[Opportunities and limitations of the synergy of psychotherapeutic interventions and neuromodulation within the framework of an enhanced psychotherapy approach].

backgroundPsychotherapy is a guideline-conform treatment approach for most mental disorders. Recently, neuromodulation techniques have also become established as independent approaches in the treatment of mental disorders. The concept of "enhanced psychotherapy" aims to expand proven evidence-based psychotherapeutic approaches through the mechanism-oriented integration of new treatment modules; however, the combination of neuromodulation and psychotherapeutic interventions is often understood as a general enhancement. Given the heterogeneous mechanisms of action, this perspective falls short and is only limitedly supported by the evidence. RESEARCH QUESTION: This article aims to provide a conceptual clarification of mechanism-based combination approaches. Enhanced psychotherapy is defined here as a targeted, synergistic combination of psychotherapeutic interventions with neuromodulation that promotes adaptive plasticity in specific neural networks.

conclusionParticularly promising are the combination of transcranial direct current stimulation (tDCS) with cognitive training paradigms and the principle of target engagement in repetitive transcranial magnetic stimulation (rTMS), although the evidence remains heterogeneous. The targeted use of complementary mechanisms of action rather than nonspecific combinations is crucial. This combination model should be further developed on a disorder-specific basis to improve the clinical application.