Franz Caspar

Universität Bern | UniBe · Institute of Psychology

Derzeit erfahren psychotherapeutische Ansätze einen Wandel in Richtung eines individualisierten, modularen Organisationsprinzips. Dabei wird an gestörten Mechanismen und weniger an Störungsbildern oder Theorien von Therapieschulen angesetzt. Die Modulare Psychotherapie bietet ein Konzept von hoher Praktikabilität in der ambulanten und stationären V...

Objectives: This paper presents a randomized controlled trial on assimilative integration, which is aimed at integrating elements from other orientations within one approach to enrich its conceptual and practical repertoire. Elements from Emotion-Focused Therapy (EFT) were integrated into a form of cognitive behavior therapy: Psychological Therapy...

Case formulation is a central tool for psychotherapists, which helps them tailor psychotherapy to the individual patient, particularly for treatments for complex and multilayered clinical problems, such as personality disorders (Kramer, 2019). Case formulation methodologies are still underutilized in psychotherapy research in the prediction of ther...

Guidance is commonly used in Internet interventions. However, there is little work on how guidance can be optimally implemented in guided self-help approaches. Despite some general models on guidance, there is no theoretical framework as how to optimally individualize the guidance to the participants needs. The Motive-Oriented Therapeutic Relations...

Cómo gestionan los terapeutas novatos el proceso de integración asimilativa? Un estudio de entrevista cualitativa sobre la aplicación de heurísticas implícitas La integración de diferentes enfoques e intervenciones psicoterapéuticas se han convertido en una experiencia de los terapeutas integradores que a menudo se ignoran. El objetivo del estudio...

Background One of the relevant case formulation methods for personality difficulties is plan analysis. The present study aimed at delivering a prototypical plan analysis for clients presenting with a diagnosis of narcissistic personality disorder (NPD). The sample consisted of 14 participants diagnosed with an NPD. Based on audio clinical material...

There is a great need to identify predictors of treatment response, and the analysis of defense mechanisms is a promising approach. Defensive functioning may influence psychotherapy outcome in two ways: First, when it is generally higher or lower for some patients relative to others and second, as it shifts in individual patients over time. The pre...

Objectives: Inflexible social interaction patterns are defining features of borderline personality disorder (BPD). Specific beliefs about the self and others may be activated across interaction situations, often leading to instable relationships. It may be pivotal to address these difficulties in early treatment phases, through appropriate therapi...

Background: Defense mechanisms play an important role in the development and maintenance of both health and psychopathology. Research is still in the early stages of investigating the specific relationships among diagnostic groups and defense mechanisms along with their response to different treatment types. Methods: For the present study a tota...

Despite meta-analytic evidence showing that alliance is associated with posttreatment outcomes, several open questions still remain regarding this relation. First, we investigate whether (or not) the progressive aggregation of early alliance assessments increases the alliance-outcome relation across 2 distress and 4 subjective change measures. Seco...

It has been shown that agreeableness of patients with borderline personality disorder (BPD) had an impact on therapy process and outcome (Hirsh, Quilty, Bagby, & McMain, 2012). The goal of our study was to test whether agreeableness affects the therapeutic alliance and outcome assessed after brief treatment for BPD, and whether this link is moderat...

Confrontation represents a way of challenging patients in psychotherapy to stimulate change. Confrontation draws attention to discrepancies, for example between elements in a patient’s functioning. The present study was designed to construct a conceptual model of confrontation used by therapists when trying to address two main questions: what are t...

Epidemiologie (die Beschäftigung mit der Verbreitung psychischer Störungen und deren Zusammenhang mit anderen Faktoren) und Ätiologie (die Beschäftigung mit der Frage der Verursachung psychischer Störungen) gehören zum Kern der Klinischen Psychologie. Ohne diese Grundlagen würden Therapie und insbesondere auch Prävention im Dunkeln tappen.

