[What do Patients Experience between Group Sessions during Inpatient Psychotherapy? An Application of the Inter-Session-Questionnaire in Psychotherapeutic Hospitals]. / Was erleben Patienten in stationärer Psychotherapie zwischen den Gruppentherapie-Sitzungen? Eine Erprobung des Inter-Session-Fragebogens in der Klinik.

The study describes an application of the Inter-Session-Questionnaire (ISF) related to inpatient group psychotherapy. The instrument should be tested with the extension of differentiating intersession experiences related to the person of the therapist as well as the group. In a cross sectional study performed in 13 different hospitals, 702 patients were assessed. These patients were treated in rehab hospitals, acute hospitals as well as special hospitals providing treatment for eating disorders. The sample should be relatively representative for psychosomatic and psychotherapeutic hospitals in Germany. Besides the type of the hospital, we also analysed the influence of group characteristics (size of group, type of group and number of completed sessions) as well as the patients' sex. Surprisingly, there were almost no marked differences of inter-session-experiences related to the the therapist or the group. The profiles of the item judgements of the ISF were similar to those reported for outpatient and day treatment samples. Inter-session-experiences differed in part according to our expectation depending on the variables mentioned above which suggests to use the ISF in specific studies dealing with the process and outcome of inpatient group psychotherapy as well as the differentiation of relevant subgroups.

[Training background, everyday practice, and training needs of group therapists working in inpatient psychotherapy - Results of a survey]. / Ausbildungshintergrund, Alltagspraxis und Weiterbildungsbedarf von Gruppenpsychotherapeuten in der stationären Psychotherapie - Ergebnisse einer Umfrage.

OBJECTIVES: A survey serves to clarify whether psychotherapists working in inpatient and day treatment psychotherapeutic hospitals feel sufficiently trained as group therapists and what their specific training needs are. METHODS: The survey queried 175 therapists from different hospitals and professions who perform group psychotherapy in their hospital. The questionnaire focussed on training experiences, everyday group practice, and training needs. RESULTS: As expected, only some of the therapists had completed training as group therapist. The therapists are faced with a wide variety of group formats and patients in their everyday work and reveal a broad spectrum of training needs. CONCLUSIONS: The survey, although not entirely representative, indicates general and specific needs of group therapists within psychotherapeutic hospitals and underlines the role of training and therapist experience in reducing uneasiness toward group psychotherapy.

[Indication decision in preliminary talks of a psychiatric day hospital]. / Indikationsstellung in Vorgesprächen einer psychiatrischen Tagesklinik.

OBJECTIVE: The aim of this study is to assess relevant patient- and therapist-associated traits for indication decision for a psychiatric day hospital. METHODS: Therapeutic assessments concerning emotional experience, initial working relationship and disorder-related criteria were investigated after 155 preliminary talks at one day hospital. RESULTS: A higher patient`s motivation and a current symptomatology predict a positive indication outcome. Patients who do not start treatment although a positive indication are significantly less motivated, a personality disorder is suspected more likely and the quality of the working relationship tends to be worse than in the admitted patients. CONCLUSIONS: Preliminary talks have a selective function concerning the indication for day hospital treatment.

SCL-90-R symptom profile clusters among inpatients undergoing psychodynamic group psychotherapy: cluster stability, associations with clinical characteristics and treatment outcome.

