psychological interventions were significantly more effective than waitlist, treatment-as-usual, or placebo post-treatment (g(SS) = 0.70, g(HA) = 1.11) and at follow-up (g(SS) = 0.33, g(HA)= 0.70). CBT outperformed other psychological interventions or pharmacotherapy for HA post- treatment (Hedge's g(HA) = 0.81). The number of sessions did not significantly predict the effect sizes. In sum, psychological interventions were effective for SHA, but the generalizability of the results for SS is limited, because only two high-quatity trials contributed to the comparison. KW - health anxiety KW - hypochondriasis KW - systematic review KW - meta-analysis KW - psychotherapy Y1 - 2020 U6 - https://doi.org/10.1027/2151-2604/a000400 SN - 2190-8370 SN - 2151-2604 VL - 228 IS - 2 SP - 68 EP - 80 PB - Hogrefe CY - Göttingen ER - TY - JOUR A1 - Maaß, Ulrike A1 - Kühne, Franziska A1 - Poltz, Nadine A1 - Lorenz, Anna A1 - Ay-Bryson, Destina Sevde A1 - Weck, Florian T1 - Live supervision in psychotherapy training BT - a systematic review JF - Training and education in professional psychology N2 - There is increasing interest in improving psychotherapy training using evidence-based supervision. One approach is live supervision (LS), in which the supervisor offers immediate feedback to the trainee (e.g., via microphone, text messages) during the session. This review summarizes the research on LS and its main results. The databases Web of Science Core Collection, PsycArticles, PsycBooks, PsycInfo, PSYNDEX, Psychology and Behavioral Sciences Collection, and PubMed were searched from inception to January 23, 2020 (including a backward search) and updated November 15, 2020. The inclusion criteria (i.e., main focus on LS, immediate feedback from a present supervisor, psychological setting) were met by k = 138 publications, including k = 8 randomized controlled trials (RCTs; N = 339). Two reviewers independently evaluated the RCTs' risk of bias using the revised Cochrane Risk-of-Bias Tool. Most publications had a family therapy background (59%), were categorized as nonempirical (55%), aimed primarily at describing or comparing specific LS methods (35%), and displayed positive views on LS (87%). Based on the RCTs, LS was superior to no-supervision in 78% of all comparisons, but only in 13% of the cases compared to a delayed supervision (DS) condition (i.e., regarding trainee skills, patient outcomes, or other variables). These results somewhat contradict the overall favorable views in the literature. However, the generalizability is limited due to a lack of high-quality studies and substantial heterogeneity in terms of LS methods, concepts, outcomes, and measurements. Ideas for more systematic research on LS regarding objectives and methods are proposed.
Public Significance Statement This review summarizes research on live supervision (LS). LS is a form of supervision in psychotherapy training in which the supervisor observes the trainee's therapy session and provides immediate feedback. The review concludes that LS is probably as effective as delayed supervision (DS), although more high-quality research is needed. KW - psychotherapy KW - feedback KW - bug-in-the-eye KW - training KW - therapist competence Y1 - 2022 U6 - https://doi.org/10.1037/tep0000390 SN - 1931-3918 SN - 1931-3926 VL - 16 IS - 2 SP - 130 EP - 142 PB - American Psychological Association CY - Washington ER - TY - JOUR A1 - Heinze, Peter Eric A1 - Weck, Florian A1 - Kühne, Franziska T1 - Assessing patient preferences BT - examination of the german cooper-norcross inventory of preferences JF - Frontiers in psychology N2 - Despite the positive effects of including patients' preferences into therapy on psychotherapy outcomes, there are still few thoroughly validated assessment tools at hand. We translated the 18-item Cooper-Norcross Inventory of Preferences (C-NIP) into German and aimed at replicating its factor structure. Further, we investigated the reliability of the questionnaire and its convergence with trait measures. A heterogeneous sample of N = 969 participants took part in our online survey. Performing ESEM models, we found acceptable model fit for a four-factor structure similar to the original factor structure. Furthermore, we propose an alternative model following the adjustment of single items. The German C-NIP showed acceptable to good reliability, as well as small correlations with Big-Five personality traits, trait and attachment anxiety, locus of control, and temporal focus. However, we recommend further replication of the factor structure and further validation of the C-NIP. KW - psychotherapy KW - preference KW - activity preference KW - preference assessment KW - validation study Y1 - 2022 U6 - https://doi.org/10.3389/fpsyg.2021.795776 SN - 1664-1078 VL - 12 PB - Frontiers Media CY - Lausanne ER - TY - JOUR A1 - Heinze, Peter Eric A1 - Weck, Florian A1 - Kühne, Franziska T1 - Assessing Patient Preferences BT - Examination of the German Cooper-Norcross Inventory of Preferences JF - Frontiers in Psychology N2 - Despite the positive effects of including patients’ preferences into therapy on psychotherapy outcomes, there are still few thoroughly validated assessment tools at hand. We translated the 18-item Cooper-Norcross Inventory of Preferences (C-NIP) into German and aimed at