TY - JOUR A1 - Weck, Florian A1 - Grikscheit, Florian A1 - Höfling, Volkmar A1 - Kordt, Anne A1 - Hamm, Alfons O. A1 - Gerlach, Alexander L. A1 - Alpers, Georg W. A1 - Arolt, Volker A1 - Kircher, Tilo A1 - Pauli, Paul A1 - Rief, Winfried A1 - Lang, Thomas T1 - The role of treatment delivery factors in exposure-based cognitive behavioral therapy for panic disorder with agoraphobia JF - Journal of anxiety disorders N2 - Treatment delivery factors (i.e., therapist adherence, therapist competence, and therapeutic alliance) are considered to be important for cognitive behavioral therapy (CBT) for panic disorder and agoraphobia (PD/AG). In the current study, four independent raters conducted process evaluations based on 168 two-hour videotapes of 84 patients with PD/AG treated with exposure-based CBT. Two raters evaluated patients’ interpersonal behavior in Session 1. Two raters evaluated treatment delivery factors in Session 6, in which therapists provided the rationale for conducting exposure exercises. At the 6-month follow-up, therapists’ adherence (r = 0.54) and therapeutic alliance (r = 0.31) were significant predictors of changes in agoraphobic avoidance behavior; therapist competence was not associated with treatment outcomes. Patients’ interpersonal behavior in Session 1 was a significant predictor of the therapeutic alliance in Session 6 (r = 0.17). The findings demonstrate that treatment delivery factors, particularly therapist adherence, are relevant to the long-term success of CBT for PD/AG. KW - Interpersonal behavior KW - Panic disorder with agoraphobia KW - Therapeutic alliance KW - Therapist adherence KW - Therapist competence Y1 - 2016 U6 - https://doi.org/10.1016/j.janxdis.2016.05.007 SN - 0887-6185 SN - 1873-7897 VL - 42 SP - 10 EP - 18 PB - Elsevier CY - Oxford ER - TY - JOUR A1 - Junga, Yvonne Marie A1 - Witthöft, Michael A1 - Weck, Florian T1 - Assessing therapist development: Reliability and validity of the Supervisee Levels Questionnaire (SLQ-R) JF - Journal of clinical psychology KW - clinical supervision KW - exploratory structural equation modeling KW - psychotherapy training KW - Supervisee Levels Questionnaire Y1 - 2019 U6 - https://doi.org/10.1002/jclp.22794 SN - 0021-9762 SN - 1097-4679 VL - 75 IS - 9 SP - 1658 EP - 1672 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Kühne, Franziska A1 - Fauth, Henriette A1 - Destina Sevde, Ay-Bryson A1 - Visser, Leonie N.C. A1 - Weck, Florian T1 - Communicating the diagnosis of cancer or depression: Results of a randomized controlled online study using video vignettes JF - Cancer Medicine N2 - Background Communicating a diagnosis is highly important, yet complex, especially in the context of cancer and mental disorders. The aim was to explore the communication style of an oncologist vs. psychotherapist in an online study. Methods Patients (N = 136: 65 cancer, 71 depression) were randomly assigned to watch a standardized video vignette with one of two communication styles (empathic vs. unempathic). Outcome measures of affectivity, information recall, communication skills, empathy and trust were applied. Results Regardless of diagnosis, empathic communication was associated with the perception of a significantly more empathic (p < 0.001, η2partial = 0.08) and trustworthy practitioner (p = 0.014, η2partial = 0.04) with better communication skills (p = 0.013, η2partial = 0.05). Cancer patients reported a larger decrease in positive affect (p < 0.001, η2partial = 0.15) and a larger increase in negative affect (p < 0.001, η2partial = 0.14) from pre- to post-video than depressive patients. Highly relevant information was recalled better in both groups (p < 0.001, d = 0.61–1.06). Conclusions The results highlight the importance of empathy while communicating both a diagnosis of cancer and a mental disorder. Further research should focus on the communication of a mental disorder in association with cancer. KW - consultation KW - mental health KW - oncology KW - psycho-oncology KW - skills Y1 - 2021 U6 - https://doi.org/10.1002/cam4.4396 SN - 2045-7634 VL - 10 SP - 9012 EP - 9021 PB - Wiley CY - Hoboken, New Jersey, USA ET - 24 ER - TY - JOUR A1 - Gropalis, Maria A1 - Bailer, Josef A1 - Weck, Florian A1 - Witthöft, Michael T1 - Optimierung von Expositionstherapie bei pathologischen Krankheitsängsten T1 - Optimization of exposure therapy for pathological health anxiety BT - Theoretische Grundlagen und praktische Implikationen BT - Theoretical principles and practical implications JF - Psychotherapeut N2 - Pathologische Krankheitsängste wurden bislang nach ICD und DSM primär als somatoforme Störung bzw. als somatische Belastungsstörung klassifiziert. Theoretische Erwägungen und empirische Befunde legen jedoch nahe, dass es sich bei pathologischen Krankheitsängsten eigentlich um eine Angststörung handelt. Innerhalb des vorliegenden Beitrags wird dafür argumentiert, dass Defizite in der aktuellen Behandlungspraxis und in der Wahrnehmung von Patienten mit Hypochondrie als „schwierige Patienten“ teilweise auf Unklarheit in der Nosologie sowie bezüglich der entscheidenden Mechanismen der Entstehung und Aufrechterhaltung zurückzuführen sind. Ausgehend von innovativen theoretischen Ansätzen zur Erklärung pathologischer Krankheitsängste werden Vorschläge für eine verbesserte therapeutische Praxis skizziert. Der Fokus liegt hierbei auf einem verstärken Einsatz expositionsbasierter Behandlungselemente, die sich am „Inhibitory-learning“-Ansatz orientieren und sich bei anderen Angststörungen bereits bewährt haben. N2 - Up to now pathological health anxiety has been classified primarily as a somatoform disorder or a somatic symptom disorder in ICD and DSM. Theoretical and empirical evidence, however, suggest that pathological health anxiety basically represents an anxiety disorder. In this paper, it is argued that deficits in the treatment and perception of patients with pathological health anxiety as "difficult patients" are partly attributable to a lack of clarity in terms of nosology and with respect to central mechanisms of etiology and pathogenesis. Based on novel theoretical approaches for the explanation of pathological health anxiety, suggestions for an improved therapeutic practice are outlined. This approach focuses on a more intensive use of exposure-based treatment elements that are oriented to the inhibitory learning approach, which has already proven its effectiveness for other anxiety disorders. KW - Hypochondriasis KW - Anxiety disorders KW - Inhibition KW - Learning KW - Cognitive behavior therapy KW - Hypochondrie KW - Angststörungen KW - Inhibition KW - Lernen KW - Kognitive Verhaltenstherapie Y1 - 2018 U6 - https://doi.org/10.1007/s00278-018-0285-1 SN - 0935-6185 SN - 1432-2080 VL - 63 IS - 3 SP - 188 EP - 193 PB - Springer CY - New York ER - TY - JOUR A1 - Weck, Florian T1 - Ein praxisnaher Leitfaden zur kognitiv-verhaltenstherapeutischen Behandlung von Auftrittsängsten bei Musikerinnen und Musikern BT - Rezension zu: Mumm, Jennifer ; Plag, Jens ; Fehm, Lydia ; Witzleben Ines von ; Fernholz, Isabel; Schmidt, Alexander; Stöhle, Andreas: Auftrittsängste bei Musikerinnen und Musikern : ein kognitiv-verhaltenstherapeutischer Behandlungsleitfaden. - Göttingen: Hogrefe, 2020. - 231 S. - ISBN 978-3-8017-2988-2 JF - Zeitschrift für Klinische Psychologie und Psychotherapie Y1 - 2021 SN - 978-3-8017-2988-2 U6 - https://doi.org/10.1026/1616-3443/a000615 SN - 1616-3443 SN - 2190-6297 VL - 50 IS - 1 SP - 46 EP - 47 PB - Hogrefe CY - Göttingen ER - TY - JOUR A1 - Ay-Bryson, Destina Sevde A1 - Weck, Florian A1 - Kühne, Franziska T1 - Can simulated patient encounters appear authentic? BT - development and pilot results of a rating instrument based on the portrayal of depressive patients JF - Training and education in professional psychology N2 - Public Significance Statement This study demonstrates that simulated patients (SPs) can authentically portray a depressive case. The results provide preliminary evidence of psychometrically sound properties of the rating scale that contributes to distinguishing between authentic and unauthentic SPs and may thus foster SPs' dissemination into evidence-based training.
