Zusammenfassung
Patientenübungen, die außerhalb des Therapieraums stattfinden und vom Therapeuten angeleitet werden, sind häufige Bestandteile kognitiv-verhaltenstherapeutischer Behandlungen. Auch wenn Guided-Practice (GP-)Übungen für viele Verhaltenstherapeuten eine Selbstverständlichkeit darstellen, gibt es bei der Planung und Umsetzung solcher Übungen Vorbehalte, die unter anderem ethische und empirische Aspekte umfassen. Der folgende Beitrag gibt zu-nächst praktische Hinweise zur Gestaltung von GP-Übungen, bevor im Anschluss die aktuelle Evidenzlage in Bezug auf therapeutenbegleitete Übungen außerhalb des Thera-pieraums skizziert und potentielle Nebenwirkungen der Me thode diskutiert werden.
Literatur
1.
Craske
MG
, Treanor
M
, Conway
CC
, Zbozinek
T
, Vervliet
B
. Maximizing exposure therapy: an inhibitory learning approach
. Behav Res Ther
. 2014
Jul
;58
:10
–23
.
[PubMed]
0005-79672.
Deacon
BJ
, Farrell
NR
, Kemp
JJ
, Dixon
LJ
, Sy
JT
, Zhang
AR
, et al. Assessing therapist reservations about exposure therapy for anxiety disorders: the Therapist Beliefs about Exposure Scale
. J Anxiety Disord
. 2013
Dec
;27
(8
):772
–80
.
[PubMed]
0887-61853.
Gloster
AT
, Hauke
C
, Höfler
M
, Einsle
F
, Fydrich
T
, Hamm
A
, et al. Long-term stability of cognitive behavioral therapy effects for panic disorder with agoraphobia: a two-year follow-up study
. Behav Res Ther
. 2013
Dec
;51
(12
):830
–9
.
[PubMed]
0005-79674.
Gloster
AT
, Wittchen
HU
, Einsle
F
, Lang
T
, Helbig-Lang
S
, Fydrich
T
, et al. Psychological treatment for panic disorder with agoraphobia: a randomized controlled trial to examine the role of therapist-guided exposure in situ in CBT
. J Consult Clin Psychol
. 2011
Jun
;79
(3
):406
–20
.
[PubMed]
0022-006X5.
Gola
JA
, Beidas
RS
, Antinoro-Burke
D
, Kratz
HE
, Fingerhut
R
. Ethical considerations in exposure therapy with children
. Cognit Behav Pract
. 2016
May
;23
(2
):184
–93
.
[PubMed]
1077-72296.
Hellström
K
, Öst
LG
. One-session therapist directed exposure vs two forms of manual directed self-exposure in the treatment of spider phobia
. Behav Res Ther
. 1995
Nov
;33
(8
):959
–65
.
[PubMed]
0005-79677.
Lang
T
, Helbig-Lang
S
. Exposure in vivo and without presence of a therapist: does it matter. In: Neudeck
P
, Wittchen
HU
, editors. Exposure
. Berlin
: Springer
; 2012
. pp. 261
–73
. 8.
Olantunji
BO
, Deacon
BJ
, Abramowitz
JS
. The cruelest cure? Ethical issues in the implementation of exposure-based treatments
. Cognit Behav Pract
. 2009
;16
(2
):172
–80
. 1077-72299.
Öst
LG
, Salkovskis
PM
, Hellström
K
. One-session therapist-directed exposure vs. self-exposure in the treatment of spider phobia
. Behav Ther
. 1991
;22
(3
):407
–22
. 0005-789410.
Pope
KS
, Keith-Spiegel
P
. A practical approach to boundaries in psychotherapy: making decisions, bypassing blunders, and mending fences
. J Clin Psychol
. 2008
May
;64
(5
):638
–52
.
[PubMed]
0021-976211.
Reinecker
H
, Lakatos
L
. Was kommt nach dem Ritual? Umgang mit Emotionen während und nach der Exposition. In: Neudeck
P
, Wittchen
HU
, editors. Konfrontationstherapie bei psychischen Störungen
. Göttingen
: Hogrefe
; 2005
. pp. 127
–42
.12.
Rosa-Alcázar
AI
, Sánchez-Meca
J
, Gómez-Conesa
A
, Marín-Martínez
F
. Psychological treatment of obsessive-compulsive disorder: a meta-analysis
. Clin Psychol Rev
. 2008
Dec
;28
(8
):1310
–25
.
[PubMed]
0272-735813.
Teismann
T
, Ertle
A
. Verhaltensexperimente in der kognitiven Therapie
. Verhaltenstherapie
. 2011
;21
(2
):117
–24
. 1016-626214.
Teismann
T
, Margraf
J
. Exposition und Konfrontation
. Göttingen
: Hogrefe
; 2018
. 15.
Zur
O
. Out-of-office experience: when crossing office boundaries and engaging in dual relationships are clinically beneficial and ethically sound.
The Independent Practitioner, 2001
; 21: 96-100.© 2019 S. Karger AG, Basel
2019
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