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Die PAGE-Studie untersuchte die Wirkungen von ambulanten analytischen/tiefenpsychologisch-fundierten und psychodramatischen Gruppenpsychotherapien im Rahmen einer naturalistischen Studie. 40 erfahrene niedergelassene Gruppenpsychotherapeuten – davon 12 PsychodramtikerInnen – kooperierten in der Studie, die vollstandige Datensatze (Pra-Post) von 244 PatientInnen analytischer/tiefenpsychologisch fundierter und von 91 PatientInnen psychodramatischer Gruppentherapien umfasst. Die Effektstarken beider Therapierichtungen sind im internationalen Vergleich uberdurchschnittlich hoch (ESPA = 1.33 und ESPD = 1.01) und unterstreichen die Bedeutung von psychotherapeutischen Langzeitbehandlungen bei einer psychisch schwerer belasteten PatientInnen-Klientel. Ein direkter Vergleich beider Therapiekonzepte ist aufgrund unterschiedlicher Inanspruchnahme-Klientelen und unterschiedlicher Therapie-Laufzeiten nicht moglich. Ebenfalls erhobene Therapieziele summierten sich uber alle PatientInnen auf fast 2.000 und geben Aufschlusse uber das Verhaltnis von intrapsychisch versus interpersonal-sozial verortbaren Zielen.

Summary Effectiveness of Outpatient Group Psychotherapy in Germany – Results of the PAGE-Study The PAGE study underlines the effectiveness of long-term psychodynamic and psychodra matic outpatient group therapies in a naturalistic setting. 40 experienced group therapists cooperated, and complete outcome data of 244 patients from psychodynamic groups and of 91 patients from psychodramatic groups (pre-post) were obtained. The effect sizes are consi derably high (ES PA = 1.33 and ES PD = 1.01) compared to internationally reported effect sizes of psychotherapeutic treatments. They highlight the importance of long-term therapeutic treatments with a severely and chronically disturbed clientele. A direct comparison between both approaches – psychodynamic and psychodramatic group therapy – is not possible due to significant differences in treatment lengths and patient demands. Approximately 2.000 treatment goals were obtained from all participating patients and provide information regarding the relationship between intrapsychic and interpersonal treatment goals of patients undergoing group psychotherapy.

Zusammenfassung In einer naturalistischen Studie wird anhand einiger zentraler Parameter der Verlauf ambulanter tiefenpsychologisch fundierter/psychoanalytischer Einzeltherapien aus Sicht des Patienten und des Therapeuten evaluiert. Neben dem globalen Funktionsniveau (GAF-Skala), kommen u. a. das Inventar zur Erfassung interpersonaler Probleme und der Helping Alliance Questionnaire (HAQ) zur Anwendung. Es wird uber erste Ergebnisse von bislang 23 Patienten, die von 13 Therapeuten behandelt werden, berichtet. Entwicklung und Verlauf der therapeutischen Beziehung zeigen, dass sich die Einschatzung der Zufriedenheit dieses Prozesses bei Patient und Therapeut sehr unterschiedlich entwickeln. In der Anfangsphase der Therapie scheint die therapeutische Beziehung von den Patienten stark idealisiert zu sein/werden, erlebt einen Einbruch, um dann in eine bessere Arbeits- und Beziehungszufriedenheit zu munden.

Zusammenfassung Die Arbeit setzt sich mit der derzeitig kontrovers gefuhrten Debatte um angemessene und notwendige Forschungsdesigns in der Psychotherapie auseinander und bezieht eindeutige Position fur einen naturalistischen, prozess-outcome-orientierten Forschungsansatz (practice-based evidence).

This article reports on one of the largest outpatient group psychotherapy studies which investigated long-term psychodynamic groups in a naturalistic setting, i.e. the PAGE (Projekt für ambulante Gruppentherapie-Evaluation)-Study. More than 450 patients of 28 group analysts in private practices were included in the Study. The analytic and psychodynamically oriented long-term outpatient groups were accompanied by a university based research team without impacting the normal patient-therapist contact, treatment contract, and treatment itself, therefore all treatments took place in a naturalistic setting with very experienced group analysts (effectiveness-study). Results of this large study clearly demonstrate that the longer psychotherapeutic treatments take place the better the outcomes are. The average effect sizes are beyond 1.30. Statistical as well as clinical significance was reached on all levels of investigation: symptoms, interpersonal problems, treatment goals, and overall psychiatric functioning.

