Marlène Sapin
Isolated or over-embedded? Family configurations of 60 individuals followed in psychotherapy
Authors
Marlène Sapin (University of Lausanne
)
Jakob Eberhard (University of Geneva and Lausanne
)
Eric D. Widmer (University of Geneva and Lausanne)
Using the Family network method (Widmer, 1999), our research explores the ways in which individuals followed in psychotherapy define their significant families and how they perceive the relationships of emotional support that characterize them. Based on a longitudinal sample (5 waves) of 60 individuals being regular clients in a private psychotherapy practice, we found that distinct family configurations coexist in terms of composition (who is cited as a significant family member) with significant variations across waves. Those configurations also greatly vary in terms of social capital, i.e. the density of ties and the connectedness of the family network, and the centrality of patients within it, both across individuals and across waves. We discuss the importance of our preliminary results for the understanding of the import of social resources for the psychological health of individuals in therapy.
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Laurence Defago
Cognitive and affective loads and quality of therapists intervention in function of degrees of formation and the client’s processing mode: An experimental study
Authors
Laurence Defago (University of Fribourg)
Michaël Reicherts (University of Fribourg)
There is no empirical evidence of the cognitive and affective « load » therapists experience during interventions, which refers to simulations of therapeutic responses to standardized client material. Our experimental study presents real client material to « therapist » subjects which engage in a series of interventions within 3-step sequences (client-therapist turnover). Real clients’ turnovers have been filmed and evaluated according their level of processing (« explication process » according to Sachse, 1992). Quality of the therapeutic responses and their implications for a series of cognitive and affective variables are evaluated. The design combines within-subjects factors (different levels and directions of the clients’ process sequences) and a between-subject factor (non-experienced vs. experienced therapists). Psychology students without or with basic skill training in client-centred therapy are compared with clinical psychologists, advanced in client-centred therapy formation. Results show that the quality of therapeutic interventions of the students with skill training and of the therapists in formation is better than for the students without practice. The students, on the other hand, evaluate their cognitive load as higher than do the advanced therapists; the opposite holds for the affective load. Implications of the research paradigm – therapy process simulation based on real client’s material – are discussed for further research and training.
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Jens Gaab
Evaluation of a multicentre randomized controlled trial of cognitive behavioural stress management (CBSM) training in HIV infected individuals under highly active antiretroviral therapy (HAART)
Authors
Jens Gaab (University of Zurich)
Simona Berger (University of Zurich)
Tanja Schad (University of Zurich)
Ulrike Ehlert (University of Zurich )
Daniel Regli (University of Berne)
Claudine Zellweger (University Hospital Berne)
Manuel Battegay (University Hospital Basel)
Hans-Jakob Furrer (University Hospital Berne)
Pietro Vernazza (Cantonal Hospital St. Gallen)
Rainer Weber (University Hospital Zurich)
Emotional distress is highly prevalent in HIV positive individuals and influences the progression of HIV. The aim of the current study was to evaluate the effect of CBSM on clinical HIV parameters, such as morbidity, CD4 cell count and viral load, and psychological well-being. In a randomized controlled multicentre study, we evaluated the effects of CBSM training in 104 HIV-infected women and men under highly active antiretroviral therapy (HAART) over the course of 15 months. Outcome measures were clinical markers (CD4 cell counts, HIV-1 RNA, morbidity and mortality) and psychological parameters (anxiety and depressive symptoms (HADS) and quality of life (MOS-HIV). The CBSM did not influence mortality, morbidity nor CD4 and HIV RNA parameters at any time. However, significant and meaningful attenuation of emotional distress and increases of quality of life were
observed. These changes were most notable in patients with high levels of pre-training distress. The results show that the clinical course of HIV is not affected over the period of 15 months, however, beneficial effects on psychological parameters are observed, which could have effects in the long run.
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Simone Munsch
Ecological Momentary Assessment (EMA) to study treatment outcome of a Cognitive Behavioral Treatment (CBT) for Binge Eating Disorder (BED)
Authors
Simone Munsch (University of Basel)
Andrea H. Meyer (University of Basel)
Jürgen Margraf (University of Basel)
Frank Wilhelm (University of Basel)
Introduction: Even though CBT is the best-established treatment for BED, only few data exist about the essential attributes of the determinants of change. We used EMA to collect repeated, simultaneous measurements of bingeing in a naturalistic setting during a CBT. Our special interest focused on the assessment of the ability to identify risk situations for bingeing. Methods: Twenty seven individuals were eligible for the treatment trial. They were randomly allocated to an immediate short-term CBT (8 weeks) or to a wait-list condition (8 weeks). Binge eating was studied according to EMA (during 7 days) at the beginning of wait-list condition, before and after treatment. We computed a risk index for bingeing by taking the difference between the standardized self-estimated risk of future bingeing (ranging from 0–10) and the actual binge status (yes/no). Results: Using univariate analysis of variance we found the ability to identify risk situations to increase between baseline and pre-treatment and even more during short-term CBT. Discussion: Our preliminary analyses indicate that there might be reactivity to self-monitoring by EMA. We further hypothesize that short-term CBT partly works through the training of identifying risk situations and hence through the development of specific coping strategies.
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Annamarie Vogt
Effects of a computerized working memory training in patients with multiple sclerosis
Authors
Annamarie Vogt (University of Basel)
Leo Geschwind (University of Basel)
Ludwig Kappos (University Hospital Basel)
Klaus Opwis (University of Basel)
Ernst-Wilhelm Radue (University Hospital Basel)
Iris-Katharina Penner (University of Basel)
Working memory deficits are already apparent at early stages in patients with multiple sclerosis (MS) and have a significant impact on their everyday lives. The aim of this study is to evaluate a newly developed working memory training tool for MS patients (BrainStim, Penner et al., 2006). As there is no consensus yet of the impact on intensity and duration of training on treatment efficacy, the study compares a short, high intensity training to a longer and distributed training. The primary outcome measure consists of a neuropsychological test battery and self-report measures. At baseline, the test battery is performed twice to control for possible learning effects. The retest is performed after four weeks, directly after the high intensity training group finishes. The follow up test is performed after eight weeks and allows evaluation of possible long-term effects. Although recruitment of participants is still ongoing, from preliminary data we observe greater effects for the high intensity training and a tendency towards selective effects in working memory outcome measures rather than executive functions or processing speed. Further data should allow more insight into the effects of intensity and duration of training and will help to develop more precise guidelines for cognitive rehabilitation in MS.
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