Abstract Background While psychotherapeutic interventions for Post Traumatic Stress Disorder (PTSD) are effective, transfer to everyday life is challenged by a shift from treatment setting to the patients’ living environment. Adding digital components to the treatment (Blended Care, BC) may support autonomous completion of therapeutic tasks and facilitate transfer but has not been studied in residential treatment settings. Objective The present study explores the implementation, usability, and preliminary effectiveness of a BC approach for PTSD treatment in a non-acute residential hospital setting. Clinician and patient perspectives are considered. Methods 36 patients participated in a two-group quasi-experimental design (intervention vs. control) with three measurements (admission, discharge, three-month follow-up). Face-to-face trauma-focused CBT was offered in both groups, complemented by a BC software in the intervention group. Also, 16 clinicians participated in the study. We collected qualitative data from semi-structured interviews, software usage-data, and psychometric questionnaire data from patients and clinicians. Results Patients reported high satisfaction with software usability; clinicians had varying opinions. Uptake was inconsistent on both sides. Capacity issues and an inaccurate definition of the intended use hampered implementation. Still, intensified collaboration and sustained engagement with treatment contents were identified as benefits of BC. Quantitative measures of symptom severity showed no significant between-group differences in exploratory analyses and no relation to software usage intensity. Conclusions This study confirms potentials and obstacles of BC to facilitate the therapeutic process in the residential treatment of PTSD. It also emphasizes the importance of a concise concept for the coordination of digital and face-to-face components to ensure sufficient uptake and raise clinical effectiveness. Trial registration drks.de, DRKS00031741, Registration date: 21 April 2023, https://drks.de/search/de/trial/DRKS00031741/details .
OBJECTIVE:Blended care (BC), the integration of Internet-based interventions into psychotherapy (PT), is thought of as a promising approach to enhance PT's effectiveness and efficiency. This randomized controlled trial aimed to investigate the effectiveness as well as the implementation and usage of BC with transdiagnostic online modules compared to PT in routine care in Germany. Routine outpatient PT is delivered by licensed psychotherapists across different therapeutic orientations (cognitive behavioral therapy, psychodynamic, systemic), with variable treatment lengths and procedures. METHOD:Psychotherapists in routine outpatient care recruited 1,159 patients who were randomized to BC or PT. The primary outcome was self-reported mental distress (the composite of anxiety and depression); secondary outcomes included self-reported satisfaction with life, level of functioning, eating pathology, and drug and alcohol use, as well as therapist-rated severity and changes. Outcomes were measured at baseline, 6 weeks, 12 weeks, 6 months, and 12 months. We examined whether BC and PT groups changed differently over time using linear mixed models. We also investigated differences in sessions and terminations and report usage metrics of the BC platform. RESULTS:Contrary to our hypotheses, we did not find differences between BC and PT in outcomes, including anxiety, depression, satisfaction with life, level of functioning, eating pathology, alcohol and drug use, therapist-rated severity, and satisfaction with treatment at 6 months postrandomization (all p > .05). BC and PT did not differ in the number of sessions or terminations. Regarding usage of the BC platform, 534 patients (91.6%) received at least one online chapter, with M = 7.26 (SD = 7.01) of a total of 39 online chapters assigned on average, and patients logged in M = 19.73 (SD = 24.66) times and spent M = 367.14 (SD = 338.27) minutes on the platform. CONCLUSIONS:In this real-world application of BC, therapists had considerable flexibility in implementing BC and integrating Internet-based interventions with sessions. Our findings suggest that the benefits observed in more structured BC setups may not fully translate to a flexible and transdiagnostic BC setup in routine care, potentially due to variations in implementation and adherence. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Politik und politische Haltungen gewinnen in einer Vielfalt an Kontexten zunehmend an Relevanz. Eine steigende Politisierung und Tendenzen affektiver Polarisierung prägen neben dem öffentlichen Diskurs die Wahrnehmung anderer Menschen und interpersonelle Beziehungen. Politische Inhalte werden zudem in den USA häufig in psychotherapeutischen Sitzungen thematisiert und könnten sich auf therapeutische Prozesse sowie die Gestaltung der therapeutischen Beziehung auswirken. Vor diesem Hintergrund hat die wissenschaftliche Auseinandersetzung mit diesem noch wenig untersuchten Forschungsfeld in den vergangenen Jahren an Bedeutung gewonnen. Das vorliegende narrative Review fasst Studienergebnisse zur Rolle von Politik, politischen Haltungen und politisch geprägten Wertvorstellungen von Psychotherapeut:innen und Patient:innen in der ambulanten psychotherapeutischen Behandlung und im Hinblick auf die therapeutische Beziehungsgestaltung zusammen. Politik und politische Haltungen scheinen in der Psychotherapie zunehmend an Bedeutung zu gewinnen und den berufspraktischen Alltag, den therapeutischen Prozess und die therapeutische Beziehung zu prägen. Befunde indizieren, dass politische Übereinstimmung den Beziehungsaufbau erleichtern kann, während politisch divergierende Haltungen, bei einem für die therapeutische Beziehung sensiblen und reflektierten Umgang, ein nutzbares klinisches Potenzial darzustellen scheinen. Angesichts der Heterogenität und begrenzten Generalisierbarkeit der bisherigen Befunde besteht ein deutlicher Bedarf an systematischer Forschung, um eine solide wissenschaftliche Grundlage für den professionellen Umgang mit politischen Themen und Politik als Einflussfaktor in der therapeutischen Praxis zu schaffen.
Abstract Introduction Adequate mental health treatment in primary care (PC) is often hindered by structural factors, such as time constraints, and the high comorbidity of mental health conditions. A transdiagnostic approach may help address these challenges, yet evidence on interventions delivered by general practitioners (GPs) remains limited. This pilot study therefore assessed the feasibility, acceptability and potential effectiveness of a GP-led transdiagnostic intervention. Methods PC practices in Munich (Germany) were randomised (1:1) to an intervention group (IG) or a control group (CG). In the IG, GPs delivered the transdiagnostic intervention focused on psychoeducation, cognitive flexibility and emotion-based avoidance. CG GPs provided improved treatment as usual based on diagnosis-specific clinical guidelines. In both groups, treatment comprised four 20-min sessions. Feasibility and acceptability (primary outcome) were assessed post-treatment from patients and GPs across key treatment aspects: recruitment, delivery, response, maintenance and unintended consequences. Potential effectiveness (secondary outcome) was observed through patients’ pre-post changes in transdiagnostic factors – beliefs about emotions, cognitive reappraisal, emotion suppression, experiential avoidance and negative affectivity – as early indicators of symptom change. Results 21 PC practices participated (IG: 11; CG: 10), recruiting 87 patients (mean age: 47 years; 68% female), with 77 (IG: 46; CG: 31) completing treatment. Feasibility and acceptability ratings tended to favour the transdiagnostic intervention. More IG GPs stated a better treatment integration into daily care, greater utility to bridge time until psychotherapy and higher satisfaction with the structure, content as well as perceived patient benefit. Similarly, IG patients rated the treatment structure and content clarity more positively. Relative to CG patients, a trend of greater improvements in transdiagnostic factors over time was observed in IG patients – most pronounced in beliefs about emotions (Emotion Beliefs Questionnaire: -8.89, 95% CI [-15.10, -2.74]), cognitive reappraisal (Emotion Regulation Questionnaire subscale: 6.03, 95% CI [2.52, 9.55]) and experiential avoidance (Brief Experiential Avoidance Questionnaire: -4.57, 95% CI [-8.69, 0.09]). Discussion The findings support the progression to a fully powered main trial. Future research should optimise recruitment strategies, streamline the intervention and improve outcome monitoring. Trial registration The study has been registered with the German Clinical Trials Register: 18th of March 2024, https://drks.de/search/en/trial/DRKS00033386 .
