Background: Levels of goal agreement between therapists and adult clients have been shown to relate to therapeutic outcomes. Understanding clients' goals for therapy, therefore, is an important area of study. Aims: The purpose of this study was to investigate the therapeutic goals that young people have in school-based counselling, and the extent to which different types of goals are achieved. Method: The study is a post-hoc analysis of data collected from two pilot randomised controlled trials (RCT) using the Goal Based Outcome (GBO) tool, in which 73 participants were allocated to either a counselling group or a waitlist control group. Thematic analysis was used to identify the main types of goals young people had; with descriptive quantitative analysis to identify the prevalence of these goals, and multi-level analysis to identify whether some goals were attained to a greater extent than others. Results: The most frequent type of goals identified by young people related to increasing self-confidence and self-acceptance, followed by controlling or reducing anger, improving relationships with family, and increasing feelings of happiness. No significant relationship was found between the type of goal and the extent to which they were attained in counselling. Conclusion: Young people in counselling are particularly concerned with improving their self-confidence, and this suggests a somewhat different focus to the counselling work than that which emerges from counsellors' reports of presenting and predominant issues. This suggests that school-based counsellors should be mindful of clients' particular therapeutic goals.

The goals of young people in school-based counselling and their achievement of these goals

Goal Attainment Scaling (GAS) bei der Evaluation der langfristigen Effektivität des kognitiv-behavioralen Trainingsprogramms SAVE für jugendliche AD(H)S Patienten

Die PAGE-Studie untersuchte die Wirkungen von ambulanten analytischen/tiefenpsychologisch-fundierten und psychodramatischen Gruppenpsychotherapien im Rahmen einer naturalistischen Studie. 40 erfahrene niedergelassene Gruppenpsychotherapeuten – davon 12 PsychodramtikerInnen – kooperierten in der Studie, die vollstandige Datensatze (Pra-Post) von 244 PatientInnen analytischer/tiefenpsychologisch fundierter und von 91 PatientInnen psychodramatischer Gruppentherapien umfasst. Die Effektstarken beider Therapierichtungen sind im internationalen Vergleich uberdurchschnittlich hoch (ESPA = 1.33 und ESPD = 1.01) und unterstreichen die Bedeutung von psychotherapeutischen Langzeitbehandlungen bei einer psychisch schwerer belasteten PatientInnen-Klientel. Ein direkter Vergleich beider Therapiekonzepte ist aufgrund unterschiedlicher Inanspruchnahme-Klientelen und unterschiedlicher Therapie-Laufzeiten nicht moglich. Ebenfalls erhobene Therapieziele summierten sich uber alle PatientInnen auf fast 2.000 und geben Aufschlusse uber das Verhaltnis von intrapsychisch versus interpersonal-sozial verortbaren Zielen.

Wirksamkeit psychodramatischer Gruppenpsychotherapie

Background Miscarriage (MC) and stillbirth (SB) can be considered as potentially traumatic events (PTE) and affect approximately 10–20% of all pregnancies. PTEs can lead to the development of post-traumatic stress disorder (PTSD). While the psychobiology of PTSD is well-understood, our knowledge on psychobiological adaptations shortly after a PTE is limited. This study aimed to shed light on early psychobiological changes associated with MC and SB. Methods We included 25 women who had experienced a MC/SB within the previous three months and compared them with 28 healthy control women. All participants were asked to attend a study appointment, during which they participated in a socially evaluated cold-pressor test (SECPT) to induce psychosocial stress. Saliva and blood samples were collected at rest, immediately and at 20, 45 and 90 min after the SECPT. We determined salivary cortisol levels and α-amylase (sAA) activity, and plasma interleukin-6 (IL-6) concentrations. We assessed symptoms of PTSD, anxiety and depression using self-report questionnaires. Results Women who had experienced MC or SB reported significantly more symptoms of PTSD (p < 0.001) and anxiety (p < 0.001), when compared to the control group. Despite elevated psychological distress in the MC/SB group, there were no significant differences of salivary cortisol, sAA and IL-6 levels between the two groups at rest or after SECPT induced stress. Conclusions Despite the high psychological strain on women after MC/SB, the stress is not yet reflected at a biological level. These results highlight the complex relationship between early trauma, PTSD symptoms, and biological responses. Further research is needed to understand the long-term effects of trauma related to MC/SB, and the development of PTSD, as well as the underlying mechanisms contributing to the observed psychological and biological changes.

Psychological, neuroendocrine and inflammatory stress responses in women after miscarriage or stillbirth: investigating early psychobiological adaptations to potential traumatic events.

Treatment goals are either proposed by a patient or deduced from the case formulation of the therapist. To optimize goal-finding procedures in psychotherapy, therapists need an empirical point of reference to estimate the degree of goal attainment that can be expected for a specific treatment goal. To establish such an empirical basis, treatment goal categories of the primary treatment goals of 2,770 inpatients undergoing cognitive–behavioral therapy were categorized by the Bern Inventory of Treatment Goals. The levels of goal attainment were then compared with respect to 48 different goal categories. The results indicate that goal attainment differs according to treatment goal categories, even if confounding characteristics of the patient are controlled for.

