Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany Germany.
Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany Germany.
Z Psychosom Med Psychother. 2022 Dec;68(4):378-396. doi: 10.13109/zptm.2022.68.4.378.
In the German healthcare system benefits include inpatient and day clinic psychotherapy of trauma-related disorders, which are often provided in gender specific groups. Despite this widespread practice, the actual impact and potential outcome have been studied relatively scarcely and are still open to debate. The present study therefore examines whether the therapeutic relationships in the group vary depending on the group composition and whether this has an effect on therapy outcome. 66 patients (N = 55 women) were treated in our multimodal, day clinic groupbased treatment program and filled out symptom questionnaires (ETI, BDI-II, PHQ-15, Questionnaire on social support) at admission and discharge and the Group Questionnaire (GQ; including subscales positive bonding, positive working and negative relationships) at the end of each of the eight weeks of treatment. Patients took part in five women-only and six mixed-gender groups and underwent therapy in a closed group format, so that they began and ended therapy within the same group. All patients were diagnosed with trauma-related disorders, which included PTSD, cPTSD, depression, somatoform disorders and further mental diseases. Outcome data were examined using functional regression analysis and linear mixed models. In women-only groups, positive bonding and positive working relationship were significantly higher than in mixed-gender groups. Negative relationship ratings were significantly lower in women-only groups, especially in the middle phase of treatment. However, no effect of an exclusively female group composition on treatment outcome was found, except for the higher increase of perceived social support for patients treated in women-only groups. Group relationships were considered more pleasant in women-only groups than in mixed-gender groups, but this had no effect on the symptom-based therapy outcome. To enhance feelings of safety and comfort, traumatized women should have the possibility to choose whether to be treated in a women-only or a mixed-gender group.
在德国的医疗保健系统中，福利包括针对与创伤相关的障碍的住院和日间诊所心理治疗，这些治疗通常在特定性别群体中提供。尽管这种广泛的做法，但实际影响和潜在结果相对较少被研究，仍存在争议。因此，本研究旨在检查小组中的治疗关系是否因小组组成而异，以及这是否对治疗结果产生影响。 我们的多模式日间诊所团体治疗计划共治疗了 66 名患者（N=55 名女性），他们在入院和出院时填写了症状问卷（ETI、BDI-II、PHQ-15、社会支持问卷），并在治疗的八周中的每一周结束时填写团体问卷（GQ；包括积极联系、积极工作和消极关系等子量表）。患者参加了五个仅限女性的小组和六个混合性别小组，并以封闭小组的形式进行治疗，因此他们在同一小组中开始和结束治疗。所有患者均被诊断为与创伤相关的障碍，包括 PTSD、cPTSD、抑郁症、躯体形式障碍和其他精神疾病。使用功能回归分析和线性混合模型检查了结果数据。 在仅限女性的小组中，积极联系和积极工作关系明显高于混合性别小组。仅限女性小组的负面关系评分明显较低，尤其是在治疗的中期。然而，除了接受仅限女性小组治疗的患者感知社会支持的增加更高外，没有发现完全由女性组成的小组构成对治疗结果的影响。 在仅限女性的小组中，小组关系被认为比混合性别小组更愉快，但这对基于症状的治疗结果没有影响。为了增强安全感和舒适感，创伤女性应该有选择是否在仅限女性小组或混合性别小组中接受治疗的可能性。
