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110 000 to 140 000 people die in Germany each year of tobacco-related diseases. Thus, measures should be taken to lower the number of persons who start smoking, encourage smokers to stop, and keep those who have stopped from starting again, in order to achieve a sustained benefit in public health.We present recommendations for the diagnostic evaluation, counseling, psychotherapy, and pharmacotherapy of smokers, derived from the findings of current Cochrane meta-analyses and from the pertinent German-language and American guidelines.Motivational interviewing by a physician, including a recommendation to stop smoking and counseling on how to do this, can reinforce a smoker's motivation to quit. Behavioral therapeutic approaches support changes in behavior, while medical aids such as nicotine replacement therapy, bupropion, and varenicline help former smokers overcome the initial withdrawal symptoms. Low-threshold measures such as self-help books, telephone counseling, and Internet-based cessation programs complement the evidence-based treatments. With a combination of medications and psychotherapeutic support, abstinence rates of up to approximately 40% can be achieved at the end of one year.Smokers who decide to quit can benefit from their doctors' support. Physicians should be taught about tobacco dependency and how to treat it as part of their undergraduate medical education, residency training, and continuing medical education.

The purpose of this article is to suggest some new directions for the presentation and reporting of data in psychotherapy outcome research. Statistical comparisons based on group means provide no information on the variability of treatment outcome, and statistical significance tests do not address clinical significance. Although psychotherapy research has begun to address these issues, it has done so unsystematically. New standards and conventions are needed to serve as criteria for classifying therapy subjects into categories of improved, unimproved, and deteriorated based on response to treatment. A two-fold criterion for determining improvement in a client is recommended, based on both statistical reliability and clinical significance. Statistical procedures for determining whether or not these criteria have been met are discussed.

Communication training is a widely practiced therapeutic approach for the treatment of marital discord. Although there is some empirical support for the theoretical assumptions underlying constructive communication patterns, it has not yet been ascertained whether changing these behaviors is sufficient in bringing about stable changes in distressed marriages. The present study was designed to investigate the efficacy of this treatment approach in a conjoint and conjoint group modality. Following therapy, conjoint couples (n = 16) when compared with a waiting list control group (n = 17) showed improvement on five of the seven outcome variables. Couples in the conjoint group modality (n = 13) improved on only two of the seven variables. Follow-up assessments one year after treatment showed that initial gains had been substantially reduced. On the basis of these results it is now open to question whether conjoint group treatments are an appropriate treatment modality for even moderately distressed c...