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Bridging inpatient treatment and outpatient treatment Can outcome monitoring guide transitions?

Bridging inpatient treatment and outpatient treatment Can outcome monitoring guide transitions?. Valiollah Golkaramnay & Hans Kordy Center for Psychotherapy Research Stuttgart. content.  Backgrounds.  Online maintenance treatment.  Questionnaires.  Online feedback.

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Bridging inpatient treatment and outpatient treatment Can outcome monitoring guide transitions?

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  1. Bridging inpatient treatment and outpatient treatment Can outcome monitoring guide transitions? Valiollah Golkaramnay & Hans Kordy Center for Psychotherapy Research Stuttgart

  2. content  Backgrounds  Online maintenance treatment  Questionnaires  Online feedback  Preliminary results

  3. Backgrounds 80 % of the patients in a German psychosomatic clinic desire or their thrapists recommend some kind of outpatient treatment. An immediate treatment can not be implemented always directly following the inpatient treatment. No or a delayed subsequent treatment can increase the relapse risk. Approx. 30% of the patients with clearly improved state of health at discharge have lost a substantial part of these improvements one year after therapy.

  4. Backgrounds In order to prevent relapse or to maintain the positive changes of patients after an inpatient treatment we are investigating an online maintenance treatment. In a cooperation project with the „Panorama Clinic Scheidegg“ and a German health insurance company („Techniker Krankenkasse“) we offer a guided internet chat group to interested patients.

  5. Maintenance Treatment Three main features of the project:  Bridging outpatient and inpatient treatment  Conducting guided internet chat groups  Continuous online outcome monitoring

  6. Maintenance Treatment Bridging outpatient and inpatient treatment Bridging the critical time after discharge

  7. Maintenance Treatment Conducting guided internet chat groups Utilizing the speed and economies of the Internet Time and place elasticity

  8. Maintenance Treatment Continuous online outcome monitoring Providing immediate feedback to the therapists regarding patient change Providing „decision help“ to the therapists regarding discharge from the online groups

  9. Design 12-15 weeks admission discharge Internet groups 1. follow up 2. follow up 35 days 6 months 6 months

  10. Questionnaires 1/2 & 1 year follow up admission discharge • SCL-90-R • OQ-45 • GBB • IIP • LQ • BSS • SCL-90-R • OQ-45 • GBB • IIP • LQ • BSS • Therapists’ rating of change • Patients’ rating of change • SCL-90-R • OQ-45 • GBB • IIP • LQ

  11. Online questionnaires Pre-session questionnaires: •  OQ-45 and GBB • by turns •  BSI and GBB Post-session questionnaire:  Session evaluation items  PC & Internet experience questionnaire  Final-questionnaire

  12. Homepage

  13. Feedback

  14. Feedback In the functional range, no reliable change Out of the functional range, no reliable change Reliable positive change Reliable negative change Clinical significant improvement Clinical significant deterioration

  15. Feedback

  16. Feedback

  17. Feedback

  18. Preliminary results

  19. Preliminary results

  20. Preliminary results  Four types of courses could be observed from the first to the last online assessment: The patients are in the functional range at the first and the last onlíne assessment. The patients are in the non-functional range at the first and the last onlíne assessment. The patients progress from the non-functional to the functional range. The patients are unstable and change from session to session.

  21. Case 1

  22. Case 1

  23. Case 1

  24. Case 2

  25. Case 2

  26. Case 2

  27. Case 3

  28. Case 3

  29. Case 3

  30. Case 4

  31. Case 4

  32. Case 4

  33. Summary relatively high satisfaction with the sessions high acceptance of chat groups practicability of online outcome monitoring immediate availability of the results high correspondance of the online assessments with the therapists‘ clinical impression of patients usefulness of continuous online outcome monitoring

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