Despite the growing relevance and applicability of elements based on and derived from the embodied mind paradigm, body psychotherapy (BPT) appears not to be a well-established treatment option. This might be due to a lack of proof for its efficacy. We searched electronic databases (Pubmed MEDLINE, PsycInfo, and PSYNDEX) for randomized controlled trials (RCTs) examining predefined BPT interventions. A total of 2,180 references were screened, of which 113 studies were scrutinized in detail and 18 RCTs finally included. The observed effect size (ES) demonstrated medium effects of BPT on primary outcomes psychopathology and psychological distress. In case of significant statistical heterogeneity, exploratory subgroup analyses revealed diagnosis and the degree of control group activity as noteworthy moderators. For secondary outcomes, evidence was scarce, and an improvement could be demonstrated only for coping abilities. The identified evidence indicates that BPT is beneficial for a wide spectrum of psychic suffering. There is a strong need for high-quality studies with bigger samples and for well-defined diagnostic entities to underpin its effectiveness.

Feedback is regarded a key element in teaching communication skills. However, specific aspects of feedback have not been systematically investigated in this context. Therefore, the aim of this study was to investigate the effectiveness of communication skills training (CST) integrating specific, structured and behavioral feedback. We condensed best practice recommendations for feedback in a CST for undergraduate medical students and compared the effect of specific, structured and behavior-orientated feedback (intervention group CST-behav) to general, experience-orientated feedback (CST- exp. as our control group) in a randomized controlled trial (RCT). We investigated changes on communication skills evaluated by independent raters, and evaluated by standardized patients (SP). To do that, every student was video-recorded in a pre and post assessment. Sixty-six undergraduate medical students participated voluntarily in our study. Randomization did not result in equally skilled groups at baseline, so valid inter-group comparisons were not possible. Therefore, we analyzed the results of 34 students of our intervention group (CST-behav). Five out of seven domains in communication skills as evaluated by independent raters improved significantly, and there was a significant change in the global evaluation by SP. Although we were unable to make between-group comparisons, the results of the within group pre-post evaluation suggest that specific feedback helps improve communication skills.

Feedback is considered a key didactic element in medical education, especially for teaching of communication skills. This study investigates the impact of a best evidence-based practice feedback concept within the context of communication skills training (CST). We evaluate this concept for acceptance and changes in students self-ratings of communication competence. Our CST integrating feedback process comprises a short theoretical introduction presenting standards for good communication and a constructive 360° feedback from three perspectives: feedback from peers, from standardized patients (SPs), and from a trainer. Feed-forward process was facilitated for documenting suggestions for improvements based on observable behaviors to maximize learning benefits. Our CST was applied to four groups of eight or nine students. We assessed the data on students’ acceptance using a 6-point scale ranging from very good (1) to poor (6), applied a forced choice question to rank didactic items, and assessed changes in student’ self-ratings of their communication competence on a 10-cm visual analogue scale (VAS). Thirty-four medical undergraduates (82 % female, 18 % male) in their first clinical year, with an average age of 21.4 years (SD = 1.0), participated in the new training. The concept achieved high acceptance from good to very good: overall impression (M = 1.56), sufficient interaction for discussion (M = 1.15), and constructive learning atmosphere (M = 1.18). Specific elements, such as practical training with SPs (M = 1.18) and feedback by SPs (M = 1.12), showed highest acceptance. The forced choice ranking placed all feedback elements at the top of the list (feedback (FB) by SPs, rank 2; FB by trainer, rank 3; FB by colleagues, rank 4), whereas theoretical elements were at the bottom (theoretical introduction, rank 7; memory card, rank 9). Overall, student self-ratings of communication competence significantly improved in nine of the ten communication items assessed by VAS and showed a pre-post effect size of ES = 0.74 on a global rating. This study demonstrates that the training concept based on 360° behavioral feedback was well accepted and generated significant changes in student self-ratings of their communication competence. Further research is needed to determine the effects on objective communication performance.