Objective: This paper addresses the results of two samples of a large naturalistic (effectiveness study) outpatient process outcome study in Switzerland (Practice-Oriented Outpatient Psychotherapy Study). Ten different types of psychotherapy were investigated by looking at the role of the sex or gender of therapists and patients with regard to treatment outcome by including several nonspecific therapeutic factors. Method: Ten different types of psychotherapy, 237 patients, and 68 therapists were included in the study. A subsample of 116 cases was analyzed with regard to therapists’ technical interventions. Results: Sex and gender issues of both therapists and patients did not play a crucial role in any type of psychotherapy investigated. Gender issues appeared to play an indirect role. Female therapists intervene more empathically, whereas male therapists tend to use more confrontational techniques. Conclusions: Since the results show that therapists differ substantially with regard to their intervention techniques due to their sex, they should become more conscious of their interventions by considering patients’ severity of psychological problems and patients’ level of psychological functioning so as to not over or underchallenge them.

The currently dominating research paradigm in evidence-based medicine is expounded and discussed regarding the problems deduced from so-called empirically supported treatments (EST) in psychology and psychotherapy. Prevalent political and economic as well as ideological backgrounds influence the present dominance of the medical model in psychotherapy by implementing the randomized-controlled research design as the standard in the field. It has been demonstrated that randomized controlled trials (RCTs) are inadequate in psychotherapy research, not the least because of the high complexity of the psychotherapy and the relatively weak role of the treatment concept in the change process itself. All major meta-analyses show that the Dodo bird verdict is still alive, thereby demonstrating that the medical model in psychotherapy with its RCT paradigm cannot explain the equivalence paradox. The medical model is inappropriate, so that the contextual model is proposed as an alternative. Extensive process-outcome research is suggested as the only viable and reasonable way to identify highly complex interactions between the many factors regularly involved in change processes in psychotherapy.

This study investigates the relationships between mindfulness, depression, and quality of life (QoL) in cancer patients.A total of 51 cancer patients were assessed with the FreiburgMindfulness Inventory (FFA;Walach et al. 2004), the Hospital Anxiety and Depression Scale (HADS-D; Herrmann et al. 1994), and the Schedule for the Evaluation of Individual Quality of Life -DW (SEI QoLDW; Browne et al. 1997). The nonlinear relationships were analyzed using the instantaneous indirect effect procedure by Hayes and Preacher (2010).The relationship between mindfulness and QoL is mediated by depression. Because the relationship between mindfulness and depression is squared, the total effect of mindfulness on QoL is not constant. Increasing the level of mindfulness results in a decrease in its effect on the QoL of cancer patients.Cancer patients benefit from mindfulness up to a medium level through a decrease in depression, resulting in higher QoL. Patients with very higher mindfulness show more depressive symptoms, which leads to a neutralization of the effect of mindfulness on QoL.

Objective The exploratory study examined the relationship between coping and survival in patients undergoing bone marrow transplantation (BMT). Methods Patients scheduled for BMT were recruited from 1990 until 1995 at the University Hospital of Ulm, Germany. They were interviewed before transplantation, and the corresponding records were checked in December 2002. Seventy-two audiotaped interviews could be analyzed for 34 coping strategies as defined in the Ulm Coping Manual (UCM). Main outcome measure was survival time post-BMT. Results On average, the patients were 35 years old, 65% were male, and 56% diagnosed acute leukemia (AL). Four coping strategies were found to show a clear trend towards an association with survival time: emotional support , acceptance , taking control , and compensation . The last strategy was associated with shorter, the others with longer survival. Conclusion We found further evidence for an association between coping and survival. Because of the possible wide-reaching consequences for clinical management, replication of the data is essential.