Das Kernmerkmal von Essstörungen ist ein gestörtes Essverhalten, wobei die Betroffenen sich konstant mit dem Thema Essen beschäftigen. Unterschieden werden vor allem zwei Arten der Essstörungen: die Anorexia nervosa und die Bulimia nervosa. Eine dritte, noch junge Diagnosekategorie ist die Binge-Eating-Störung. Die Anorexia nervosa (Magersucht) ist...

Klinische Psychologie ist der Teil der Psychologie, der sich mit psychischen Störungen, deren Behandlung und Prävention befasst. Für ein Verständnis des heutigen Umganges mit psychischen Störungen ist ein Einblick in die Geschichte desselben wichtig. In diesem Kapitel wird „psychische Störung“ definiert und mit verwandten Begriffen verglichen und e...

Diagnostik und Klassifikation dienen in erster Linie der Behandlungsplanung sowie der Evaluation des Behandlungsverlaufs und des -ergebnisses. Dazu werden die Symptome von PatientInnen (z. B. Niedergeschlagenheit) im diagnostischen Prozess exploriert und u. a. mithilfe von Klassifikationssystemen wie ICD-10 oder DSM-5 in diagnostische Kategorien ei...

Depressive Störungen zeichnen sich durch niedergeschlagene Stimmung, Interessen- und Freudverlust sowie Aktivitätsminderung aus. Am anderen Ende des Kontinuums der Affektivität findet sich die Manie, die mit einer euphorischen Stimmung oder Reizbarkeit und einem stark erhöhten Aktivitätsniveau einhergeht. Störungen mit einem Wechsel zwischen den Po...

Schizophrenie beschreibt eine psychische Störung mit tief greifenden Veränderungen im Erleben und Verhalten der Betroffenen und umfasst eine Vielzahl sehr unterschiedlicher möglicher Symptome. Keines der Symptome tritt jedoch bei allen Betroffenen auf, sodass sehr heterogene klinische Erscheinungsbilder als Schizophrenie diagnostiziert werden könne...

Persönlichkeit kann als die charakteristische Art und Weise verstanden werden, mit der ein Mensch sowohl seinen Bedürfnissen als auch den Anforderungen der Gesellschaft gerecht zu werden versucht. Wenn Menschen sich im Kontakt mit der Umwelt durch rigide Erlebens- und Interaktionsmuster auszeichnen, wird von Persönlichkeitsstil oder -akzentuierung...

Psychotherapie ist die gezielte professionelle Behandlung psychischer und/oder psychisch bedingter körperlicher Störungen mit psychologischen Mitteln. Hier wird der auf Grawe zurückgehende schulübergreifende und stark auf psychologische Grundlagen rekurrierende „Berner Ansatz“ dargestellt. Es beschäftigt sich insbesondere mit Themen wie Therapiebez...

Die Angststörungen sind mit einer Lebenszeitprävalenz von etwa 30 % die häufigsten psychischen Störungen überhaupt. In der ICD-10 werden die Phobien (Agoraphobie, soziale und spezifische Phobie), andere Angststörungen (Generalisierte Angststörung und Panikstörung), Zwangsstörungen und die Belastungs- und Anpassungsstörungen unterschieden, wobei bei...

Dauerhafte körperliche Beschwerden (in unterschiedlichen Körperregionen) oder eine gestörte Organfunktion sind das Leitsymptom der somatoformen Störungen. Betroffene erleben wiederkehrende, subjektiv beeinträchtigende Körperbeschwerden oder sind der Überzeugung, an einer Krankheit zu leiden, welche noch unentdeckt ist (Krankheitsängste = Hypochondr...

In diesem Kapitel werden die sexuellen Funktionsstörungen behandelt. Wann ist sexuelles Erleben und Verhalten „gestört“? Die Antworten auf diese Frage wandeln sich in Abhängigkeit von den jeweils vorherrschenden soziokulturellen und individuellen Normen. Eine Klassifikation von gestörter und normaler Sexualität erscheint vor diesem Hintergrund frag...

