Inanspruchnahme, Verlauf und Ergebnis ambulanter Psychotherapie

Gallas, Christine; Kächele, Horst; Kraft, Susanne; Kordy, Hans; Puschner, Bernd

doi:10.1007/s00278-008-0641-7

Cited by 21 publications

(5 citation statements)

References 27 publications

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“…In addition, participants in this study were highly educated (503/843, 59.7% had the test level of education). Higher education is associated with a positive view of psychotherapy in general and higher service use in routine care [69,70], and the distribution of educational levels in our sample is comparable with distributions in trials on iCBT for the treatment of depression [13]. The higher proportion of female participants is in line with the use rates of psychotherapy found in epidemiological studies in Germany and elsewhere [71,72].…”

Section: Principal Findingssupporting

confidence: 82%

The Evaluation of the GET.ON Nationwide Web-Only Treatment Service for Depression- and Stress-Related Symptoms: Naturalistic Trial

Etzelmueller,

Heber,

Horvath

et al. 2024

J Med Internet Res

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Background GET.ON (HelloBetter) treatment interventions have been shown to be efficacious in multiple randomized controlled trials. Objective This study evaluated the effectiveness of 2 GET.ON interventions, GET.ON Mood Enhancer and GET.ON Stress, in a national digital mental health service implemented across Germany. Methods Following an initial web-based questionnaire, participants were allocated to either intervention based on their baseline symptom severity and personal choice and received a semistandardized guided, feedback-on-demand guided, or self-guided version of the treatment. Uncontrolled routine care data from 851 participants were analyzed using a pretest-posttest design. Half of the participants (461/851, 54.2%) were allocated to the stress intervention (189/461, 41% semistandardized; 240/461, 52% feedback on demand; and 32/461, 6.9% self-guided), and almost all participants in the mood intervention (349/352, 99.2%) received semistandardized guidance. Results Results on depression-related symptom severity indicated a reduction in reported symptoms, with a large effect size of d=−0.92 (95% CI −1.21 to −0.63). Results on perceived stress and insomnia indicated a reduction in symptom severity, with large effect sizes of d=1.02 (95% CI −1.46 to −0.58) and d=−0.75 (95% CI −1.10 to −0.40), respectively. A small percentage of participants experienced deterioration in depression-related symptoms (11/289, 3.8%), perceived stress (6/296, 2%), and insomnia (5/252, 2%). After completing treatment, 51.9% (150/289) of participants showed a clinically reliable change in depression-related symptoms, whereas 20.4% (59/289) achieved a close to symptom-free status. Similar improvements were observed in perceived stress and insomnia severity. Guidance moderated the effectiveness of and adherence to the interventions in reducing depressive symptom severity. Effect sizes on depression-related symptom severity were d=−1.20 (95% CI −1.45 to −0.93) for the semistandardized group, d=−0.36 (95% CI −0.68 to −0.04) for the feedback-on-demand group, and d=−0.83 (95% CI −1.03 to −0.63) for the self-guided group. Furthermore, 47.6% (405/851) of the participants completed all modules of the intervention. Participant satisfaction was high across all patient groups and both interventions; 89.3% (242/271) of participants would recommend it to a friend in need of similar help. Limitations include the assignment to treatments and guidance formats based on symptom severity. Furthermore, part of the differences in symptom change between groups must be assumed to be due to this baseline difference in the measures. Conclusions Future digital health implementation and routine care research should focus on monitoring symptom deterioration and other negative effects, as well as possible predictors of deterioration and the investigation of individual patient trajectories. In conclusion, this study supports the effectiveness of tailored digital mental health services in routine care for depression- and stress-related symptoms in Germany. The results highlight the importance of guidance in delivering internet-based cognitive behavioral therapy interventions and provide further evidence for its potential delivered as web-only solutions for increasing access to and use of psychological treatments.

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Section: Principal Findingssupporting

confidence: 82%

The Evaluation of the GET.ON Nationwide Web-Only Treatment Service for Depression- and Stress-Related Symptoms: Naturalistic Trial

Etzelmueller,

Heber,

Horvath

et al. 2024

J Med Internet Res

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“…For approximately half of PSIW participants, this resulted in need for further treatment in regular mental health care. Reducing symptoms and sickness absence of patients with manifest illness often takes time ( 58 , 75 ), and reduction of sickness absence often only follows symptom reduction ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

Psychotherapeutic Consultation Services in the Workplace: A Longitudinal Analysis of Treatments and Sick Leave Using Health Insurance Data