BACKGROUND/AIMS: Based on pretreatment psychopathological symptoms measured with the Symptom Checklist 90 Revised (SCL-90-R), this study investigated whether stable symptom clusters exist among psychotherapy inpatients. Furthermore, it was examined whether the identified clusters would differ with respect to clinical characteristics and treatment outcome. SAMPLING AND METHODS: We collected data from a total of 3,688 psychotherapeutic inpatients involved in psychodynamic group psychotherapy from 10 hospitals. Ipsatized SCL-90-R presymptom data were used as input variables for a series of cluster analyses combining hierarchical (Ward algorithm) and non-hierarchical (k-means) procedures. RESULTS: The cluster analyses revealed a 7-cluster solution with the following subgroups: (1) insecure-paranoid, (2) neutralizing, (3) phobic-anxious, (4) aggressive, (5) insecure-phobic, (6) somatizing, and (7) obsessive-depressive. Cross-validation with independent data sets, as well as alternative statistical procedures, confirmed the stability of the 7-cluster solution. Correlations with clinical diagnoses and interpersonal problems indicate the clinical relevance of the cluster differentiation. The cluster insecure-phobic proved to be less beneficial when used as a predictor of treatment outcome. Furthermore, we found moderator effects between cluster assignment and pretreatment interpersonal problems: the overall amount of interpersonal problems seemed to be detrimental to the patients from the clusters insecure-phobic and somatizing, whereas a relatively (ipsatized) heightened level of dominance was advantageous for improving psychopathological complaints of the patients from the cluster aggressive. CONCLUSIONS: We could identify typical and clinically meaningful symptom clusters for the population of inpatients undergoing psychodynamic group psychotherapy in Germany. This finding could help strengthen clinical research which is led by the assumption that it is relevant to characterize patients by a specific pattern of psychopathological symptoms rather than or in addition to one (or more) distinct diagnostic categories.

Associations among attachment characteristics, patients' assessment of therapeutic factors, and treatment outcome following inpatient psychodynamic group psychotherapy.

Within a multisite study, including 289 inpatients from six different hospitals who underwent interpersonal-psychodynamic group psychotherapy, associations among attachment characteristics, therapeutic factors, and treatment outcome were investigated. Attachment characteristics were assessed with an interview-based measure (Adult Attachment Prototype Rating [AAPR]) as well as an attachment self-report (Bielefeld Questionnaire of Client Expectations [BQCE]). Therapeutic factors were measured retrospectively with the Dusseldorf Therapeutic Factors Questionnaire and treated as an individual- as well as a hospital-specific characteristic. On an individual level, only the group climate factor independently predicted treatment outcome (i.e., Symptom Checklist-90-R Global Severity Index and Inventory of Interpersonal Problems mean). If simultaneously but separately included into a path model, analyses revealed independent significant effects of AAPR-Security and BQCE-Security on group climate. If modeled as a latent variable (common attachment security), a substantially higher proportion of group climate variance could be explained. Further analyses revealed interactions between particular therapeutic factors and attachment characteristics, indicating a particular importance of these therapeutic factors for different attachment categories.

[Day hospital treatment of depressive patients]. / Tagesklinische Behandlung von Menschen mit depressiven Erkrankungen.

OBJECTIVE: Day hospital treatment offers diverse therapeutical options for depressive patients. Which are those and which depressive clientele visits a general psychiatric day hospital? METHODS: In order to find answers to this question the literature was searched, a 7-year-evaluation of the clientele of the day hospital of the Hannover Medical School and two vignettes are presented. RESULTS: The effectiveness of day hospital treatment for depressive patients is proved by the literature, especially for the elderly. Advantages and limitations of day hospital treatment in depressive patients are discussed including results of an own study. CONCLUSIONS: An individually adapted day hospital treatment can be an effective treatment for depressive patients.

Treatment concepts of day hospitals for general psychiatric patients. Findings from a national survey in Germany.

Psychiatric day hospital treatment concepts have to deal with a wide spectrum of mental disorders. We raised the question, if day hospitals can be differentiated concerning their treatment concepts and if so how much this is reflected in their structural and procedural features. In 1999 a survey was initiated concerning structure, concept and method of treatment in psychiatric day hospitals for adults in Germany. Furthermore data concerning rate of utilization, patients' characteristics and aspects of referral and further treatment were ascertained. One hundred and seventy-three (63.4%) of 273-day hospitals contacted took part in the inquiry. The data were interpreted using multivariate as well as non-parametric procedures. The results show that treatment concepts of day hospitals can be specified as three main areas of function (psychotherapy, crisis intervention orientated treatment alternative, rehabilitation) and four therapeutic orientations (psychodynamic social psychiatric, behavioral social psychiatric, psychodynamic, sociotherapeutic). Structural features are predominantly comparable and the differences found concerning the treatment concepts are especially related to patients' characteristics and some procedural features. The conclusion is that the differentiation of day hospital treatment concepts should be taken into consideration in planning psychosocial treatment services as well as in day hospital evaluation research.

