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Die therapeutische Allianz (TA) zwischen Patient*innen und Therapeut*innen wird als ein zentrales Konzept der Psychotherapieforschung begriffen. Dabei wurde die TA als essentieller Erfolgsfaktor mit einem direkten Einfluss auf das Therapieergebnis belegt. Aktuelle Forschungsbemühungen versuchen die TA als dynamisches Konzept über einen zeitlichen Verlauf zu beschreiben und konnten den Verlauf der TA über den gesamten Therapiezeitraum dokumentieren. Dennoch scheinen Patient*innen und Therapeut*innen die TA unterschiedlich wahrzunehmen. Während zahleiche Ergebnisse für die kognitive Verhaltenstherapie (KVT) vorliegen, existieren nahezu keine Ergebnisse für die psychoanalytische Therapie (PAT). Ziel der Arbeit war es eine vergleichende Untersuchung zwischen KVT und PAT hinsichtlich der TA, dem Therapieoutcome und der Kongruenz der Dyaden durchzuführen. Dafür wurde die TA mittels des Helping Alliance Questionnaire (HAQ) und dem Beck-Depression-Inventory (BDI) als Outcomemaß in einem nicht repräsentativen Subsample von N=152 chronisch depressiver Patient*innen der LAC-Depressionsstudie - unterteilt in je eine KVT-Gruppe (N=65) und eine PAT-Gruppe (N=87) - untersucht. Es standen vier Messzeitpunkte innerhalb des ersten Jahres und einer nach Therapieende zur Verfügung. Für beide Therapieformen konnte ein linearer Zuwachs der TA über den gesamten Therapieverlauf gezeigt werden. Es zeigen sich keine Unterschiede zwischen KVT und PAT. Lediglich die HAQ-Subskala Erfolgszufriedenheit wird von Patient*innen der KVT höher bewertet. Die HAQ-Wertungen der Therapeut*innen fielen signifikant niedriger als Patient*innen-Wertungen aus. Die Kongruenz innerhalb der Dyaden war mit lediglich moderat ausgeprägt (r=.428, p=.000). Es konnten keine Belege für einen Zusammenhang zwischen Kongruenz und Therapieoutcome sowie der Depressivität der Patient*innen gefunden werden. Der gesicherte Zusammenhang zwischen TA und Therapieoutcome konnte auch für chronisch depressive Patient*innen durch eine, The concept of therapeutic alliance (TA) is broadly seen as a central determinant in psychotherapy research. It is commonly stated that the TA has a direct impact on therapy outcome. Surprisingly there is a significant disagreement in the assessment of the TA among patients and therapists. To our knowledge there are various publications on cognitive behavioral therapy (CBT) and TA, but there is a lack of publications on psychoanalytic therapy (PAT). The goal of this thesis is to conduct a comparative TA examination between CBT and PAT over the course of therapy, the congruence of patients and therapists’ ratings and to examine the relation between TA and therapy outcome. The TA was operationalized by the Helping Alliance Questionnaire (HAQ) and the Beck Depression Inventory (BDI) was used to objectify the therapy outcome. The population was drawn from a non-representative subsample of N=152 chronic depressive patients of the LAC – depression study and grouped into one CBT group (N=65) and one PAT group (N=87). The TA measurements were conducted at four points within the first year of therapy and the therapy endpoint. There is a prove for a linear growth of the TA in both types of therapy. There is no evidence for differences in TA between CBT and PAT. Only the HAQ-subscale collaboration was rated higher by patients in the CBT group. The HAQ ratings of the therapists were significant lower compared to the patients’ ratings. Furthermore, we found only a moderate congruence among the ratings (r=.428, p=.000) and could not find a correlation between the congruence and therapy outcome, as well as the depressive symptoms and outcome. We could show a small relation of r=-.264, p=.000 between TA and outcome in the sample of chronic depressive patients. We find contradictory results for the two therapies which makes a critical consideration of the methods and HAQ necessary., eingereicht von Yannick Daniel Wiberg, in englischer Sprache, Masterarbeit Universität Innsbruck 2022