Zu den substanzbezogenen Störungen gehört ein Spektrum an Störungen, welche durch den exzessiven Konsum von psychotropen Substanzen gekennzeichnet sind. Psychotrope Substanzen können Medikamente sowie illegale oder legale Drogen sein, welche die Wahrnehmung, das Denken, Fühlen und Handeln beeinflussen. In der ICD-10 werden folgende diagnostische Ka...

Einleitend wurde in diesem Buch eine diagnose-übergreifende Sicht dargestellt. Es folgten mehrere Kapitel zu einzelnen Störungen. Dieses Kapitel beschäftigt sich mit der Frage, wie störungsspezifisches Veränderungswissen genutzt und mit störungsübergreifenden Ansätzen verbunden werden kann. Das ist besonders wichtig bei Komorbidität (wenn auf einen...

Klar, übersichtlich und in verständlicher Sprache vermittelt dieses Buch Grundkenntnisse zu den wichtigsten psychischen Störungen aus einer integrativen, störungsübergreifenden Sichtweise. Behandelt werden Angststörungen, Essstörungen, Depression, Manie und bipolare Störungen, verschiedene Störungen aus dem verhaltensmedizinischen Bereich, Schizoph...

Biased thinking is a common feature of patients presenting with borderline personality disorder (BPD). For the treatment of BPD, it was shown that the individualizing of the treatment, by using the motive-oriented therapeutic relationship (MOTR), had a beneficial short-term effect on process and outcome. So far, it remains unclear what the role of...

Objective: Deficits in emotion regulation (ER) skills are discussed as a transdiagnostic factor contributing to the development and maintenance of various mental disorders. However, systematic comparisons of a broad range of ER skills across diagnostic groups that are based on comparable definitions and measures of ER are still rare. Method: The...

Ciuca, Berger, and Miclea (2017) and Schulz, Vincent, & Berger (2017) each present a pair of process-focused, systematic case studies, one with good outcome and one with a poorer outcome. These cases were drawn from a randomized controlled trial (RCT) of an Online self-help therapy for panic disorder and social anxiety disorder, respectively. In bo...

Ausgehend von verschiedenen psychotherapeutischen Richtungen und Schulen gibt es kognitiv-behaviorale, analytisch-»aufdeckende«, humanistisch-erlebnisorientierte, interpersonelle und systemische Therapieverfahren, daneben Verfahren mit eingeschränkterem Wirkungsspektrum wie Entspannungsverfahren oder suggestive Methoden. Neuere Ansätze wie die Dial...

The automatic, involuntary reactivation of disturbing emotional memories, for example, of interpersonal pain, causes psychological discomfort and is central to many psychopathologies. This study aimed at elucidating the automatic brain processes underlying emotional autobiographical memories by investigating the neurophysiological dynamics within t...

Objective: The marked impulsivity and instability of clients suffering from borderline personality disorder (BPD) greatly challenge therapists' understanding and responsiveness. This may hinder the development of a constructive therapeutic relationship despite it being of particular importance in their treatment. Recent studies have shown that usi...

Negative self-views have proved to be a consistent marker of vulnerability for depression. However, recent research has shown that a particular kind of cognitive conflict, implicative dilemma, is highly prevalent in depression. In this study, the relevance of these conflicts is assessed as compared to the cognitive model of depression of a negative...

Objective: There is little research on short-term treatments for borderline personality disorder (BPD). While the core changes may occur only in long-term treatments, short-term treatments may enable the study of early generic processes of engagement in therapy and thus inform about effective treatment components. It was shown that a 10-session ve...

Background: Difficulty in emotion regulation is a hallmark feature of patients with borderline personality disorder (BPD). Therefore, change in the frequency of certain patients' coping strategies-aiming at emotion regulation-are among the most promising mechanisms of change in treatments for BPD. In parallel, it was highlighted that therapist res...

