Author: Nadia Micali, Copenhague

Avoidant/restrictive food intake disorder (ARFID) was added to DSM-5 Feeding and Eating Disorders chapter in 2013, and recently to ICD-11. Given the similarity between ARFID and other restrictive-type eating disorders, as well as the heterogeneity within the ARFID diagnosis (i.e., food avoidance due to sensory sensitivity, lack of interest in eating, and fear of aversive consequences), comprehensive multi-disciplinary assessment is critical to effective treatment planning.
This masterclass aims to: 1. Describe and clarify the diagnosis of ARFID, and its etiology. 2. Illustrate key diagnostic features ARFID presentations and their variability across the age ranges (early, late childhood, adolescence and adulthood), 3. Highlight differential diagnoses, relevant psychiatric and medical comorbidities and potential diagnostic pitfalls, 4. List structured clinical assessment tools, and present briefly available treatment options.
Clinical vignettes might be discussed with participants if time allows.

Author: Fiammetta Cosci, Florence

Abstract:

Clinimetrics was funded by Alvan Feinstein in 1987 as the science of clinical measurements. Over the time it has been recognized as a domain concerned with indices, rating scales, expressions, and tools that are used to describe or measure clinical phenomena which do not find room in the customary taxonomy. Indeed, the standard taxonomy in psychiatry and in clinical psychology does not include features, such as patterns of symptoms, severity of illness, effects of comorbid conditions, timing of phenomena, rate of progression of illness, functional capacity, that may demarcate major prognostic and therapeutic differences among patients who otherwise seem deceptively similar since they have the same diagnosis.

Clinimetrics has a set of rules that govern the structure of its tools, the choice of component variables, the testing of indexes characteristics (e.g., sensitivity, validity). In the last decades, clinimetrics has been largely developed, the properties of the instruments have been widely refined, and the availability of tools has greatly increased.
The Masterclasses will provide details on how to apply clinimetrics in psychosomatic medicine as source of complementary tools which allow to reach a comprehensive assessment of patients under the principles of the bio-psycho-social model. Participants will be involved in the activities via the presentation of clinical cases to be discussed in the group.

Author: Fernando Fernández-Aranda, Barcelona

Abstract:

The construct of food addiction (FA) has become a topic of increasing interest in the scientific community over the last five years, with diagnostic, clinical and potential therapeutic implications. Although basic research has shown similar vulnerabilities between food intake and addictive behaviours, there are conflicting results in the literature and a lack of longitudinal data.

This masterclass will cover the following topics: a) state of the art of the FA construct, from neurobiological factors to clinical implications; b) patient characteristics in different clinical pictures (ED, obesity, behavioural addictions) and associated risk factors; c) assessment procedures; d) interventions (specific vs. non-specific); e) future research.

This masterclass will discuss the state of the field of FA, including different clinical populations, from eating disorders (ED) and obesity to behavioural addictions, and the potential impact of FA on treatment response. The main aim of this masterclass is also to provide basic clinical guidelines for the assessment and treatment of such patients, and videotaped cases will be presented. The potential role of ultra-processed foods in the overall process will also be discussed.

Participants will be expected to relate what they learn to their own clinical experience and to take an active role. The masterclass should be of interest to all those involved in the assessment and treatment of patients with eating disorders, addictive behaviours and obesity, such as psychologists, psychiatrists, therapists, dieticians, social workers and nurses.

A bibliography and relevant handouts including a case study will be provided.

Author: Simone Behrens, Tübingen

Abstract:

In recent years, virtual reality (VR) technology has become more affordable and increasingly popular in the treatment of mental health problems. Currently, most commercial providers of VR environments for psychotherapy sell VR versions of established psychotherapeutic techniques such as exposure or relaxation. The general evidence for the effectiveness of these approaches is solid, but the added value compared to established procedures has yet to be evaluated. In contrast, current research is developing VR applications for psychotherapy that rely on specific features of the technology and cannot be readily implemented in the real world. The success of these approaches depends on how carefully the specific features of VR are utilized and whether both the technological implementation and the therapeutic application are carefully selected.
In this masterclass, I aim to enable participants to use VR for their own clinical research or practice. First, I will teach the basics of VR technology, give advice on how to choose suitable hardware and explain differences between existing providers of VR environments for psychotherapy. Then we will look at clinical cases where VR has been successfully used for psychotherapy and discuss when and why the use of VR can be better than real-life practice or imaginary experiences. Finally, part of the masterclass will be reserved for practical demonstrations and an open discussion.
Participants do not need any special prior knowledge. First-hand experience in conducting psychotherapy is advantageous.