Die therapeutische Allianz (TA) zwischen Patient*innen und Therapeut*innen wird als ein zentrales Konzept der Psychotherapieforschung begriffen. Dabei wurde die TA als essentieller Erfolgsfaktor mit einem direkten Einfluss auf das Therapieergebnis belegt. Aktuelle Forschungsbemühungen versuchen die TA als dynamisches Konzept über einen zeitlichen Verlauf zu beschreiben und konnten den Verlauf der TA über den gesamten Therapiezeitraum dokumentieren. Dennoch scheinen Patient*innen und Therapeut*innen die TA unterschiedlich wahrzunehmen. Während zahleiche Ergebnisse für die kognitive Verhaltenstherapie (KVT) vorliegen, existieren nahezu keine Ergebnisse für die psychoanalytische Therapie (PAT). Ziel der Arbeit war es eine vergleichende Untersuchung zwischen KVT und PAT hinsichtlich der TA, dem Therapieoutcome und der Kongruenz der Dyaden durchzuführen. Dafür wurde die TA mittels des Helping Alliance Questionnaire (HAQ) und dem Beck-Depression-Inventory (BDI) als Outcomemaß in einem nicht repräsentativen Subsample von N=152 chronisch depressiver Patient*innen der LAC-Depressionsstudie - unterteilt in je eine KVT-Gruppe (N=65) und eine PAT-Gruppe (N=87) - untersucht. Es standen vier Messzeitpunkte innerhalb des ersten Jahres und einer nach Therapieende zur Verfügung. Für beide Therapieformen konnte ein linearer Zuwachs der TA über den gesamten Therapieverlauf gezeigt werden. Es zeigen sich keine Unterschiede zwischen KVT und PAT. Lediglich die HAQ-Subskala Erfolgszufriedenheit wird von Patient*innen der KVT höher bewertet. Die HAQ-Wertungen der Therapeut*innen fielen signifikant niedriger als Patient*innen-Wertungen aus. Die Kongruenz innerhalb der Dyaden war mit lediglich moderat ausgeprägt (r=.428, p=.000). Es konnten keine Belege für einen Zusammenhang zwischen Kongruenz und Therapieoutcome sowie der Depressivität der Patient*innen gefunden werden. Der gesicherte Zusammenhang zwischen TA und Therapieoutcome konnte auch für chronisch depressive Patient*innen durch eine, The concept of therapeutic alliance (TA) is broadly seen as a central determinant in psychotherapy research. It is commonly stated that the TA has a direct impact on therapy outcome. Surprisingly there is a significant disagreement in the assessment of the TA among patients and therapists. To our knowledge there are various publications on cognitive behavioral therapy (CBT) and TA, but there is a lack of publications on psychoanalytic therapy (PAT). The goal of this thesis is to conduct a comparative TA examination between CBT and PAT over the course of therapy, the congruence of patients and therapists’ ratings and to examine the relation between TA and therapy outcome. The TA was operationalized by the Helping Alliance Questionnaire (HAQ) and the Beck Depression Inventory (BDI) was used to objectify the therapy outcome. The population was drawn from a non-representative subsample of N=152 chronic depressive patients of the LAC – depression study and grouped into one CBT group (N=65) and one PAT group (N=87). The TA measurements were conducted at four points within the first year of therapy and the therapy endpoint. There is a prove for a linear growth of the TA in both types of therapy. There is no evidence for differences in TA between CBT and PAT. Only the HAQ-subscale collaboration was rated higher by patients in the CBT group. The HAQ ratings of the therapists were significant lower compared to the patients’ ratings. Furthermore, we found only a moderate congruence among the ratings (r=.428, p=.000) and could not find a correlation between the congruence and therapy outcome, as well as the depressive symptoms and outcome. We could show a small relation of r=-.264, p=.000 between TA and outcome in the sample of chronic depressive patients. We find contradictory results for the two therapies which makes a critical consideration of the methods and HAQ necessary., eingereicht von Yannick Daniel Wiberg, in englischer Sprache, Masterarbeit Universität Innsbruck 2022