Empirically based guidelines for goal-finding procedures in psychotherapy: Are some goals easier to attain than others?

The results of a study evaluation in practicability of two newly developed documentation forms are presented. Examined are 82 inpatient treatment episodes in an already published clinical concept with different treatment settings. Parallel versions of the forms were completed by patients and therapists. The 'Erge-Doku-A-Form' allows for the naming of up to five therapy goals determined at the beginning of therapy and evaluated in relation to their achieved quality at the end of therapy. The 'Erge-Doku-B-Form' describes a variety of problem areas as well as questions related to medication and changes induced by therapy. Surprising there were a high number of 230 Individual Therapy Goals (ITG) by patients and 262 ITG by therapists which could be arranged into 89 content categories and 5 main categories. Outcome measurement shows different results. There was a significant relationship between the 'well-being', the impression of 'satisfying treatment' at the end of the inpatient period and 'success in the main ITG'. The documentation forms presented here allow an outcome-measurement depending on differential indications.

[Individual therapy goals: on outcome documentation of inpatient psychotherapy from the patient and therapist viewpoint].

Von den in der Arbeitsgemeinschaft wissenschaftlich medizinischer Fachverbande (AWMF) vertretenen psychotherapeutischen Fachgesellschaften wurde kurzlich ein einheitliches Kernmodul zur Basisdokumentation psychotherapeutischer Behandlungsverlaufe, die sog. „PSY-BaDo“ vorgelegt. In diesem Therapieschulenubergreifenden und zeitokonomisch einzusetzenden Instrument dient die Formulierung individueller Therapieziele (ErgeDoku A) und eine allgemeine Veranderungsdokumentation von Befindensstorungen und Problembereichen des Patienten (ErgeDoku B) der Evaluation von psychotherapeutischen Behandlungen (1).

Individuelle Therapieziele aus Patienten- und Therapeutensicht: Welche Behandlungsziele in der Psychotherapie alter Menschen werden wie erreicht?

Die Dokumentation des Therapieoutcome eines je spezifischen Therapiesettings ist sowohl unter der Perspektive der Evaluation eingesetzter okonomischer Ressourcen wie der Qualitatssicherung zukunftig unverzichtbar. Dokumentation des Therapie-Outcome ist Teil der Basisdokumentation. Diese mus praxisgerecht, zeitokonomisch und Therapieschulen-ubergreifend sein und sich von Forschungsanliegen im engeren Sinne abgrenzen lassen. Abb. 1 zeigt eine Ubersicht der Elemente einer PSY-BaDo als Kernmodul einer Basisdokumentation, wie sie in Kurze von den Fachgesellschaften in der Arbeitsgemeinschaft wissenschaftlich-medizinischer Fachgesellschaften (AWMF) verabschiedet werden wird. Die Item-Formulierungen der PSY-BaDo stutzen sich zum uberwiegenden Teil auf publizierte und eingefuhrte Instrumente zur Basisdokumentation, insbesondere auch die DKPM-BaDo (Broda et al., 1993), die Basisdokumentation des Wissenschaftsrates der AHG (Meermann, 1993; Fachausschus Psychosomatik des Wissenschaftsrates der AHG, 1994; Zielke et al., 1995) und die psychiatrische Basisdokumentation gemas den Empfehlungen der DGPPN (Cording et al., 1995). Die Versuche, eine einheitliche Basisdokumentation vorzuschlagen, haben sowohl im psychiatrischen Fachgebiet wie im psychosomatisch-psy-chotherapeutischen Fachgebiet bereits vor Etablierung des Facharztes fur Psychotherapeutische Medizin schon „Tradition“ (z.B. Dilling et al., 1982; Grawe et al., 1990; Schmidt et al., 1992). Von der Ergebnisdokumentation psychotherapeutischer Behandlungen ist die Strukturdokumentation (Ubersicht bei Laireiter, 1994) zur Spezifizierung des therapeutischen Settings abzugrenzen. Eine solche Strukturdokumentation wurde sinnvoller Weise wahrscheinlich nur alle 1–2 Jahre einmal fur die entsprechende Institution/Praxis durchgefuhrt werden.

Individuelle Therapieziele in der Ergebnisdokumentation psychotherapeutischer Behandlung

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[Individual therapy goals: on outcome documentation of inpatient psychotherapy from the patient and therapist viewpoint].

Individuelle Therapieziele aus Patienten- und Therapeutensicht: Welche Behandlungsziele in der Psychotherapie alter Menschen werden wie erreicht?

Individuelle Therapieziele in der Ergebnisdokumentation psychotherapeutischer Behandlung