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Bechtold S, Hall M, Scherner PV, Kaven L, Rubel J. [Therapists' Perspectives on Changes in the Therapeutic Relationship after Switching from in-Person to Online Video Therapy Due to Corona: A Qualitative Analysis]. Psychother Psychosom Med Psychol 2023; 73:221-230. [PMID: 36878308 DOI: 10.1055/a-2017-5338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the extent to which the therapeutic relationship changed as a result of the COVID-19-related switch from face-to-face to video therapy. METHOD Twenty-one psychotherapists, who had changed the setting of therapy from face-to-face to video therapy were interviewed. The interviews were then transcribed, coded and superordinate themes were created in the context of a qualitative analysis. RESULTS More than half of the therapists reported that the therapeutic relationship with their patients remained stable. In addition, the majority of therapists described uncertainties in dealing with and responding to non-verbal signals, as well as maintaining an appropriate distance to their patients. Overall, both an improvement and a deterioration of the therapeutic relationship was reported. DISCUSSION The stability of the therapeutic relationship was mainly attributed to the therapists' previous face-to-face contact with their patients. The uncertainties expressed could be interpreted as risk factors for the therapeutic relationship. Although the sample represented only a small portion of working therapists, the findings from this study represent an important milestone in understanding how psychotherapy has changed as a result of the COVID-19 pandemic. CONCLUSION The therapeutic relationship remained stable despite the change from face-to-face to video therapy.
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Affiliation(s)
- Sara Bechtold
- Abteilung für Psychotherapieforschung, Justus Liebig Universität Giessen
| | - Mila Hall
- Abteilung für Psychotherapieforschung, Justus Liebig Universität Giessen
| | | | - Leonie Kaven
- Professur für Klinische Psychologie und Psychotherapie, Universität Greifswald
| | - Julian Rubel
- Abteilung für Psychotherapieforschung, Justus Liebig Universität Giessen
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Reck J, Gawlytta R, Kesselmeier M, Böttche M, Niemeyer H, Knaevelsrud C, Rosendahl J. [Differential Effects of an Internet-Based Cognitive-Behavioral Writing Therapy for Reducing PTSD Symptoms after Intensive Care: Results of a Per-Protocol Analysis]. PSYCHIATRISCHE PRAXIS 2023. [PMID: 36758588 DOI: 10.1055/a-1997-9556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
OBJECTIVE To investigate the differential effects of an internet-based cognitive-behavioral writing therapy (iCBT) on post-traumatic stress disorder (PTSD) symptoms after intensive care in patients and their spouses. METHODS This reanalysis of a randomized controlled trial compared PTSD symptom severity (measured by PCL-5) before and after therapy considering potential influencing factors in the per-protocol population. RESULTS A significant reduction in post-traumatic symptom severity after iCBT was found. Eleven of the 25 treated participants showed a clinically significant change (PCL-5 difference≥10 points). The number of words written by the participants in the therapy modules had a significant impact on iCBT efficacy. CONCLUSION iCBT appears to be a promising option to augment therapy for PTSD, particularly for physically impaired patients following critical illness.
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Affiliation(s)
- Johannes Reck
- Institut für Psychosoziale Medizin, Psychotherapie und Psychoonkologie, Universitätsklinikum Jena, Jena, Germany
| | - Romina Gawlytta
- Institut für Psychosoziale Medizin, Psychotherapie und Psychoonkologie, Universitätsklinikum Jena, Jena, Germany
| | - Miriam Kesselmeier
- Institut für Medizinische Statistik, Informatik und Dokumentation, Universitätsklinikum Jena, Jena, Germany
| | - Maria Böttche
- Arbeitsbereich Klinisch-Psychologische Intervention, Freie Universität Berlin, Berlin, Germany.,Zentrum ÜBERLEBEN gGmbH, Berlin, Germany
| | - Helen Niemeyer
- Arbeitsbereich Klinisch-Psychologische Intervention, Freie Universität Berlin, Berlin, Germany
| | - Christine Knaevelsrud
- Arbeitsbereich Klinisch-Psychologische Intervention, Freie Universität Berlin, Berlin, Germany
| | - Jenny Rosendahl
- Institut für Psychosoziale Medizin, Psychotherapie und Psychoonkologie, Universitätsklinikum Jena, Jena, Germany
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Lincke L, Ulbrich L, Reis O, Wandinger E, Brähler E, Dück A, Kölch M. Attitudes toward innovative mental health treatment approaches in Germany: E-mental health and home treatment. Front Psychiatry 2022; 13:889555. [PMID: 35911231 PMCID: PMC9334816 DOI: 10.3389/fpsyt.2022.889555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
E-mental health and home treatment are treatment approaches that have proven to be effective, but are only slowly implemented in the German health care system. This paper explores the attitudes toward these innovative treatment approaches. Data was collected in two large, non-clinical samples representative of the German population in spring 2020 (N = 2,503) and winter 2020/2021 (N = 2,519). Statistical associations between variables were examined using two-tailed tests. Binary and multinomial logistic regressions were performed to predict attitudes toward online-based treatment concepts and home treatment approaches. Only few (<20%) people preferred online-based treatment approaches, while a larger proportion (~50%) could imagine being treated at home. Overall, younger subjects were more open to online-therapy approaches, while people with lower education preferred more often a traditional therapy setting. Acceptance of online-therapy did not raise significantly during the first months of the COVID-19 pandemic. When different online-based treatment options were available, the probability of accepting home treatment significantly increased with increasing levels of therapeutic support. Further promotion of acceptance for online-therapy and home treatment seems to be necessary. In the future, more information on innovative treatment approaches should be actively provided.