OBJECTIVE: To explore therapists' experiences of the therapeutic process in successful cases of psychoanalytic psychotherapy. METHOD: A two-stage, mixed-method design was used. Sixteen successful cases were drawn from a sample of 92 young adults in psychoanalytic psychotherapy according to Jacobson's criteria for reliable and clinically significant improvement. Therapist interviews at baseline and termination were analyzed applying Inductive Thematic Analysis. RESULTS: Three core themes emerged: Being Particularly Motivated to be This Patient's Therapist, Maintaining a Safe and Attentive Therapeutic Position, and Assiduous Work Every Session. The therapists experienced positive feelings towards the patient from the outset of treatment and described active, relational work that included paying attention to incongruities in the patient's self-presentation and being mindful of patient's avoidant behavior. The therapist's motivation and attentive position made it possible to balance support and challenge in the therapeutic relationship. CONCLUSIONS: Successful therapeutic work presupposes positive expectations, an active therapeutic stance and assiduous work session-by-session. Therapist expertise may involve the ability to mobilize and work effectively with patient-specific resources and obstacles from the beginning of treatment. In addition to identifying the characteristics and actions of effective therapists, research should also focus on processes emerging within effective therapeutic dyads. Clinical or methodological significance of this article: Our study indicates several factors that seem to characterize therapist expertise and can inform psychotherapy training. Successful therapeutic work presupposes positive expectations, an active therapeutic stance, courage to challenge the patient, and assiduous work session-by-session. Therapist expertise may involve the ability to mobilize and work effectively with patient-specific resources and obstacles from the beginn

Parenting programmes are recommended for conduct disorders in 5-11 year olds, but ineffective for 25-33%. A feasibility trial was needed to determine whether a confirmatory trial of second-line, manualised short-term psychoanalytic child psychotherapy (mPCP) versus treatment as usual (TaU) is practicable. This was a two-arm, pragmatic, parallel-group, multi-centre, individually-randomised controlled feasibility trial with blinded outcome assessment. Child-primary carer dyads were recruited from National Health Service Child and Adolescent Mental Health Services and mPCP delivered by routine child psychotherapists. Thirty-two dyads (50% of eligible, 95% CI 37 to 63%) were recruited, with 16 randomised to each arm. Eleven (69%) completed ≥50% of 12 week mPCP and 13 (81%) . Follow-up was obtained for 24 (75%) at 4 months and 14/16 (88%) at 8 months. Teacher follow-up was 16 (50%) ≥1 session. Manual adherence was good. Baseline candidate primary outcomes were 37.4 (SD 11.4) and 18.1 (SD 15.7) on the Child Behaviour Checklist/Teacher Report Form externalising scale and 102.8 (SD 28.4) and 58.8 (SD 38.9) on the total score. Health economics data collection was feasible and the trial acceptable to participants. Recruitment, teacher follow-up and the manual need some refinement. A confirmatory trial is feasible, subject to funding of research child psychotherapists.

BACKGROUND Research in suicide prevention using psychosocial interventions is rapidly advancing. However, randomised controlled trials are published across a range of medical, psychological and sociology journals, and it can be difficult to locate a full set of research studies. In this paper, we present a database of randomised controlled outcome studies on psychosocial interventions targeting suicidal behaviour. The database is updated annually and can be accessed by contacting the corresponding author. DESCRIPTION A comprehensive literature search of the major bibliographical databases (PsycINFO; PubMed; Cochrane Central Register of Controlled Trials) was conducted for articles published between 1800 to July 30 2013, and examined reference lists of previous relevant reviews and included papers to locate additional references. Studies were included if they featured a randomised controlled design in which the effects of a psychosocial intervention were compared to a control condition (no intervention, attention placebo, wait-list, treatment-as-usual [TAU]), another psychosocial intervention or a pharmacological intervention. In total, 12,250 abstracts were identified. Of these, 131 studies met eligibility criteria and were included. Each paper was then coded into categories of participant characteristics (age, gender, formal diagnosis, primary reason for recruitment); details of the intervention (recruitment setting, content, intervention setting, administering individual, delivery type, delivery format, delivery frequency, delivery length); and study characteristics (control and experimental conditions, primary outcome/s, secondary outcome/s, follow-up period). One paper has been published from the database using studies collected and coded prior to 2012. CONCLUSION The database and listing of 131 studies is available for use by suicide prevention researchers. It provides a strong starting point for systematic reviews and meta-analyses of treatments and interventi

Research suggests that group psychotherapy for adults with a history of child sexual abuse (CSA) is generally beneficial. Only few studies have included random assignment. This study compared the effects of analytic (A) and systemic group psychotherapy (S) on CSA.

Research suggests that group psychotherapy for adults with a history of child sexual abuse (CSA) is generally beneficial. Only few studies have included random assignment. This study compared the effects of analytic (A) and systemic group psychotherapy (S) on CSA.

