title: Real-Time Monitoring of Psychotherapeutic Processes: Concept and Compliance.
abstract: OBJECTIVE
  The feasibility of a high-frequency real-time monitoring approach to psychotherapy is outlined and tested for patients' compliance to evaluate its integration to everyday practice. Criteria concern the ecological momentary assessment, the assessment of therapy-related cognitions and emotions, equidistant time sampling, real-time nonlinear time series analysis, continuous participative process control by client and therapist, and the application of idiographic (person-specific) surveys.
  
  
  METHODS
  The process-outcome monitoring is technically realized by an internet-based device for data collection and data analysis, the Synergetic Navigation System. Its feasibility is documented by a compliance study on 151 clients treated in an inpatient and a day-treatment clinic.
  
  
  RESULTS
  We found high compliance rates (mean: 78.3%, median: 89.4%) amongst the respondents, independent of the severity of symptoms or the degree of impairment. Compared to other diagnoses, the compliance rate was lower in the group diagnosed with personality disorders.
  
  
  CONCLUSIONS
  The results support the feasibility of high-frequency monitoring in routine psychotherapy settings. Daily collection of psychological surveys allows for the assessment of highly resolved, equidistant time series data which gives insight into the nonlinear qualities of therapeutic change processes (e.g., pattern transitions, critical instabilities).
authors.affiliation: Institute of Synergetics and Psychotherapy Research, Paracelsus Medical UniversitySalzburg, Austria; Department of Psychosomatics and Inpatient Psychotherapy, Christian Doppler University Hospital, Paracelsus Medical UniversitySalzburg, Austria; Faculty of Psychology and Educational Sciences, Ludwig Maximilians UniversityMunich, Germany.
authors.forename: Günter
authors.initials: G
authors.lastname: Schiepek
authors.affiliation: Institute of Synergetics and Psychotherapy Research, Paracelsus Medical UniversitySalzburg, Austria; Department of Psychosomatics and Inpatient Psychotherapy, Christian Doppler University Hospital, Paracelsus Medical UniversitySalzburg, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Aichhorn
authors.affiliation: Department of Psychosomatics and Inpatient Psychotherapy, Christian Doppler University Hospital, Paracelsus Medical University Salzburg, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Gruber
authors.affiliation: Complexity Research Vienna, Austria.
authors.forename: Guido
authors.initials: G
authors.lastname: Strunk
authors.affiliation: Institute of Psychoanalysis and Family Therapy Salzburg, Austria.
authors.forename: Egon
authors.initials: E
authors.lastname: Bachler
authors.affiliation: Institute of Synergetics and Psychotherapy Research, Paracelsus Medical UniversitySalzburg, Austria; Faculty of Psychology and Educational Sciences, Ludwig Maximilians UniversityMunich, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Aas
keywords: compliance; momentary ecological assessment; nonlinear dynamics; process-outcome research; real-time monitoring