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Treatment adherence and outcome in psychotherapy.

Treatment adherence and outcome in psychotherapy.

The outpatient psychotherapy project PAP-S investigates patients treated in outpatient psychotherapies. 10 different therapy concepts (humanistic, psychodynamic, body therapies) with approx. 100 therapists and about 350 patients are included in the study and will be investigated in several regards: time-dosage-outcome relationships in the treatment concepts under study, therapeutic relationship and outcome, treatment adherence and outcome. All therapy sessions are audiotaped and therapists do not know which sessions will be drawn by chance for objective ratings by raters who are blind towards school affiliation of therapists. 
Raters are trained using an intervention manual which covers school specific and nonspecific interventions. This presentation reports about first preliminary results regarding treatment fidelity and outcome across concepts involving 107 therapy sessions from 37 patients, treated by 22 therapists from 7 out of the 10 concepts under study. In sharp contrast to therapists’ own subjective ratings measured after each session, the objective ratings reveal that the school true interventions add up to a maximum of 10 – 20 percent or less while unspecific and interventions from other concepts range between 30 and 50 percent each.

Nevertheless treatment outcomes reflect in most cases that therapies ended successful. If these preliminary results should be confirmed by including remaining concepts and therapists, an answer would be found for the question as to why different therapy schools achieve comparable results (so-called outcome equivalence or dodo bird verdict): therapists would do rather similar things and would intervene less school specific than they themselves assume.

Areas of Interest / Categories: Psychotherapy, WCP 2011

WCP 2011

The individual and the couple in the context of the perinatal experience. A dream or a nightmare?

"There is no such thing as marriage - merely two scapegoats sent out by their families to perpetuate themselves". Whittaker & Keith 1981. This presentation will explore the experience of Anxiety and Depression for both men and women, in the perinatal period. The perinatal period offers a unique opportunity to provide comprehensive care for parents diagnosed with perinatal Anxiety and/or Depression. There is significant evidence that the partner's risk for developing a related Anxiety or Depression, is increased from 4.8% to 36% at 6 weeks postnatally. 

The universality of infant-parent psychotherapy - a South African model

The birth of the democratic South Africa opened up the possibility of meeting with fellow citizens who had previously been kept apart.  Since 1995 a model of  infant-parent psychotherapy has been developed resulting in a mental health service which has come to be valued within the community.

Complex trauma: voices of healing

Within the context of the recent natural disasters occurring around the world, attention has been focussed on trauma's psychological consequences. The trauma spotlighted here is on that of childhood maltreatment and the effects on subsequent adult life. Described in this paper are experiences of recovery from patient perspectives, and an examination of how these are different from, and interact with, representations of therapy derived from published expert theoristpractitioner experience. It is based on a phenomenological study of reports from seven women with histories of chronic childhood maltreatment. These women have since been through significant recovery from dissociative symptoms, and it is this part of their journey that was the focus of this research. From the data, two models are proposed.

The Light In Darkness - Art-therapy, a powerful tool in Palliative Care!

Over the years, we as health care providers have proven that a good perinatal preparation, a good birthing process and a good postnatal care ensures the physical and mental well being of the newborn and his mother. A similar opportunity for quality outcome should be afforded at life`s final phase - preparation and a good 'gateway' for the dying person, as well as a good follow - up period of those left behind. A good death needs guidance to settle outstanding issues, to articulate values, beliefs and doubts and to live the remaining period of life in the fullest and most meaningful way. Early contact is pivotal to learn about our client and his life history. This time is needed to build our client`s trust, to endorse our commitment, and to collect the tools needed to guide him through the gateway and when taking his last breath. It is equally important to meet the immediate needs of his family and to develop the crucial trusting partnership that will ensure a good dying process for their loved one in setting of his choice, and a better acceptance of their loss. It is realistic to assume that people in the future will invest in their final time. 

Lateral violence and Indigenous peoples.

Lateral violence occurs when the violence associated with oppression is internalised by those who are oppressed, and redirected between the members of the oppressed group. Among Aboriginal and Torres

Clinical dream incubation and body

For 1000 years during the beginning of Western medicine (500 B.C. - 500 A.D.,) of the hundreds of medical treatments offered at the time, only dream-based medicine was ubiquitously practiced throughout

Effects of childhood sexual abuse on marital functioning: implications for couples therapy

The goal of this workshop is to sensitize marital and family therapists to the unique issues involved in treating couples with history of childhood sexual trauma in one or both partners, and to prepare them to successfully meet the challenges inherent in working with this population. Individual therapists working with adults abused as children can also benefit from the workshop. First, is reviewed existing literature and research on gender-specific impact of childhood sexual trauma on adult functioning in the area of sexuality and intimate relationships. Second, a familiarization with existing models of treating couples with history of childhood sexual trauma such as psychoeducation, sex therapy, Susan Johnson's Emotionally Focused Therapy, and integrative model of Basham and Miehls. Third, a focus on practical implications: challenges for the therapists and common pitfalls and risk factors in working with such couples, including issues of vicarious traumatization, countertransference, complex dynamics of projective identification, and role of cultural factors.