Ergebnisse der PAGE-Studie zur Evaluation ambulanter psychodramatischer Gruppenpsychotherapie im deutschsprachigen Raum werden vorgestellt. Vollstandige Daten von 163 behandelten Patienten weisen eine mit der Forschungsliteratur vergleichbare durchschnittliche Effektstarke psychodramatischer Gruppenpsychotherapie nach. Differenzielle Betrachtungen erbringen vor allem eine relativ gute Zufriedenheit, weil sich auf der einen Seite eine gute Annaherung an Zielerreichung und verbessertes allgemeines psychisches Funktionsniveau aus Sicht der Behandler ergeben, allerdings auf der anderen Seite objektiv auch relativ geringere Symptomentlastung und geringe Verhaltensanderungen festgestellt werden mussen. Im Rahmen anderer Befunde der Psychotherapieforschung wird diskutiert, ob die erzielten Gewinne ausreichend fur einen dauerhaft gunstigen Therapieeffekt sein konnen.

Psychoonkologische Interventionen bewirken nachweislich bedeutsame Reduzierungen von Angst,Verzweiflung,Depression, Stress und helfen haufig bei der Verbesserung der Lebensqualitat und den sozialen-kommunikativen Problemen bei an Krebs Erkrankten. Forschungen zu den komplexen Verbindungen zwischen Erlebens- und hormonellem und Immunsystem sind bislang kaum unternommen worden; sie versprechen aber weiter gehende Aufschlusse uber die Einflussnahme auf korperliche Erkrankungen wie z.B. Krebs. Mangels ausreichend guter methodischer Qualitat von Studien ist die Frage derzeit immer noch unbeantwortet, ob djuvante psychologische oder psychotherapeutische Masnahmen dazu beitragen, dass Krebspatienten langer oder uberhaupt mit groserer Wahrscheinlichkeit ihre Erkrankungen uberleben konnen. Studien, die diese Hypothese stutzen, stehen gleich vielen gegenuber, die diese These zuruckweisen.

Gruppenpsychotherapeutische Weiterbildung stutzt sich wesentlich auf Selbsterfahrungen in Gruppen. Die Bedeutung des Leitererlebens in der Gruppenweiterbildung ist kaum Gegenstand empirischer Forschung gewesen, obwohl gerade die Leitung therapeutischer Gruppen eine hochqualifizierte und -spezialisierte Tatigkeit darstellt. Im Sinne einer Sicherstellung der Prozessqualitat in der gruppenpsychotherapeutischen Weiterbildung wurden die Effekte des Leitererlebens auf die berichteten Lerneffekte von kurzzeitigen Selbsterfahrungs- und thematisch fokussierten Weiterbildungsgruppen der American Group Psychotherapy Association (AGPA) untersucht. Es wurden 35 Gruppen mit 413 Teilnehmern/innen in der gruppenpsychotherapeutischen Weiterbildung im Erleben ihrer eigenen Person, des Gruppenklimas sowie des/r Gruppenleiters/in in den ersten zwei von vier Sitzungen in Beziehung zu den nach allen vier Sitzungen von ihnen berichteten Lerneffekten untersucht. Gruppenleiter/innen haben demnach einen nachhaltig gunstigen Effekt auf das erlebte Arbeitsklima der Gruppen und die Lernwirkungen, wenn sie v. a. entschieden, nicht vage und charismatisch, in Verbindung mit Kompetenz erlebt werden. Lerneffekte sind umgekehrt dann deutlich minimiert, wenn speziell Entschiedenheit und Strukturierung durch den/die Gruppenleiter/in, selbst bei vorhandener Kompetenz und Empathie, nicht gegeben ist. Die Ergebnisse werden im Hinblick auf die Bedurftigkeit angehender Gruppenpsychotherapeuten diskutiert, angesichts befurchteter, moglicher kritischer zukunftiger Gruppendynamiken ein Rollenmodell zur Verfugung zu haben, das eine glaubwurdige Identifikation mit Autoritat und Souveranitat bietet.

