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SUMMARY The paper describes the concept for a form of in-patient treatment for anxiety disorders based on a combination of psychodynamic and cognitive-behavioral therapy which is currently still being applied as a model. We present the case history of one male patient with an anxiety disorder and in addition a severe personality disorder as an example of our therapeutic approach. The diagnose, according to the ICD-IO classification system is an agoraphobia with a narcistic and dependent personality disorder. The idea for a form of treatment based on a combination of behavioral and psychodynamic therapy is based primarily on the hypothesis that there is a subgroup of patients, still to be identified, who benefit more from an interrelated combination of both therapeutic approaches than from one therapy alone. As far as the psychodynamic component is concerned, the 12-week combination treatment essentially comprises a highfrequency group therapy with a psychodynamic orientation and a distinct focus of treatment. The behavioral therapy is conducted in an individual setting with co-therapeutic support and consists of an exposure and response prevention as the central component of treatment. A significant and steady improvement in the goal symptoms was achieved in the patient in the course of treatment. In addition to a concrete description of the therapeutic approach, the paper provides psychometric evaluation data, including an eighteen-month catamnesis. [ABSTRACT FROM AUTHOR]

SUMMARY Within inpatient psychotherapy traditionally different therapeutic approaches are combined. Usually verbal interventions of different orientations and settings (e.g. individual and group therapy), nonverbal procedures (e.g. music and art therapy) and body-oriented techniques are included. The combinations is merely additive, integrated or eclectic. Little is known about the reciprocal interrelation of such combinations. Along the example of a definite additive combination of psychodynamic and behavioural psychotherapy for agoraphobias and obsessive disorders a rationale for the interrelationship of the different therapeutic components is discussed. [ABSTRACT FROM AUTHOR]

For more than 30 years counselling and psychotherapy services in China have progressed rapidly. Currently, various Chinese universities, hospitals, official mental health centres, and private mental health service organizations provide psychotherapy training programs. However, little is known about Chinese psychotherapy trainees and their development. This pilot study investigated the characteristics and perceived professional development of 20 Chinese trainees during and after an advanced training program for psychosomatic medicine and psychotherapy, which is a collaboration project between Peking Union Medical College Hospital and the Department of Psychosomatic Medicine and Psychotherapy from the University Medical Center Freiburg in Germany. Trainees completed questionnaires from the SPRISTAD (Society for Psychotherapy Research Interest Section on Therapist Training and Development) study at the beginning (T1), at the end (T2), and one year after finishing the program (T3). Seventeen of the twenty participants were clinicians. Trainees reported a prominent rise of Currently Experienced Growth throughout the training period, which nearly dropped to the baseline level after the training, although Retrospective Career Development showed a trend of an overall increase. Both 'experience in therapy with patients' and 'participation in courses or seminars' were the most important positively perceived sources of influence on trainees' development. This implies the importance of continuous psychotherapy training for the development of therapists during their career. Future research with a larger sample size should also assess trainees' development from the viewpoint of trainers, supervisors, and patients.