We tested the efficacy of an integrative psychotherapeutic group treatment (IPGT) in reducing vertigo/dizziness-related impairment along with depression, anxiety, and somatization by conducting a randomized controlled superiority trial comparing IPGT to self-help groups moderated by a clinical psychologist (SHG). Adult patients with functional vertigo and dizziness symptoms were randomly allocated to either the IPGT or SHG as active control group. Outcomes were assessed at baseline (t0), after treatment lasting 16 weeks (t1), and 12 months after treatment (t2). A total of 81 patients were assigned to IPGT and 78 patients were assigned to SHG. Vertigo-related impairment was reduced in both conditions (IPGT: t0–t1: d = 1.10, t0–t2: d = 1.06; SHG: t0–t1: d = 0.86, t0–t2: d = 1.29), showing the efficiency of both IPGT and SHG. Clinically relevant improvements were also obtained for depression in both groups. Linear mixed model analyses revealed no differences between groups for all outcomes (effect of group for the primary outcome: b = −1.15, SE = 2.13, t = −0.54, p = 0.59). Attrition rates were higher in SHG (52.6%) than in IPGT (28.4%). Both conditions improved primary and secondary outcomes while IPGT was better accepted by patients than SHG. Trial registration: ClinicalTrials.gov, Identifier: NCT02320851.

Nicht-spezifische, funktionelle und somatoforme Körperbeschwerden (NFS) sind ein häufiges und oft chronisches Phänomen in der Haus- und Facharztmedizin. Die Patienten sind erheblich in ihrer Lebensqualität beeinträchtigt, die direkten und indirekten Folgekosten sind hoch. Für den Arzt bedeutet ihre Behandlung eine Herausforderung, im ungünstigen Falle kann das Verhalten des Arztes den Verlauf negativ beeinflussen. Unter Federführung der beiden Fachverbände für Psychosomatische Medizin wurde kürzlich eine umfassende, evidenzbasierte und interdisziplinäre S3-Leitlinie zum Umgang mit Patienten mit NFS entwickelt. Diese beschreibt die wesentlichen Elemente der ärztlichen Grundhaltung und Gesprächsführung sowie des diagnostischen und therapeutischen Vorgehens aufgrund der aktuellen empirischen Befundlage. Der Aufbau einer partnerschaftlichen Arbeitsbeziehung sowie eine symptom- und bewältigungsorientierte Grundhaltung begünstigen die Behandlung von Patienten mit NFS. Die biopsychosoziale Simultandiagnostik umfasst die Erhebung der Körperbeschwerden plus organischer Basisdiagnostik und von Beginn an eine psychosoziale Basisanamnese, die bei Hinweisen auf psychosoziale Belastungen erweitert wird. Bei leichteren Verläufen reicht meist die Behandlung durch den Hausarzt, auf der Grundlage therapeutischer Maßnahmen aus der psychosomatischen Grundversorgung. Schwerere Verläufe werden in einem stärker strukturierten Setting behandelt, sie bedürfen regelmäßiger und beschwerdeunabhängiger Termine und erfordern die Mitarbeit des Patienten in höherem Maße. Erforderlich ist der koordinierte und kooperative Einsatz weiterer Elemente aus den Bereichen gestufte Aktivierung, Psychotherapie, Entspannungsverfahren sowie ggf. befristete Medikation. Besonders schwere Verläufe bedürfen einer multimodalen Behandlung, ggf. im (teil-)stationären Setting. In primary and secondary medicine “non-specific, functional, and somatoform bodily complaints” are common and often take a chronic course, with the patients’ quality of life usually markedly impaired, and give rise to high direct and indirect costs. They are challenging as they can deteriorate in case of inappropriate behavior on the physician’s part. Coordinated by both German professional associations of Psychosomatic Medicine a new evidence based guideline was developed, aiming to transfer relevant diagnostic and therapeutic knowledge to all physicians who are in charge of these patients. After establishing a stable therapeutic alliance a symptom- and coping-oriented attitude could be demonstrated to be helpful. A biopsychosocial diagnostic evaluation combines a thorough assessment of bodily complaints and early introduces a sensitive discussion of signs of psychosocial stress, which can be extended carefully in case problems of this type are present. In less severe courses, physical/social activation is recommended and the patient’s explanatory disease model should be extended towards a psychological dimension. More severe and complicated courses require a more structured approach consisting of regular appointments (as opposed to ad-hoc appointments whenever the patient feels worse) and an active cooperation of the patient. A coordinated, multimodal management includes additional measures as graded activation, psychotherapy, relaxation training or – if indicated – temporary medication.