Adaptación de La Relación Terapéutica orientada/centrada sobre los motivos orientada a un contexto de grupo en la terapia dialéctica-conductual para el trastorno límite de la personalidad La relación terapéutica es estudiada como un proceso frecuentemente en la terapia individual y menos en la terapia de grupo. Una razón para la escasez de este tip...

Eine Behandlung anzubieten geht mit einem Versprechen einher, es handele sich um das unter den gegebenen Umständen beste Vorgehen. Wissenschaftliche Fundierung ist dabei als Versuch zu verstehen, beim Ableiten von Erfolgserwartungen aus früheren Fällen die bekanntesten Irrtümer zu vermeiden. Randomisierte kontrollierte Studien liefern die kausal sc...

Das Impact Message Inventory (IMI) von Don Kiesler ist ein interpersonaler Fragebogen, der zur Beurteilung zwischenmenschlicher Eigenschaften durch Zweitpersonen eingesetzt wird. Ein besonderes Merkmal: Die beurteilende Person beschreibt die Wirkung der beurteilten Person auf sich. Das IMI wird mit seiner Einbettung in den Interpersonalen Ansatz un...

Background This currently recruiting randomized controlled trial investigates the effects of integrating components of Emotion-Focused Therapy (EFT) into Psychological Therapy (PT), an integrative form of cognitive-behavioral therapy in a manner that is directly mirroring common integrative practice in the sense of assimilative integration. Aims of...

In psychotherapy, therapist and patient influence each other constantly. We aimed to investigate how therapists respond to patient impression management and influence tactics. For 60 videotaped intake interviews, judges rated therapist responses to patient tactics as neutral, desired, or undesired from the patient perspective. Judges rated the ther...

This online study investigated motivational incongruence (=discrepancy between psychological needs and actual experiences) in patients with schizophrenia spectrum disorders and tested the hypothesis that motivational incongruence and psychotic symptoms are associated. Incongruence was associated with negative symptoms and paranoia, and was largest...

Background: Mild to moderate depressive symptoms are common but often remain unrecognized and treated inadequately. We hypothesized that an Internet intervention in addition to usual care is superior to care as usual alone (CAU) in the treatment of mild to moderate depressive symptoms in adults. Methods: This trial was controlled, randomized and...

This article describes the application of a dual-regulation model to a case example of a female suicide attempter. The model complements the traditional goal-and-feedback view with self-organizing processes, which may help to better understand the suicidal process. From this view, impulsive suicidal behavior can be interpreted as a dysfunctional pa...

Purpose: Patients with chronic depression (CD) by definition respond less well to standard forms of psychotherapy and are more likely to be high utilizers of psychiatric resources. Therefore, the aim of this guidance paper is to provide a comprehensive overview of current psychotherapy for CD. The evidence of efficacy is critically reviewed and re...

The marked impulsivity and affective instability of clients suffering from Borderline Personality Disorder (BPD) greatly challenge therapists’ understanding and responsiveness. This may hinder the development of a constructive therapeutic relationship despite it being of particular importance in their treatment. Recent studies have shown that using...

Objectives: The early therapeutic alliance is an important predictor for therapy outcome. However, knowledge about predictors of the therapeutic alliance is still limited. We examined if patients' self-presentational behaviors can predict the early therapeutic alliance. Method: Videotaped intake interviews of 60 randomly selected patients were c...

• We focus here on decision making in the everyday clinical situation and do not address decision making in politics and administration, although obviously it affects clinical practice and vice versa. For example, decisions against providing sufficient face-to-face psychotherapy is one factor that may increase the demand for Internet therapy, and v...

Psychotherapy research has shown that cognitive-affective meaning making is related to beneficial therapy outcomes. This study explores the underlying micro-processes by inducing specific cognitive-affective states and studying their immediate effects on emotional activation, the resolution of interpersonal grievances, and factors related to therap...

