Terapia Cognitivo-Comportamental em Grupo: Estratégia de Psicoeducação com Estudantes de Enfermagem / Group Cognitive Behavioral Therapy: Strategy for Psychoeducation with Nursing Students / Terapia Cognitivo-Conductual en Grupo: Estrategia para la Psicoeducación con Estudiantes de Enfermeira

Este estudo teve por objetivo apresentar os resultados de um grupo psicoterápico psicoeducativo desenvolvido junto a estudantes de Enfermagem. Foram realizados seis encontros com cinco estudantes de uma universidade pública do Estado de São Paulo. Os encontros foram audiogravados, transcritos e submetidos à análise temático-reflexiva. Os resultados encontrados permitiram a construção de cinco categorias temáticas: (1) Desafios da adaptação ao ensino superior; (2) Concepções sobre saúde mental na universidade; (3) Autocuidado e equilíbrio entre a vida universitária e pessoal; (4) Relações interpessoais e vida universitária; (5) Perspectivas e expectativas sobre a formação. O processo de integração à universidade requer mobilização cognitiva, afetiva e social, sendo que as relações com os pares, professores e familiares foram destacadas como importantes para essa adaptação. As participantes destacaram conhecer a importância do cuidado em saúde mental, mas admitiram dificuldades de promoverem o autocuidado. O espaço grupal foi utilizado como ambiente de escuta, estabelecimento de vínculo e autocuidado. Os grupos psicoeducativos demonstraram ser importantes para a construção de estratégias de enfrentamento e um espaço para o acolhimento de demandas que emergem nessa etapa do desenvolvimento.

This study aimed to present the results of a psychoeducational psychotherapy group developed with Nursing students. Six meetings were held with five students from a public university in the state of São Paulo. The meetings were audio-recorded, transcribed and submitted to a reflexive-thematic analysis. The results found allowed the construction of five thematic categories: (1) Challenges of adapting to higher education; (2) Conceptions about mental health at the university; (3) Self-care and balance between university and personal life; (4) Interpersonal relationships and university life; (5) Perspectives and expectations about training. The process of integration into the university requires cognitive, affective and social mobilization, and relationships with peers, teachers and family members were highlighted as important for this adaptation. The participants highlighted knowing the importance of mental health care, but also admitted difficulties in promoting self-care. The group space was used as a listening environment, bonding and self-care. Psychoeducational groups proved to be important for the construction of coping strategies and a space for the reception of emerging demands.

Este estudio tiene como objetivo presentar los resultados de un grupo de psicoterapia psicoeducativa desarrollado con estudiantes de Enfermería. Se realizaron seis reuniones con cinco estudiantes de una universidad pública del Estado de São Paulo. Las reuniones fueron grabadas en audio, transcritas y sometidas a un análisis temático-reflexivo. Los resultados encontrados permitieron la construcción de cinco categorías temáticas: (1) Desafíos de la adaptación a la educación superior; (2) Concepciones sobre la salud mental en la universidad; (3) Auto cuidado y conciliación de la vida universitaria y personal; (4) Relaciones interpersonales y vida universitaria; (5) Perspectivas y expectativas sobre la formación. El proceso de integración universitaria requiere de una movilización cognitiva, afectiva y social, y las relaciones con pares, docentes y familiares son importantes para la adaptación. Los participantes destacan conocer la importancia del cuidado de la salud mental, pero admiten que tienen dificultad para promover el auto cuidado. El espacio grupal fue utilizado como ambiente de escucha, vinculación y auto cuidado. Los grupos psicoeducativos demostraron ser importantes para la construcción de estrategias de afrontamiento y un espacio de recepción de demandas emergentes.

Efetividade das terapias em grupo na qualidade de vida de pacientes com fibromialgia: uma revisão sistemática / Effectiveness of group therapies on the quality of life of patients with fibromyalgia: a systematic review

Introdução: A fibromialgia é uma síndrome dolorosa muito comum na prática clínica, caracterizada, principalmente, por dor musculoesquelética crônica e generalizada, bem como fadiga, rigidez articular e distúrbios do sono. No entanto, possui uma apresentação clínica bastante vasta e heterogênea, comprometendo diversas esferas da vida dos pacientes. O objetivo foi verificar a efetividade das terapias em grupo na qualidade de vida dos pacientes fibromiálgicos. Método: Trata-se de uma revisão sistemática, a qual buscou analisar as pesquisas relacionadas ao tema entre 2010 e 2020. A busca dos artigos ocorreu na BVS nas bases de dados LILACS e MEDLINE, sendo incluídos apenas artigos originais disponíveis na íntegra. Resultados: Foram encontradas 86 publicações científicas e, após exclusão de duplicados, aplicação de filtros e análise inicial, foram selecionados 6 artigos para compor o corpo amostral. Posteriormente, os artigos foram agrupados de acordo com a sua temática central em: 1) Efeitos positivos da terapia interdisciplinar em grupo nos sintomas físicos e psicossociais da fibromialgia; 2) Empoderamento do paciente no enfrentamento da fibromialgia; e 3) Qualidade da assistência profissional e a rede de apoio social da terapia em grupo. Conclusão: Verificou-se que a aplicação das terapias em grupos impactou, positivamente, a qualidade de vida dos pacientes em sua dimensão física, psicoemocional e social. Além disso, concluiu-se que incluir o paciente como protagonista do seu tratamento e construir uma rede de apoio são fundamentais para o enfrentamento da doença. [au]

