Search

Objective: The objective of this study is to evaluate current evidence for the effectiveness of distance-based interventions to support smoking cessation (SC) or alcohol moderation (AM) among cancer survivors. Secondary, differences in effectiveness are explored regarding multibehaviour interventions versus single-behaviour interventions targeting SC or AM only., Methods: A systematic search of PubMed, PsycINFO, Web of Science, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials was conducted. Intervention studies with and without control groups and randomized controlled trials were included. Random effects meta-analyses were conducted for the main outcomes: SC and AM rates at the follow-up closest to 6 months. Using subgroup analyses and meta-regression, effectiveness of single-behaviour versus multibehaviour interventions was evaluated., Results: A total of 17 studies with 3796 participants; nine studies on SC only, eight studies on multibehaviour interventions including an SC or AM module, and no studies on AM only were included. All studies had at least some concerns regarding bias. Distance-based SC interventions led to higher cessation rates than control conditions (10 studies, odds ratio [OR] = 1.56; 95% CI, 1.13-2.15, P = .007). Single-behaviour SC interventions reduced smoking rates compared with baseline (risk difference [RD] = 0.29; 95% CI, 0.19-0.39, P < .0001), but multibehaviour interventions did not (RD = 0.13; 95% CI, -0.05 to 0.31, P = 0.15). There was insufficient evidence that distance-based multibehaviour interventions reduced alcohol use compared with controls (three studies, standardized mean difference [SMD] = 0.12; 95% CI, -0.08 to 0.31, P = .24)., Conclusions: Distance-based SC interventions are effective in supporting SC among cancer survivors. Single-behaviour SC interventions appear more effective than multibehaviour interventions. No evidence was found for the effectiveness of distance-based AM interventions for cancer survivors., (© 2019 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.)

This paper addresses consequences of exposure to violence and trauma. Traumata are defined as events with an extraordinary threat or catastrophic extent. Beside Posttraumatic Stress Disorder (PTSD), affected people may develop Complex PTSD, Prolonged Grief Disorder or Adjustment Disorder as direct consequences of exposure with extreme stress. Indirect trauma-related disorders are amongst others Major Depression, Substance Dependency and Personality Disorders. These disorders develop often comorbid to PTSD. The likelihood to develop a PTSD at one point during the life course is 1-4% in Germany. A PTSD is diagnosed if for any length of time the traumatic situation is re-experienced (e.g. in pictures or nightmares), potential triggers are avoided, emotional reactivity is numb and a permanent hyperarousal is experienced. The intensity, the duration and the frequency of traumatic experiences as well as the lack of social support after the trauma are important risk factors for the development of a PTSD. In the last two decades successful treatment approaches for PTSD have been developed. The main focus of all evidence-based treatment approaches is the exposure in sensu of the traumatic experiences. Behavioral therapy approaches have shown to be most effective in the treatment of PTSD. A better understanding of the consequences of exposure to violence and trauma may help us to identify people at risk for developing trauma-related disorders already at an early stage.

Smoking cessation as a therapeutic intervention has largely not the significance that it should have according to its potential influence on diseases in the pulmonary practice. Barriers against smoking cessation apart from the addiction character of tobacco dependence are mainly the almost complete absence of reimbursement as well as concerns regarding low achievable long-term abstinence. The presented study shows that despite these barriers smoking cessation in pulmonology practice is successful if carried out by using a 2-step motivation of the participants. The long-term abstinence success of 46 % after 12 months (point prevalence) presented here was achieved with the use of behavioral therapy and medical support. Success factors are doctor's office setting and consequent information and encouragement for medical support (mostly varenicline)., (© Georg Thieme Verlag KG Stuttgart · New York.)

The Strengthening Families Program was developed in the USA and is regarded as an effective family-based prevention programme for youth. The evaluation of an adapted German version was carried out as a randomised-controlled multicentre trial. 292 families were recruited, 150 followed the intervention, and 142 received a minimal intervention. Acceptance from families and programme facilitators was high. Results about the effectiveness will be reported as soon as follow-up assessments are completed., (© Georg Thieme Verlag KG Stuttgart · New York.)