Gantner¹,

Jarzcok²,

Schneider

et al. 2022

Front. Psychiatry

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BackgroundPsychotherapeutic consultation services in the workplace (PSIW) have been developed to provide collaborative mental health care for employees. The aim of this study was to analyze participant characteristics, the role of PSIW in treatment courses, and the development of sick leave before and after PSIW start.MethodsRoutine data from PSIW and health insurance of 155 participants were analyzed descriptively and by means of a multilevel negative binomial regression.ResultsEighty-four percent of users were male, and 72% were diagnosed with a mental disorder. The number of PSIW consultations varied from 1 to 13 (mean = 4). For 34% of participants, PSIW sessions were sufficient, 33% received a recommendation for outpatient psychotherapy, and 20% for inpatient mental health treatment. While recommendations for inpatient treatment displayed a high adherence rate (74%), recommendations for outpatient treatment were followed by 37%. Compared with the period of a half-year before PSIW, sick-leave days were reduced from the period of the second half-year after PSIW start and in the subsequent observed half-year periods. Trajectories of sick leave by subgroups showed differences.ConclusionsPSIW is a flexible care offer, and results indicate a possible effect of PSIW on sick leave. In future studies, control group designs and inclusion of further variables are needed.

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“…The investigated sample represents a typical outpatient sample in Germany regarding the level of education. However, it comprises more patients in a partnership [61,62], more females [61], patients with a higher depressive symptom severity than the average in other clinical samples [26], and an patients aged about 10 years younger than the average outpatients [61,62]. As participation was voluntary, our recruiting strategy probably led to the selection of patients motivated for self-help and with an affinity for web-based applications.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a Guided Web-Based Intervention to Reduce Depressive Symptoms before Outpatient Psychotherapy: A Pragmatic Randomized Controlled Trial

Krämer

Grünzig

Baumeister

et al. 2021

Psychother Psychosom

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Introduction: Psychotherapy is a first-line treatment for depression. However, capacities are limited, leading to long waiting times for outpatient psychotherapy in health care systems. Web-based interventions (WBI) could help to bridge this treatment gap. Objective: This study investigates the effectiveness of a guided cognitive-behavioral WBI in depressive patients seeking face-to-face psychotherapy. Methods: A 2-arm randomized controlled trial was conducted. Depressive patients (n = 136) recruited from the waiting lists of outpatient clinics were randomly assigned to an intervention group (IG; treatment as usual [TAU] + immediate access to WBI) or a control group (CG; TAU + access to WBI after follow-up). Depressive symptoms and secondary outcomes were assessed at baseline, 7 weeks, and 5 months after randomization. Results: Mixed-model analyses revealed a significant group × time interaction effect on depressive symptoms (F2, 121.5 = 3.91; p < 0.05). Between-group effect sizes were d = 0.55 at 7 weeks and d = 0.52 at 5 months. The IG was superior regarding psychological symptoms and mental health quality of life but not on physical health quality of life, attitudes, motivation for psychotherapy, or subjective need and uptake of psychotherapy. Conclusions: Patients waiting for face-to-face psychotherapy can benefit from a WBI when compared to TAU. Despite the reduction of depressive symptoms in the IG, the uptake of subsequent psychotherapy was still high in both groups. The effects remained stable at the 5-month follow-up. However, this study could not determine the proportion of specific intervention effects vs. nonspecific effects, such as positive outcome expectations or attention. Future research should focus on the long-term effects and cost-effectiveness of WBI before psychotherapy.

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Inanspruchnahme, Verlauf und Ergebnis ambulanter Psychotherapie

Abstract: Die maskuline Schreibweise wird ausschließ-lich der besseren Lesbarkeit wegen verwendet. Selbstverständlich sind mit Patienten auch Patientinnen gemeint, mit Therapeuten auch Therapeutinnen usw. RedaktionB. Strauß, Jena H. Kächele,

Cited by 21 publications

References 27 publications

The Evaluation of the GET.ON Nationwide Web-Only Treatment Service for Depression- and Stress-Related Symptoms: Naturalistic Trial

The Evaluation of the GET.ON Nationwide Web-Only Treatment Service for Depression- and Stress-Related Symptoms: Naturalistic Trial

Psychotherapeutic Consultation Services in the Workplace: A Longitudinal Analysis of Treatments and Sick Leave Using Health Insurance Data

Effectiveness of a Guided Web-Based Intervention to Reduce Depressive Symptoms before Outpatient Psychotherapy: A Pragmatic Randomized Controlled Trial

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