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An exploration of activity and therapist preferences and their predictors in German-speaking samples
(2023)
According to current definitions of evidence-based practice, patients’ preferences play an important role for the psychotherapeutic process and outcomes. However, whereas a significant body of research investigated preferences regarding specific treatments, research on preferred activities or therapist characteristics is rare, investigated heterogeneous aspects with inconclusive results, lacked validated assessment tools, and neglected relevant preferences, their predictors as well as the perspective of mental health professionals. Therefore, the three studies of this dissertation aimed to address the most fundamental drawbacks in current preference research by providing a validated questionnaire, focus efforts on activity and therapist preferences and add preferences of psychotherapy trainees. To this end, Paper I reports the translation and validation of the 18-item Cooper-Norcross Inventory of Preference (C-NIP) in a broad, heterogeneous sample of N = 969 laypeople, resulting in good to acceptable reliabilities and first evidence of validity. However, the original factor structure was not replicated. Paper II assesses activity preferences of psychotherapists in training using the C-NIP and compares them with the initial laypeople sample. There were significant differences between both samples, with trainees preferring a more patient-directed, emotionally intense and confrontational approach than laypeople. CBT trainees preferred a more therapist-directed, present-focused, challenging and less emotional intense approach than psychodynamic or -analytic trainees. Paper III explores therapist preferences and tests predictors for specific preference choices. For most characteristics, more than half of the participants did not have specific preferences. Results pointed towards congruency effects (i.e., preference for similar characteristics), especially for members of marginalized groups. The dissertation provides both researchers and practitioners with a validated questionnaire, shows potentially obstructive differences between patients and therapists and underlines the importance of therapist characteristics for marginalized groups, thereby laying the foundation for future applications and implementations in research and practice.
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. <br /> 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.
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.
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.
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.
Zur Abschaffung des Gutachterverfahrens in der Vertragspsychotherapie – ein Qualitätsverlust?
(2021)
Zielsetzung: Der vorliegende Artikel befasst sich mit der Fragestellung, inwiefern das Gutachterverfahren in der Vertragspsychotherapie ein zuverlässiges Qualitätsinstrument darstellt und ob sich aus der geplanten Abschaffung des Gutachterverfahrens das Risiko einer Qualitätsminderung in der ambulanten Psychotherapie ergibt.
Methodik: Es wurde eine Literaturrecherche durchgeführt. Arbeiten von den Jahren 2000 bis 2020 wurden berücksichtigt, welche sich mit dem Gutachterverfahren als Qualitätsmerkmal der ambulanten Psychotherapie befassen. Um die unterschiedlichen Standpunkte der zitierten Autor_innen zu diskutieren, wurde auch Bezug auf weiterführende Literatur genommen.
Ergebnisse: Das Gutachterverfahren scheint empirisch nicht sicher als zuverlässiges Qualitätsmerkmal der ambulanten Psychotherapie herangezogen werden zu können. Die Annahme, dass sich durch eine gutachterbefreite Vertragspsychotherapie eine Qualitätsminderung der Psychotherapie ergibt, wird durch die hier zusammengefassten Arbeiten insgesamt nicht gestützt.
Hintergrund: Im Rahmen des reformierten Psychotherapeutengesetzes wird eine starkere Praxisorientierung in der klinisch-psychologischen Lehre und in der Prufung psychotherapeutischer Kompetenzen verankert. Hierbei sollen Studierende durch die Interaktion mit standardisierten Patient*innen (SP) therapeutische Kompetenzen erwerben und demonstrieren. Fragestellung: Das Ziel des vorliegenden Beitrags ist es, eine evidenzbasierte Umsetzung dieser neuen Lehr- und Prufungsformate zu unterstutzen, indem bisherige Forschungsbefunde zum Einsatz von SP dargestellt und Bereiche, in denen weitere Forschung notwendig ist, aufgezeigt werden. Ergebnisse: Empirische Befunde zeigen, dass SP psychische Storungen authentisch darstellen konnen. Voraussetzung dafur sind beispielsweise die Auswahl geeigneter SP, detaillierte Rollenanleitungen, spezifisches Training, Feedback und Nachschulungen. Auch wenn einige Forschungsfragen, wie zur vergleichenden Wirksamkeit des Einsatzes von SP, noch unbeantwortet sind, lassen sich praktische Implikationen fur SP-Programme in Lehre, Prufung und Forschung ableiten, die in einem Ablaufschema dargestellt werden. Schlussfolgerungen: Der Einsatz von SP bietet gro ss es Potenzial fur die klinisch-psychologische Lehre und Ausbildungsforschung. Um den Einsatz von SP an anderen Standorten zu unterstutzen, werden Beispielmaterialien (z.B. Rollenanleitung) in den elektronischen Supplementen (siehe www.karger.com/doi/10.1159/000509249 fur alle Supplemente) zum Artikel zur Verfugung gestellt.
Eine veränderte Interozeption ist ein zentrales Korrelat der Anorexia nervosa (AN) und stellt einen potentiellen Ansatz in der Genesung der AN dar. Erste Ergebnisse zur Wirksamkeit von Yoga als körperorientierte Methode in der Therapie der AN sind vielversprechend. Dennoch liegen bislang unzureichende empirische Befunde bezüglich der Frage vor, auf welche Weise Yoga-Strategien und Yoga-Elemente wie Körperhaltungen, Entspannungs-, Atem-, und Meditationsübungen eingesetzt werden sollten. Vor diesem Hintergrund führten wir eine qualitative Pilotstudie mit einer Stichprobe von n=6 Patientinnen mit AN durch, die sich im Anschluss an eine klinische stationäre Behandlung in einer pädagogisch-therapeutischen Facheinrichtung der Jugend- und Eingliederungshilfe (SGB VIII/XII) befanden. Die Studienteilnehmerinnen erhielten eine einstündige Hatha-Yoga-Intervention über mindestens 12 Wochen. Nach der Yoga-Intervention wurden ½- bis 1-stündige halbstrukturierte Leitfadeninterviews zu den Erfahrungen mit den verwendeten Yoga-Strategien durchgeführt. Die Interviews wurden mittels Grounded Theory ausgewertet. Auf der obersten Analyseebene wurden 4 Kategorien differenziert: Angaben 1) zum Beschwerdebild der Studienteilnehmerinnen, 2) zu als hilfreich erlebten Elementen des therapeutischen Rahmens, 3) zu als hilfreich erlebten Yoga-Strategien sowie 4) zu subjektiv wahrgenommenen Konsequenzen der Yoga-Strategien. Bezüglich der als hilfreich erlebten Yoga-Strategien ergaben die Analysen 4 Subkategorien: Merkmale 1) der Bewegungselemente, 2) der Meditations- und Atemübungen, 3) der Entspannungsübungen sowie 4) allgemeine Hinweise zur Durchführung. Die Ergebnisse geben erste Hinweise für die Konzeption von Yoga in der Therapie der AN und zu potentiellen Wirkmechanismen. Weiterführende qualitative sowie quantitative Studien zu u. a. Wirksamkeit, Kontraindikationen oder Mediator- sowie Moderatorvariablen sind erforderlich, um das Potenzial von Yoga in der Therapie der AN noch besser bewerten zu können.
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.
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.