Author: Paula Schwenke, Munich

Abstract:

Short description:
The climate crisis is a medical emergency, but also a great opportunity for social change that will enable the society to live a good and healthy life on a healthy planet.

The health sector and those working in this field play a central role in communicating, preventing and handling the effects of the planetary crisis. Therefore, it is essential that the topic of Planetary Health is anchored in the work and education of all health professions.

Background:
Planetary crises, including climate change, extinction of species and pollution of air, water and soil, pose the greatest health risk of the 21st century. For example, there is an increase in mortality due to heat waves, reduced food security after prolonged periods of drought and reduced mental health after floods or other extreme weather events. As humans increasingly overstep planetary boundaries, these planetary crises threaten to become a determining factor for the global burden of disease in the coming decades. At the same time, the implementation of effective measures and education offers great potential to reduce morbidity and mortality across the globe (e.g. active mobility through walking and cycling, adaptation of the medical care and healthcare system). People in health-related professions have the potential to actively shape the necessary transformation processes in a variety of areas (e.g.
patient care, public health services, research, policy advice) and thus contribute to a healthy and sustainable life for all people.

As the multiple effects of overshooting planetary boundaries are now clearly visible in the literature, there is no longer a primary lack of scientific evidence on the connections between ecological crises and health (knowledge challenge), but rather a need to translate existing knowledge into concrete transformation towards sustainability in policy and practice (implementation challenge). In order to mitigate (= mitigating the expected further effects of the climate crisis through consistent climate protection) and adapt (= adapting to the unavoidable effects of the climate crisis), rapid and societal measures are required in order to meet international agreements such as the Paris Climate Agreement and the UN’s Social Development Goals (SDGs) and thus continue to enable, maintain and promote health within planetary boundaries.

The aim of the workshop is to provide information about the concept of planetary health and to discuss implementation possibilities with the participants, as well as to enable them to recognize issues of planetary health in their own impact areas and to actively initiate transformation as change agents.

References:
1 Intergovernmental Panel on Climate Change (IPCC). Climate Change 2022: Impacts, Adaptations and Vulnerability – Summary for Policymakers https://www.ipcc.ch/report/ar6/wg2/downloads/report/IPCC_AR6_WGII_FinalDraft_FullReport.pdf
(accessed Apr 05 2022).
2 Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES). Global assessment report of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services; 2019. Brondízio ES, Settele J, Díaz S, Ngo HT (Hrsg.). IPBES Sekretariat: Bonn, Deutschland.
3 Watts N, Adger WN, Agnolucci P, et al. Health and climate change: policy responses to protect
public health. Lancet 2015; 386: 1861–914. https://doi.org/10.1016 S0140-6736(15)60854-6.
4 Whitmee S, Haines A, Beyrer C, et al. Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health. Lancet 2015; 386: 1973–2028. https://doi.org/10.1016/S0140-6736(15)60901-1.
5 Berrang-Ford L, Siders AR, Lesnikowski A, et al. (2021). A systematic global stocktake of evidence on human adaptation to climate change. Nature Climate Change, 11(11), 989-1000.
6 Wissenschaftlicher Beirat der Bundesregierung Globale Umweltveränderungen (2011): Factsheet Nr. 4/2011: Transformation zur Nachhaltigkeit.

— Participation is no longer possible because the course is fully booked —

Author: Jane Walker, Oxford

Abstract:

Problem-solving therapy is a short-term therapy that can be used either on its own, or as an add-on to another therapy. It focuses on empowering people to cope better with the problems they are facing and to feel more in control of their lives. Its ‘common-sense’ approach makes it readily acceptable and practically useful in the medical setting.
Problem-solving therapy can be helpful in a number of situations; for example, where a problem needs to be dealt with in a short period of time, when a problem needs to be solved before the patient can focus on deeper issues, or as an accessible starting point for patients who are new to therapy.
This interactive masterclass will introduce participants to problem-solving therapy and enable them to practice it whilst receiving guidance and feedback from experts.

Author: Wolfgang Lutz, Trier

Abstract:

Psychotherapy is an effective treatment for mental disorders and is often superior to psychopharmacological interventions. However, enthusiasm for many popular new treatment approaches is contrasted by limited knowledge of the differential evidence compared to established treatment programs. An important goal of psychotherapy and psychotherapy research may therefore be to move away from a focus on schools of therapy to a focus on outcomes, and in particular to improve the treatment of those patients at risk for negative outcomes. This requires the development towards a more measurement-based and data- informed approach to the psychological interventions.

