ABSTRACT
RESUMO Este artigo relata a experiência de ensino da primeira disciplina no Brasil sobre a Prática da Psicologia Baseada em Evidências (PPBE), oferecida pelo Instituto de Psicologia da Universidade de São Paulo. O curso instruiu os alunos sobre os conceitos da PPBE, fontes de evidências primárias e secundárias, adequação da pergunta de pesquisa ao delineamento, delineamento experimental de caso único, estudos observacionais, ensaios clínicos randomizados e sobre a execução de revisões sistemáticas, com ou sem metanálise. É importante destacar que o desenvolvimento da disciplina oportunizou a reflexão sobre a importância da PPBE no âmbito clínico, acadêmico, institucional e na gestão de políticas públicas na saúde mental. Recomenda-se a inserção da disciplina na grade curricular dos cursos de graduação e pós-graduação na área da Psicologia.
ABSTRACT This article reports the experience of teaching the first course in Brazil on the Evidence-Based Practice in Psychology (EBPP), offered by the Institute of Psychology of the University of São Paulo. The course instructed students on the concepts of EBPP, primary and secondary sources of evidence, adequacy of the research question to the experimental design, single-subject design, observational studies, randomized controlled trials and implementation of systematic reviews with or without meta-analysis. It is noteworthy that the development of the discipline allowed reflections on the importance of EBPP in clinical, academic, institutional and public policy management on mental health. It is recommended the inclusion of EBPP course in the curriculum of undergraduate and graduate students in Psychology.
ABSTRACT
El suicidio constituye un problema de salud pública que tiene un gran impacto económico, social y psicológico a nivel mundial. Cada año se estima que mueren cerca de un millón de pers-nas en todo el mundo debido al suicidio. De lo anterior se desprende la importancia de contar con investigaciones empíricas que sustenten todo tipo de accionar en la problemática del suicidio, desde políticas en salud pública hasta tratamientos psicológicos. Dada la relevancia del tema, el estudio bibliométrico realizado tuvo como principal objetivo verificar la producción empírica sobre el suicidio en Argentina, haciendo especial énfasis en el lugar de la Psicología en dicha producción. Sintetizando, los resultados permiten concluir que la producción empírica sobre el suicidio en los principales países de Sudamérica es muy baja; más aún si se considera solamente a Argentina. Otra conclusión importante tiene que ver con la menor implicancia de la ciencia psicológica en el abordaje empírico del suicidio, comparando los aportes desde un enfoque médico. Estas conclusiones invitan a reflexionar sobre la necesidad de un mayor abordaje empírico del suicidio en la región, y particularmente en Argentina.
Suicide is a major problem of public health leading to great economic, social, and psychological costs worldwide. Around one million people die every year on the world due to suicide. Furthermore, suicide is responsible for half of violent deaths worldwide exceeding even the combination of deaths due to war or homicide. Taking into account the above, researchers around the world recommended concerted efforts to generate actions, research, and investigation with the objective of reduce risk to suicide. Therefore, evidence from empirical research supporting public health policies and psychological treatments is needed. The present article introduces a bibliometric study aimed to examine the state of empirical research on suicide in Argentina, and specially the amount of psychological empirical research. Specifically, research methodology consists of the following aspects: As regards the criteria of inclusion / exclusion of articles, the search focused on the detection of empirical suicide articles. In this sense, the main criterion for inclusion in the analysis was based on studies that have been published or were being published in scientific journals. For the aforementioned reasons, they were excluded from this study theoretical article, books, book chapters, theses, and conference presentation. Also, those articles that used the term suicide to address problems outside the addressed (e.g., Suicide Gene Therapy) were excluded from the analysis. In relation to the search strategy, the main database used has been Scopus, which maintains a leading position among bibliographic databases. In this sense, the journals included in the database have very high quality standards. The two principal terms used in the search have been suicide and suicidal. The selection of these two words is because account for the main variables involved in suicide, as expressed in terms such Suicide attempt, Suicidal act, Suicidal behavior and Suicide ideation. The full search term applied in SCOPUS is transcribed below: TITLE (suicide) OR TITLE (suicidal) AND