Treatment options for patients with schizophrenia demand further improvement. One way to achieve this improvement is the translation of findings from basic research into new specific interventions. Beyond that, addressing the therapy relationship has the potential to enhance both pharmacological and non-pharmacological treatments. This paper introd...

Limited research exists on internal risk processes in suicide at- tempters and factors that distinguish them from nonsuicidal depressive individ- uals. In this qualitative study, we investigated Plans, motives, and underlying self-regulatory processes of the two groups and conducted a comparative analysis. We analyzed narrative interviews of 17 sui...

Background: Studies have shown that certain Internet interventions can help alleviate depression. However, many such interventions contain personal support elements, making it difficult to ascertain whether the program or the support drives the effects. Studies are needed to investigate whether Internet interventions contribute to symptom reduction...

This study examines the effects of a borderline-specific treatment, called general psychiatric management, on emotional change, outcome and therapeutic alliance of an outpatient presenting with borderline personality disorder. Based on the sequential model of emotional processing, emotional states were assessed in a 10-session setting. The case sho...

The therapeutic alliance consists of a mutual dependency between patient and therapist. Whereas earlier studies have focused on the therapists' behavioral influence, the present study examined patients' impression management tactics. The motivation to manage the impressions one has on others is particularly strong during first contact. Patients' be...

Objective: Processes occurring in the course of psychotherapy are characterized by the simple fact that they unfold in time and that the multiple factors engaged in change processes vary highly between individuals (idiographic phenomena). Previous research, however, has neglected the temporal perspective by its traditional focus on static phenomen...

Motive-oriented therapeutic relationship (MOTHER), a prescriptive concept based on an integrative form of case formulation, the Plan Analysis (PA) method (Caspar, in: Eells (ed.), Handbook of psychotherapy case formulations, 2007), has shown to be of particular relevance for the treatment of patients presenting with personality disorders, in partic...

Motive-oriented therapeutic relationship (MOTHER), a prescriptive concept based on an integrative form of case formulation, the Plan Analysis (PA) method (Caspar, in: Eells (ed.), Handbook of psychotherapy case formulations, 2007), has shown to be of particular relevance for the treatment of patients presenting with personality disorders, in partic...

Der vorliegende Betrag gibt einen Überblick über die Geschichte der verhaltenstherapeutischen Beschäftigung mit Konflikten, gefolgt von einer Darstellung plananalytischer und konsistenztheoretischer Konfliktkonzepte. Möglichkeiten einer modernen, integrativ-orientierten Verhaltenstherapie zum Umgang mit Konflikten werden skizziert. Abstract An o...

Background: Motive-oriented therapeutic relationship (MOTR) was postulated to be a particularly helpful therapeutic ingredient in the early treatment phase of patients with personality disorders, in particular with borderline personality disorder (BPD). The present randomized controlled study using an add-on design is the first study to test this...

Objective: Two patient-focused long-term research projects performed in the German outpatient psychotherapy system are focused on in this article. The TK (Techniker Krankenkasse) project is the first study to evaluate a quality assurance and feedback system with regard to its practical feasibility in German routine care. The other study ("Quality...

Depressive disorders are among the leading causes of worldwide disability with mild to moderate forms of depression being particularly common. Low-intensity treatments such as online psychological treatments may be an effective way to treat mild to moderate depressive symptoms and prevent the emergence or relapse of major depression.Methods/design:...

Internet-delivered self-help with minimal therapist guidance has shown promising results for a number of diagnoses. Most of the evidence comes from studies evaluating standardized disorder-specific treatments. A recent development in the field includes transdiagnostic and tailored Internet-based treatments that address comorbid symptoms and a broad...

Abstract We examined interpersonal problems in psychotherapy outpatients with a principal diagnosis of a depressive disorder in routine care (n=361). These patients were compared to a normative non-clinical sample and to outpatients with other principal diagnoses (n=959). Furthermore, these patients were statistically assigned to interpersonally de...