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Affiliation(s)
- Lena Lincke
- Department for Child and Adolescent Psychiatry, Rostock University Medical Center, Rostock, Germany
| | - Lisa Ulbrich
- Department for Child and Adolescent Psychiatry, Rostock University Medical Center, Rostock, Germany
| | - Olaf Reis
- Department for Child and Adolescent Psychiatry, Rostock University Medical Center, Rostock, Germany
| | - Elisa Wandinger
- Department for Child and Adolescent Psychiatry, Rostock University Medical Center, Rostock, Germany
| | - Elmar Brähler
- Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig, Leipzig, Germany
- Medical Center Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander Dück
- Department for Child and Adolescent Psychiatry, Rostock University Medical Center, Rostock, Germany
| | - Michael Kölch
- Department for Child and Adolescent Psychiatry, Rostock University Medical Center, Rostock, Germany
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Leuchtenberg S, Gromer D, Käthner I. Videoconferencing versus
face‐to‐face
psychotherapy: Insights from patients and psychotherapists about comparability of therapeutic alliance, empathy and treatment characteristics. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sophie Leuchtenberg
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy University of Würzburg Würzburg Germany
| | - Daniel Gromer
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy University of Würzburg Würzburg Germany
| | - Ivo Käthner
- Department of Psychology I, Biological Psychology, Clinical Psychology and Psychotherapy University of Würzburg Würzburg Germany
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Schmidt-Hantke J, Vollert B, Hagner F, Beintner I, Hütter K, Nitsch M, Jacobi C, Waldherr K. Stakeholders' perspectives on online interventions to improve mental health in eating disorder patients and carers in Germany. Eur J Public Health 2021; 31:i80-i87. [PMID: 34240153 PMCID: PMC8266537 DOI: 10.1093/eurpub/ckab057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Eating disorders are causing severe consequences for those affected as well as a high burden for their carers. Although there is a substantial need for psychological assistance, different factors are hindering access to support. Internet-based interventions can help to overcome these barriers. To date, there is only little knowledge on attitudes of potential users, facilitators (e.g. psychologists) and decision makers (e.g. health insurances) regarding these interventions. METHODS We conducted focus groups with potential users (N = 30) and semi-structured interviews with potential decision makers (N = 4). Potential facilitators (N = 41) participated in an online survey. Stakeholders' experiences, attitudes, and their needs regarding Internet-based interventions for eating disorder patients and carers were assessed. Furthermore, hindering and fostering factors related to reach, adoption, implementation and maintenance were analyzed. RESULTS About two-thirds of the participating facilitators have heard or read about Internet-based interventions in general. In contrast, the other stakeholders mentioned to have no or little experience with such interventions. Factors like anonymity, availability and cost-effectiveness were seen as major advantages. Also disadvantages, e.g. lack of personal contact, limitations by disease severity and concerns on data safety, were mentioned. Stakeholders stated the need for interventions which are usable, evidence-based, tailored and provide personal support. CONCLUSION Stakeholders considered Internet-based programmes to have more advantages than disadvantages. Effort should be put in providing systematic education to address prejudices. When offering an online intervention, stakeholders' needs, as well as a continuous evaluation and adaptation, have to be taken into account.