In a randomised controlled study (n=34 intervention group, n = 32 control group) the effects of a 6-month outpatient training for overweight but not obese children and adolescents (BMI > 90(th) ≤ 97(th) percentile) were assessed up to 12 months after the end of intervention. BMI-SDS reduction was the main outcome. The results show that the lifestyle intervention "Obeldicks light" is effective to reduce overweight, as well as blood pressure and several other risk parameters in overweight children. Effects are stable over a 12 months period., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objective: of the study was to investigate whether behaviour therapy may be an economic niche within practice management., Material and Methods: A questionnaire was used to analyze to what extent veterinarians have already applied behaviour therapy (BT) and how they evaluate economic efficiency and patient owners' attitude. The descriptive analysis included the data from 312 practicing veterinarians (167 randomly selected, interviewed and 145 signed on for training sessions, veterinarians) and of 23 veterinarians specialized in BT., Results: Two-thirds (67% of n=288) of the practicing veterinarians offered BT in their practices. The economic efficiency of BT was evaluated as positive by 64% (of n=281) of the practicing veterinarians and by 83% (of n=23) of specialists. 32% (of n = 146) of practitioners who offered behavioural therapy confirmed an increase in sales through the application of BT. Among the specialists, 84% (of n=19) confirmed this experience. In comparison to the specialists and literature data, most of the practicing veterinarians spent insufficient time (61% of n=180) for a behaviour consultation. Furthermore, most of them (86% of n=162) charged less for BT than the amounts fixed by the German Payment Regulations (Gebührenordnung für Tierärzte), as compared to the specialists., Conclusion: The specialized veterinarians offered, in contrast to most practitioners, a consultation of BT with sufficiently calculated time and accurate payment planning to realise a therapeutic and commercial outcome. Therefore, the assessment of the economic efficiency of BT and their sales increase through BT were better than the estimation of the practicing veterinarians. Behaviour therapy cannot be managed by providing advice free of charge or charging less. Veterinarians have to become aware that BT is a veterinary area of specialization for which an adequate qualification is necessary. If the veterinarian is not specialized in BT he should refer to a qualified colleague.

So far in German literature no empirical data are present concerning parallel medications of behavioral therapy. Also the international research does not treat this topic sufficiently. For this reason this work examines on the basis from reports of requests for behavioral therapy, which medications or groups of substances were used for which child and adolescent psychiatric disorders treated by behavioral therapy. It examines additionally whether correlations of such combinations exist to specific socio-demographic or school-characteristics. Out of 1021 first and subsequent requests for behavioral therapy from the years 2001 variables were retrospectively evaluated regarding intear alia diagnosis, sociodemographic data, school situation, somatic comorbidities or therapies and therapy indication. Results reveal out of five children or adolescents one has an behavioral therapy plus an additional psychopharmacological treatment. 80% of these medications are psychostimulants. Half of the children and adolescents suffering from ADHD or conduct disorders are treated with such, while diagnosis of other domains contribute to combined therapies only with a small percentage. Differences between non-treated and psychopharmacologically treated children and adolescents with ADHD or conduct disorders are presented.

Background: Multiple sclerosis (MS) is a challenging disease for patients, the social environment, and therapists. We analysed how coping training and compliance of MS patients are assessed by neurologists in private practice., Method: One thousand five hundred and seventy-five neurologists in private practice were asked to fill in short, standardised, anonymous questionnaires concerning number of MS patients treated per year, experience with coping training methods, assessments of requirements, aims, location, and suitable trainer, financial aspects of coping training, assessment of patient compliance concerning immunomodulating therapies, and possibilities of increasing compliance., Results: The response rate was 25.7% (404 questionnaires). Of these, 344 (21.8%) could be included in the analysis. Many neurologists had no experience with coping training methods but saw a reasonable demand, especially for newly diagnosed MS patients, those with psychological problems, and for their relatives. Most of them would like to provide such training themselves in their own locations. Useful aims of coping training included reduction of anxiety, uncertainty, and depression and increased patient compliance and well-being. They proposed that coping training should mainly be financed by health care insurers and patients. Neurologists assessed the compliance of MS patients concerning immunomodulating therapies as being moderate to high. Increased compliance was understood as better doctor-patient conversations, involvement of MS nurses, and support from self-help groups., Conclusion: There is a reasonable need of coping training for MS patients that is also seen by privately practicing neurologists, the main therapists for MS patients. The selection of adequate and scientifically reliable training should be improved. Thus coping with the disease, compliance, and well-being can all be improved.