Introduction: Fibromyalgia is a very common pain syndrome in clinical practice, characterized mainly by chronic and generalized musculoskeletal pain, as well as fatigue, joint stiffness and sleep disorders. However, it has a very wide and heterogeneous clinical presentation, compromising several spheres of patients' lives. The objective was to verify the effectiveness of group therapies on the quality of life of fibromyalgia patients. Method: This is a systematic review, which sought to analyze research related to the topic between 2010 and 2020. The search for articles took place in the VHL in the LILACS and MEDLINE databases, including only original articles available in full. Results: 86 scientific publications were found and, after exclusion of duplicates, application of filters and initial analysis, 6 articles were selected to compose the sample body. Subsequently, the articles were grouped according to their central theme in: 1) Positive effects of interdisciplinary group therapy on the physical and psychosocial symptoms of fibromyalgia; 2) Empowerment of the patient in coping with fibromyalgia; and 3) Quality of professional assistance and the social support network of group therapy. Conclusion: It was found that the application of therapies in groups positively impacted the quality of life of patients in their physical, psycho-emotional and social dimensions. In addition, it was concluded that including the patient as the protagonist of their treatment and building a support network are essential for coping with the disease. [au]

As vozes dos usuários participantes de grupos de ouvidores de vozes / Voices of users participating in voice hearing groups / Voix d'utilisateurs participant à des groupes entendeurs de voix / Las voces de los usuarios que participan en grupos de oyentes de voz

O objetivo deste artigo é investigar as vivências e possíveis efeitos da participação em grupos de Ouvidores de Vozes. Trata-se de um estudo qualitativo com participantes acima de 18 anos, que concordaram em fazer parte do estudo e frequentaram os grupos por um período mínimo de três meses. Foram realizadas 14 entrevistas até obtenção de saturação em grupos de Centros de Atenção Psicossocial, em seguida transcritas e analisadas usando a hermenêutica Gadameriana. A análise evidenciou cinco núcleos argumentais: a chegada no grupo; modo de funcionamento; uso de medicamentos; sentidos e efeitos. Demonstrou-se que os grupos podem ser uma das estratégias de cuidado e recuperação dos indivíduos, permitindo com que as suas experiências sejam reconhecidas e ressignificadas, promovendo, além da melhora clínica, acolhimento, compartilhamento entre pares e socialização.

This qualitative study investigates the experiences and possible effects of taking part in Voice-hearing Groups. Participants over the age of 18 who agreed to participate and attended the groups for at least 3 months were included in the research. Fourteen interviews were carried out in groups at Psychosocial Support Centers until saturation, and then transcribed and analyzed using Gadamerian hermeneutics. The analysis highlighted five argument cores: arrival in the group; mode of operation; use of medication; and meanings and effects. Results shown that these groups can be a strategy for the care and recovery of individuals, allowing their experiences to be recognized and reframed, promoting clinical improvement, user embracement, sharing among peers, and socialization.

Cette étude qualitative examine les expériences vécues et les effets possibles de la participation à des groupes d'entendeurs de voix. Les participants âgés de plus de 18 ans qui ont accepté de participer et ont participé aux groupes pendant au moins trois mois. Quatorze entretiens ont été réalisés dans des centres de soutien psychosocial jusqu'à saturation, puis transcrits et analysés selon l'herméneutique gadamérienne. L'analyse a mise en évidence cinq noyaux thématiques: l'arrivée dans le groupe; le mode de fonctionnement; l'utilisation de médicaments; les significations et les effets. Les résults montrent que ces groupes peuvent constituer une stratégie de soins et de rétablissement pour les individus, permettant de reconnaître et de recadrer leurs expériences, favorisant l'amélioration clinique, l'adhésion des utilisateurs, le partage entre pairs et la socialisation.

El objetivo de este artículo es identificar las experiencias y los posibles efectos de la participación en los Grupos de Oyentes de Voces. Se trata de un estudio cualitativo con participantes mayores de 18 años, que aceptaron participar del estudio y asistieron al grupo durante al menos tres meses. Se realizaron 14 entrevistas hasta que se obtuvo la saturación en grupos de Centros de Apoyo Psicosocial, luego se las transcribieron y analizaron utilizando la hermenéutica gadameriana. El análisis mostró cinco focos de discusión: la llegada al grupo; el modo operativo; el uso de medicamentos; y los sentidos y efectos. En cuanto a los resultados, se ha demostrado que los grupos pueden ser una de las estrategias de atención y recuperación de los individuos, permitiendo que sus experiencias sean reconocidas y replanteadas, y promoviendo la acogida del usuario, el intercambio entre pares y la socialización, además de la mejora clínica.

Cognitive-behavioral group therapy for women with hypoactive sexual desire: A pilot randomized study

Abstract Background: Hypoactive Sexual Desire Disorder (HSDD) is a very prevalent sexual problem, with limited options for treatment. Given that psychological factors are major contributors to the disorder, a therapy such as Cognitive-Behavioral Therapy (CBT) may be useful to treat HSDD. Objective: To evaluate the effects of group CBT on women with HSDD. Method: Clinical trial randomized study with 106 women diagnosed with HSDD, who were divided as follows: Group 1 (n = 53) underwent group CBT for 8-weeks, and Group 2 (n = 53), were put on a waiting list and used as a control group. Sexual function was assessed by the Female Sexual Quotient (FSQQ) at the initial interview and after 6-months. Mann Whitney test was used for group comparison. Main Outcome Measures: demographics, education, sexual history, FSQQ and its domains for sexual function assessment. Results: Both groups had similar characteristics regarding sexual response, self-image, and relationship with a partner at the initial interview. Women undergoing therapy showed significant improvement in sexual function when compared with the control group. The overall FSQQ result showed an average growth of 18.08 points (95% CI 12.87‒23.28) for the therapy group against a decrease of 0.83 points (95% CI 3.43‒1.77) for controls (p < 0.001). The five domains of the questionnaire also exhibited significant improvement in the therapy group: desire and interest (p = 0.003), foreplay (p = 0.003), excitation and tuning (p < 0.001), comfort (p < 0.001), and orgasm and satisfaction (p < 0.001). Conclusion: Group CBT was shown to be an effective tool for treating HSDD.

