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The psychoanalytic societies in Germany as in many other countries are concerned by a decline in the number of candidates for full psychoanalytic training. While this situation is partly attributable to changes both in society and in educational and healthcare systems, it is questionable whether psychoanalytic training institutions have yet found adequate responses to it. Under the banner of 'evidence-based treatment', behaviour therapy has come to be widely disseminated, with major implications for the teaching of different psychotherapy paradigms at universities. To investigate the determinants of this trend in the specific German situation, a large-scale, multi-method exploratory study supported by IPA's DPPT programme was undertaken, focusing on the reasons given by a population (N = 679) of German psychology, medical, and education students for embarking on training in psychoanalysis or behaviour therapy. The results suggest that behaviour therapy is more compatible with the prevailing scientific understanding and with current societal and cultural trends, owing in part to inadequacies or bias in university teaching of the various paradigms of psychotherapy. While most of the psychology students expressed a preference for behavioural training, the psychotherapy option proved less attractive for their counterparts in the fields of medicine and education. Semi-standardized qualitative interviews were used to gain a deeper understanding of the students' decisions for or against training in a specific paradigm, and led to the identification of seven decision-making prototypes. Possible reasons for the students' decisions are discussed, and concrete proposals and recommendations are presented.

The psychoanalytic societies in Germany as in many other countries are concerned by a decline in the number of candidates for full psychoanalytic training. While this situation is partly attributable to changes both in society and in educational and healthcare systems, it is questionable whether psychoanalytic training institutions have yet found adequate responses to it. Under the banner of 'evidence-based treatment', behaviour therapy has come to be widely disseminated, with major implications for the teaching of different psychotherapy paradigms at universities. To investigate the determinants of this trend in the specific German situation, a large-scale, multi-method exploratory study supported by 's programme was undertaken, focusing on the reasons given by a population (N = 679) of German psychology, medical, and education students for embarking on training in psychoanalysis or behaviour therapy. The results suggest that behaviour therapy is more compatible with the prevailing scientific understanding and with current societal and cultural trends, owing in part to inadequacies or bias in university teaching of the various paradigms of psychotherapy. While most of the psychology students expressed a preference for behavioural training, the psychotherapy option proved less attractive for their counterparts in the fields of medicine and education. Semi-standardized qualitative interviews were used to gain a deeper understanding of the students' decisions for or against training in a specific paradigm, and led to the identification of seven decision-making prototypes. Possible reasons for the students' decisions are discussed, and concrete proposals and recommendations are presented.

The psychoanalytic societies in Germany as in many other countries are concerned by a decline in the number of candidates for full psychoanalytic training. While this situation is partly attributable to changes both in society and in educational and healthcare systems, it is questionable whether psychoanalytic training institutions have yet found adequate responses to it. Under the banner of 'evidence-based treatment', behaviour therapy has come to be widely disseminated, with major implications for the teaching of different psychotherapy paradigms at universities. To investigate the determinants of this trend in the specific German situation, a large-scale, multi-method exploratory study supported by IPA's DPPT programme was undertaken, focusing on the reasons given by a population (N = 679) of German psychology, medical, and education students for embarking on training in psychoanalysis or behaviour therapy. The results suggest that behaviour therapy is more compatible with the prevailing scientific understanding and with current societal and cultural trends, owing in part to inadequacies or bias in university teaching of the various paradigms of psychotherapy. While most of the psychology students expressed a preference for behavioural training, the psychotherapy option proved less attractive for their counterparts in the fields of medicine and education. Semi-standardized qualitative interviews were used to gain a deeper understanding of the students' decisions for or against training in a specific paradigm, and led to the identification of seven decision-making prototypes. Possible reasons for the students' decisions are discussed, and concrete proposals and recommendations are presented.

