Progressive Changes in Patients' Lives After Psychotherapy: Which Treatment Effects Support Them?

Abstract

The endurance of psychotherapeutic effects after conclusion of inpatient treatment is examined in a follow-up study of 49 patients with psychosomatic, neurotic, and personality disorders. The perspective is not symptomatological but rather relates to the concrete changes occurring in the lives of the patients after treatment. The investigators hypothesized that the probability of progressively coping with life demands depends on the extent to which patients have gained insight into their central psychological problems. Using the Heidelberg Structural Change Scale (HSCS) to gauge the extent to which patients succeed in gaining cognitively and emotionally definitive insight into their intrapsychic conflicts and the structural vulnerabilities determining their condition, the authors were able to confirm their hypothesis. The HSCS, compared with other measures, offered the only possibility of predicting progressive (i.e., symptomatic) changes. The authors concluded that the demands of external life present opportunities for therapy success to be realized as progressive changes and that these changes can form a basis for further positive development.

Extending the Assimilation of Problematic Experiences Scale: Commentary on the special issue

“…Some versions of the APES have been renamed, including the APES-enlarged version, in which the vague awareness/emergence stage was divided into three stages for a study on effects of antidepressant medication (Teusch, Bö hme, Finke, Gastpar, & Skerra, 2003), the Assimilation of Problematic Voices Scale (APVS; Honos-Webb, Stiles, & Greenberg, 2003), the Assimilation of Problematic and Overwhelming Experiences Scale (APOES); Varvin, 2003), and the Heidelberg Structural Change Scale (HSCS; Grande, Rudolf, Oberbracht, & Jakobsen, 2001;Grande, Rudolf, Oberbracht, & Pauli-Magnus, 2003;Rudolf, Grande, & Oberbracht, 2000). Other variations have not been given separate names (e.g., Glick, Salvi, Stiles, & Greenberg, in press;Honos-Webb, Stiles, Greenberg, & Goldman, 1998;Honos-Webb, Surko, Stiles, & Greenberg, 1999;Knobloch, Endres, Stiles, & Silberschatz, 2001;Laitila & Aaltonen, 1998;Stiles & Angus, 2001;Stiles et al, 1991Stiles et al, , 1992bStiles et al, , 1997Stiles, Osatuke, Glick, & Mackay, 2004;Williams, Stiles, & Shapiro, 1999).…”

The Operationalized Psychodynamic Diagnostics System: Clinical Relevance, Reliability and Validity

“…The causative characteristics which maintain the disorder and therefore play a decisive role in the psychodynamics of the clinical picture are the foci of therapy. It seems that 5 foci are enough [19,20,22,25] to capture the different aspects of a disorder; it appears advantageous to choose one relationship focus and at least one conflict (the most prominent conflict assessed in axis III) and one structure focus (the most prominent structural deficiency assessed in axis IV). In the research projects, independent observers interviewed the patients at regular intervals to assess their development concerning the foci; in the practice projects, the therapists chose both foci and arranged treatment.…”

Psychoanalytische Therapie

“…Mit Hilfe dieses Instruments können Veränderungen in der Verarbeitung intrapsychischer Konflikte und struktureller Beeinträchtigungen erfasst werden (Grande et al , 2003. Darüber hinaus findet das psychoanalytisch bedeutsame Konzept der "strukturellen Veränderung" in der Skala eine Operationalisierung, so dass die spezifischen Wirkungen von Psychoanalysen im Unterschied zu Psychotherapien messbar werden Grande et al 2003).…”