Figure 5. Prediction of cumulative abstinence probability during 4-year follow-up (Kaplan-Meier presentation). Interaction of the predictors personality disorder and chronicity

(analysis of extreme groups). Therapist rotation: a major element of OLITA Apart from the regained quality of life of these patients, the general health care cost reduction is enormous. How can we explain the unusual success of our very structured, intensive, and comprehensive long-term treatment? A major “mechanism of action” of OLITA seems to be the therapist rotation.107 Inhibitors,research,lifescience,medical This element of OLITA represents a revolution in psychotherapy. The fact that six to seven therapists are equally responsible for each patient translates the ordinary two-way relation between therapist and patient into a most efficient multiway therapeutic network. Therapists stick to the rules of the program and the ideas of alcoholism treatment realized within

the concept (congruence) and frequently repeat these rules and ideas (repetition). Thereby, a variety of individual Inhibitors,research,lifescience,medical therapists with a variety of different thoughts create a therapeutic atmosphere characterized by vivid and multifaceted variation. We hypothesize that these specific factors activate common factors of psychotherapy and that, as an element Inhibitors,research,lifescience,medical of OLITA, therapist rotation has a major contribution to its success. How can we prove efficacy in a psychotherapeutic setting? In contrast to pharmacological Inhibitors,research,lifescience,medical agents, psychotherapeutic effects are much more difficult to define or to measure. In addition, quality control for psychotherapy is widely missing. Therefore, and also to prove our hypotheses of how OLITA works, we have developed

the VideoAssisted Monitoring of Psychotherapeutic Processes in Chronic Psychiatric Disease (VAMP). This diagnostic measure is a standardized, manualized, and video-based observational system that Inhibitors,research,lifescience,medical focuses mainly on the patients’ behavior and makes it possible to assess treatment processes based on transcribed video recordings of therapy sessions.114 The scales evaluated in the VAMP are grouped into seven modules: (1) common psychotherapeutic factors; (ii) addictive behavior; (iii) disease concept; (iv) working atmosphere; (v) psychopathological symptoms; (vi) therapeutic alliance; and (vii) problem solving. A total until of 64 patients have been analyzed over the past 4 years using the VAMP. Each patient had 17 videotapes of psychotherapeutic sessions within the 2 years of OLITA recorded. These videos are the basis of both, a macroanalytical and a microanalytical evaluation of therapeutic processes and their influence on long-term outcome. An ongoing project explores the use of the VAMP in a prospective longitudinal study investigating (i) processes of change during the first year of OLITA; (ii) associations between therapeutic processes and Fulvestrant mw essential outcome variables (eg, abstinence, relapse, addiction severity, course of comorbidity, and neuropsychological regeneration).