Akzeptanz- und Commiment-Therapie mit therapieresistenten Störungen im stationären Setting
Eine Beobachtungsstudie
Abstract
Zusammenfassung.Hintergrund: Stationäre psychotherapeutische Behandlungen haben eine große Bedeutung im Versorgungsalltag. Ihre Bewährung bei schwergradigen und komorbiden Störungsbildern ist jedoch nur lückenhaft untersucht. Dies gilt besonders für die zunehmend angewendete Akzeptanz- und Commitment-Therapie (ACT). Fragestellung: In erster Linie soll die Wirksamkeit einer stationären störungsübergreifenden ACT-basierten Behandlung in erwähnten Stichproben untersucht werden. Ergänzend wird der zeitliche Verlauf der psychischen Flexibilität (PF), dem Kernkonzept der ACT, explorativ untersucht. Methode: Eine konsekutive Stichprobe von 47 Patientinnen und Patienten mit heterogenen und komorbiden Störungsbildern in stationärer Psychotherapie wurde im Rahmen einer explorativen Beobachtungsstudie mittels wöchentlicher Verlaufsmessungen sowie umfassender Prä-Post-Vergleiche untersucht. Ergebnisse: Die Effektstärken hinsichtlich allgemeiner Symptomreduktion, der Zunahme psychischer Flexibilität sowie weiterer ACT-spezifischer Fertigkeiten sind moderat bis hoch. Die Verlaufsmessungen weisen auf lineare Verbesserungen sowie hohe Übereinstimmungen zwischen Selbst- und Fremdrating hin. Schlussfolgerungen: Die Ergebnisse zeigen positive Effekte der ACT im stationären Setting bei einer diagnostisch heterogenen Stichprobe mit einem hohen Anteil komorbider Störungen.
Abstract.Background: Inpatient psychotherapeutic treatments are of great importance in everyday clinical care. However, research of specific inpatient treatments for severe and comorbid disorders is lacking. This is particularly true for acceptance and commitment therapy (ACT), which is increasingly used. Aim: The efficacy of an inpatient ACT-based treatment for transdiagnostic patients was investigated in the aforementioned sample. In addition, weekly process data on psychological flexibility, the core concept of ACT, were analyzed. Method: A consecutive sample of 47 patients with heterogeneous and comorbid disorders was investigated in an exploratory observational study using weekly progression measurements and pre-to-post comparisons. Results: The effect sizes regarding overall symptomatology, increase of psychological flexibility, and other ACT-specific processes were moderate to high. The process measures indicated linear improvements and high concurrence between self-report and clinical assessment. Conclusion: The results demonstrate the positive effects of an ACT-based inpatient therapy in a transdiagnostic sample with a high proportion of severe and comorbid disorders.
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