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Affiliation(s)
- Juliane Schmidt-Hantke
- TU Dresden, Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany
| | - Bianka Vollert
- TU Dresden, Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany
| | - Franziska Hagner
- TU Dresden, Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany
| | - Ina Beintner
- TU Dresden, Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany
| | - Kristian Hütter
- TU Dresden, Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany
| | - Martina Nitsch
- Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, Wiener Neustadt, Austria
| | - Corinna Jacobi
- TU Dresden, Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany
| | - Karin Waldherr
- Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, Wiener Neustadt, Austria
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Marsico G. Numérique, virtuel, réseaux sociaux, objets connectés : leviers ou freins à la confiance dans la relation de soins ? PSYCHO-ONCOLOGIE 2020. [DOI: 10.3166/pson-2020-0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Le numérique doit faciliter la vie des usagers ainsi que des professionnels. Il peut être un levier de promotion de la santé, de réduction des inégalités et de renforcement de la confiance dans la relation de soins. Mais c’est à condition que certains préalables soient assurés :
- le numérique ne se substitue pas aux professionnels de santé ;
- derrière l’outil, il y aura toujours une intervention humaine ;
- en cas de difficultés, des interventions en présentiel seront toujours prévues ;
- le numérique s’attache à respecter les droits des usagers tels qu’énoncés par la loi (confidentialité, sécurité des données, etc.) ;
- le numérique doit viser la réponse aux besoins de l’ensemble des usagers (principe d’égalité).
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Probst G, Berger T, Flückiger C. The Alliance-Outcome Relation in Internet-Based Interventions for Psychological Disorders: A Correlational Meta-Analysis. VERHALTENSTHERAPIE 2019. [DOI: 10.1159/000503432] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Probst G, Berger T, Flückiger C. Die Allianz als Prädiktor für den Therapieerfolg internetbasierter Interventionen bei psychischen Störungen: Eine korrelative Metaanalyse. VERHALTENSTHERAPIE 2019. [DOI: 10.1159/000501565] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Hannig W, Etzelmüller A, Zarski AC, Ebert DD. Vorstellung einer internet- und videobasierten Nachsorge zur Stabilisierung stationärer Therapieerfolge in der Routineversorgung von depressiv Erkrankten. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2019. [DOI: 10.1026/1616-3443/a000519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Wiebke Hannig
- Abteilung für Klinische Psychologie und Psychotherapie, Philipps-Universität Marburg
- Fachklinik für Psychosomatik, Schön Klinik Bad Arolsen
| | - Anne Etzelmüller
- Fachklinik für Psychosomatik, Schön Klinik Bad Arolsen
- Abteilung für Klinische Psychologie und Psychotherapie, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - Anna-Carlotta Zarski
- Abteilung für Klinische Psychologie und Psychotherapie, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - David D. Ebert
- Fachklinik für Psychosomatik, Schön Klinik Bad Arolsen
- Abteilung für Klinische Psychologie und Psychotherapie, Friedrich-Alexander Universität Erlangen-Nürnberg
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Vollert B, Beintner I, Musiat P, Gordon G, Görlich D, Nacke B, Schmidt-Hantke J, Potterton R, Spencer L, Grant N, Schmidt U, Jacobi C. Using internet-based self-help to bridge waiting time for face-to-face outpatient treatment for Bulimia Nervosa, Binge Eating Disorder and related disorders: Study protocol of a randomized controlled trial. Internet Interv 2018; 16:26-34. [PMID: 30775262 PMCID: PMC6364326 DOI: 10.1016/j.invent.2018.02.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/19/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Eating disorders are serious conditions associated with an impaired health-related quality of life and increased healthcare utilization and costs. Despite the existence of evidence-based treatments, access to treatment is often delayed due to insufficient health care resources. Internet-based self-help interventions may have the potential to successfully bridge waiting time for face-to-face outpatient treatment and, thus, contribute to overcoming treatment gaps. However, little is known about the feasibility of implementing such interventions into routine healthcare. The aim of this study is to analyze the effects and feasibility of an Internet-based self-help intervention (everyBody Plus) specifically designed for patients with Bulimia Nervosa, Binge Eating Disorder and other specified feeding and eating disorders (OSFED) on a waiting list for outpatient face-to-face treatment. The aim of this paper is to describe the study protocol. METHODS A multi-country randomized controlled trial will be conducted in Germany and the UK. N = 275 female patients awaiting outpatient treatment will be randomly allocated either to the guided online self-help intervention "everyBody Plus" or a waitlist control group condition without access to the intervention. everyBody Plus comprises eight weekly sessions that cover topics related to eating and exercise patterns, coping with negative emotions and stress as well as improving body image. Participants will receive weekly individualized feedback based on their self-monitoring and journal entries. Assessments will take place at baseline, post-intervention as well as at 6- and 12-months follow up. In addition, all participants will be asked to monitor core eating disorder symptoms weekly to provide data on the primary outcome. The primary outcome will be number of weeks after randomization until a patient achieves a clinically relevant improvement in core symptoms (BMI, binge eating, compensatory behaviors) for the first time. Secondary outcomes include frequency of core symptoms and eating disorder related attitudes and behaviors, as well as associated psychopathology. Additional secondary outcomes will be the participating therapists' confidence in treating eating disorders as well as perceived benefits of everyBody Plus for patients. DISCUSSION To the best of our knowledge, this is the first randomized controlled trial examining the effects of Internet-based self-help for outpatients with eating disorders awaiting face-to-face outpatient treatment. If proven to be effective and successfully implemented, Internet-based self-help programs might be used as a first step of treatment within a stepped-care approach, thus reducing burden and cost for both patients and health care providers.
