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When does psychotherapy work and when does it not? What makes a good therapist? And how can their competencies be measured? These questions are on Florian Weck’s mind, and research has not yet found the answers. He wants to determine how best to prepare people with mental issues for challenges at work and home. Born in Frankfurt on Main, Weck moved from Mainz to the state of Brandenburg in 2016. He has since been Professor of Clinical Psychology and Psychotherapy at the University of Potsdam while serving as Director of its affiliated Psychological and Psychotherapeutic Outpatient Department (PPA) where he has already implemented some changes by focusing on adult psychotherapy and by strengthening psychotherapeutic research.
One of his specific research topics is fear of disease. He first became interested in it 12 years ago as a PhD student at the University of Mainz; he was then also involved in establishing it as a focus of research and treatment.
It is no coincidence, then, that Florian Weck is now establishing fear of disease as a new treatment focus at the PPA in Potsdam. The phenomenon is socially relevant, since it can drastically impact people’s private and working lives. If, for example, a headache lasts longer than usual or a lymph node starts to swell, they immediately panic and are unable to relax. They pore over internet forums for hours and self-diagnose. The nightmare then turns into a vicious cycle: While some complaints subside, they discover – and misinterpret or overinterpret – new symptoms. Experts see fear of disease phases lasting over six months as pronounced; they may even diagnose more extreme cases as hypochondria or – more recently – as disease anxiety disorder. About 7-10% of the German population worry more about their health than the average, and almost 1% suffer from hypochondria that necessitates treatment. But very few of them immediately seek out psychotherapy. As a rule, they have consulted many specialists before finding their way here – more anxious than ever. “Such odysseys could be avoided if the potentials of psychotherapy were better known,” Weck says. Fear of disease can now be treated quite successfully – especially compared to other mental disorders. One of his studies indicated that even three years after treatment, two thirds of the subjects showed no more signs of pronounced fear. “Those who come to us can be confident that we will be able to help them fairly quickly,” assures the researcher. In many cases, a lot of progress can be made in just six months. While the fear will never completely subside, patients do learn to deal with it. His team is well prepared for this new task. His first patients with fear of disease have already started their treatment. Over the course of their 20-25 one-on-one behavioral therapy sessions, they learn how to handle their anxiety. “Generally speaking, many habits have to be changed. For instance, it is very important to stop searching the internet for diseases and symptoms and to address the conditions which perpetuate the problem.” Men and women are equally likely to suffer from the disorder. “No particular type of person is more likely than another to suffer from it,” Weck knows.
The professor is very happy about the fact that psychotherapy has become increasingly important in Germany in recent years. Profound economic effects were among the main reasons for this development – quite often, mental disorders lead to long absences from work. “Research has shown that psychotherapy can treat a number of clinical pictures very effectively,” says Weck. “All in all, the outcome of the cost-benefit analysis is positive.” But the researcher also points to another fact that has contributed to the growing importance of the specialty: Psychotherapy has come out from the periphery, where it never belonged in the first place. People with mental conditions were long seen as outsiders in Germany; working with them was taboo. “But that was long ago. The media now provide information on mental disorders and people are also speaking out about them; those suffering from mental conditions are encouraged to get help,” Weck explains. Laying the theoretical foundation for it and providing scientifically based assistance are what appeals to him.
In his current project – funded by German Research Foundation – Weck and his assistant Yvonne Junga research how competency feedback impacts the success of a therapy. Weck dealt with this very issue from 2009-2014 while working in Frankfurt on Main. At the time, a study done by his research team found that young therapists receiving feedback during a session from experienced colleagues via a monitor can be very effective. “Those who received immediate supervision ultimately did better than those who received feedback later,” Weck summarizes the results. Feedback is extremely important for young therapists, he says. The preliminary study of his current project confirms this: Those who received concrete written feedback after their sessions with patients increased their competencies more than the control group, who received no immediate feedback. “The question is, however, whether these higher competencies result in better therapeutic outcomes for patients.” No data on this are available yet. The German Research Foundation just extended the project through early 2019. It addresses a fundamental question: What makes a good therapist? Research has yet to find a clear answer, but we do know for sure that the therapist-client relationship matters. What makes for good therapy, though, has also not yet been resolved. Only one thing is clear: “Being successful requires having sufficient structural capabilities, empathy, and specialty knowledge,” Weck states. Because too little is known about which training units are particularly useful in equipping therapists with the necessary competencies, researchers at the University of Potsdam are working to learn more about it. A video studio is going to be set up to research how particular training measures influence the development of therapeutic competencies. While the idea is still in its infancy, Weck underlines: “I am very much interested in finding the best way to train future therapists, so that they become good therapists.”
The Psychological and Psychotherapeutic Outpatient Department at the University of Potsdam has offered psychodiagnostics, psychotherapy, and counseling for children, youth, and adults presenting pathological mental disorders since 1990. Its behavioral-therapeutic approach has proven particularly effective in scientific studies. The team consists of 14 therapists, all of whom are licensed psychotherapists.
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The term hypochondriasis refers to the excessive fear of being or becoming ill. Those affected overvalue or misinterpret physical symptoms. Likely less than 1% of the German population suffers from it; studies indicate that another 7-10% experience temporary health fears.
Prof. Dr. Florian Weck studied psychology at Johannes Gutenberg University in Mainz. Since 2016, he has been Professor of Clinical Psychology and Psychotherapy at the University of Potsdam while also serving as Director of the University-affiliated Psychological and Psychotherapeutic Outpatient Department.
Text: Petra Görlich
Translation: Monika Wilke
Published online by: Marieke Bäumer
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Read this and other articles on research at the University of Potsdam in our research magazine Portal Wissen.