replicating its factor structure. Further, we investigated the reliability of the questionnaire and its convergence with trait measures. A heterogeneous sample of N = 969 participants took part in our online survey. Performing ESEM models, we found acceptable model fit for a four-factor structure similar to the original factor structure. Furthermore, we propose an alternative model following the adjustment of single items. The German C-NIP showed acceptable to good reliability, as well as small correlations with Big-Five personality traits, trait and attachment anxiety, locus of control, and temporal focus. However, we recommend further replication of the factor structure and further validation of the C-NIP. KW - psychotherapy KW - preference KW - activity preference KW - preference assessment KW - validation study Y1 - 2021 U6 - https://doi.org/10.3389/fpsyg.2021.795776 SN - 1664-1078 VL - 12 PB - Frontiers Research Foundation CY - Lausanne ER - TY - JOUR A1 - Heinzel, Stephan A1 - Rapp, Michael A. A1 - Fydrich, Thomas A1 - Ströhle, Andreas A1 - Teran, Christina A1 - Kallies, Gunnar A1 - Schwefel, Melanie A1 - Heissel, Andreas T1 - Neurobiological mechanisms of exercise and psychotherapy in depression BT - the SPeED studyRationale, design, and methodological issues JF - Clinical Trials N2 - Background/Aims: Even though cognitive behavioral therapy has become a relatively effective treatment for major depressive disorder and cognitive behavioral therapy-related changes of dysfunctional neural activations were shown in recent studies, remission rates still remain at an insufficient level. Therefore, the implementation of effective augmentation strategies is needed. In recent meta-analyses, exercise therapy (especially endurance exercise) was reported to be an effective intervention in major depressive disorder. Despite these findings, underlying mechanisms of the antidepressant effect of exercise especially in combination with cognitive behavioral therapy have rarely been studied to date and an investigation of its neural underpinnings is lacking. A better understanding of the psychological and neural mechanisms of exercise and cognitive behavioral therapy would be important for developing optimal treatment strategies in depression. The SPeED study (Sport/Exercise Therapy and Psychotherapyevaluating treatment Effects in Depressive patients) is a randomized controlled trial to investigate underlying physiological, neurobiological, and psychological mechanisms of the augmentation of cognitive behavioral therapy with endurance exercise. It is investigated if a preceding endurance exercise program will enhance the effect of a subsequent cognitive behavioral therapy. Methods: This study will include 105 patients diagnosed with a mild or moderate depressive episode according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). The participants are randomized into one of three groups: a high-intensive or a low-intensive endurance exercise group or a waiting list control group. After the exercise program/waiting period, all patients receive an outpatient cognitive behavioral therapy treatment according to a standardized therapy manual. At four measurement points, major depressive disorder symptoms (Beck Depression Inventory, Hamilton Rating Scale for Depression), (neuro)biological measures (neural activations during working memory, monetary incentive delay task, and emotion regulation, as well as cortisol levels and brain-derived neurotrophic factor), neuropsychological test performance, and questionnaires (psychological needs, self-efficacy, and quality of life) are assessed. Results: In this article, we report the design of the SPeED study and refer to important methodological issues such as including both high- and low-intensity endurance exercise groups to allow the investigation of dose-response effects and physiological components of the therapy effects. Conclusion: The main aims of this research project are to study effects of endurance exercise and cognitive behavioral therapy on depressive symptoms and to investigate underlying physiological and neurobiological mechanisms of these effects. Results may provide important implications for the development of effective treatment strategies in major depressive disorder, specifically concerning the augmentation of cognitive behavioral therapy by endurance exercise. KW - Major depressive disorder KW - depression KW - psychotherapy KW - cognitive behavioral therapy KW - endurance exercise KW - training KW - functional magnetic resonance imaging KW - brain-derived neurotrophic factor KW - basic psychological needs KW - cortisol Y1 - 2017 U6 - https://doi.org/10.1177/1740774517729161 SN - 1740-7745 SN - 1740-7753 VL - 15 IS - 1 SP - 53 EP - 64 PB - Sage Publ. CY - London ER - TY - JOUR A1 - Jeglinski-Mende, Melinda A. A1 - Schmidt, Hendrikje T1 - Psychotherapy in the Framework of Embodied Cognition BT - Does Interpersonal Synchrony Influence Therapy Success? JF - Frontiers in Psychiatry N2 - Mental health problems remain among the main generators of costs within and beyond the health care system. Psychotherapy, the tool of choice in their treatment, is qualified by social interaction, and cooperation within the therapist-patient-dyad. Research into the factors influencing therapy success to date is