Clinical intervention and training

Online intervention for complicated grief

Online interventions have been firmly shown to be as efficient as face-to-face psychotherapy to treat several mental disorders. However, empirically validated online interventions are still very scarce in French, and to our knowledge, no such intervention exists to support people struggling with grief and separation. The present project aims to develop and test such an online intervention, based on an existing German program developed at the University of Bern (LIVIA), but without individual guidance for participants. In order to foster adherence and efficiency of the program, we will bring about the following developments:

  • A focus on personal resources and hope induction
  • Innovative ways to foster relationships and support
  • Interactive content and design of the website

Find more information on this document.

The present project is part of the IP212 of the NCCR LIVES

 

CARLA collaborators:
Anik Debrot, PhD, project leader
Prof. Valentino Pomini
Liliane Efinger, PhD student
Esther Liekmeier, student assistant
Tanja Bellier-Teichmann, PhD, research partner

From the University of Bern:
Dr. Jeannette Brodbeck
Prof. Thomas Berger
Prof. Hansjörg Znoj

 

Alliance repair in psychotherapy

Research suggests that the best therapists are the ones that are better able to identify and repair alliance ruptures, which are common in therapy. Developing the capacity to manage these disruptions should be an important component of the therapist training curricula. However, this type of training is currently not widely available.

This study examines the effects of a two-day training workshop on the repair of alliance ruptures, based on the model developed by Safran & Muran (1996, 2000). This research involves 37 participants, who are therapists in their first or second year of postgraduate training in psychotherapy. They were randomized in two separate groups: 1) participants assigned to the experimental condition were trained in therapeutic alliance repair strategies and 2) control condition participants were placed on a waiting list and had the opportunity to participate in the training once the study was completed. The therapists' competence to manage the alliance was assessed before and after the training through a standardized role-playing setup realized with professional actors who simulated an episode of alliance rupture. Based on the video recordings of these role-playing games, coders used a hetero-evaluative instrument (the 3RS) to measure the frequency of use of resolution strategies, their clarity and their impact.

The results show that the evolution of competences is significantly different according to the experimental condition. While there is no change in control group participants, experimental group participants improve their ability to restore the alliance, use more resolution strategies and formulate them more clearly. The impact of the resolution strategies employed by participants who received training is also increased.

In general, these results support the benefit of the integration of alliance-centered training into the psychotherapy training curriculum.

CARLA collaborators:
Diana Ortega
Valentino Pomini

Supported employment for borderline personality disorders

Employment has shown highly positive effects on recovery from mental health problems, because of financial as well as interpersonal reasons. In that sense, several vocational rehabilitation programs have been developed to help people suffering from psychiatric disorders regain employment. The Individual Placement and Support (IPS) model has proved to be the most efficient program to help people with severe mental illness find an employment. Its main aim is to help people with psychiatric disorders to reintegrate competitive employment as quickly as possible, rather than going through long periods of training or sheltered jobs. However, no study has yet proved IPS efficiency with people suffering from borderline personality disorder. These patients show several serious functional deficits that negatively affect their employment trajectories. The goal of this research is to establish the picture of vocational rehabilitation programs for borderline personality disorder patients, and to test the IPS effectiveness with this population. The final aim is to improve the clinical practice of supported employment team when facing this category of patients.

CARLA Collaborators :
Noëllie Dunand
Valentino Pomini
Philippe Golay

External Collaborators :
Daniele Spagnoli
Charles Bonsack

Online intervention for people who have difficulties overcoming the loss of a dear one

Losing a close person, either by death, divorce or separation, is inherent to the human condition, but still is a particularly stressful life event. It is associated with poor psychological, social and physical health outcomes. Some people show major difficulties in coping with this event that can lead to pathological symptoms.

Regarding the access to preventive treatment, innovative tools have been developed, such as Internet interventions. These have been shown to be effective in a variety of disorders (e.g., anxiety, eating and depressive disorders), including complicated grief. With the aim of preventing symptoms of complicated grief, Brodbeck, Berger and Znoj (2017) have developed a German online program based on cognitive-behavioural therapy elements (LIVIA I) for bereaved and separated individuals. Initial results indicate positive effects. However, to date, there is no empirically validated grief treatment in French. Thus, the first objective of this research is to test the French version of LIVIA I. The second and main goal is to develop a new version of LIVIA (II) including the following elements:

a) an integration of participants’ and experts’ feedback about LIVIA I

b) a focus on the core aspects of positive psychology - namely fostering positive emotions, meaning of life and commitment

c) an organization around the four central tasks to overcome grief – namely accepting the loss, experiencing and regulating the pain of the loss, adapting to an environment without the lost person, and redefining the relationship to the lost person

We will compare the effects of LIVIA I and II at post-intervention and six month follow-up. The main goal of this research is to offer an effective and handy preventive intervention, an accessible travel companion at all times to French-speaking people who have difficulties overcoming the loss of a loved one.

 

CARLA Collaborators
Liliane Efinger
Anik Debrot
Valentino Pomini

GĂ©opolis - CH-1015 Lausanne
Switzerland
Tel. +41 21 692 35 25