Objective: Inpatients of psychosomatic rehabilitation with a latent or manifest desire for a pension are a risk group with regard to successful participation in rehabilitation and return to work. Reaching this group of patients, is both a legal requirement (rehabilitation before retirement), and important from an economic and health perspective. This study examines patients who are considering applying for a reduced earning capacity. The questions are whether these patients differ in socio-demographic variables and the success of rehabilitation from patients without pension considerations, and which patients benefitted from their rehabilitation despite pension considerations. Particular attention is paid to the therapeutic relationship., Methods: Data are routinely collected from patients of 2 rehabilitation clinics who were undergoing inpatient psychosomatic treatment between October 2012 and February 2017 (n=8503)., Results: Inpatients with pension considerations were slightly older, more often incapacitated for work and more often receiving unemployment benefits. Both groups reported a significant reduction in symptoms over the course of the rehabilitation. Within the group considering retirement, patients who reported an improvement in symptoms reported a more positive relationship satisfaction., Discussion/conclusion: Patients who are thinking about retirement often have difficult socio-demographic and health-related conditions for successful rehabilitation. Despite these conditions, many report an improvement in psychosomatic symptoms and a positive therapeutic relationship., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Aim of This Study: Apart from the reduction of symptoms and the restoration of working ability, return to work is a long-term goal of medical rehabilitation. The aim of this study is to analyze the influence of work motivation on the outcome of rehabilitation., Methods: The data basis consists of N=998 patients at the psychosomatic department of the Oberharz Rehabilitation Center as well as data from insurance accounts. Using multiple linear regression analysis the predictive power of work motivation on rehabilitation outcome as well as different facets of work motivation in their function as predictors are analyzed., Results: Only minor statistical relations could be found between work motivation and rehabilitation success when also taking employment status of the previous year and subjective vocational disability into account. A small predictive power can be attributed to work motivation as a factor in rehabilitation success in the sense of a reduction of symptoms. Particular facets of work motivation are suitable to predict rehabilitation success. Patients with a work motivation risk profile differ from patients with a normal work motivation profile as regards their capacity to work in the year following rehabilitation treatment., Conclusion: Work motivation represents a relevant construct in rehabilitation success but is strongly influenced by individual factors. During rehabilitation, individual problems which influence work motivation should be taken into account more strongly., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Introduction The Helping Alliance Questionnaire developed by Luborsky was psychometricly examined for the first time and translated into German by Bassler et al. in the mid-1990s. It consists of 11 Items, which are summarized to the scales "relation to the therapist" and "satisfaction with therapeutic outcome". HAQ is now one of the most used instruments to measure therapeutic alliance. The goal of this study was to test the psychometric properties based on three large patient samples in different treatment settings. Material and methods Analyses were conducted based on 2 samples of patients in inpatient psychosomatic/psychotherapeutic rehabilitation (n=655, n=2494) and one sample in outpatient psychotherapy (n=1477). Exploratory factor analyses and for verification confirmatory factor analyses were applied. Furthermore reliability and validity analysis were conducted. Results The 2-factorial structure found in literature was replicated with an increasing stability at the end of treatment. Item 2 and 3 had inconsistent factor loadings at different points of measurement and study. Reliability and validity indices were satisfying to good. The fit of the model, on the other hand, was less satisfying and suggests a solution without Item 2 and 3. For reasons of content as well as for reasons of dissemination, it is pleaded for the maintenance of the existing item assignments in the HAQ for the present., Competing Interests: Interessenkonflikt: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background and Objective: The present study compares patient characteristics and treatment outcome of 138 patients from a day-care psychosomatic rehabilitation and 540 patients from an inpatient psychosomatic rehabilitation. It was analyzed if patients differ in demographic-, clinical- and socio-medical characteristics, if there are different treatment effects between the 2 types of rehabilitations and if other patient characteristics can predict success of treatment., Methods: Data was assessed twice (at intake and at discharge of rehabilitation) by self-reported surveys and external assessment of clinical discharge reports. Success of treatment was measured by changes in somatic and mental complaints, psychological well-being, work motivation, subjective forecast of employment, and externally estimated ability to work., Results: RESULTS indicate that day-care patients were higher burdened than inpatients at intake. They showed more complaints, had a higher number of days of incapacity and a higher chance of work difficulties. Furthermore, the prevalence of a migration background was higher. Both kinds of rehabilitation were successful in reducing somatic and mental complaints and in increasing psychological well-being. The "Würzburger Screening", which measures the subjective forecast of employment and occupational stress, turned out to be the best predictor for success of treatment., Conclusion: Both day-care- and inpatient rehabilitation were mostly successful, even if day-care patients were more burdened at intake. Therefore day-care rehabilitation can be seen as a good alternative to inpatient rehabilitation., (© Georg Thieme Verlag KG Stuttgart · New York.)

The aim of this study is to explore whether or not being already on sick leave at admission to a psychosomatic clinic indicates a higher level of severity of symptoms in patients with anxiety disorders, and whether or not this has an impact on therapy outcome. We examined 194 in-patients at 8 psychosomatic clinics upon admission and discharge by interview and psychometric testing. Being on sick leave before admission proved to be an indicator for higher global symptom distress as well as a higher severity of anxiety symptoms. Treatment duration was longer for the sick leave group than for the patients that had not been on sick leave, but each group experienced the same degree of change in pre-and-post treatment symptoms. We conclude that sick leave before admission does give information about illness severity and need of treatment in patients with anxiety disorders.