Evaluación del efecto de intervenciones grupales basadas en TF-CBT e IPT en el funcionamiento psicosocial de adolescentes expuestos a violencia interpersonal en Chile: un protocolo de ensayo clínico piloto / TF-CBT and IPT based group intervention on psychosocial functioning in adolescents exposed to interpersonal violence in Chile: a pilot clinical trial protocol

Este artículo describe el protocolo para evaluar intervenciones con adolescentes expuestos a violencia interpersonal y sigue los lineamientos de CONSORT (Shulz et al., 2010). El objetivo es evaluar la efectividad de dos modelos de intervención grupal (Terapia Cognitivo Conductual Centrada en el Trauma, TF-CBT y Terapia Interpersonal, IPT) en la estabilización del funcionamiento psicosocial de adolescentes. Método. Este es un ensayo controlado aleatorizado con tres grupos: dos grupos de intervención (TF-CBT e IPT) y un grupo de control activo (arteterapia). Los participantes serán 84 adolescentes entre 13 a 17 años que están en lista de programas especializados. Los participantes serán asignados a uno de los tres grupos y participarán en 12 sesiones de terapia grupal. Se evaluará el progreso de los participantes en sintomatología de estrés postraumático y depresión, problemas de autorregulación e interpersonales. Las medidas se administrarán antes del inicio de la intervención, en sesiones seis, siete, doce y dos meses después de finalizada la intervención. También se evaluará la adherencia a la intervención y su aceptabilidad por parte de los participantes. Discusión. Este estudio busca contribuir al desarrollo de intervenciones basadas en evidencia en Chile para mejorar el acceso a la intervención especializada. Registro del protocolo: 19/05/2021, código ISRCTN10290141.

This paper describes the protocol developed in Chile to evaluate interventions for adolescents exposed to interpersonal violence and follows CONSORT guidelines (Shulz et al., 2010). The objective is to evaluate the effectiveness of two group intervention models (Trauma Focused Cognitive Behavioral Therapy and Interpersonal Therapy) in stabilising the psychosocial functioning of adolescent participants. Methods/Design. It is a randomised controlled trial with three groups: two intervention groups (TF-CBT and IPT) and an active control group (art therapy). The participants will be eighty-four adolescents between 13 to 17 years old on the waiting list for treatment in specialist trauma services. Participants will be assigned to one of three groups and participate in 12 group therapy sessions. Participants' progress in post-traumatic stress and depression symptomatology, self-regulation and interpersonal problems will be assessed. Measures will be administered before the start of the intervention, in sessions six, seven, twelve and two months after the end of the intervention. Adherence to the intervention and its acceptability by the participants will also be evaluated. Discussion. This study seeks to contribute to developing scalable, evidence-based interventions in the Chilean context to improve access to specialist intervention. Trial Registration. 19/05/2021, code ISRCTN10290141.

Jogos dramáticos sobre sexualidade em um centro de atenção psicossocial / Dramatic games about sexuality at a psychosocial care center / Juegos dramáticos sobre la sexualidad en el centro de atención psicosocial

RESUMO Entendendo as oficinas como uma das principais formas de intervenção terapêutica nos Centros de Atenção Psicossocial (CAPS), o objetivo deste artigo foi refletir sobre seu processo de planejamento, desenvolvimento e avaliação a partir da experiência de jogos dramáticos sobre sexualidade. Foram realizadas 10 oficinas, com 43 usuários. Elas foram audiogravadas e transcritas. A análise temática produziu duas categorias: "Desafios na facilitação das oficinas" e "Avaliações da participação". As oficinas se basearam na coconstrução e na reflexão sobre o cotidiano, respondendo ao ideário da desinstitucionalização. Elas produziram novas percepções de si e do outro no debate sobre sexualidade, indo além das visões biomédicas e essencialistas. Essa experiência ilustra a viabilidade e importância de jogos dramáticos sobre sexualidade no CAPS.

ABSTRACT Understanding workshops as one of the main forms of therapeutic intervention in Psychosocial Care Centers, the aim of this article was to reflect on their planning, development and evaluation process based on the experience of dramatic games about sexuality. Ten workshops were held, with 43 users. They were audio-recorded and transcribed. The thematic analysis produced two categories: "Challenges in facilitating the workshops" and "Assessments of participation." The workshops were based on coconstruction and reflection on everyday life, responding to the ideas of deinstitutionalization. They produced new perceptions of the self and the other in the debate on sexuality, going beyond biomedical and essentialist views. This experience illustrates the feasibility and importance of dramatic games about sexuality at Psychosocial Care Centers.

RESUMEN Entendiendo los talleres como una de las principales formas de intervención terapéutica en los Centros de Atención Psicosocial (CAPS), el objetivo de este artículo fue reflexionar sobre su proceso de planificación, desarrollo y evaluación a partir de juegos dramáticos sobre sexualidad. Hubo 10 talleres, con 43 participantes. Fueron audiograbadas y transcritas. El análisis temático produjo dos categorías: "Desafíos en la facilitación de los talleres" y "Evaluaciones de participación". Los talleres se basaron en la coconstrucción y la reflexión sobre la vida cotidiana. Produjeron nuevas percepciones del yo y del otro en el debate sobre la sexualidad, superando visiones biomédicas y esencialistas. Esta experiencia ilustra la viabilidad y la importancia de los juegos dramáticos sobre la sexualidad en los CAPS.

Grupos de terapia ocupacional em telessaúde na pandemia de Covid-19: perspectivas de um Hospital-Dia de Saúde Mental / Occupational therapy telehealth groups in Covid-19 pandemic: perspectives from a Mental Health Day Hospital

Resumo A pandemia de COVID-19 teve sério impacto ocupacional em pessoas com transtornos mentais pré-existentes. Para prestar o cuidado nesse contexto, os grupos de telessaúde foram uma opção terapêutica para terapeutas ocupacionais para o cuidado em saúde mental. Este artigo apresenta uma experiência de terapia ocupacional com grupos de telessaúde no Brasil, sustentada pelo Método Terapia Ocupacional Dinâmica, buscando discutir o uso da tecnologia durante a pandemia de Covid-19, além dos limites e das potencialidades do cuidado em terapia ocupacional diante da necessária mudança do trabalho com grupos. Trata-se de análise crítica da prática sustentada por uma perspectiva de produção de evidências baseadas na prática por meio de uma parceria colaborativa entre profissionais e acadêmicos do Brasil e do Reino Unido. Os profissionais refletiram sobre as habilidades necessárias no contexto online, destacando suas preocupações iniciais e suas descobertas neste novo cenário de prática. A prática de cuidado em grupo de terapia ocupacional em telessaúde na prática de saúde mental requer o uso de múltiplas ferramentas digitais. Além disso, a(o) terapeuta ocupacional precisa entender das questões de desigualdade digital (acesso digital e/ou habilidades digitais), aprimorar-se digitalmente para atender às necessidades das pessoas sob seu acompanhamento, além de possuir referenciais teórico-metodológicos claros que permitam sustentar práticas em telessaúde.

