Browsing by Author "Schmeck, Klaus"

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    A design for process-outcome psychotherapy research in adolescents with Borderline Personality Pathology
    (2018) Zimmermann, Ronan; Krause Jacob, Mariane; Weise, Sindy; Schenk, Nathalie; Fürer, Lukas; Schrobildgen, Christian; Schlüter-Müller, Susanne; Valdés, Nelson; Koenig, Julian; Kaess, Michael; Schmeck, Klaus
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    Digital use of standardised assessment tools for children and adolescents : can available paper-based questionnaires be used free of charge in electronic format?
    (2022) Cottin Arredondo, Marianne; Blum, Kathrin; Konjufca, Jon; Quevedo Labbé, Iván Yamil; Kaaya, Sylvia; Behn Berliner, Alex Joseph; Schmeck, Klaus; Sharp, Carla; Zimmermann, Ronan
    Question: Most adolescents live in low- and middle-income countries (LMIC), and about 10% of them face mental problems. The mental health provision gap in low- and middle-income countries could be addressed by evidence-based practices, however costs are implementational barriers. Digitalization can improve the accessibility of these tools and constitutes a chance for LMIC to use them more easily at a low cost. We reviewed free and brief evidence-based mental health assessment tools available for digital use to assess psychopathology across different domains in youth. Methods: For the current study, instruments from a recent review on paper-based instruments were re-used. Additionally, a systematic search was conducted to add instruments for the personality disorder domain. We searched and classified the copyright and license terms available from the internet in terms of free usage and deliverability in a digital format. In the case that this information was insufficient, we contacted the authors. Results: In total, we evaluated 109 instruments. Of these instruments, 53 were free and digitally usable covering 11 mental health domains. However, retrieving information on copyright and license terms was very difficult. Conclusions: Free and digitally adaptable instruments are available, supporting the strategy of using instruments digitally to increase access. The instrument’s authors support this initiative, however, the lack of copyright information and the difficulties in contacting the authors and licence holders are barriers to using this strategy in LMIC. A comprehensive, online instrument repository for clinical practice would be an appropriate next step to make the instruments more accessible and reduce implementation barriers.
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    Effectiveness of Adolescent Identity Treatment (AIT) Versus DBT-A for the Treatment of Adolescent Borderline Personality Disorder
    (2022) Schmeck, Klaus; Weise, Sindy; Schlueter-Mueller, Susanne; Birkhoelzer, Marc; Fuerer, Lukas; Koenig, Julian; Krause, Mariane; Lerch, Stefan; Schenk, Nathalie; Valdes, Nelson; Zimmermann, Ronan; Kaess, Michael
    Borderline personality disorder (BPD) is among the most severe mental health problems with long-lasting deterioration of functioning. According to a Cochrane review, evidence for methods focused on treatment for adolescent BPD patients is very limited. Aims of the study were to demonstrate the noninferiority of adolescent identity treatment (AIT) compared with dialectical behavior therapy for adolescents (DBT-A), and that intensive early treatment of BPD leads to significant improvement of psychosocial and personality functioning in adolescent patients. In a nonrandomized controlled trial using a noninferiority approach, we compared 37 patients treated with DBT-A with 23 patients treated with AIT. Both treatments included 25 weekly individual psychotherapy sessions and five to eight family sessions. Patients were assessed at four timepoints: baseline, posttreatment, 1- and 2-year follow-up. Primary outcome was psychosocial functioning at 1-year follow-up. We performed both intention-to-treat analyses and per-protocol analyses (completers). Baseline characteristics of both groups were not significantly different except for age and self-injurious behavior. In all, six AIT patients (26%) and 10 DBT-A patients (27%) dropped out of treatment. Both DBT-A and AIT significantly improved adolescents' psychosocial functioning (AIT: d = 1.82; DBT-A: d = 1.73) and personality functioning. BPD criteria and depression were significantly reduced by both treatments. Overall, AIT was found to be not inferior to DBT-A and even more efficient in reducing BPD criteria. Both treatments are highly effective in improving psychosocial functioning and personality functioning in adolescent BPD patients. AIT is a promising approach and not inferior to DBT-A in respect to treatment efficiency.
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    Trajectories of alliance ruptures in the psychotherapy of adolescents with borderline personality pathology : timing, typology and significance
    (2019) Schenk, N.; Zimmermann, Ronan; Furer, L.; Krause Jacob, Mariane; Weise, S.; Kaess, M.; Schluter Muller, S.; Schmeck, Klaus