How do licensed psychotherapists in Germany feel about treating patients with posttraumatic stress symptoms? – an experimental study based on case vignettes

Figures & data

Figure 1. Examples of case vignettes – 14-year-old boy with externalizing or internalizing PTSD symptoms

Table 1. Demographic information about the participating LPTs

Variable	N = 768
	n	M	SD	Mdn	Min	Max
Age (years)	767	48.4	11.2	48	28	80
Licenced for (years)	761	11.9	8.5	10	0	50
Own practice for (years)	595	11.5	9.8	8	0	40
Employed by a clinic/hospital since (years)	148	9.2	8.5	6	0	40
Therapy sessions per week	766	21.5	8.2	22	0	50

Table 2. Demographic information about the participating LPTs

Variable	N=768		Variable	N=768
	n	%		n	%
Type of license			German Federal State
Psychotherapist for children and adolescents	172	22.5	BW	62	8.1
			BY	130	16.9
Psychological psychotherapist	463	60.3	BE	48	6.3
PP also licensed for treating children and adolescents	82	10.7	BB	22	1.4
			HB	59	7.7
Medical psychotherapist	49	6.5	HH	19	2.5
Other	2	0.3	HE	37	4.8
Working in own practice			MV	7	0.9
Own practice	599	78.0	NI	108	14.1
No own practice	165	21.5	NW	171	22.3
Not specified	4	0.5	RP	29	3.8
Working in a clinic/hospital			SL	5	0.7
Clinic/hospital	155	20.2	SN	9	0.3
No clinic/hospital	506	65.9	SH	67	1.2
Not specified	107	13.9	ST	2	8.7
			TH	4	0.5
Approved for public health care insurance			Therapeutic approach
Approved	616	80.2	CBT	479	62.3
Not approved	152	19.8	PDT	241	31.4
Majority of patients			Multiple (including n = 29 with ST)	46	6.0
Under 18 years (<18)	187	24.3	Different	3	0.3
Over 18 years (≥18)	581	75.7
Specific training			Gender
Trauma therapy (incl. EMDR)	311	40.5	Female	564	73.4
Other (e.g. Ego State, ACT, PMR)	359	46.7	Male	203	26.4
None or no specification	98	12.8	Diverse	1	0.2

Abbreviations: LPT – Licenced psychotherapist, CBT – Cognitive Behavioural therapeutic approach, PDT – Psychodynamic therapeutic approach (including psychoanalysis & depth psychology), ST – Systemic therapeutic approach, EMDR – Eye Movement Desensitization and Reprocessing, ACT – Acceptance and commitment therapy, PMR – Progressive Muscle Relaxation, German federal states (BW – Baden-Wuerttemberg, BY – Bavaria, BE – Berlin, BB – Brandenburg, HB – Bremen, HH – Hamburg, HE – Hesse, MV – Mecklenburg Western Pomerania, NI – Lower Saxony, NW – North Rhine-Westphalia, RP – Rhineland Palatinate, SL – Saarland, SN – Saxony, SH – Schleswig Holstein, ST – Saxony-Anhalt, TH – Thuringia).

Table 3. Descriptive statistics of all relevant dependent variables

Variable		N = 768
	n	M	SD	Mdn	Min	Max
Case example – Readiness to treat	690	79.9	22.0	87	0	100
Case example – Fears/doubt about treatment	642	24.9	22.7	17	0	100
Case example – Objective barriers	625	20.5	22.3	11	0	100

Table 4. Results of the ANOVA for LPTs’ readiness to treat the case patient based on patients’ characteristics (age, gender, symptoms)

Variable	SS	MS	F	p	Partial η^2
age^a,b (<18 years; >18 years)	7097.94	7097.94	15.06	<.001	.022
gender^b (female; male)	333.87	333.87	.71	.40	.001
symptoms^b (internalizing; externalizing)	1284.56	1284.56	2.73	.10	.004
age x gender^b	353.11	353.11	.75	.39	.001
age x symptoms^b	1351.08	1351.08	2.87	.09	.004
gender x symptoms^b	149.54	149.54	.32	.57	<.001
age x gender x symptoms^b	1164.54	1164.54	2.47	.12	.004

Model: F(7, 682) = 4.01, p < .001, adjusted R² = 0.03.

Abbreviations: SS = sum of Squares. MS = mean square. df = degrees of freedom.

^aPredominantly treated age group (binary: psychotherapists for adults or for children and adolescents).

^bdf = 1; 682

Figure 2. Descriptive results for LPTs’ readiness to treat the case patient based on the following patients’ characteristics: patients’ age (<18 years vs. >18 years), gender (male vs. female), PTSD symptoms (externalizing vs. internalizing)

Table 5. Final hierarchical regression model for LPTs readiness to treat the case patient

	Perceived competence
	B (SE)	p	standardized beta	R^2	R^2 Change	F	p
Intercept	100.51 (5.04)	< .001
First Block				.047	.047	3.12	.002
Age of LPTs	−.23 (.12)	.063	−.12
Trauma-specific training	−4.56 (21.77)	.010	−.10
Gender (male)	1.58 (1.98)	.425	.03
Number of therapy session per week	−.02 (.10)	.834	−.01
Therapeutic approach (psychodynamic)	−.70 (1.96)	.719	−.02
Years since licensure	.08 (.16)	.607	.03
Second Block				.279	.232	19.65	<.001
Self-perceived fears/doubts	−.44 (.04)	<.001	−.45
Self-perceived objective barriers	−.12 (.04)	.002	−.12