Abstract COVID-19 pandemic had a serious occupational impact on people with pre-existing mental disorders. To deliver care in this context, telehealth groups were a therapeutic option for occupational therapists for mental health care. This paper presents an occupational therapy experience with telehealth groups in Brazil, sustained by the Dynamic Occupational Therapy Method, seeking to discuss the use of technology during the COVID-19 outbreak, the limits and potential of occupational therapy in the face of the necessary change in work with groups. The paper is a critical analysis of practice sustained by a practice-based evidence perspective through a collaborative partnership between practitioners and academics from Brazil and the UK. Practitioners reflected on their professional skills in an online context, highlighting their initial concerns and their discoveries within this new practice scenario. The delivery of telehealth groupwork in occupational therapy in mental health practice requires multiple digital tools, and the occupational therapist needs to understand digital inequity issues (digital access or skills), be digitally upskilled to meet client needs, and also be guided by clear occupational therapy theoretical and methodological frameworks that underpin telehealth practices.

ACT em grupo para manejo de ansiedade entre universitários: ensaio clínico randomizado / Group therapy based on act for anxiety management among university students: randomized clinical trial / Terapia grupal basada en ACT para el manejo de la ansiedad entre estudiantes universitarios: ensayo clínico aleatorizado

Estima-se que um a cada cinco estudantes universitários ao redor do mundo apresenta algum tipo de transtorno psicológico, dentre os quais os transtornos de ansiedade são os mais prevalentes. Este estudo consiste em um ensaio clínico randomizado com o objetivo de avaliar a eficácia e efetividade de um protocolo semiestruturado de psicoterapia em grupo baseado nos princípios da Terapia de Aceitação e Compromisso (ACT) para o tratamento de ansiedade entre estudantes universitários. Os participantes foram alocados aleatoriamente entre os grupos intervenção e controle. Os níveis de ansiedade pré e pós-intervenção foram avaliados por meio do instrumento General Anxiety Disorders-7 (GAD-7). A amostra final do estudo foi composta por 15 pessoas, dentre as quais 10 foram alocadas no grupo intervenção e 5, no grupo controle. Os resultados foram analisados de duas formas: a) por protocolo (Per-protocol analysis); e b) por intenção de tratar (Intention-to-treat Analysis). Este tratamento reduziu a sintomatologia ansiosa em 39,7% entre os pacientes que completaram o tratamento (por protocolo, p=0,030) e em 30,8% entre todos alocados para o grupo intervenção (i.e., por intenção de tratar, incluindo os dropouts, p=0,035), enquanto os controles não tiveram redução significativa no mesmo período. Portanto, recomenda-se a utilização deste protocolo dentro do contexto universitário como uma alternativa viável ao acompanhamento individual em situações de transtornos de ansiedade. Pesquisas futuras com amostras maiores podem contribuir na consolidação deste protocolo.

One in every five university students around the world is estimated to have some type of psychological disorder, considering anxiety disorders as the most prevalent. This study consists in a randomized clinical trial aimed to evaluate efficacy and effectiveness of a semi-structured group psychotherapy protocol based on the principles of Acceptance and Commitment Therapy (ACT) for the treatment of anxiety among university students. Participants were randomly allocated in the intervention and control groups. Pre- and post-intervention anxiety levels were measured using the General Anxiety Disorders-7 (GAD-7) questionnaire. The study sample was composed of 15 people, 10 of whom were allocated to the intervention group and 5 to the control group. Results were analyzed in two ways: 1) Per protocol analysis; and 2) Intention-to-treat analysis. This treatment reduced anxiety symptoms by 39.7% among patients who completed treatment (Per protocol, p=0.003) and by 30.8% among all those allocated to the intervention group (i.e., by Intention-to-treat, including dropouts, p=0.035), whereas controls showed no significant reduction in same period. Therefore, we recommend the use of this protocol within the university context as a viable alternative to individual counselling in situations of anxiety disorders. Future research with larger samples may contribute to consolidate this protocol.

Se estima que uno de cada cinco estudiantes universitarios en todo el mundo tiene algún tipo de trastorno psicológico, entre los cuales los trastornos de ansiedad son los más frecuentes. Este estudio consiste en un ensayo clínico aleatorizado cuyo objetivo fue evaluar la eficacia y efectividad de un protocolo de psicoterapia grupal semiestructurada basado en los principios de la Terapia de Aceptación y Compromiso (ACT) para el tratamiento de la ansiedad en estudiantes universitarios. Se asignaron aleatoriamente a los participantes en los grupos de intervención y control. Los niveles de ansiedad antes y después de la intervención se midieron utilizando el instrumento General Anxiety Disorders-7 (GAD-7). La muestra final del estudio estuvo compuesta por 15 personas, de las cuales 10 fueron asignadas al grupo de intervención y 5 al grupo de control. Los resultados se analizaron de dos maneras: 1) por protocolo (Per protocol analysis); y 2) por intención de tratar (Intention-to-treat Analysis). Con este tratamiento los síntomas de ansiedad se redujeron en un 39,7% entre los pacientes que completaron el tratamiento (por protocolo, p=0,030) y en un 30,8% entre todos los asignados al grupo de intervención (es decir, por intención de tratar, incluidos los dropouts, p=0,035), mientras que los controles no tuvieron una reducción significativa en el mismo periodo. Por lo tanto, se recomienda utilizar este protocolo dentro del contexto universitario como una alternativa viable a lo asesoramiento individual en situaciones de trastornos de ansiedad. La investigación futura con muestras más grandes puede contribuir a la consolidación de esta modalidad.