Background The social integration of children with an immigrant background has become one of the most urgent social responsibilities in Germany. They are more likely to live in high-risk environments and are disadvantaged with respect to health related variables as well as educationally. Quite a number of projects supporting their integration into the German society exist although many are hardly scientifically evaluated. Most of them focus on the acquisition of German language and therefore address older children (and adults). However, international experts agree that social integration is not only a matter of language but also of earlier developmental processes of children in their first months of life connected to adequate early parenting. Methods/Design The model project FIRST STEPS focuses on earliest prevention for children with an immigrant background, supporting their parents in the critical phase of migration and early parenthood. In a prospective randomized comparison group design the effectiveness of a psychoanalytically oriented early prevention program (intervention A) is compared to the outcomes of groups offered by paraprofessionals with an immigrant background (intervention B). Intervention A is a professional offer supporting immigrant families based on developmental psychological and on knowledge on early parenting. 180 families are randomly assigned to intervention A or B. They are supported during the first 3 years of the children’s lives. Social and family stressors, the quality of the parent–child-interaction, child attachment security, the affective, cognitive and social-emotional development of the children and the social integration of the families are assessed during and after the intervention. Discussion The project aims at evaluating the implementation as well as the short- and long-term effectiveness of psychoanalytically oriented intervention A compared to the outcomes of intervention B. It is expected that professionally supported early parenting (intervention A) improves the social-emotional, cognitive and language development of immigrant children as well as the social integration of their families to a greater extent than in the comparison groups. In case the model project proves to be effective, a rollout across Germany is possible. Due to the “difficult-to-reach” immigrant families challenges in recruitment, uptake and retention of participants are anticipated. Trial registration DRKS-ID: DRKS00004632 , trial registration date: 05.02.2013

Zusammenfassung Angesichts eines steigenden Bedarfes psychotherapeutischer Leistungen gewinnt das Interesse Studierender an einer psychotherapeutischen Tätigkeit an Bedeutung. Gleichzeitig haben die psychoanalytischen Ausbildungsinstitute und Fachverbände einen Rückgang an Ausbildungsteilnehmenden zu verzeichnen. Psychologie-, Medizin- sowie Pädagogik- und Sozialpädagogikstudierende (Letztere nur im kinder- und jugendtherapeutischen Bereich) können in Deutschland eine kassenärztlich anerkannte Psychotherapieausbildung absolvieren; hierbei stehen ihnen verhaltenstherapeutische und psychodynamisch orientierte Ausbildungsgänge offen. Studierende dieser Studiengänge (n=679) wurden in dieser multimethodischen Querschnittstudie zu ihrem Interesse an einer psychotherapeutischen Ausbildung allgemein und, wenn vorhanden, zur von ihnen präferierten Ausbildungsrichtung befragt. Unter den Psychologiestudierenden würde der größte Teil derjenigen mit Interesse an einer psychotherapeutischen Ausbildung eine verhaltenstherapeutische wählen. Bei den Medizin- so wie den Pädagogik- und Sozialpädagogikstudierenden wird eine psychotherapeutische Weiterbildung generell eher selten in Betracht gezogen. In den pädagogischen Studiengängen sind mehr potenziell Weiterzubildende an psychodynamischen/psychoanalytischen Verfahren interessiert. Mögliche Gründe für die Entscheidungen der Studierenden werden im Kontext der spezifischen gesetzlichen Regelungen zur psychotherapeutischen Versorgung in Deutschland im Rahmen des Gesetzes über die Berufe des Psychologischen Psychotherapeuten und des Kinder- und Jugendlichenpsychotherapeuten (Psychotherapeutengesetz, PsychThG) diskutiert.

Zusammenfassung Im Rahmen der Diskussion um eine Reform der Psychotherapieausbildung stellt sich die Frage, welche Einflüsse bei Ärzten und Psychologen zur Entscheidung für eine bestimmte psychotherapeutische Ausbildung beitragen. In einer retrospektiven Querschnittstudie wurden 343 Kandidaten in analytischen, tiefenpsychologischen und verhaltenstherapeutischen Ausbildungsgängen mit einem teilstandardisierten Fragebogen zu ihren Motiven für die Ausbildung, zu generellen beruflichen Zielen und zur Zufriedenheit mit der Ausbildung befragt. Die Entscheidung der Kandidaten für einen bestimmten Ausbildungsgang war mit persönlichen Einstellungen und beruflichen Zielen, der Kenntnisvermittlung im Studium sowie der Studienrichtung verbunden. Die Befragten äußerten sich zum größten Teil unzufrieden mit der Qualität und Quantität der Darstellung psychotherapeutischer Verfahren im Studium. Kandidaten in analytischer Ausbildung äußerten sich insgesamt zufriedener mit ihrer Ausbildung und wünschten seltener die Aufnahme einer weiteren psychotherapeutischen Ausbildung als Kandidaten in verhaltenstherapeutischer Ausbildung. Die Konsequenzen der Ergebnisse insbesondere für die Studieninhalte (inhaltlich ausgewogenere und quantitativ ausreichende Darstellung psychotherapeutischer Verfahren in medizinischen und psychologischen Studiengängen) werden diskutiert.