Topic of this study is the acquisition and documentation of all German services of early psychosocial interventions as well as the description of attributes of these care providers. On the basis of this attributes the quality of the offers is evaluated. The services provide counseling and therapy for parents with babies and toddlers. Their aim is to assess and treat disorders of behavior regulation in the context of dysfunctional parent-child-relationships. The expertise was initiated by the German Federal Centre for Health Education. It is based on data of 288 services in Germany. Different attributes of structural and process qualities are described and evaluated e.g. the institutional context, presented problems, training of specialists, kind of interventions. Number and attributes of the early interventions show great variation from region to region. The discrepancy between the number of services and the prevalence of early childhood regulation disorders is high. Due to the unresolved question of financing, parents often have to pay the treatment by themselves. On the basis of the results different implications for the improvement of structural quality are formulated. Relevant issues of research in psychosocial early childhood interventions are discussed.

Background: Attention deficit/hyperactivity disorder (ADHD) is one of the most frequent psychic disorders of childhood, characterized by high persistence and an increased risk for the development of externalising disorders of behavior. Due to ADHD increased problems can be frequently observed at school as well as in the social and emotional context of the child. Concepts for in-patient rehabilitation have not been developed, although effective modifications of the behavior of ADHD patients appeared to be achievable under the conditions found in in-patient rehabilitation., Objective: The present pilot study aimed to evaluate whether this newly developed concept has any benefit on psychological problems, coping and quality of life., Method: In total, n = 28 boys with ADHD 7 to 12 years old were included into a quasi-experimental pre-post design and completed self-report questionnaires on psychological problems, coping and quality of life. In addition, 26 mothers evaluated the behavior problems, psychological problems and quality of life of their sons at the beginning and the end of in-patient rehabilitation. During a 4-week in-patient rehabilitation all children and their mothers took part in a multimodal training containing components of behavior therapy and cognitive-behavioral therapy (self-instruction, self-management, and stress management), applied in child-, parent-child- and parent-centered interventions., Results: Parents estimated the behavior problems of their children as significantly reduced after in-patient rehabilitation as compared to before. In addition, psychological problems and quality of life improved significantly in self- and parent-proxy reports during the in-patient rehabilitation., Conclusion: Our results support the hypothesis that this multimodal therapy concept is an effective tool for the treatment of ADHD patients. However, a replication of our results in a control-group study on a larger population is required.

Outpatient behavior therapy has been paid for in the Federal Republic of Germany since 1980 as a service of the health insurance system that covers most of the population. This therapeutic approach is used with children, adolescents and adults, but up to now it has played only a minor role in the treatment of psychological and psychiatric problems in children and adolescents. A content analysis of 221 applications for approval of long-term therapy for children or adolescents provided information on sociodemographic data, symptoms, diagnoses, treatment goals and treatment methods. Data were also obtained on the patients' social situation. The analysis suggests that mainly 7- to 11-year-old boys undergo treatment. The number of girls receiving treatment increases during puberty, and during adolescence more girls are treated than boys. Applications for outpatient behavior therapy are predominantly for developmental disorders, hyperkinetic disorders, emotional disorders, phobias, enuresis, adjustment disorders, conduct disorders and eating disorders. The main treatment goals are the development of new behavioral skills and the maintenance of or strengthening of behavior that is incompatible with the symptoms. Cognitive-behavioral methods are frequently used.