For training purposes, simulated patients (SPs), that is, healthy people portraying a disorder, are disseminating more into clinical psychology and psychotherapy. In the current study, we developed an observer-based rating instrument for the evaluation of SP authenticity-namely, it not being possible to distinguish them from real patients-so as to foster their use in evidence-based training. We applied a multistep inductive approach to develop the Authenticity of Patient Demonstrations (APD) scale. Ninety-seven independent psychotherapy trainees, 77.32% female, mean age of 31.49 (SD = 5.17) years, evaluated the authenticity of 2 independent SPs, each of whom portrayed a depressive patient. The APD demonstrated good internal consistency (Cronbach's alpha = .83) and a strong correlation (r = .82) with an established tool for assessing SP performance in medical contexts. The APD scale distinguished significantly between an authentic and unauthentic SP (d = 2.35). Preliminary evidence for the psychometric properties of the APD indicates that the APD could be a viable tool for recruiting, training, and evaluating the authenticity of SPs. Strengths, limitations, and future directions are also discussed in detail. KW - authenticity KW - evidence-based training KW - standardized patients KW - role-play KW - mental disorders Y1 - 2022 U6 - https://doi.org/10.1037/tep0000349 SN - 1931-3918 SN - 1931-3926 VL - 16 IS - 1 SP - 20 EP - 27 PB - American Psychological Association CY - Washington ER - TY - JOUR A1 - Richtberg, Samantha A1 - Jakob, Marion A1 - Hoefling, Volkmar A1 - Weck, Florian T1 - Patient Characteristics and Patient Behavior as Predictors of Outcome in Cognitive Therapy and Exposure Therapy for Hypochondriasis JF - Journal of clinical psychology N2 - ObjectivePsychotherapy for hypochondriasis has greatly improved over the last decades and cognitive-behavioral treatments are most promising. However, research on predictors of treatment outcome for hypochondriasis is rare. Possible predictors of treatment outcome in cognitive therapy (CT) and exposure therapy (ET) for hypochondriasis were investigated. MethodCharacteristics and behaviors of 75 patients were considered as possible predictors: sociodemographic variables (sex, age, and cohabitation); psychopathology (pretreatment hypochondriacal symptoms, comorbid mental disorders, and levels of depression, anxiety, and somatic symptoms); and patient in-session interpersonal behavior. ResultsSeverity of pretreatment hypochondriacal symptoms, comorbid mental disorders, and patient in-session interpersonal behavior were significant predictors in multiple hierarchical regression analyses. Interactions between the predictors and the treatment (CT or ET) were not found. ConclusionsIn-session interpersonal behavior is an important predictor of outcome. Furthermore, there are no specific contraindications to treating hypochondriasis with CT or ET. KW - cognitive-behavioral therapy KW - hypochondriasis KW - illness anxiety disorder KW - interpersonal behavior KW - predictors of outcome Y1 - 2016 U6 - https://doi.org/10.1002/jclp.22356 SN - 0021-9762 SN - 1097-4679 VL - 73 IS - 6 SP - 612 EP - 625 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Weck, Florian A1 - Kaufmann, Yvonne Marie A1 - Witthöft, Michael T1 - Topics and techniques in clinical supervision in psychotherapy training JF - Cognitive Behaviour Therapist N2 - Clinical supervision is regarded as one of the most important components of psychotherapy training. In clinical practice, it has been found that the implementation of clinical supervision varies substantially and often differs from the recommendations made in the literature. The objective of the current study was to investigate the frequency of topics (e.g. ethical issues) and techniques (e.g. role play) in the clinical supervision of psychotherapy trainees in Germany. To this end, we considered supervisions in cognitive behavioural therapy (CBT) and psychodynamic therapy (PT). A total of 791 psychotherapy trainees (533 CBT and 242 PT) were asked via the internet to provide information about their current supervision sessions. We found that clinical supervision in psychotherapy training addressed topics that are central for the effective treatment of supervised patients (i.e. therapeutic interventions, therapeutic alliance, maintaining factors, and therapeutic goals). However, the most frequently used intervention in clinical supervision in psychotherapy training was case