Projects

Whereas it is evident that psychotherapy works, it is still not exactly clear how it works nor precisely what works in psychotherapy. There is considerable disagreement about the factors responsible for eliciting psychotherapeutic change. This refers to the mixed results of comparative psychotherapy research: On one hand, comparisons of different psychotherapy approaches revealed only minor effect-size differences. Meta-analyses showed an average effect-size difference of about 0.2 between different forms of psychotherapy. This finding has been labelled the “Dodo bird verdict” or "equivalence paradox". On the other hand, however, it has been repeatedly shown that some psychotherapy approaches are more effective than others in the treatment of certain mental disorders and patients with certain interactional characteristics. These inconsistent findings of comparative psychotherapy research led to two rivaling assumptions about the therapeutically active factors in psychotherapy: the specific ingredients assumption and the common factors model. The "Taxonomy Project" tries to resolve these inconsistencies.

In several studies employing expert surveys and analyses of psychotherapeutic sessions in outpatient and day clinics as well as inpatient psychiatric settings the interplay of specific and common psychotherapeutic factors was analyzed.

The findings indicate that

1. specific factors can be defined as specific psychotherapeutic techniques and common factors as higher-level psychotherapeutic strategies,
2. specific techniques realize common factors and
3. specific techniques and common factors are intertwined and synergistically contribute to therapeutic change mediated by patient characteristics such as emotional processing or coping stile.

Over the past 30 years, a large number of meta-analyses summarizing the findings of hundreds of therapy studies provided robust evidence for the efficacy and effectiveness of different psychotherapeutic therapy approaches in the treatment of schizophrenia.

In an own comprehensive meta-analysis the results of randomized controlled trials were extracted and transformed into weighted mean effect size differences between the different experimental psychotherapeutic treatment and control comparison groups regarding various types of outcomes were estimated. Their significance was tested by confidence intervals, and heterogeneity tests were applied to examine the consistency of the effects. Social skills trainings, cognitive remediation trainings, psychoeducational interventions with families and cognitive behavioral therapy approaches for hallucinations and delusions emerged as effective adjuncts to pharmacotherapy improving social skills, cognitive functioning, relapse prevention and persisting positive symptoms accompanied by slight improvements in social functioning. However, regarding the small effect size differences between the different effective psychotherapeutic interventions open questions remain as to the specifically therapeutic ingredients and components, the synergistic effects and the differential indication.

A planned meta-analysis of all available process-outcome studies aims to identify the treatment variables and components that promote therapeutic change and their interactions with relevant patient characteristics. The purpose of this analysis is the outline of an integrative psychotherapy approach for psychoses that precisely can be tailored, i. e., personalized to the preconditions and resources of the individual patient.

Resilience, i.e. a person's ability to adapt to stress, has become one of the most important issues in healthcare. The degree of resilience determines the extent to which a person is able to maintain health during or after severe stress or to recover quickly. Identifying the determinants of resilience is therefore one of the most active areas of health research.

In recent years, research has focused on the development and evaluation of interventions to promote resilience. The results of intervention research on resilience have been summarized in numerous systematic reviews and meta-analyses over the past 15 years. It is now almost impossible to gain an overview of their results. With the help of an umbrella review, we aim to systematically and quantitatively summarize the currently available evidence on the effectiveness of interventions to promote resilience in stress-related mental health problems and to identify the effective components of such interventions in order to develop personalized interventions tailored to the conditions, needs, resources and abilities of the target individuals or populations.

By searching relevant electronic literature databases, all systematic reviews and meta-analyses published by the end of 2024 are identified and selected based on predefined inclusion criteria. The selection process is documented in a flowchart according to the PRISMA criteria. The reasons for the exclusion of reviews and meta-analyses as well as the characteristics of the included systematic reviews and meta-analyses are listed. The included quantitative reviews are assessed for methodological quality and certainty of evidence, and their weighted pooled effect estimates are aggregated for different interventions, target groups and outcome variables. The integrated effect sizes are tested for statistical precision, significance and homogeneity. If possible, additional subgroup analyses (gender, age, psychopathology status, type of comparison condition, quality of evidence) and regression analyses of the relationships between individual therapeutic components of the interventions or trainings and the therapy outcome are performed. To illustrate the integrated weighted effect sizes and the respective confidence intervals, forest plots are used to display the individual and overall effects as well as the results of the subgroup analyses. Possible publication bias is analyzed using funnel plots.

In recent decades, embodiment has become an important construct in psychology and cognitive sciences. Researchers and practitioners use this construct to denote the position that mental processes (cognition, thinking, emotion, the psychological self) should be viewed in the context of the moving body. By this they depart from the 'computer metaphor' of mind – the embodiment stance instead posits that abstract information processing is not the essence of cognition. Accordingly, the mind cannot be fully understood without considering its embedding, the body. This has far-reaching implications for psychological research as well as for practical applications such as psychotherapy. The conventional view emphasizes that environmental stimuli entail mental (cognitive and perceptual) responses in a perceiver, which may result in emotions and bodily behavior. Embodiment complements this view by acknowledging the less evident, but equally important, reverse sequence – motor action and body postures may have an impact on the mind, often at an unattended level. Both sequences together comprise the bi-directionality of embodiment and are the focus of embodiment research.

An important operationalization of embodiment is the degree of synchrony. In a series of projects, we have shown that psychotherapy dyads were significantly synchronized in their nonverbal behavior during sessions. Synchrony also correlated significantly with patients' interaction problems, self-efficacy and attachment style. Therapeutic dyads with higher synchrony had higher patient self-efficacy and better therapeutic alliance as a result. Patients' insecure attachment patterns, stress due to interpersonal problems, and higher levels of psychopathology all correlated with lower synchrony during sessions.

In an international collaboration, we also conducted an empirical study of the synchrony of physiological parameters of visitors of classical concert in order to describe the shared experience in more detail.

In an international collaboration with Prof. Martin Tröndle (Zeppelin University, Friedrichshafen), Prof. Melanie Wald-Fuhrmann (Max-Planck Institute, Frankfurt) and Prof. Hauke Egermann (University of York), we initiated an empirical project on aesthetic perception in classical concerts. The classical concert is a highly sophisticated format of performance and reception. Which parameters of its highly ritualized sequence of events are topical, which others are irrelevant to aesthetic experiencing and immersion? We wish to explore the potentials of experience in this setting, with a focus of the bodily embedding of aesthetic experience, and ultimately find out what constitutes the concert experience in a classical music concert.

In spring 2022, we organized a series of public concerts with identical programming in the concert venues Radialsystem and Pierre Boulez Saal in Berlin. In each performance, one aspect of the concert format was altered. We recorded the subjective experiences of close to 800 audience members’ before and after concerts and monitored their physiological and nonverbal responses during concerts. As a result, we expect to gain insights regarding several open questions: Which setting can optimize listening? When do people feel connected to the other audience members? When is the musical experience specifically intense and uplifting? To what extent do listeners synchronize during concerts, and may we regard their physiological and behavioral synchrony as a signature of music immersion?