Interference of the different realities when working with psychodrama online and its effect on the protagonist and the group / Interferência das diferentes realidades quando se trabalha com psicodrama online e seu efeito sobre o protagonista e o grupo / Interferencia de las diferentes realidades a la hora de trabajar con psicodrama online y su efecto sobre el protagonista y el grupo

RESUMO In online psychodrama, with all its peculiarities and risks, is it possible to a complete therapeutic process take place, moved by the therapeutic factors: action catharsis, action insight, action learning, corrective emotional experience and reintegration of the new experience; the same as in psychodrama in therapeutic room? The focus is on possible effects and challenges of interference of different realities when working with psychodrama in the space of a virtual platform. Invasion ofexternal reality in the individual space and reality of the auxiliary ego could influence the online group reality. The result can be a mixture of different times, spaces and realities, as well as the chance to unlock a deep process, catalyzing a personal work for the protagonist.

RESUMO No psicodrama online, com todas as suas peculiaridades e riscos, é possível realizar um processo terapêutico completo, executado pelos fatores terapêuticos: catarse de ação, insight de ação, aprendizagem de ação, experiência emocional corretiva e reintegração da nova experiência; o mesmo que em psicodrama na sala terapêutica? O foco está nos possíveis efeitos e desafios da interferência de diferentes realidades ao trabalhar com psicodrama no espaço de uma plataforma virtual. A invasão da realidade externa no espaço individual e na realidade do ego auxiliar poderia influenciar a realidade online do grupo. O resultado pode ser uma mistura de diferentes tempos, espaços e realidades, bem como a chance de desbloquear um processo profundo, catalisando um trabalho pessoal para o protagonista.

RESUMEN ¿En el psicodrama online es posible llevar a cabo un proceso terapéutico completo, realizado por los factores terapéuticos: catarsis de acción, insight de acción, aprendizaje de acción, experiencia emocional correctiva y reintegración de la nueva experiencia; el aunque sea en psicodrama en la sala terapéutica? El foco se centra en los posibles efectos y desafíos de la interferencia de diferentes realidades cuando se trabaja con psicodrama en el espacio de una plataforma virtual. La invasión de la realidad externa en el espacio individual y la realidad del ego auxiliar podría influir en la realidad grupal online. El resultado puede ser una mezcla de diferentes tiempos, espacios y realidades, así como la posibilidad de desbloquear un proceso profundo, catalizando un trabajo personal para el protagonista.

Effect of supportive-expressive group therapy on the fear of disease progression and self perceived burden in patients with early chronic kidney disease / 中国实用护理杂志

Objective:To explore the impact of supportive-expressive group therapy on the fear of disease progression and self-perceived burden of patients with early chronic kidney disease (CKD).Methods:A total of 150 early CKD patients in the Nephrology Department of Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine from May 2018 to July 2020 were selected and divided into research group with 88 cases and control group with 88 cases by random number table method. There were 12 cases were lost in the research group, 14 cases were lost in the control group. 76 cases in the research group and 74 cases in the control group were involved in the statistical analysis. The control group was treated with routine nursing while the research group was treated with nursing measures based on supportive-expressive group therapy as well as routine nursing. The effect of intervention was assessed by Fear of disease Progression (FoP) Questionnaire and Self-Perceived Burden Scale (SPBS) before and 12 weeks after the intervention.Results:There was no significant difference in the scores of FoP and Self Perceived Burden Scale (SPBS) between the two groups before the intervention ( P>0.05). After intervention, the scores of emotional reactions, loss of autonomy, partnership/family, anxiety response and the total score of FoP in the research group were (35.79 ± 5.82), (18.52 ± 3.16), (16.23 ± 2.27), (21.57 ± 2.92), (110.81 ± 17.12) respectively, which were lower than those in the control group (47.61 ± 7.13), (24.61 ± 3.97), (24.52 ± 3.71), (31.67 ± 3.87), (147.32 ± 21.72), and the differences were statistically significant ( t values were -18.07 - -10.41, all P<0.05). After intervention, the scores of physical factors, emotional factors and the total score of SPBS in the research group were (10.15 ± 1.82), (10.17 ± 1.86), (24.01 ± 4.25), which were lower than those in the control group (15.87 ± 2.57), (16.81 ± 3.14), (36.39 ± 6.32), and the differences were statistically significant ( t values were -15.76, -15.92, -14.11, all P<0.05). Conclusions:Supportive-expressive group therapy can effectively reduce the early CKD patients′ fear of disease progression and relieve their self-perceived burden.

Implementação de um ambulatório psicossocial para pessoas expostas a situação de violência em um hospital universitário / Implementation of a psychosocial outpatient clinic for people exposed to violence in a university hospital / Implementación de una clínica psicosocial ambulatorial para personas expuestas a la violencia en un hospital universitario

RESUMO Discute-se o processo de implementação de um ambulatório que oferta psicoterapia de grupo com base psicanalítica às crianças, adolescentes e adultos expostos à violência, adscritos à região Norte de Campinas-SP. A implementação acontecerá no Hospital Universitário - Unicamp, em parceria com o Laboratório de Saúde Coletiva e Saúde Mental - Interfaces, a Assistência Social e de Saúde da Prefeitura Municipal de Campinas. Objetiva-se qualificar a assistência e articulação da rede de serviços públicos no território (Atenção Primária à Saúde e Assistência Social), ofertando-se apoio matricial e seguimento conjunto dos casos; e construir evidências sobre a efetividade da psicanálise de grupo na terapia de transtornos associados à exposição à violência. Utilizar a psicanálise justifica-se no contexto da abordagem e da prevenção à violência na medida em que espaços seguros de escuta possibilitam à pessoa em situação de exposição à violência um lugar de legitimação do sofrimento, elaboração e ressignificação da experiência traumática; do contrário há riscos de invalidar, negar, calar e perpetuar a violência naturalizando-a. A psicanálise tem contribuições significativas para compreensão das causas e consequências individuais e coletivas da violência, bem como para intervir e prevenir a transmissão transgeracional por meio de dispositivos terapêuticos que consideram os níveis coletivo, intersubjetivo e intrapsíquico.

