CBASP – eine evidenzbasierte und praxisorientierte Einführung

Das Cognitive Behavioral Analysis System of Psychotherapy (CBASP) ist die bislang einzige störungsspezifische Psychotherapie, welche sich mit den psychopathologischen Besonderheiten von Patient*innen mit chronischen Depressionen befasst. Dieser Beitrag will die Ergebnisse der bisher erfolgten Forschung zu CBASP übersichtlich und für die praktische Anwendung komprimiert zusammenfassen und die Anwendung des CBASP-Verfahrens anhand eines Beispiels veranschaulichen.

Kernaussagen

• Die chronische Depression (DSM-5: Persistierende depressive Störung) stellt eine häufige Verlaufsform depressiver Erkrankungen dar.

• Chronische Depressionen unterscheiden sich im Verlauf der Erkrankung, der Psychopathologie sowie im Ansprechen auf eine Behandlung von episodischen Verlaufsformen der Depression.

• Das Cognitive Behavioral Analysis System of Psychotherapy (CBASP) stellt eine spezifische Behandlungsform der chronischen Depression dar und wird aufgrund mehrerer positiver RCT in verschiedenen Behandlungsleitlinien zur Behandlung der chronischen Depression empfohlen.

• In den letzten Jahren konnten in diversen Studien spezifische Merkmale für psychologische Funktionsdefizite bei Patient*innen mit einer chronischen Depression identifiziert werden: Hierzu gehören das sogenannte präoperatorische Denken, möglicherweise eine mangelnde Empathiefähigkeit sowie ein verschlossenes und distanziertes interpersonelles Verhalten, welche gemeinsam mit widrigen Kindheitserfahrungen in einer komplexen Interaktion stehen.

• Im CBASP werden diese Funktionsdefizite mit spezifischen Techniken (wie z.B. der Situationsanalyse, dem Kiesler-Kreis, der kontingenten persönlichen Rückmeldung und der interpersonellen Diskriminationsübung) adressiert. Veränderungen in diesen Bereichen korrelieren dabei teilweise mit einer Verbesserung der depressiven Symptomatik.

• CBASP scheint besonders gut wirksam (auch im Vergleich zu anderen Psychotherapieverfahren) bei belastenden Kindheitserfahrungen, komorbider sozialer Angststörung sowie einem submissiven Interaktionsverhalten.

Schlüsselwörter

Chronische Depression - persistierende depressive Störung - soziale Kognition - belastende Kindheitserfahrungen - Psychotherapie

Publication History

Article published online:
18 July 2022

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