NOT TITLE (suicidal gene) AND NOT TITLE (gene therapy) AND NOT TITLE (suicidal dna) AND NOT TITLE (suicide dna) AND NOT TITLE (suicide drugs) AND NOT TITLE (eryptosis) AND NOT TITLE (streptococcus pneumoniae) AND NOT TITLE (assisted suicidal) AND NOT TITLE (assisted suicide) AND NOT TITLE (iron suicide) AND NOT TITLE (proton suicide method) AND LIMIT-TO (DOCTYPE, "ar") OR LIMIT-TO (DOCTYPE, "re") OR LIMIT-TO (DOCTYPE,"ip"). Other databases consulted were LILACS and PUBMED. PUBMED is open access and is the main database of health sciences in the world, produced by the National Library of Medicine in the United States. These bases were mainly used to supplement the data obtained by SCOPUS and specifically, were used to achieve a broader and more complete picture of empirical studies on suicide, carried out specifically in Argentina. LILACS search term used was suici$ (Argentina). In PUBMED search term used was suici* (Argentina). The sign * and $ were used to retrieve words of the same family, such as suicide or suicidal. Finally, for the calculation of bibliometric indicators we took into account the suggestions given in the international literature. Thus, the following descriptive data were analyzed: number of items by country, number of items by country depending on the year, international collaboration of , considering year too, language of publication of articles, and thematic areas involved. Results show that scientific literature concerning suicide in South America is limited, even more in Argentine. Moreover, most research in suicide is based on medical rather than psychological approach. Indeed, regarding the number of publications (f = 443) in South American countries, they only represent 1.49% of the articles published worldwide. The scientific research on suicide is even more critical in Argentina. Specifically, when considering publications on Scopus, LILACS and PUBMED, empirical research in this country represents only 1.41% of the extant literature on suicide. However, in recent years there have been an increasing number of publications from which may reflects a burgeoning interest in this topic. Results also indicate a greater collaboration between Argentina and other countries, particularly United States, as indicated by co-authorship studies (f = 6). Surprisingly, collaboration with (main producer of scientific articles in the South American region) is scarce (f = 2). Finally, take into account publications from in research data bases analyzed (Scopus, LILACS, and PUBMED) we note that most research on suicide has been published in medical journals (f = 30;71.42%), while a lower number of articles has been published in psychological journals (f = 5; 1.19%).Globally, these results claim for more empirical research in suicide from psychologist, particularly in Argentina.
ABSTRACT
Actualmente, y tras una larga historia de desarrollo y evolución, la psicoterapia es un campo en el que se presentan diferentes modelos de intervención, donde cada uno busca obtener un reconocimiento propio y su respectiva promoción. Ante esto, se plantea inicialmente la cuestión acerca de la utilidad de los modelos y que estos ofrezcan realmente resultados, haciéndose urgente contar con indicadores de eficacia respecto a los tratamientos empleados. En ese sentido, un paso importante ha sido la consolidación de los Tratamientos Psicológicos Eficaces (Chambless & Hollon, 1998), y más importante aún la meta de instaurar una Psicología Clínica Basada en la Evidencia (Spring, 2007). El presente artículo hace un análisis y revisión de esta propuesta, destacando la necesidad de adoptarla a favor de la coherencia con la idea de la psicología como ciencia; por otro lado también se describen las críticas o limitaciones planteadas, así como respuestas documentadas ante las mismas, considerando los retos futuros a los que conllevan para el avance de la psicología clínica y de la psicoterapia.
Currently, and after a long history of development and evolution, psychotherapy is a field where different models of intervention meet together, and everyone wants to obtain its own recognition and promotion. Considering this, it is contemplated the problem with the usefulness of the models and if them really present results, making the urgency of have an efficacy indicator of the treatments in use. In that sense, an important advance was the consolidation of the Efficacy of Psychological Treatments (Chambless & Hollon, 1998), and even more important the target of establish an Evidence-based Clinical Psychology (Spring, 2007). In this paper, it is made an analysis and review of this proposal, emphasizing the need of adopt it supporting the coherence with the idea of psychology as a science. What is more, it is described the criticism or the limitations of this point of view and some informed responses to them, considering the future challenges in the advance of clinical psychology and psychotherapy.