ABSTRACT The process of implementation of an outpatient clinic offering psychoanalytic group psychotherapy to children, adolescents and adults exposed to violence, assigned to the northern region of Campinas-SP, is discussed. The implementation will take place at the University Hospital - Unicamp, in partnership with the Collective Health and Mental Health Laboratory - Interfaces, the Social and Health Care of the Campinas City Hall. The objective is to qualify the assistance and articulation of the public services network in the territory (Primary Health Care and Social Assistance), offering matrix support and joint follow-up of cases; and to build evidence on the effectiveness of group psychoanalysis in the therapy of disorders associated with exposure to violence. Using psychoanalysis is justified in the context of the approach and prevention of violence as safe listening spaces allow the person in a situation of exposure to violence a place of legitimation of suffering, elaboration and resignification of traumatic experience; otherwise there are risks of invalidating, denying, silencing and perpetuating violence by naturalizing it. Psychoanalysis has significant contributions to understand the individual and collective causes and consequences of violence, as well as to intervene and prevent transgenerational transmission through therapeutic devices that consider the collective, intersubjective and intrapsychic levels.

RESUMEN Se discute el proceso de implementación de una clínica ambulatoria que ofrece psicoterapia grupal psicoanalítica a niños, adolescentes y adultos expuestos a la violencia, asignados a la región norte de Campinas-SP. La implementación tendrá lugar en el Hospital Universitario - Unicamp, en colaboración con el Laboratorio de Salud Colectiva y Salud Mental - Interfaces, la Atención Social y de Salud del Ayuntamiento de Campinas. El objetivo es calificar la asistencia y articulación de la red de servicios públicos en el territorio (Atención Primaria de Salud y Asistencia Social), ofreciendo apoyo matricial y seguimiento conjunto de casos; y para construir evidencia sobre la efectividad del psicoanálisis grupal en la terapia de trastornos asociados con la exposición a la violencia. El uso del psicoanálisis se justifica en el contexto del enfoque y la prevención de la violencia, ya que los espacios seguros de escucha permiten a la persona en una situación de exposición a la violencia un lugar de legitimación del sufrimiento, elaboración y resignificación de la experiencia traumática; de lo contrario, existe el riesgo de invalidar, negar, silenciar y perpetuar la violencia al naturalizarla. El psicoanálisis tiene contribuciones significativas para comprender las causas y consecuencias individuales y colectivas de la violencia, así como para intervenir y prevenir la transmisión transgeneracional a través de dispositivos terapéuticos que consideran los niveles colectivos, intersubjetivos e intrapsíquicos.

The effects of cognitive-behavioral group therapy for reducing symptoms of internet addiction disorder and promoting quality of life and mental health

Abstract Introduction Internet addiction disorder has reportedly become an important cause of health and social problems. The aim of this study was to investigate the effectiveness of cognitive-behavioral group therapy for internet addiction symptoms, quality of life, and mental health of students with internet addiction. Methods This was a quasi-experimental study with pretest-posttest measures and a control group. The statistical population of the study consisted of all students at Tehran universities in the academic year of 2018-19. The target group was selected through an internet addiction test and a clinical interview using a targeted sampling method and was divided into experimental and control groups by randomization. The experimental group participated in fifteen 90-minute cognitive-behavioral group therapy sessions. Before, immediately after, and 3 months after the treatment, the internet addiction symptoms of both groups were evaluated to assess mental health with the IAT, quality of life (QOL), and SCL-90-R questionnaires. Data were analyzed with ANCOVA analysis using SPSS Statistics 20 software. Results After treatment, cognitive-behavioral therapy groups showed reductions in internet addiction scores (p < 0.05). Results showed that the cognitive-behavioral group therapy was effective for improving quality of life (p < 0.05) and mental illnesses (p < 0.05) in students with internet addiction. Conclusions Cognitive-behavioral group therapy can enhance awareness and mental health of students with internet addiction. Therefore, this intervention can be used as a beneficial treatment to reduce internet addiction symptoms and improve the condition of people with behavioral addictions such as internet dependency.

Virtual cognitive stimulation therapy: perspectives of people living with dementia / Terapia de estimulação cognitiva virtual: Perspectivas de pessoas vivendo com demência

Cognitive Stimulation Therapy (CST) is a group treatment in which people with mild to moderate dementia participate in 14 activity and discussion sessions. During the COVID-19 pandemic, CST was adapted for online delivery, as virtual-CST (V-CST). To determine the acceptability of online delivery, we piloted a V-CST group, monitored attendance, and assessed qualitative feedback from the participants. Five people with dementia participated. Except for one session with four attendees, all participants attended every session. Qualitative analysis identified four themes that were verified by participants: (1) positive emotional experiences despite dementia, (2) confidence building and related strategies and challenges, (3) enjoyable and stimulating inclusive activities and group dynamics, and (4) appreciation of discussion about current affairs. This pilot study contributes evidence about the acceptability of V-CST. Although access to CST in the United States is limited, expanded delivery of V-CST could fill service gaps.

