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S C HW E R P U N K T 22 Sepsis is the most frequent cause of death among infectious diseases. Those having survived it not only suffer from considerable physical impairments, also their mental health is impaired because of the experience of a life-threatening disease and intensive care. The experiences change the patient’s life and that of the partner. A therapy is often inevitable to overcome the experiences. One of the projects at the Center for Sepsis Control and Care (CSCC) aims to help the persons affected by offering them an Inter- net-based writing therapy. The treatment »zwei leben« is accompanied by a study examining its efficacy. More about the project and the therapy in the following interview with the psychologists PD Dr Jenny Rosendahl (project manager) and Romina Gawlytta (project coordinator). »We take the therapy to the patient« INTERVIEW: JULIANE DÖLITZSCH In Jena, the research on sepsis is rather intensive at the moment. Your project was launched in February 2016. Could you explain your approach please? Rosendahl: As part of our research at the CSCC, we have been dealing with the psychological long-term consequences of those who had survived sepsis. Some of these consequences are, for instance anxiety, depression, adjustment disor- der, and post-traumatic stress disorder (PTSD). This may occur as a psychologi- cal response to an extremely overwhel- ming event, i.e. a trauma. For example, a trauma may be a traffic accident or experiencing violence, but also a death threat in extreme medical cases. For many, the helplessness encountered then is inescapable. What are the effects of PTSD? Gawlytta: Patients often have nightma- res, they experience flashbacks and in- trusions reminding them of intensive care. They also suffer from sleep distur- bances or may have a lack of concentra- tion. As a result, the quality of life may be reduced and they may encounter an enormous emotional stress frequently. Most of them are not able to overcome the experiences without professional as- sistance. What is new about the project? Rosendahl: In our study, we examine the efficacy of the Internet-based writing therapy which is applied after intensive care of a critical illness. In this regard, we apply a new approach: the partners of our patients participate in the treat- ment actively, too, and are being trea- ted themselves if they also suffer from PTSD. If the partners are not affected, they still receive information on the the- rapy and attend the first telephone in- terview. This is reflected in the project’s name zwei leben; firstly, it is about both partners, secondly, the patients often consider their life after intensive care as their second chance. So the partners could also be affected, couldn’t they? Gawlytta: Yes, some of the partners are also affected due to their experiences. While the patients are in a life-threate- ning condition over a period of sever- al days or even weeks the partners are also in a stressful situation. They do not know whether their partner will still be alive when they will be back for a visit in the hospital. Sometimes they fear the situation when they have to decide whether the life-sustaining me- dical devices should be switched off or not. Many of the partners still deal with these memories even weeks or months after their partner has already left the in- tensive care unit. How many patients suffer from PTSD? Rosendahl: The numbers vary depending on the respective study. Generally, every fifth patient with sepsis and every fifth partner suffers from PTSD. If the pati- ents themselves are affected by PTSD, often their partners are affected, too. They share the same fate, yet from two perspectives. How does your project help them? Rosendahl: After being affected by sep- sis, the patients are discharged even if they still have residual symptoms. The process of physical recovery often evokes negative memories. As a conse- quence, a trauma therapy is necessary. However, long waiting times and great distances, particularly in the country- side, often hinder the patients. We the- refore offer an Internet-based writing therapy and take the therapy to the pati- ent. In recent years, psychological treat- ment via the Internet has become an important treatment method. Various research projects have been working on its improvements. In comparison to the common face-to-face psychothera- py, the therapist and the patient are in contact with each other via computer. What are the advantages of the Inter- net-based writing therapy? Rosendahl: In particular it is the fact that it can take place everywhere and at any time. Patients do not have to wait for a therapy as it is common to the face- to-face therapy and can plan their wri- ting sessions at home easily instead. Especially for disabled persons it is a real benefit. In addition, some patients may become more accessible since they do not have to sit in front of their the- rapist. For some of them, it may be ea- sier to write about feelings of guilt and shame. The project »zwei leben« is a coopera- tion project – with whom do you work? Rosendahl: On site, we cooperate with an