Skip to main content
Published Online:https://doi.org/10.1027//0227-5910.23.2.59

Summary: The remediation processes in psychosocial crisis intervention were modeled focusing on cognitive orientation. Frequent observations and subsequent process modeling constitute a novel approach to process research and reveal process-outcome associations. A sample of 40 inpatients who were assigned to treatment in a crisis intervention unit was monitored in order to study the process of crisis intervention. The process data consisted of patients' self-ratings of the variables mood, tension, and cognitive orientation, which were assessed three times a day throughout hospitalization (M = 22.6 days). Linear time series models (vector autoregression) of the process data were computed to describe the prototypical dynamic patterns of the sample. Additionally, the outcome of crisis intervention was evaluated by pre-post questionnaires. Linear trends were found pointing to an improvement of mood, a reduction of tension, and an increase of outward cognitive orientation. Time series modeling showed that, on average, outward cognitive orientation preceded improved mood. The time series models partially predicted the treatment effect, notably the outcome domain “reduction of social anxiety,” yet did not predict the domain of symptom reduction. In conclusion, crisis intervention should focus on having patients increasingly engage in outward cognitive orientation in order to stabilize mood, reduce anxiety, and activate their resources.

References

  • Akaike, HCanonical correlations analysis of time series and the use of an information criterion.. In R Mehra & DG Lainiotis (Eds.), Advances and case studies in system identification (pp.27-96). New York: Academic Press (1976). First citation in articleCrossrefGoogle Scholar

  • Bandura, ASelf-efficacy: The exercise of control.. New York: Freeman (1997). First citation in articleGoogle Scholar

  • Beck, ABeck-Depressions-Inventar: Testhandbuch ‘Beck Depression Inventory: Manual’.. Bern: Huber (1994). First citation in articleGoogle Scholar

  • Beckmann, D, Braehler, E, Richter, HEDer Giessen-Test (GT): Ein Test für Individual- und Gruppendiagnostik ‘The Giessen-Test (GT): Test for individual and group diagnosis’.. Bern: Huber (1990). First citation in articleGoogle Scholar

  • Bulik, CM, Sullivan, PF, Joyce, PRTemperament, character and suicide attempts in anorexia nervosa, bulimia nervosa and major depression.. Acta Psychiatrica Scandinavica, (1999). 100, 27–32 First citation in articleCrossref MedlineGoogle Scholar

  • Carver, CS, Scheier, MFOn the self-regulation of behavior.. Cambridge: Cambridge University Press (1998). First citation in articleCrossrefGoogle Scholar

  • Ciompi, LKrise und Krisenintervention in der modernen Psychiatrie ‘Crisis and crisis intervention in modern psychiatry’.. Schweizerische Wochenzeitschrift, (1977). 10, 893–898 First citation in articleGoogle Scholar

  • de Jong-Meyer, R, Schmitz, S, Ehlker, M, Greis, S, Hinsken, U, Sonnen, B, Dickhoever, NHandlungsorientierte Interaktionsbeiträge in verschiedenen Therapien: Prozesssteuerung und Erfolgsrelevanz ‘Action-oriented interactions in different types of psychotherapy: Relevance for psychotherapeutic processes and outcomes’.. Zeitschrift für Klinische Psychologie, Psychiatrie und Psychotherapie, (1999). 47, 172–190 First citation in articleGoogle Scholar

  • Derogatis, LRSCL-90-R: Administration, scoring, and procedures manual-I for the r(evised) version.. Baltimore: Johns Hopkins University School of Medicine (1977). First citation in articleGoogle Scholar

  • Franke, GSCL-90-R: Die Symptom-Checkliste von Derogatis ‘SCL-90-R: Symptom Checklist 90 Items-Revised’.. Weinheim: Beltz (1994). First citation in articleGoogle Scholar

  • Grawe, KResearch-informed psychotherapy.. Psychotherapy Research, (1997). 7, 1–19 First citation in articleCrossrefGoogle Scholar

  • Hayes, AM, Strauss, JLDynamic systems theory as a paradigm for the study of change in psychotherapy: An application to cognitive therapy for depression.. Journal of Consulting and Clinical Psychology, (1998). 66, 939–947 First citation in articleCrossref MedlineGoogle Scholar

  • Hartung, J, Schulte, DAction and state orientation during therapy of phobic disorders.. In J Kuhl & J Beckmann (Eds.), Volition and personality: Action versus state orientation (pp.217- 231). Göttingen: Hogrefe & Huber (1994). First citation in articleGoogle Scholar

  • Hautzinger, MAction control in the context of psychopathological disorders.. In J Kuhl & J Beckmann (Eds.), Volition and Personality: Action versus state orientation(pp.209-215). Göttingen: Hogrefe & Hube (1994). First citation in articleGoogle Scholar

  • Ingram, RESelf-focused attention in clinical disorders: Review and a conceptual model.. Psychological Bulletin, (1990). 107, 156–176 First citation in articleCrossref MedlineGoogle Scholar

  • Kanfer, FH, Reinecker, H, Schmelzer, DSelbstmanagement-Therapie.. Berlin: Springer-Verlag (1996). First citation in articleCrossrefGoogle Scholar