A terapia de estimulação cognitiva (CST) é um tratamento em grupo no qual pessoas com demência leve a moderada participam de 14 atividades e sessões de discussão. Durante a pandemia de COVID-19, a CST foi adaptada para entrega online, como CST virtual (V-CST). Para determinar a aceitabilidade da entrega online, testamos a V-CST, monitoramos a frequência, e os participantes deram feedback qualitativo. Participaram cinco pessoas com demência. Exceto por uma sessão com quatro participantes, todos os participantes compareceram a todas as sessões. A análise qualitativa identificou quatro temas que foram verificados pelos participantes: (1) experiências emocionais positivas apesar da demência, (2) construção de confiança e estratégias e desafios relacionados, (3) atividades inclusivas agradáveis e estimulantes e dinâmica de grupo e (4) apreciação da discussão sobre assuntos atuais. Este estudo piloto contribui com evidências sobre a aceitabilidade da V-CST. Embora o acesso à CST nos Estados Unidos seja limitado, a oferta expandida da V-CST pode preencher lacunas desse serviço.

Características deseables de un programa educativo para mujeres con exceso de peso del cantón Central de Alajuela, Costa Rica, según las participantes y profesionales en salud / Desirable characteristics of an educational program for excess weight women of the Central County of Alajuela, Costa Rica, according to women and health professionals

Resumen: Introducción: En Costa Rica, según la segunda encuesta de vigilancia de los factores de riesgo cardiovascular del 2014, el exceso de peso en mujeres alcanza un 70.6 %. Esto trae múltiples consecuencias para su salud física y emocional. Se ha tratado de abordar este problema, a partir del criterio de profesionales en salud sin consultar a las personas afectadas acerca de sus preferencias. Objetivos: Identificar las características deseables que debe incluir un programa educativo dirigido a mujeres con exceso de peso en el Cantón Central de la provincia de Alajuela, Costa Rica, desde el punto de vista de las participantes y del personal de salud. Metodología: Se utilizaron tanto técnicas cualitativas (2 grupos de discusión, 5 grupos focales, 7 entrevistas a profundidad y 2 sesiones de devolución de resultados con 28 mujeres), como cuantitativas (una encuesta a 16 profesionales en salud de diferentes disciplinas). Resultados: Tanto para la mayoría de las mujeres participantes como para todo el personal de salud, el programa debe contar con tres componentes: el nutricional, el psicológico y el de actividad física. Ambos grupos coinciden en que idealmente debería ser un programa grupal con un componente individual. Las mujeres indican que el programa debería motivarlas, ejercer control y ofrecerles una "dieta". Conclusiones: Un programa dirigido a mujeres con exceso de peso, debe ser preferiblemente grupal, tratar la parte nutricional, promover la actividad física y priorizar el abordaje de los factores emocionales. Se recomienda trabajar en forma interdisciplinaria; siendo básico contar con una persona profesional en nutrición.

Abstract: Introduction: In Costa Rica, according to the second 2014 cardiovascular risk factor surveillance survey, excess body weight reaches 70.6% in women. Excess body weight has multiple consequences for women´s physical and emotional health. That problem has been addressed taking into consideration the criteria of health professionals, without consulting the women with excess body weight. Objectives: To identify the desirable characteristics of an educational program for excess weight women of the province of Alajuela, Costa Rica, taking into consideration both health personnel and excess weight women´s opinions. Methodology: We conducted two discussion groups, 5 focus groups, 7 in-depth Interviews, and 2 member-checking sessions with 28 women, and a survey with 16 health personnel from different disciplines. Results: For most of the women and all the health personnel, the program must have three components: nutrition, psychology, and physical activity. For both, it should be a group program with some individual sessions. For women, the program should motivate them, "exercise control" over them, and offer a structured diet plan which they can follow. Conclusions: A weight loss program for excess weight women should be a group therapy. It should have three components: nutritional education, promoting physical activity and addressing emotional factors. It is recommended to work in an interdisciplinary team that should have a Nutritionist.

Intervención grupal para díadas madre- infante privadas de libertad: efectos sobre la depresión materna y el desarrollo infantil / Group Intervention for Imprisoned Mother-Infant Dyads: Effects on Mother's Depression and on Children's Development

Resumen La sintomatología depresiva es frecuente en las mujeres durante el período periparto, impacta negativamente el desarrollo infantil y puede mostrar un incremento cuando la maternidad se desarrolla en contextos carcelarios. Objetivo: realizar intervenciones grupales en dos grupos, uno conformado por mujeres embarazadas y otro por díadas madre-infante, que se encontraban cumpliendo condena en cárceles chilenas, y evaluar su efecto en la sintomatología depresiva materna y en el desarrollo socioemocional infantil. Método: Participaron 60 madres recluidas en recintos carcelarios chilenos, 30 embarazadas y 30 díadas (madres-infante). Se realizaron análisis de regresión multinivel para medidas repetidas de la sintomatología depresiva materna (BDI) en ambos grupos y del desarrollo socioemocional (ASQ-SE) en los niños/as participantes en la intervención para díadas. Resultados: se observó una reducción significativa de la sintomatología depresiva en las mujeres embarazadas (b=-3.60, t(29)=-2.66, p=.031) y en las madres con hijos/as nacidos (b=-0.1499, t(93)=-5.3, p=<.001), así como una reducción de las dificultades en el desarrollo socioemocional infantil (b=-15.26, t(18)=-4.107, p=.001). Conclusión: se discute la relevancia de contar con alternativas psicoterapéuticas para el abordaje de la depresión en madres privadas de libertad y la promoción de un desarrollo socioemocional saludable de sus hijos/as.

Abstract Women may frequently present depressive symptomatology during the peripartum period, it impacts negatively child development and may show an increase when motherhood takes place in prison contexts. Furthermore, the negative effects of maternal depression on children's development have been demonstrated by research findings. Aim: To evaluate the effect of two group interventions for pregnant women and mother-infant dyads with children under 2 years of age, on maternal depressive symptomatology and on the children's development. Method: The sample considered 60 incarcerated women from Chilean prisons all over the country; 30 pregnant women and 30 mothers with children under 2 years of age. Multilevel regression analysis for repeated measures were performed for maternal symptomatology (BDI) in both groups and for children's development (ASQ-SE) in the dyad's group. Results: It was observed Significant reductions in the depressive symptomatology frequencies in the pregnant women (b=-3.60, t(29)=-2.66, p=.031) and in the mothers who participated in the dyad's intervention group (b=-0.1499, t(93)=-5.3, p=<.001), as well as a reduction in child social-emotional development difficulties (b=-15.26, t(18)=-4.107, p=.001). Conclusion: The discussion section addresses the relevance of providing psychological support to imprisoned mother/child dyads, to treat maternal depression and to promote a healthy development of the children who grow up in prison contexts.