Objectives: Against the background of insufficient medical care for patients with psychiatric and psychosomatic disorders it is important to ascertain the interests and attitudes of medical students towards mental disorders, psychotherapeutic treatment and training. Methods: Medical students (N = 366) in their clinical training were given half-standardized questionnaires about their attitudes towards psychotherapeutic treatments, their career plans, psychosocial distress and sociodemographic characteristics. Results: There was an overall high interest in psychological distress of patients and in psychotherapeutic treatment methods. Contrary to these findings, however, only few medical students were willing to specialize in psychosomatic medicine, psychiatry or psychotherapy. Psychosomatic and psychotherapeutic career choices were more frequent in women as well as in students who had experienced psychological distress themselves, and who had undergone psychotherapy, and who were less oriented toward economic success and careers. Conclusions: Medical students regarded psychological characteristics as generally interesting and important for medical care, but rarely considered specializing in these medical fields after graduation. Potential remedies (e.g., improved teaching of psychosocial competences and psychotherapeutic knowledge, career counselling) are discussed. Hintergrund und Fragestellung: Vor dem Hintergrund einer ärztlichen Unterversorgung von Patienten mit psychischen und psychosomatischen Erkrankungen gewinnt die Frage nach dem Interesse von Studierenden der Medizin für psychische Erkrankungen und ihren Einstellungen zu psychotherapeutischen Behandlungsverfahren beziehungsweise dem Erwerb des Facharzttitels in diesen Fachgebieten an Bedeutung. Methode: Studierende der Medizin (N = 366) im klinischen Ausbildungsabschnitt wurden mit teilstandardisierten Fragebögen zu ihren Interessen und Einstellungen gegenüber psychotherapeutischen Behandlungsverfahren, zu ihren beruflichen Plänen, zu psychischen und sozialen Belastungen sowie soziodemographischen Basisdaten befragt. Ergebnisse: Insgesamt wurde von den Studierenden ein hohes Interesse an seelischen Problemen von Patienten und an psychotherapeutischen Behandlungsverfahren angegeben. Demgegenüber steht eine geringe Bereitschaft zu einer späteren Facharzttätigkeit im Gebiet Psychosomatische Medizin und Psychotherapie. Überlegungen zu einer späteren beruflichen Tätigkeit in diesem Bereich wurden häufiger von Frauen sowie von Personen mit psychischen Belastungen, Behandlungsvorerfahrungen und geringen ökonomischen beziehungsweise Karriereinteressen geäußert. Diskussion: Studierende der Medizin betrachten psychische Faktoren zwar als interessant und wichtig in der Behandlung ihrer zukünftigen Patienten, ziehen aber nur selten in Betracht, später in diesem Bereich tätig zu werden. Mögliche Lösungsansätze (bessere Vermittlung psychosozialer Kompetenzen und Kenntnisse über psychotherapeutische Verfahren und Karrierechancen) werden diskutiert.

The integration guides are working on a voluntary basis, whereby it needs to be mentioned that the kind of employment as well as the connection to the Sigmund-Freud-Institut has a different quality than that of the intervention group. Project staff regularly presents the project in the integration courses and is informed by the integration course teachers when a woman is pregnant in order to contact her as soon as possible. In 2010, forty-eight percent of children living in families with an immigrant background grew up exposed to at least one situation of risk such as unemployed, low income earning or educationally disadvantaged parents. The curriculum's conceptualisation closely refers to other existing psychoanalytical oriented parenting programmes. Preliminary insights and evaluation of mothers' social stressors show that particularly their socioeconomic situation and problems of residency and citizenship of the newborn often occupy their minds.