[Long-term stability of body experience after in-patient group psychotherapy with concentrative movement therapy]. / Katamnestische Stabilität des Körpererlebens nach stationärer Gruppenbehandlung mit Konzentrativer Bewegungstherapie.

Body experience of 34 patients was investigated two years after the end of treatment with Concentrative Movement Therapy (KBT) in an in-patient integrative psychotherapy. Change in body experience at the end of treatment and after the two year period was compared to symptomatic strain and the amount of interpersonal problems. Body experience was rather restricted in the beginning of treatment. The improvement of body experience during treatment showed to be stable after two years, as did the symptomatic strain. Interpersonal problems were not reduced as much during treatment but in the follow-up period. Patients with benefit from KBT treatment through a better approach to their body, felt more bodily self-confident at the end of treatment. They also had less feelings of insecurity and apprehension concerning their body than those who could profit little from KBT. In both groups a reduction of symptomatic strain was found. Patients with little profit from KBT had higher symptomatic and interpersonal strain and more feelings of insecurity concerning their body in the beginning of the treatment. Their improvement at the time of follow-up was low. Results are discussed regarding the relevance of different elements of integrative in-patient therapy and the possibility of differential indications for body-oriented psychotherapy.

[Consensus paper on the terminological differentiation of various aspect of body experience]. / Konsensuspapier zur terminologischen Abgrenzung von Teilaspekten des Körpererlebens in Forschung und Praxis.

In the past, phenomenological research on subjective body experience was characterised by vaguely defined terminology and methodological shortcomings. The term "body image" has been applied heterogeneously in literature in order to describe a variety of bodily phenomena. In this paper, the German terminology applied to the phenomenology of body experiences is described systematically. In developing a systematic terminology the authors refer to scientific evidence as well as recent reviews, and closely adhere to definitions commonly used in English literature. Different perspectives are utilised, particularly anthropological concepts and theories from developmental and self-psychology. Distinct aspects of body experience are described within the context of a network of external determinants and along a continuum between somatic and mental anchor points. Applying the term "body experience" as umbrella term, different aspects are defined: perceptive (body schema/-perceive), affective (body-cathexis), cognitive-evaluative (body-image, body-ego) and body-consciousness. It is emphasized, that the distinct description of functional levels has to be taken as an approximation of the reality of integrated body experience.

[Burned-out or stimulated? - professional experience of body-oriented psychotherapists based on therapists for concentrative movement therapy (KBT)]. / Ausgebrannt oder angeregt? - Beruflicher Erfahrungshintergrund von Körperpsychotherapeuten am Beispiel von Therapeuten für Konzentrative Bewegungstherapie (KBT).

The results of 91 therapists, trained in Concentrative Movement Therapy (KBT), in the "Development of Psychotherapist Common Core Questionnaire (DPCCQ)" are compared to the therapists' results in other DPCCQ-studies, to find out whether there are differences in professional experiences. It is shown that KBT-therapists agree with other therapists concerning a positive valuation of their professional development and competence but they have more currently experienced flow. Similarities to other therapists predominate in regard to working morale, burn-out, difficulties and coping strategies in the therapeutic practice too. A few special features for KBT-therapists can be found which seem to reflect characteristic aspects of the method.

[Is body oriented psychotherapy a female matter? A clinical process-outcome-study of concentrative movement therapy]. / Ist körperorientierte Psychotherapie Frauensache? - Eine klinische Prozess-Ergebnis-Studie zur Konzentrativen Bewegungstherapie -

It is often thought, that men have more difficulties in body oriented psychotherapy than women because of the gender specific differences in the attitude towards the body. Using a sample of 62 in-patients, the present study considers the question, whether in clinical psychotherapy influences of sex and age (as control variables) on course and outcome of treatment with Concentrative Movement Therapy (KBT) are found. Course of treatment is recorded by the Group Experience Questionnaire for KBT. Global results of treatment are recorded multidimensionally. KBT related results are determined by ratings of the group therapist. Both global scores are computed. Main result is, that sex and age have no predictive meaning for treatment results and do not clearly differentiate the treatment course. Some effects of sex and age are found concerning the connection of group experience and treatment results. The results lead to hypotheses about differential therapeutic mechanism of KBT depending on age and sex. They need further empirical confirmation.