Background: The impact of psychosocial variables on the survival of cancer is discussed controversially. In a prospective study, we investigated whether the quality of coping strategies are of prognostic value in newly diagnosed glioblastoma. Methods: In a prospective study, patients with newly diagnosed glioblastoma underwent audiotaped interviews immediately following surgery and before initiating radiochemotherapy. The patients’ coping strategies were then identified from each interview using the Ulm Coping Manual that describes 34 different coping strategies. An exploratory factor analysis was conducted to assess patterns of coping strategies that reflect the same underlying general coping mechanism (also known as factor). These factors are characterized by a set of highly correlated coping strategies. Patients who are highly associated (loaded highly on) with a specific factor were compared against those with low loadings. In a Kaplan-Meier analysis, we compared overall survival (OS) between patients loading highly on a specific factor and those with negative loadings. A Cox regression analysis served to detect independent prognostic variables. Results: Eighteen patients were eligible for interviewing. Six factors have been retained based on the amount of variation they explain in all coping strategies. Among those, factor 1 (F1) explained the overall highest amount of variation and was characterized almost exclusively by high loadings of active coping strategies, including taking the initiative, problem analysis, emotional support, optimism/hope, and active compliance with factor loadings ranging from 54%-92%. The top two-thirds of patients with the highest loadings on F1 were compared against the lower third with poor loadings. Canonical prognostic factors were balanced between those groups. The high F1 loadings group had a particularly high median OS (24.1 months) as compared to the one with low F1 loadings (median OS, 10.6 months, p=0.0002). In a multivariable Cox regression analysis, F1 emerged as a prognostic factor (p

Background: To investigate associations between coping strategies and length of survival in a sample of 52 adult leukemia patients receiving allogeneic bone marrow transplantation (BMT). Methods: 52 adult patients, diagnosed with acute (AML) and chronic myeloid leukemia (CML) admitted for allogeneic BMT to a university hospital BMT unit in preparation for a transplantation of genotypically matched HLA donor marrow, were interviewed immediately after informed consent and prior to preparatory treatment for transplantation. Semistructured interviews were conducted and recorded for analysis to assess coping styles and were evaluated by a new content analytic coping measure [Ulm Coping Manual (UCM)]. Patients were a random sample of all eligible patients on the BMT unit between May 1990 and May 1994. Results: Complete audiotaped interviews were rated by blind raters, employing a newly developed content analysis for the identification of patients' coping strategies. Multivariate analysis using a Cox model revealed three pretransplant variables that demonstrated a statistically significant influence on 5-year survival: Stage of Disease at transplant (P

The article is based on the preliminary data derived from a larger German outpatient group therapy study. Under the auspices of the German Group Psychotherapy Association (DAGG) the PAGE (Projekt für ambulante Gruppentherapie-Evaluation) got under way in late 1996. It aims at the evaluation of group therapeutic treatments of physicians and psychologists in private practice.

Two long-term analytic inpatient psychotherapy groups, comprised of severely disturbed neurotic and personality disordered patients, were intensively investigated using process ratings and therapist and patient reports to examine the contribution of interpersonal feedback to treatment outcome. We found that feedback was important throughout the course of therapy, and that patients who derived the most benefit from the groups were those who experienced a greater level of group cohesiveness and were most active in terms of self-disclosure, receipt of feedback, and making significant behavioral modifications within treatment. These successful patients received both positive and negative feedback, primarily from other group members, and worked effectively toward the goals that brought them to treatment.

Two long-term analytic inpatient groups comprised of severely disturbed neurotic and personality disordered patients were intensively investigated through process ratings and therapist and patient reports with regard to five therapeutic factors: cohesiveness, self-disclosure, feedback, interpersonal learning-output, and family re-enactment. The process variables were correlated with outcome assessments at 12 and 18 months following treatment. The study applied a single case (group) approach with replication to cross-validate the findings from one group to the next. Results demonstrated that all five therapeutic factors were meaningfully associated with clinical improvement. Although different treatment groups may generate unique psychological climates for producing change, the findings suggest that group cohesiveness is an important ingredient for effective group process to occur. The multimethod, multiperspective nature of this study lends considerable credence to the findings, despite the small sample size.

Two inpatient psychoanalytic therapy groups were investigated by sequential applications of repertory grid technique (Kelly, 1955) and a method for rating interactive behaviour in groups (Orlik, 1986). Results concerning characteristics of construing at the beginning of therapy, and the process of change during therapy, discriminating successful patients from unsuccessful ones, are presented. Therapy process factors contributing to change of construing of the self in relation to significant others are suggested and the contribution of interactional behaviour in the group to the development of therapy process as well as to treatment outcome is considered.