Coaching as a growth- or security-oriented process-How regulatory fit increases coaching success.

Regulatory focus theory suggests that promoters are more concerned with growth and preventers are more concerned with security. Since coaching is a growth-oriented process, it seems to be more suitable for clients high on promotion than for clients high on prevention. Applying regulatory fit theory, the present research investigates how preventers can also benefit from coaching. First, a study looking at real coaching processes (N1 = 103) found that a higher promotion than prevention focus was indeed related to more coaching success, i.e., satisfaction and approach motivation. Next, testing the hypothesis that fit effects should also be present in coaching, a study using a vignette approach (N2 = 99) shows that participants experiencing a fit between their focus and a promotion versus a prevention coaching indicate a better coaching evaluation than participants experiencing no fit. In three studies (N3a = 120, N3b = 85, N3c = 189), we used an experimental approach and manipulated the regulatory focus of coaching interventions. We found promotion as well as prevention fit effects showing that participants experiencing a fit indicate more coaching success than participants experiencing no fit. Two studies (N4a = 41, N4b = 87) further tested interpersonal fit, i.e., the fit between the coach's and client's regulatory focus. We found promotion as well as prevention fit effects on participants' satisfaction with and trust in a coach (Study 4a) and promotion fit effects on participants' goal attainment and coaching progress (4b). The findings suggest that by adapting coaching to the client's focus, coaching success can be increased not only for promoters but also for preventers. Thus, we found that regulatory fit effects, albeit small to medium, are also present in coaching. Multiple studies assessing multiple variables relevant to coaching showed that the findings differ regarding the interventions used and the variables that we looked at. The practical implications of these findings are discussed.

Music therapy in palliative setting.

The expectations on the care of humans with an incurable disease are to console, to relieve pain and to take away somebody's fears. Therefore, palliative care tries to support terminally ill persons during the last stage of life and to ameliorate the living conditions. The question is how far music therapy can increase the quality of life. Until now, there is only small evidence for that, because there are too few applicable studies.

Therapy of the burnout syndrome.

BACKGROUND: The prevalence, diagnostics and therapy of the burnout syndrome are increasingly discussed in the public. The unclear definition and diagnostics of the burnout syndrome are scientifically criticized. There are several therapies with unclear evidence for the treatment of burnout in existence. OBJECTIVES: The health technology assessment (HTA) report deals with the question of usage and efficacy of different burnout therapies. METHODS: For the years 2006 to 2011, a systematic literature research was done in 31 electronic databases (e.g. EMBASE, MEDLINE, PsycINFO). Important inclusion criteria are burnout, therapeutic intervention and treatment outcome. RESULTS: 17 studies meet the inclusion criteria and are regarded for the HTA report. The studies are very heterogeneous (sample size, type of intervention, measuring method, level of evidence). Due to their study design (e.g. four reviews, eight randomized controlled trials) the studies have a comparable high evidence: three times 1A, five times 1B, one time 2A, two times 2B and six times 4. 13 of the 17 studies are dealing with the efficacy of psychotherapy and psychosocial interventions for the reduction of burnout (partly in combination with other techniques). Cognitive behaviour therapy leads to the improvement of emotional exhaustion in the majority of the studies. The evidence is inconsistent for the efficacy of stress management and music therapy. Two studies regarding the efficacy of Qigong therapy do not deliver a distinct result. One study proves the efficacy of roots of Rhodiola rosea (evidence level 1B). Physical therapy is only in one study separately examined and does not show a better result than standard therapy. DISCUSSION: Despite the number of studies with high evidence the results for the efficacy of burnout therapies are preliminary and do have only limited reach. The authors of the studies complain about the low number of skilled studies for the therapy of burnout. Furthermore, they point to the insufficient evaluation of the therapy studies and the need for further research. Some authors report the effects of considerable natural recovering. Numerous limitations affect the quality of the results. Intervention contents and duration, study design and study size are very diverse and do not permit direct comparison. Most of the samples are small by size with low statistical power, long-term follow-ups are missing. Comorbidities and parallel utilized therapies are insufficient documented or controlled. Most of the studies use the Maslach Burnout Inventory (MBI) as diagnostic or outcome-tool, but with different cut-off-points. It should be noticed that the validity of the MBI as diagnostic tool is not proved. Ethical, juridical and social determining factors are not covered or discussed in the studies. CONCLUSION: The efficacy of therapies for the treatment of the burnout syndrome is insufficient investigated. Only for cognitive behavioural therapy (CBT) exists an adequate number of studies which prove its efficacy. Big long-term experimental studies are missing which compare the efficacy of the single therapies and evaluate their evidence. The natural recovering without any therapy needs further research. Additionally, it has to be examined to what extent therapies and their possible effects are thwarted by the conditions of the working place and the working conditions.