Jeannette Brodbeck
Pathological, problem and at-risk gambling in German- and Italian-speaking Switzerland
Authors
Jeannette Brodbeck (University of Berne)
The purpose of the study was to assess prevalence rates of pathological, problem and at-risk gambling among a representative population-based random-random-sample of 4997 persons living in German- and Italian-speaking Switzerland. With computer-assisted telephone interviews we assessed gambling behaviour and employed the NORC DSM Screen for Gambling Problems (NODS) to identify gambling problems. Lifetime prevalence of at-risk gambling was 2.3%, of problem gambling 0.6% and pathological gambling 0.3%. The most popular gambling activities in month prior to the interviews were Lotto /Toto (30.7%) and participating on SMS- and TV- games for prizes (6.8%). Fewer participants were gambling in casinos (1.5%), used slot-machines (0.3%) or other games of chance (2%). The use of slot-machines increased the odds for pathological gambling, participting at lotteries decreased the odds for pathological gambling. The results show lower prevalences than previous Swiss studies which is due several measures to avoid false-positive diagnoses. Implications for interventions will be discussed.
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Helene Hofer
Coping with Brain Injury. Considering patient and family caregivers.
Authors
Helene Hofer (Inselspital Bern
)
Eveline Frischknecht (University of Bern
)
Hansjörg Znoj (University of Bern
)
Klemens Gutbrod (Inselspital Bern
)
René Müri (Inselspital Bern)
Reintegration into society after an acquired brain damage is an enormous challenge. Apart from the emotional pressure of handling the impairment, it is always a question of learning to live with the handicap. The patient will be faced with psychological problems such as Adjustment Disorders. These represent an important and frequently limiting factor for rehabilitation and are a considerable heavy burden for the family to cope with (Schütte, 2002). In the present study, the coping process and the effectiveness of psychotherapy in the management of grief after a brain injury will be investigated. An objective is to outline the central aspects of the therapeutic process and to find out conditions under which psychotherapy after brain injury is helpful. Ten patients were recruited for this study. The therapy usually took 20 - 25 sessions during a period of 12 - 18 months. In accordance with preliminary data, a significant change can be noted. From the results, the conclusion can be drawn that psychotherapy can help these patients to improve self-awareness and hence to realistically evaluate their deficits and their residual capacity.
So far research has paid little attention to family caregivers, although literature clearly suggests that stroke caregiving is highly stressful and could lead to clinically significant depression in caregivers (Han & Haley, 1999). Further investigation is needed. A short overview and outlook of the literature will be presented.
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Oliver Egger
Modes of functioning and techniques as predictors of therapy process with depressive patients
Authors
Oliver Egger (University of Berne)
Consistency theory (Grawe, 2006) proposes that the satisfaction of basic needs within therapy activates the patients approach system (e.g. attachment by experiencing a good relationship). This leads to greater openness and facilitates disorder-specific interventions as compared to a hindering impact in the avoidance mode. We tested 1) the impact of the patients operating in the approach vs. avoidance mode on session outcome and 2) several types of therapist interventions on session outcome. For this, we employed the research strategy “selection from natural variation”. The process characteristics of the selected therapy sessions (N=30) were coded by independent observers. Explorative analyses show that an activated approach mode is a strong predictor of session outcome. In addition, the application of clarifying and interpersonal techniques is facilitated. Results will be discussed with regard to their theoretical and clinical implications.
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Christoph Flückiger
Individual case formulations on patients strengths - forlorn hope?
Authors
Christoph Flückiger (University of Berne)
Resource activation is a therapeutic short-term strategy to foster a patient's approach mode of functioning by providing immediate need-satisfying experiences in therapy (Grawe, 2006). In this way resource activation is the short-range "twin brother" of motivational attunement, i.e. the medium-range strategy to foster the therapeutic alliance by satisfying the patient's interpersonal motives and needs (Flückiger & Grosse-Holtforth, 2007). The impact of early resource activation is tested with a specific priming-module. (Standardized) assessment of patient resources is the prerequisite for resource activation in the therapeutic process and is included in the priming module. The impact from the priming module to the therapeutic process and outcome is presented by a experimental study (N = 40): 1) The priming module has a specific effect to the early resource activation rated by different observer perspectives; 2) Resource activation has an impact to the interactional process quality rated by patient and therapist; 3) fostered resource activation has an impact to the goal attainment, psychopathology and affectivity after 20 sessions. The results will be discussed by need-satisfying strategies and experimental process-outcome paradigms in general.
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Martin Grosse Holtforth
Emotional avoidance in the psychotherapy of depression
Authors
Martin Grosse Holtforth (University of Berne)
Avoiding aversive experiences and specifically avoiding the expression of emotions (AEE) have been shown to be associated with psychological problems as well as with impeded psychotherapy processes in previous research. In this pilot study we examine the change of AEE and its relationship to the process and outcome of psychotherapy for depression. AEE of 16 outpatients was rated by independent observers from video recordings of single sessions in four phases of therapy. From each phase the session with the largest emotional activation as rated by the patient was analyzed. Avoidance showed a curvilinear progression over the course of therapy with a peak in the second phase. Less successful patients showed higher levels of avoidance. High avoidance was also associated with a worse psychotherapy relationship as well as the therapists perceiving the patients as more interactionally problematic. The results are discussed with regard to therapeutic consequences and directions for future research.
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René Lehmann
It’s all the therapist’s fault – an empirical study of therapy dropout
Authors
René Lehmann (University of Berne)
Therapy dropout has rarely been investigated by the literature so far. Especially rare is empirical work that explores dropout as a principal theme. In this study no pre-treatment patient characteristics were found to predict therapy dropout or therapy outcome (N = 627). Interestingly, the patients didn’t differ regarding interpersonal variables. However, an ANOVA showed that groups differed highly significant in therapy alliance within the first ten therapeutic sessions, both from the patient’s and from the therapist’s perspective. A poor alliance was an excellent predictor of later dropout or a poor outcome. The therapist’s perception of difficulties during the therapeutic process differed significantly between dropouts and those patients who completed treatment. It may be interpreted that it is not primarily the condition in which a patient enters the treatment per se that predicts dropout. More important for a favourable outcome may be the therapist’s capacity to build a good alliance.
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