Familiendynamik

Schiepek, Günter; Schöller, Helmut; Aichhorn, Wolfgang; Kratzer, Leonhard; Goditsch, Hannes; Viol, Kathrin

Prozessmonitoring in der Psychotherapie

Der Therapie-Prozessbogen und seine psychometrischen Eigenschaften

, 47. Jahrgang, Heft 3, pp 210-224

DOI 10.21706/fd-47-3-210

Link: Online-Material

Zusammenfassung

Prozessfeedback gehört inzwischen zur Routinepraxis in der Psychotherapie, wobei internet- und app-basierte Technologien hochfrequente (z. B. tägliche) Messungen und deren Analyse in Echtzeit ermöglichen. Zu diesem Zweck wurde der Therapie-Prozessbogen (TPB) entwickelt, der für Anwendungen in der stationären und ambulanten Therapie vorliegt. Der Beitrag stellt die Ergebnisse einer explorativen und konfirmatorischen Faktorenanalyse sowie die psychometrischen Eigenschaften des TPB vor. Die Analysen beruhen auf den Zeitreihendaten von 150 stationär und teilstationär behandelten Patienten unterschiedlicher Diagnosen (tägliche Messungen, mittlere Zeitreihenlänge: 69,1 Messpunkte). Gefunden wurde eine 7-Faktor-Lösung, die 68,7 % der Varianz aufklärt und 43 Items den Faktoren »Wohlbefinden und positive Emotionen«, »Beziehung zu Mitpatienten«, »Therapeutische Beziehung und klinisches Setting«, »Emotionale und Problembelastung«, »Verständnis / Zuversicht / therapeutische Fortschritte«, »Veränderungsmotivation« und »Achtsamkeit / Körpererleben / Bedürfnisse« zuordnet. Die interne Konsistenz (Cronbachs α), die Inter-Item-Korrelationen der Faktoren und die Trennschärfe der Items entsprechen hohen psychometrischen Standards. In der klinischen Praxis ist es wichtig, Vorläufer von Phasenübergängen, wechselnde Synchronisationsmuster und kritische Perioden eines Prozesses zu identifizieren, um das therapeutische Vorgehen darauf abstimmen zu können. Dies wird an einem Fallbeispiel illustriert.

Abstract

Process Monitoring in Psychotherapy: the Therapy Process Questionnaire and Its Psychometric Properties
Many outcome measures and session-related questionnaires in psychotherapy are designed for weekly or biweekly administration. Yet today, technical developments allow for higher frequency assessments to monitor human change dynamics more closely, by daily assessments. For this purpose, the Therapy Process Questionnaire (TPQ) was developed, which can be applied in inpatient as well as outpatient psychotherapy. We present an explorative and confirmative factor analysis of the TPQ together with some important psychometric properties. The analysis methods are based on the time series data of 150 patients collected during their hospital stay (mean time series length: 69.1 measurement points). A seven factor solution was identified which explains 68.7 % of variance and associates 43 items onto the factors »well-being and positive emotions«, »relationship with fellow patients«, »therapeutic relationship and clinical setting«, »emotional and problem intensity«, »insight / confidence / therapeutic progress«, »motivation for change«, and »mindfulness / self-care«. The internal consistency (Cronbach’s α), the inter-item correlations of the subscales, and the discriminative power of the items are excellent. The TPQ can be applied in practice and research for creating time series with equidistant measurement points and time series lengths which are appropriate for the application of nonlinear analysis methods. In clinical practice it is important to identify precursors of phase transitions, changing synchronization patterns, and critical or instable periods of a process, which is illustrated by a short case study.

Schlüsselwörter
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