Watzke Birgit, Rueddel Heinz, Koch Uwe, Rudolph Matthias, Schulz Holger
University Medical Centre Hamburg-Eppendorf, Centre of Psychosocial Medicine, Hamburg-Eppendorf University Clinic, Germany.
Clin Psychol Psychother. 2008 Nov-Dec;15(6):404-17. doi: 10.1002/cpp.595.
It is still an open question whether psychotherapists adhere to their therapeutic conceptions in routine practice (clinician's treatment adherence) and thus to what extent the two most common approaches, cognitive-behavioural (CBT) and psychodynamic therapy (PDT), differ from each other as theoretically expected (treatment differentiation). This holds true especially in case of group therapy.The study compares essential process components of CBT and PDT group treatments under clinically representative conditions using non-participating observer ratings. Results demonstrate that CBT group therapists use more cognitive, behavioural and psychoeducational strategies, foster self-efficacy to a larger extent and are more supporting and empathetic. PDT group therapists use more interpretative and confrontative interventions and focus on interactional and dynamic aspects. The results strongly support that not only in individual psychotherapy-as shown in prior research-but also in the group setting do CBT and PDT reveal very distinct profiles and that therapists primarily abide by their theoretical training also in clinical practice. They allow one to identify differential process components of the group setting and to trace back parameters of outcome to the process of CBT and PDT for clinical routines.
心理治疗师在日常实践中是否坚持其治疗理念（临床医生的治疗依从性），以及两种最常见的方法——认知行为疗法（CBT）和心理动力疗法（PDT）——在多大程度上如理论预期那样彼此不同（治疗差异），这仍然是一个悬而未决的问题。在团体治疗的情况下尤其如此。该研究使用非参与观察评分，在具有临床代表性的条件下比较了CBT和PDT团体治疗的基本过程组成部分。结果表明，CBT团体治疗师使用更多的认知、行为和心理教育策略，在更大程度上培养自我效能感，并且更具支持性和同理心。PDT团体治疗师使用更多的解释性和对抗性干预措施，并关注互动和动态方面。结果有力地支持了，不仅如先前研究所表明的在个体心理治疗中，而且在团体治疗环境中，CBT和PDT也呈现出非常明显不同的特点，并且治疗师在临床实践中也主要遵循其理论培训。这些结果使人们能够识别团体治疗环境中的不同过程组成部分，并将结果参数追溯到CBT和PDT在临床常规中的过程。
