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Institute
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.
ObjectivesThe use of simulated and standardized patients (SP) is widely accepted in the medical field and, from there, is beginning to disseminate into clinical psychology and psychotherapy. The purpose of this study was therefore to systematically review barriers and facilitators that should be considered in the implementation of SP interventions specific to clinical psychology and psychotherapy.MethodsFollowing current guidelines, a scoping review was conducted. The literature search focused on the MEDLINE, PsycINFO and Web of Science databases, including Dissertation Abstracts International. After screening for titles and abstracts, full texts were screened independently and in duplicate according to our inclusion criteria. For data extraction, a pre-defined form was piloted and used. Units of meaning with respect to barriers and facilitators were extracted and categorized inductively using content-analysis techniques. From the results, a matrix of interconnections and a network graph were compiled.ResultsThe 41 included publications were mainly in the fields of psychiatry and mental health nursing, as well as in training and education. The detailed category system contrasts four supercategories, i.e., which organizational and economic aspects to consider, which persons to include as eligible SPs, how to develop adequate scenarios, and how to authentically and consistently portray mental health patients.ConclusionsPublications focused especially on the interrelation between authenticity and consistency of portrayals, on how to evoke empathy in learners, and on economic and training aspects. A variety of recommendations for implementing SP programs, from planning to training, monitoring, and debriefing, is provided, for example, ethical screening of and ongoing support for SPs.