Especially, outcome measurement has substantially evolved in recent decades, making it an integral part of clinical practice and training. This workshop addresses fundamental issues of change and empirical-based decision making in psychotherapy: how to measure, monitor or to predict it and how to provide feedback on treatment change. The presentations starts with a historical overview of psychotherapy research, covering several approaches applied to a data-informed clinical practice. The focus will be on the impact of assessments and feedback into clinical practice, the tracking and prediction (with machine learning algorithms) of individual change, therapist differences, and continuous and discontinuous patterns of change within treatments as well as differences between treatments. A research program and treatment navigation system will be presented (the Trier Treatment Navigator), that investigates the change processes as well as progress and outcome on different levels of the psychotherapeutic endeavor. Such new treatment navigation systems allow the inclusion of individually tailored problem-solving strategies for treatment selection and adaptation, especially for those patients at risk for treatment failure. Furthermore, the integration and implementation of outcome measurement into clinical practice and training and its hurdles will be discussed.

Recommended readings:

Lutz, W., Schaffrath, J., Eberhardt, S. T., Hehlmann, M. I., Schwartz, B., Deisenhofer, A.-K., Vehlen, A., Vaccarezza Schürmann, S., Uhl, J., & Moggia, D. (2023). Precision Mental Health and Data-Informed Decision Support in Psychological Therapy: An Example. Administration and Policy in Mental Health and Mental Health Services Research. DOI: 10.1007/s10488-023-01330-6.

Lutz, W., Schwartz, B., & Delgadillo, J. (2022). Measurement-based and data-informed psychological therapy. Annual Review of Clinical Psychology. https://doi.org/10.1146/annurev-clinpsy-071720-014821

Lutz, W., Deisenhofer, A.-K., Rubel, J., Bennemann, B., Giesemann, J., Poster, K., & Schwartz, B. (2022). Prospective evaluation of clinical decision support system in psychological therapy. Journal of Consulting and Clinical Psychology. https://doi.org/10.1037/ccp0000642

Lutz, W., de Jong, K., Rubel, J., & Delgadillo, J. (2021). Measuring, Predicting and Tracking Change in Psychotherapy. In M. Barkham, W. Lutz, & L. G. Castonguay (Eds.), Bergin and Garfield`s Handbook of Psychotherapy and Behavior Change (7th ed.), (pp. 89-133),. New York, NY: Wiley.

Author: Joram Ronel, PD Dr. med., is head of the Department of Psychosomatic Medicine and Psychotherapy at the Clinic Barmelweid, one of the largest in-patient psychosomatic treatment centers in Switzerland. He has qualified in Internal Medicine as well as in Psychosomatic Medicine and is a psychoanalyst and group analyst. Joram is Associate Professor at the Technical University Munich, Germany, and Lecturer for Psychosomatic and Psychosocial Medicine, ETH Zurich, Switzerland. He was a member of the steering committee for the German national guidelines on functional disorders. Further research interests include psychocardiology and transgenerational transmission of extreme traumatization of Holocaust survivors.

Judith Gorgass is an actress from Munich, Germany. She graduated from the International Michael Chekhov School for Acting in 2001 and has been playing in over 50 theater productions. Since 2011 she belongs to the simulation actors team of the Technical University and Ludwig-Maximilians-University in Munich. She works with Joram in various workshops and trainings for health care professionals all over Europe.

Abstract:

Dealing with patients, who suffer from functional/somatoform (“bodily distress”) disorders is very often regarded as strenuous, unpopular and not very promising. This holds true for most groups of health professionals, regardless of their field, whether in a somatic or a mental-health setting.

There is a variety of well examined explanatory models to better understand bodily distress symptoms, which range from neurobiological to learning theories. However, in this workshop, principles of developmental psychology and psychodynamic comprehension are put in the forefront as relational challenges between the patient and health care professionals are often described as adverse and disappointing. Therefore, the aim of this workshop is to convey to the participants alternative approaches to transform these interactional irritations into a more integrated and creative encounter.

The workshop will be divided into two parts:

1.) An interactive input part that deals with the developmental mechanisms of how humans develop skills to distinguish between emotional and bodily suffering and what the consequences can be if this development is disrupted by traumatic impairments. Furthermore, attendees will learn a variety of basic intervention techniques to handle interactional irritations, stabilize and shape the relationship with the patient towards a beneficial experience.

2.) “Therapy lab”: Together with an experienced simulation actress, the attendees will be able to playfully apply the learnings and receive instant feedback from the workshop group and from a patients’ perspective. By means of this “stop and rewind”-technique, valuable experiences will be provided, which reach the core of the relational irritations of patients with functional/bodily distress symptoms.