  • Kuhl, JA theory of self-regulation: Action versus state orientation, self-discrimination, and some applications.. Applied Psychology, (1992). 41, 97–129 First citation in articleCrossrefGoogle Scholar

  • Kuhl, JWille und Freiheitserleben: Formen der Selbststeuerung.. In J Kuhl & H Heckhausen (Eds.), Motivation, Volition und Handlung, Enzyklopädie der Psychologie, Themenbereich C, Theorie und Forschung, Serie IV, Motivation und Emotion, Band 4 ‘Volition and the experience of freedom: Forms of self-managment. In J Kuhl & H Heckhausen (Eds.), Encyclopedia of psychology: Motivation, volition and action’. Göttingen: Hogrefe, pp.665-765) (1996). First citation in articleGoogle Scholar

  • Kuhl, J, Beckmann, JIntroduction: Action versus state orientation in the context of personality and volition.. In J Kuhl & J Beckmann (Eds.), Volition and personality: Action versus state orientation(pp.1-5). Göttingen: Hogrefe & Huber (1994). First citation in articleGoogle Scholar

  • Kuhl, J, Kazén, MSelf-discrimination and memory: State orientation and false self-ascription of assigned activities.. Journal of Personality and Social Psychology, (1994). 66, 1103–1115 First citation in articleCrossref MedlineGoogle Scholar

  • Orlinsky, DE, Grawe, K, Parks, KBProcess and outcome in psychotherapy—noch einmal.. In AE Bergin & SL Garfield (Eds.), Handbook of psychotherapy and behavior change(pp.270- 376). New York: Wiley (1994). First citation in articleGoogle Scholar

  • Ormel, J, Kempen, G, Penninx, B, Brilman, E, Beekman, A, Van, Sonderen EChronic medical conditions and mental health in older people: Disability and psychosocial resources mediate specific mental health effects.. Psychological Medicine, (1997). 27, 1065–1077 First citation in articleCrossref MedlineGoogle Scholar

  • Osgood, CE, Suci, GJ, Tannenbaum, PHThe measurement of meaning.. Urbana, IL: University of Illinois Press (1957). First citation in articleGoogle Scholar

  • Perrez, M, Reicherts, MA computer-assisted self-monitoring procedure for assessing stress-related behavior under real life conditions.. In J Fahrenberg & M Myrtek (Eds.), Ambulatory assessment (pp.51-67). Seattle: Hogrefe & Huber (1996). First citation in articleGoogle Scholar

  • Reilly, PM, Sees, KL, Shopshire, MS, Hall, SMSelf-efficacy and illicit opioid use in a 180-day methadone detoxification treatment.. Journal of Consulting and Clinical Psychology, (1995). 63, 158–162 First citation in articleCrossref MedlineGoogle Scholar

  • Reisch, T, Schlatter, P, Tschacher, WEfficacy of crisis intervention.. Crisis, (1999). 20, 78–85 First citation in articleLinkGoogle Scholar

  • SAS InstituteSAS/ETS(R) User's guide.. Cary, NC: SAS Institute Inc. (1991). First citation in articleGoogle Scholar

  • Schnyder, U, Klaghofer, R, Leuthold, A, Buddeberg, CCharacteristics of psychiatric emergencies and the choice of intervention strategies.. Acta Psychiatrica Scandinavica, (1999). 99, 179–187 First citation in articleCrossref MedlineGoogle Scholar

  • Schnyder, U, Sauvant, JDKrisenintervention in der Psychiatrie ‘Crisis intervention in psychiatry’.. Bern: Huber (1993). First citation in articleGoogle Scholar

  • Schulte, D, Hartung, J, Wilke, FHandlungskontrolle der Angstbewältigung: Was macht Reizkonfrontationsverfahren so effektiv? ‘Action control in treatment of anxiety disorders: What makes exposure so effective?’. Zeitschrift für Klinische Psychologie, Psychiatrie und Psychotherapie, (1997). 26, 118–128 First citation in articleGoogle Scholar

  • Sexton, HC, Hembre, K, Kvarme, GThe interaction of the alliance and therapy microprocess: A sequential analysis.. Journal of Consulting and Clinical Psychology, (1996). 64, 471–480 First citation in articleCrossref MedlineGoogle Scholar

  • Tschacher, WThe dynamics of psychosocial crises: Time courses and causal models.. Journal of Nervous and Mental Disease, (1996). 184, 172–179 First citation in articleCrossref MedlineGoogle Scholar

  • Tschacher, W, Baur, N, Grawe, KTemporal interaction of process variables in psychotherapy.. Psychotherapy Research, (2000). 10, 296–308 First citation in articleCrossrefGoogle Scholar

  • Ullrich, R, Ullrich, RDer Unsicherheitsfragebogen (Testmanual U) ‘Insecurity questionnaire’.. München: Pfeiffer (1977). First citation in articleGoogle Scholar

  • Ullrich, R, Ullrich, RDas Emotionalitätsinventar (Testmappe EMI-B) ‘Emotional Comfort Inventory, test manual’.. München: Pfeiffer (1978). First citation in articleGoogle Scholar

  • Woody, SR, Rodriguez, BFSelf-focused attention and social anxiety in social phobics and normal controls.. Cognitive Therapy and Research, (2000). 24, 473–88 First citation in articleCrossrefGoogle Scholar