discussion. Rarely were techniques used that allowed the supervisor to give the supervisee feedback based on the supervisee's demonstrated competencies. For example, 46% of the supervisors never used audiotapes or videotapes in the supervision. Differences between CBT and PT were rather small. Current practice regarding the techniques used in clinical supervision for psychotherapy trainees contradicts recommendations for active and feedback-oriented clinical supervision. Thus the potential of clinical supervision might not be fully used in clinical practice. KW - clinical supervision KW - psychotherapy trainees KW - psychotherapy training KW - supervisory strategies KW - therapeutic competence Y1 - 2017 U6 - https://doi.org/10.1017/S1754470X17000046 SN - 1754-470X VL - 10 PB - Cambridge University Press CY - Cambridge ER - TY - JOUR A1 - Probst, Thomas A1 - Jakob, Marion A1 - Kaufmann, Yvonne Marie A1 - Müller-Neng, Julia M. B. A1 - Bohus, Martin A1 - Weck, Florian T1 - Patients’ and therapists’ experiences of general change mechanisms during bug-in-the-eye and delayed video-based supervised cognitive-behavioral therapy BT - a randomized controlled trial JF - Journal of clinical psychology N2 - ObjectiveThis secondary analysis of a randomized controlled trial investigated whether bug-in-the-eye (BITE) supervision (live computer-based supervision during a psychotherapy session) affects the manner in which patients and therapists experience general change mechanisms (GCMs) during cognitive-behavioral therapy (CBT). MethodA total of 23 therapists were randomized either to the BITE condition or the control condition (delayed video-based [DVB] supervision). After each session, both patients (BITE: n=19; DVB: n=23) and therapists (BITE: n=11; DVB: n=12) completed the Helping Alliance Questionnaire (HAQ) and the Bernese Post Session Report (BPSR). The HAQ total score and the 3 secondary factors of the BPSR (interpersonal experiences, intrapersonal experiences, problem actuation) functioned as GCMs. Multilevel models were performed. ResultsFor patients, GCMs did not develop differently between BITE and DVB during CBT. Therapists rated the alliance as well as interpersonal and intrapersonal experiences not significantly different between BITE and DVB during CBT, but they perceived problem actuation to increase significantly more in BITE than in DVB (p<.05). ConclusionBITE supervision might be helpful in encouraging CBT therapists to apply interventions, which focus on the activation of relevant problems and related emotions. KW - alliance KW - general change mechanisms KW - live supervision KW - randomized controlled trial Y1 - 2018 U6 - https://doi.org/10.1002/jclp.22519 SN - 0021-9762 SN - 1097-4679 VL - 74 IS - 4 SP - 509 EP - 522 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Weck, Florian A1 - Nagel, Laura Carlotta A1 - Richtberg, Samantha A1 - Neng, Julia M. B. T1 - Personality disorders in hypochondriasis BT - a comparison to panic disorder and healthy controls JF - Journal of personality disorders N2 - Previous studies found high prevalence rates of personality disorders (PDs) in patients with hypochondriasis; however, assessment was often based only on questionnaires. In the current study, a sample of 68 patients with hypochondriasis was compared to 31 patients with panic disorder and to 94 healthy controls. Participants were investigated with the Structured Clinical Interview for DSM-IV Personality Disorders questionnaire (SCID-II questionnaire) and the SCID-II interview. Based on the cut-off scores of the SCID-II questionnaire, we found a prevalence rate of 45.6% for PD in patients with hypochondriasis. In comparison to healthy controls, patients with hypochondriasis showed characteristics of paranoid, borderline, avoid ant, and-dependent PDs in the dimensional assessment significantly more often. However, no significant differences were found between the clinical samples. Based on the SCID-II interview, only 2.9% of the patients with hypochondriasis fulfilled the criteria for a PD. These results suggest that PDs are not a specific characteristic of hypochondriasis. Y1 - 2017 SN - 0885-579X SN - 1943-2763 VL - 31 SP - 567 EP - 576 PB - Guilford Press CY - New York ER -