ABSTRACT
Tradicionalmente, a escolha pelo tipo de intervenção psicoterápica para diferentes quadros clínicos depende fundamentalmente da experiência profissional do terapeuta e de sua predileção por determinadas estratégias clínicas. Todavia, esse cenário tem se modificado no contexto da prática baseada em evidências. Apesar do extenso e acalorado debate na literatura internacional da Psicologia nos últimos anos, o tema da prática baseada em evidências tem sido pouco discutido na Psicologia brasileira. Em vista disso, este artigo tem por objetivo apresentar o paradigma de prática baseada em evidências em Psicologia sob uma perspectiva histórica, enfatizando o embate entre os diferentes posicionamentos sobre o assunto e os esforços da American Psychological Association em elaborar um modelo representativo das diversas perspectivas teóricas, metodológicas, conceituais e práticas com o intuito de preencher a lacuna entre ciência e prática ainda existente na Psicologia Clínica. Espera-se que este artigo possa contribuir para uma maior participação da Psicologia brasileira nesse movimento.
Traditionally, the choice of the type of psychotherapeutic intervention for various clinical conditions fundamentally depends on the professional experience of the therapist and his/her predilection for certain clinical strategies. However, this scenario has been changing in the context ofevidence-based practice. Despite the extensive and heated debate in international psychology literature over the past few years, evidence-based practice has been scarcely discussed in Brazilian Psychology. Hence, this article aims at introducing the paradigm of evidence-based practice in psychology from a historical perspective, with particular emphasis on the clash between the different positions on the issue. It also focuses on the efforts of the American Psychological Association to design a model that is representative of various theoretical, methodological, conceptual, and practical perspectives in order to bridge the gap between science and practice that still exists in clinical Psychology. This article seeks to contribute to a greater participation of Brazilian psychology in this movement.
Tradicionalmente, la elección del tipo de intervención psicoterapéutica para diversas condiciones clínicas depende fundamentalmente de la experiencia profesional del terapeuta y de su predilección por determinadas estrategias clínicas. Sin embargo, este escenario ha ido cambiando en el contexto de lapráctica basada en la evidencia. A pesar del debate extenso y arduo en la literatura internacional de la psicología en los últimos años, el tema de la práctica basada en la evidencia ha sido poco discutido en la Psicología brasileña. En vista de ello, este artículo tiene como objetivo presentar el paradigma de la práctica basada en la evidencia en la psicología desde una perspectiva histórica, haciendo hincapié en el choque entre las diferentes posiciones sobre el tema y los esfuerzos de laAmerican Psychological Association para desarrollar un modelo representativo de las distintas perspectivas teóricas, metodológicas, conceptuales y prácticas con el fin de rellenar la brecha entre la ciencia y la práctica aún vigente en Psicología clínica. Se espera que este artículo permita contribuir para una mayor participación de la psicología brasileña en este movimiento.
Subject(s)
Humans , Evidence-Based Practice , Psychology, Clinical , PsychotherapyABSTRACT
La Psicología Basada en la Evidencia resultaría incompleta si no indagara el rol de la relación terapéutica. No obstante la ausencia de instrumentos adaptados obstaculiza el desarrollo de estudios empíricos en el contexto local. Este trabajo tuvo por objetivo principal adaptar la versión para pacientes del Cuestionario de Alianza de Ayuda Revisado (HAq-II). A su vez, como objetivo adicional se efectuó una comparación de tres modelos teóricos de alianza terapéutica. De esta manera, luego de traducir los ítems y evaluar la equivalencia mediante un panel de expertos se administró el HAq-II a una muestra de 119 participantes que se encontraban en tratamiento psicoterapéutico breve. Los resultados del análisis factorial confirmatorio sugieren un modelo subyacente de dos dimensiones: vinculo positivo con el terapeuta (alfa = .70) y acuerdo con los objetivos y tareas (alfa = .71). Cabe destacar que dicho modelo integra coherentemente las teorías propuestas por Luborsky y Bordin.
Evidence-based psychology would be incomplete if the role of the therapeutic relationship was not investigated. However, the absence of adapted instruments impedes the development of empirical studies in the local context. The principal objective of this work was to adapt the patient version of the revised helping alliance questionnaire (HAq-II). As an additional objective a comparison of three theoretical models of therapeutic alliance was carried out. After translating the items and evaluating their equivalency via a panel of experts, the HAq-II was administered to a sample of 119 participants undergoing brief psychotherapy. The results of the confirmatory factorial analysis suggest an underlying model of two dimensions: positive bond with the therapist (alpha = .70) and goal and task agreement (alpha = .71). It should be noted that this model fits coherently with the theories proposed by Luborsky and Bordin.