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Hans Kordy

Publications and source records attributed to Hans Kordy.

7 recordsLinked to original sources

The relationship between interpersonal problems and the helping alliance.

Using data from a large longitudinal naturalistic study on course and outcome of psychotherapy, the present paper investigates the amount of interpersonal problems in an outpatient sample (N = 714) and the extent to which a patient's interpersonal problems determine the quality of the helping alliance. The results show that at the beginning of psychotherapy, subjects reported significant interpersonal distress on 2.43 of the eight IIP scales. Interpersonal problems were most prevalent in the octants "introverted," "submissive," "exploitable," and "overly nurturant." Furthermore, interpersonal problems were related to the helping alliance in different ways: "Too hostile" patients reported relatively poor initial helping alliance whereas "too friendly" patients rated more favorably the relationship to the therapist. However, interpersonal problems at intake did not predict the therapeutic alliance one-and-a-half years later. The results indicate that a poor initial helping alliance might be reversed during the course of treatment. Implications for future research and psychotherapeutic practice are discussed.

Adult↗

[Patient and therapist satisfaction in outpatient psychotherapy].

Increasing attention is devoted to the patient perspective in mental health services research. Consequently, patient satisfaction has taken a prominent role and is frequently applied as an indicator of treatment quality and even outcome. However, the suitability of patient satisfaction for assessing quality of mental health services is doubtful, and there is a lack of longitudinal data especially for outpatient psychotherapy. By using data of the TRANS-OP study, we examine the course of patient satisfaction in outpatient psychotherapy over time and its predictors such as symptom change and duration of treatment. Furthermore, the relation between treatment satisfaction ratings of patients and therapists will be scrutinized. This study was conducted by the Center for Psychotherapy Research in Stuttgart (now Heidelberg) in cooperation with the Deutsche Krankenversicherung. N = 714 participants who applied for reimbursement of outpatient psychotherapy were consecutively recruited and asked to provide data at five (therapists two) measurement points during a two-year period. In line with previous evidence, high rates of patient satisfaction have been found, and also therapists appraised favorably the quality of their treatments. Course of patient satisfaction was found to be markedly stable over time. While some variables related to initial patient satisfaction, its course could hardly be predicted. Treatment outcome and session number moderately affected satisfaction at treatment termination. Concordance between patients' and therapists' satisfaction ratings was poor. Implications of these findings for research and practice are discussed.

Adult↗

Computer-supported monitoring of patient treatment response.

The use of information technology (IT) for the purpose of improving psychotherapy outcomes in the context of routine clinical practice is described. IT efforts from two research programs, one in Germany and the other in the United States, are based on evidence that not all patients who enter treatment have a positive outcome and that continuous monitoring of patient treatment response with immediate feedback to therapists can be used to increase the likelihood of success for the poorly responding client. Such monitoring and feedback can best be accomplished by IT methodologies. Suitable IT systems are described, and their strengths and limitations are highlighted. Evidence is presented that supports the positive value of such efforts for improving patient treatment response.

Humans↗

Remission, recovery, relapse, and recurrence in eating disorders: conceptualization and illustration of a validation strategy.

In a consensus-building process a group of experts from 19 European countries (COST Action B6) adapted the terms partial and full remission, relapse, recovery, and recurrence according to principles described by Frank et al. for depression. The empirical validity of the operationalizations was illustrated by longitudinal data on the post treatment course of 233 anorectic and 422 bulimic patients (diagnosed according to DSM-IIIR) from the German Project TR-EAT. These data were collected 2.5 years after admission using the Longitudinal Interval Follow-up Evaluation (LIFE) and statistically explored by survival-analysis. It was demonstrated that these consensus definitions measure what they intend to measure. They open a longitudinal perspective in that one can learn not only whether, but also when and with what probability patients change for the better or worse. Data suggest that persistence of symptom improvement has different implications for anorexia and bulimia nervosa. For example, relapse prevention would be most beneficial for bulimic patients for about 4 months after key symptoms remit, while this would be of less importance for anorexic patients. It is discussed whether and how this longitudinal approach can contribute to an empirically based rationale for targeted and individualized treatment.

Adult↗

[New bridges for gaps in psychotherapeutic service provision by the internet: hopes, challenges and a solution].

Modern communication technologies such as internet, e-mail or SMS open up new possibilities for the optimization of the psychotherapeutic service provision. However, their use places new challenges. Ethical and legal requirements must be considered, technical and communicative aspects must be integrated into supplying concepts. This paper presents central requirements for the use of the Internet and a possible solution by the example of the project "Internet-Brücke" (internet bridge). In this project internet chat groups are tested as an aftercare program following inpatient treatment in a specialized hospital for psychotherapy and psychosomatic medicine. It is discussed, in what respect the solutions fit the specific requirements of this project and what can be learned for further applications.

Aftercare↗

[E-mail in psychotherapy--an aftercare model via electronic mail for psychotherapy inpatients].

We introduce an aftercare program for psychotherapy inpatients, which is based on regular communication via E-mail. The organizational and operational structure of the program are described within the context of computer mediated communication. First results on utilization and acceptance are reported. In comparison to patients who did not participate in either aftercare program of the clinic, the E-mail participants are younger and higher educated. Inpatient treatment of the participants was three days shorter in duration than that of non participants. Both groups were similar with regard to symptom distress at discharge from hospital. A low dropout rate of 8%, the high activity and satisfaction emphasize the positive acceptance of the program. Therapists' E-mail activity turned out to be important for the participants. Neither age, internet experience or symptom related variables nor the own E-mail activity were associated with participants' evaluation of the new service. Based on these first positive experiences the perspectives of using E-mail in psychotherapy will be discussed.

Adult↗