Rief Winfried, Wilhelm Marcel, Bleichhardt Gaby, Strauss Bernhard, Frostholm Lisbeth, von Blanckenburg Pia
Division of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany.
Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, University Hospital Jena, University of Jena, Jena, Germany.
Clin Psychol Eur. 2024 Apr 26;6(Spec Issue):e13277. doi: 10.32872/cpe.13277. eCollection 2024 Apr.
Although in most countries psychotherapy trainings focus on one treatment orientation, such an approach is associated with systematic shortcomings. The priorities from teaching one theoretical framework should be moved to a more rigorous orientation in science and evidence-based practice, and to the needs of patients, even if strategies of different theoretical approaches need to be combined.
We discuss whether competence-based trainings in psychological treatments offer a better framework to facilitate the progress of psychological treatments to a professional academic discipline with transtheoretical exchange, and we provide an example of a transtheoretical education in the basic competences of psychological treatments. A transtheoretical education program requires an umbrella model for case formulation and a transtheoretical definition of intervention goals.
We provide an adaptation of the traditional model distinguishing vulnerability/resilience, exacerbation, and maintenance of clinical problems for case conceptualization. Dynamic network models offer a further perspective for developing modern, transtheoretical case formulations. Treatment methods should be better classified according to their transtheoretical goals, which offers opportunities to better compare or combine them. We report a case example of how to transform a general competence-based approach in the training of psychological treatments in the academic education system, which found exceptional acceptance from participating students.
Thus, a rigorous competence-based approach to training early clinicians in applying psychological treatments helps to bridge the artificial divide between psychotherapeutic traditions. It also supports the evolution of psychological treatments into an academically robust and highly professional, integrative discipline.
尽管在大多数国家，心理治疗培训专注于一种治疗取向，但这种方法存在系统性缺陷。教学中对单一理论框架的侧重应转向更严谨的科学和循证实践取向，以及患者的需求，即便不同理论方法的策略需要结合使用。
我们讨论基于能力的心理治疗培训是否能提供一个更好的框架，以促进心理治疗发展成为一门通过跨理论交流的专业学科，并提供一个心理治疗基本能力跨理论教育的示例。跨理论教育项目需要一个用于病例制定的总体模型以及干预目标的跨理论定义。
我们对传统模型进行了调整，以区分用于病例概念化的临床问题的易损性/恢复力、恶化及维持情况。动态网络模型为开发现代跨理论病例制定提供了进一步的视角。治疗方法应根据其跨理论目标进行更好的分类，这为更好地比较或结合它们提供了机会。我们报告了一个案例，展示了如何在学术教育系统中对心理治疗培训中的一般基于能力的方法进行转变，该转变得到了参与学生的特别认可。
因此，一种严谨的基于能力的方法用于培训早期临床医生应用心理治疗，有助于弥合心理治疗传统之间人为的鸿沟。它还支持心理治疗发展成为一门学术稳固、高度专业的综合学科。