In psychotherapy, the crucial question of indication-and more particularly, the question of differential indication-has, for a long time, not received the attention it deserves. This has been the case both in research and in the training of psychotherapists, and the decisions made by psychotherapists when choosing a type of intervention for a patient (or the patient for an intervention), have scarcely been informed by research results. This state of things is changing due to a series of factors, and the scientific, the clinical, the socio-political, and the legal aspects of the problem gain more and more attention. The fact that a psychoanalysis during five years with four sessions a week (the therapeutic effects of which are not established) takes almost the same therapeutic effort as the treatment of fourty patients receiving a short-term therapy of twenty six sessions during a half year, or of eighty patients having thirteen sessions (these twenty six or thirteen sessions likely to yield quite satisfying therapeutic effects) is something of which everybody begins to be strikingly aware. But differential indication-globally the question: what therapy for what patient?- continues to pose problems. Do we have valuable criteria for choosing, and why don't we use those we have? In this paper we distinguish two types of problems: those at the conceptual and technical level and the problems pertaining to the ethical and professional domain. Their description will be followed by some conclusions and recommendations that might be useful for treatment selection.

Cette thèse, dans sa première partie théorique, nous a amenés à mettre en évidence que la dépression est une affection qui touche plus de 10% de notre population, qui corresponde à une réelle affection au long cours avec plus de 60% de récidive. Près de 30% des dépressifs ne réagissent pas aux traitements antidépresseurs. Plus de 20% passent à une chronicité souvent très longue et difficile à aborder sur le plan thérapeutique. Qui plus est, la dépression s’accompagne d’une comorbidité importante et ses complications à long terme apparaissent très graves : suicide, augmentation de la morbidité et de la mortalité médicales, passage à la chronicité et altérations graves du fonctionnement social. L’analyse de la littérature met en évidence qu’aucune étiologie unique et définitive n’a été mise en évidence à l’heure actuelle même s’il apparaît évident qu’il existe des facteurs de vulnérabilités qui fragilisent le patient face à des situations personnelles, conjugales ou professionnelles difficiles qui précipiteront l’éclosion du trouble dépressif. Nous avons mis en évidence que seule une approche triaxiale de la dépression permet réellement de guérir ce trouble : approche thérapeutique individuelle, traitement antidépresseur et approche familiale. La deuxième partie expérimentale, réalisée sur un échantillon aléatoire de troubles dépressifs graves pris en charge pendant une période de terrain de trois mois, puis suivis à un an et à deux ans par des chercheurs qualifiés nous a amenés à tirer les conclusions suivantes : - Il faut remettre en question les critères habituellement retenus pour décider de l’abord thérapeutique des patients dépressifs (gravité symptomatique, caractéristiques diagnostiques, risque de passage à l’acte). Au contraire, ce sont des critères peut investigués d’habitude qui s’avèrent significatifs : capacité de mobilisation familiale, alliance thérapeutique du patient à l’égard du thérapeute. - Mettre l’accent sur l’instauratio, Thèse d'agrégation de l'enseignement supérieur -- UCL, 1995

Psychotherapie is een vorm van toegepaste wetenschap die veel varianten kent. Er zijn veel scholen en methoden binnen de psychotherapie die in een aantal aspecten overeenk:omen~ maar ook in meer of mindere mate van elkaar verschillen. Sommige van deze verschillen zijn gradueel., andere vormen een waterscheiding in het psychotherapeutische veld. Tot deze Iaatste categorie behoort het verschil in ruimtelijke opstelling. Er zijn vormen van psychotherapie waar de patient op een stoel zit en er zijn vonnen waar de patient op een bank ligt. Over het algemeen valt dit verschil samen met het verschil in intensiteit van de behandeling. In de psychoanalyse ligt de patient vijf keer per week op een bank, terwijl de patient die een of twee keer per week komt op een steel zit. Dit is echter geen absoluut onderscheid. Er zijn psychoanalytici die bet liggen geen absolute voorwaarde vinden, maar bet hooguit zien als de preferente positie. Met andere woorden; als een patient wil zitten op de bank, dan zal er verrnoedelijk geen analyticus in eerste instantie bezwaar tegen maken. De mate waarin dit gedrag gezien wordt als ageren, kan echter sterk verschillen. De ene analyticus zal bet zonder veel aandacht laten passeren, terwijl de ander zich zeer zal inspannen om te achterhalen welke gevoelens met dit gedrag worden afgeweerd en hoe dit inzicht aan de patient kan worden overgebracht. In minder frequente behandelingen wordt ook niet altijd gezeten. Er zijn psychotherapieen beschreven met een frequentie van drie keer per week waarbij de patient op een bank ligt.