neither exhaustive nor conclusive. Among many others, the quality of the relationship between therapist and patient stands out regardless of the followed psychotherapy school. Emerging research points to a connection between interpersonal synchronization within the sessions and therapy outcome. Consequently, it can be considered significant for the shaping of this relationship. The framework of Embodied Cognition assumes bodily and neuronal correlates of thinking. Therefore, the present paper reviews investigations on interpersonal, non-verbal synchrony in two domains: firstly, studies on interpersonal synchrony in psychotherapy are reviewed (synchronization of movement). Secondly, findings on neurological correlates of interpersonal synchrony (assessed with EEG, fMRI, fNIRS) are summarized in a narrative manner. In addition, the question is asked whether interpersonal synchrony can be achieved voluntarily on an individual level. It is concluded that there might be mechanisms which could give more insights into therapy success, but as of yet remain uninvestigated. Further, the framework of embodied cognition applies more to the current body of evidence than classical cognitivist views. Nevertheless, deeper research into interpersonal physical and neurological processes utilizing the framework of Embodied Cognition emerges as a possible route of investigation on the road to lower drop-out rates, improved and quality-controlled therapeutic interventions, thereby significantly reducing healthcare costs. KW - psychotherapy KW - embodied cognition KW - hyperscanning KW - motion energy analysis KW - neurofeedback KW - EEG KW - fMRI KW - fNIRS Y1 - 2021 U6 - https://doi.org/10.3389/fpsyt.2021.562490 SN - 1664-0640 VL - 12 PB - Frontiers Research Foundation CY - Lausanne ER - TY - JOUR A1 - Domhardt, Matthias A1 - Gesslein, Helene A1 - von Rezori, Roman Enzio A1 - Baumeister, Harald T1 - Internet- and mobile-based interventions for anxiety disorders BT - a meta-analytic review of intervention components JF - Depreddion and anxiety N2 - 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. KW - active ingredient KW - change mechanism KW - common and specific factor KW - e-health KW - guidance KW - psychotherapy Y1 - 2019 U6 - https://doi.org/10.1002/da.22860 SN - 1091-4269 SN - 1520-6394 VL - 36 IS - 3 SP - 213 EP - 224 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Philipp, Rebecca A1 - Kriston, Levente A1 - Lanio, Jana A1 - Kühne, Franziska A1 - Härter, Martin A1 - Moritz, Steffen A1 - Meister, Ramona T1 - Effectiveness of metacognitive interventions for mental disorders in adults-A systematic review and meta-analysis (METACOG) JF - Clinical psychology & psychotherapy N2 - 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. KW - mental disorders KW - meta-analysis KW - metacognition KW - psychotherapy KW - systematic review Y1 - 2018 U6 - https://doi.org/10.1002/cpp.2345 SN - 1063-3995 SN - 1099-0879 VL - 26 IS - 2 SP - 227 EP - 240 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Kühne, Franziska A1 - Lacki, Fiona Janina A1 - Muse, Kate A1 - Weck, Florian T1 - Strengthening competence of therapists-in-training in the treatment of health anxiety (hypochondriasis) BT - validation of the assessment of Core CBT Skills (ACCS) JF - Clinical psychology & psychotherapy : an international journal of theory and practice N2 - 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. KW - adherence KW - assessment KW - process research KW - psychotherapy KW - skill Y1 - 2019 U6 - https://doi.org/10.1002/cpp.2353 SN - 1063-3995 SN - 1099-0879 VL - 26 IS - 3 SP - 319 EP - 327 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Kühne, Franziska A1 - Lesser, Hannah A1 - Petri, Franziska A1 - Weck, Florian T1 - Do mental health patients learn what their cognitive-behaviour therapists think they do? BT - A short report on qualitative interviews comparing perspectives JF - International Journal of Qualitative Studies on Health and Well-being N2 - Purpose: The acquisition of skills is essential to the conceptualization of cognitive-behavioural therapy. Yet, what experiences are encountered and what skills actually learned during therapy, and whether patients and therapists have concurrent views hereof, remains poorly understood. Method: An explorative pilot study with semi-structured, corresponding interview guides was conducted. Pilot data from our outpatient unit were transcribed and content-analyzed following current guidelines. Results: The responses of 18 participants (patients and their psychotherapists) were assigned to six main categories. Educational and cognitive aspects were mentioned most frequently and consistently by both groups. Having learned Behavioural alternatives attained the second highest agreement between perspectives. Conclusions: Patients and therapists valued CBT as an opportunity to learn new skills, which is an important prerequisite also for the maintenance of therapeutic change. We discuss limitations to generalizability but also theoretical and therapy implications. KW - cognitive-behavioural therapy (CBT) KW - psychotherapy KW - interview study KW - learning KW - skills Y1 - 2018 U6 - https://doi.org/10.1080/17482631.2018.1527598 SN - 1748-2631 SN - 1748-2623 VL - 13 IS - 1 PB - Taylor & Francis Group CY - London ER -