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Affiliation(s)
- Bianka Vollert
- Technische Universität Dresden, Institut für Klinische Psychologie und Psychotherapie, Chemnitzer Str. 46, D-01187 Dresden, Germany,Corresponding author.
| | - Ina Beintner
- Technische Universität Dresden, Institut für Klinische Psychologie und Psychotherapie, Chemnitzer Str. 46, D-01187 Dresden, Germany
| | - Peter Musiat
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Box P059, De Crespigny Park, London SE5 8AF, UK
| | - Gemma Gordon
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Box P059, De Crespigny Park, London SE5 8AF, UK
| | - Dennis Görlich
- Westfälische Wilhelms-Universität Münster, Institute of Biostatistics and Clinical Research, Schmeddingstraße 56, Münster, Germany
| | - Barbara Nacke
- Technische Universität Dresden, Institut für Klinische Psychologie und Psychotherapie, Chemnitzer Str. 46, D-01187 Dresden, Germany
| | - Juliane Schmidt-Hantke
- Technische Universität Dresden, Institut für Klinische Psychologie und Psychotherapie, Chemnitzer Str. 46, D-01187 Dresden, Germany
| | - Rachel Potterton
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Box P059, De Crespigny Park, London SE5 8AF, UK
| | - Lucy Spencer
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Box P059, De Crespigny Park, London SE5 8AF, UK
| | - Nina Grant
- South London and Maudsley NHS Foundation Trust, Eating Disorders Outpatient Unit, The Maudsley Hospital, Denmark Hill, London SE5 8AF, UK
| | - Ulrike Schmidt
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Box P059, De Crespigny Park, London SE5 8AF, UK
| | - Corinna Jacobi
- Technische Universität Dresden, Institut für Klinische Psychologie und Psychotherapie, Chemnitzer Str. 46, D-01187 Dresden, Germany
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Bengtsson J, Nordin S, Carlbring P. Therapists' Experiences of Conducting Cognitive Behavioural Therapy Online vis-à-vis Face-to-Face. Cogn Behav Ther 2015; 44:470-9. [PMID: 26090947 DOI: 10.1080/16506073.2015.1053408] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study has explored therapists' experiences of conducting cognitive behavioural therapy (CBT) online and face-to-face. Eleven therapists partook in semi-structured interviews, which were thematically analysed using an abductive approach. The results indicate that the therapists viewed face-to-face therapy as a stronger experience than Internet-based CBT (ICBT), and the latter as being more manualised, but providing more work-time control. Several participants also thought that working alliance may be achieved faster and more easily in face-to-face therapy, and might worsen with fewer modalities of communication. Clinical implications in need of investigation are whether working with ICBT might buffer therapist exhaustion, and whether this therapy form can be improved by becoming less manual dependant in order to be easier to individualise.
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Affiliation(s)
- Jonas Bengtsson
- a Department of Psychology , Umeå University , Umeå , Sweden
| | - Steven Nordin
- a Department of Psychology , Umeå University , Umeå , Sweden
| | - Per Carlbring
- b Department of Psychology , Stockholm University , Stockholm , Sweden
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