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Background
Despite the prevalence of obsessive-compulsive disorder (OCD), its precise identification remains challenging. With the Zohar-Fineberg Obsessive-Compulsive Screen (ZF-OCS; 5 or 6 items), a brief instrument is widely available mainly in English. As there is a lack of empirical studies on the ZF-OCS, the aim of the present study was to translate the items into German and investigate the instrument in a nonclinical sample.
Methods
In two consecutive online surveys, n = 304 and n = 51 students participated. Besides the ZF-OCS, they answered established measures on OCD, depression, health anxiety, general anxiety and health-related well-being.
Results
Whereas internal consistency was low (α = .53–.72; ω = .55–.69), retest reliability (rt1,t2 = .89) at two weeks was high. As expected, we found high correlations with other OCD instruments (r > .61; convergent validity), and significantly weaker correlations with measures of depression (r = .39), health anxiety (r = .29), and health-related well-being (r = −.28, divergent validity). Nonetheless, the correlations with general anxiety were somewhere in between (r = .52).
Conclusions
Due to heterogeneous OCD subtypes, the ZF-OCS asks diverse questions which probably resulted in the present internal consistency. Nevertheless, the results on retest reliability and validity were promising. As for other OCD instruments, divergent validity regarding general anxiety seems problematic to establish. Even so, the ZF-OCS seems valuable for screening purposes, as it is short and easy to administer, and may facilitate initiating subsequent clinical assessment. Further studies should determine the instrument’s diagnostic accuracy.
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.
Theoretischer Hintergrund:Supervision spielt eine zentrale Rolle zum Wissens- und Kompetenzerwerb sowie in der Qualitätssicherung.
Fragestellung:Ziel war es, den aktuellen Forschungsstand zur Supervision im Rahmen der kognitiven Verhaltenstherapie abzubilden, um daraus Schlussfolgerungen für die zukünftige Forschung abzuleiten.
Methode:Zur Evidenzsynthese wurde ein Scoping Review durchgeführt, das die Darstellung zentraler Konzepte, aktueller Evidenz und möglicher Forschungsbedarfe ermöglichte. Neben einer systematischen Literaturrecherche wurden Vorwärts- und Rückwärtssuchstrategien eingesetzt.
Ergebnisse:Eingeschlossen wurden zwölf Publikationen basierend auf zehn empirischen Studien. Alle Studien beschrieben Ausbildungssettings, aber nur wenige untersuchten übende Interventionen (z. B. Rollenspiele). Häufig wurden Effekte subjektiv erfasst, die methodische Qualität der Begleitstudien variierte.
Schlussfolgerungen:Notwendig sind weitere methodisch hochwertige Studien, experimentell orientiert oder in der klinischen Praxis, die die Supervisionsforschung bereichern können.
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.
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.
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. <br /> 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.
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.
Theoretischer Hintergrund:Supervision spielt eine zentrale Rolle zum Wissens- und Kompetenzerwerb sowie in der Qualitätssicherung.
Fragestellung:Ziel war es, den aktuellen Forschungsstand zur Supervision im Rahmen der kognitiven Verhaltenstherapie abzubilden, um daraus Schlussfolgerungen für die zukünftige Forschung abzuleiten.
Methode:Zur Evidenzsynthese wurde ein Scoping Review durchgeführt, das die Darstellung zentraler Konzepte, aktueller Evidenz und möglicher Forschungsbedarfe ermöglichte. Neben einer systematischen Literaturrecherche wurden Vorwärts- und Rückwärtssuchstrategien eingesetzt.
Ergebnisse:Eingeschlossen wurden zwölf Publikationen basierend auf zehn empirischen Studien. Alle Studien beschrieben Ausbildungssettings, aber nur wenige untersuchten übende Interventionen (z. B. Rollenspiele). Häufig wurden Effekte subjektiv erfasst, die methodische Qualität der Begleitstudien variierte.
Schlussfolgerungen:Notwendig sind weitere methodisch hochwertige Studien, experimentell orientiert oder in der klinischen Praxis, die die Supervisionsforschung bereichern können.
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.
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.