Effectiveness of mindfulness-integrated cognitive behavior therapy on anxiety, depression and hope in multiple sclerosis patients: a randomized clinical trial

Abstract Introduction Multiple sclerosis (MS) is a chronic medical condition that attracts particular attention because of the high risks associated with it. MS patients suffer from medical problems, depression, anxiety, and reduced hopefulness. These issues can increase the severity of the disease and treatment resistance and reduce patients' individual and social efficacy. Mindfulness-integrated cognitive behavior therapy (MICBT) is a new approach that is being applied in chronic diseases and can be used in combination with existing treatments. Therefore, the present study investigated the efficacy of MICBT in terms of anxiety, depression, and hope in MS patients. Methods A sample of 20 patients with MS was randomly selected at Shafa Hospital in Kerman City, Iran. Patients were then assigned to one of two groups of 10 people using a random number table. The experimental group received MICBT. The control group also received the same therapy after study completion. The assessment tools used in this study included the Beck Depression Inventory-Second Edition (BDI-II), Beck Anxiety Inventory (BAI), and Miller Hope Scale (MHS). Measurements were conducted at three stages: pre-test, post-test, and follow-up. For data analysis, means and standard deviations were calculated and one-way analysis of covariance was conducted using SPSS 24. Results Compared with controls, MICBT was effective for reducing depression (P < 0.001, F = 72.55), anxiety (P < 0.001, F = 100.75). Additionally, MICBT was effective in improving hope (P < 0.001, F = 45.36). Changes were maintained in the follow-up phase. Conclusion The MICBT affects depression, anxiety and hope of MS patients. Therefore, mental health professionals can benefit from the results obtained in the present study to reduce depression and anxiety and increase hope in this group of patients. Clinical trial registration: Iranian Registry of Clinical Trials, IRCT201601030258N4.

Intervenção psicológica grupal em dor crônica publicadas na Psycinfo em 2018 / Group psychological interventions in chronic pain published in Psycinfo in 2018 / Intervenções psicológicas grupal em dor crônica publicadas na Psycinfo em 2018

A dor crônica, como doença (sinal biológico inútil), acomete um e cada cinco pessoas mundialmente, aumenta com a idade, atinge mais mulheres, em trabalhos extenuantes ou naqueles com menores níveis de escolaridade, portanto, população mais vulnerável. Há diversas formas de intervenção psicológica que podem tornar o atendimento a essa demanda mais barato e acessível, portanto, neste estudo de revisão sistemática da literatura, objetivou-se buscar e analisar as publicações sobre o tema 'Intervenção psicológica grupal na dor crônica' disponível on line, na base de dados PsycINFO (APA). Os resultados da leitura e análise dos 29 artigos científicos, indicam que: O (1) Tipo de estudo majoritariamente de pesquisas de campo (93%), com delineamento do tipo experimental (55%); Com (2) Sujeitos da pesquisa oriundo de pequenas amostras (n=16) ou grandes amostras (n= 2898), somando um total de 5367 pessoas abordadas, a maior parte (62%) dos participantes 'não identificados'; 86% foram pesquisas interventivas, embora 38% não tenha citado o (3) Tipo de intervenção, das citadas, as mais frequente foram grupo e individual (24% cada); Por último os (4) Principais resultados foram significativos (48%).

Chronic pain, as a disease (a useless biological sign), affects one in five people worldwide, increases with age, affects more women, strenuous work, or those with lower levels of schooling, and therefore the most vulnerable population. There are several forms of psychological intervention that can make attendance to this demand cheaper and accessible, therefore, in this study of systematic literature review, we aimed to search and analyze the publications on the theme 'Group psychological intervention in chronic pain' available on line, in the PsycINFO (APA) database. The results of the reading and analysis of the 29 scientific articles indicate that: (1) Type of study, mostly field surveys (93%), with an experimental design (55%); With (2) Research subjects from small samples (n = 16) and large samples (n = 2898), totaling 5367 people approached, 86% were interventional surveys, although 38% did not mention the (3) Type of intervention, of those cited, the most frequent were group and individual (24% each); Finally (4) Main results were significant (48%).

El dolor crónico, como una enfermedad (un signo biológico inútil), afecta a una de cada cinco personas en todo el mundo, aumenta con la edad, afecta a más mujeres, trabajo extenuante o con menores niveles de escolaridad y, por lo tanto, a la población más vulnerable. Existen varias formas de intervención psicológica que pueden hacer que la asistencia a esta demanda sea más barata y accesible, por lo tanto, en este estudio de revisión bibliográfica sistemática, nuestro objetivo fue buscar y analizar las publicaciones sobre el tema "Intervención psicológica grupal en dolor crónico" disponible en línea, en la base de datos PsycINFO (APA). Los resultados de la lectura y el análisis de los 29 artículos científicos indican que: (1) Tipo de estudio, en su mayoría encuestas de campo (93%), con un diseño experimental (55%); Con (2) encuestados de muestras pequeñas (n = 16) o muestras grandes (n = 2898), un total de 5367 personas se acercaron, la mayoría (62%) de los participantes "no identificados"; El 86% fueron encuestas intervencionistas, aunque el 38% no mencionó el (3) Tipo de intervención, de las citadas, las más frecuentes fueron de grupo e individuales (24% cada una); Finalmente (4) Los principales resultados fueron significativos (48%).

Effect of reminiscence group therapy on depression, self-esteem and loneliness among elderly women residing in old age home

Background: Elderly women residing in old age home requires greater adaptability. Prevalence of depression, low self-esteem and feelings of loneliness are more among them. RGT has proven as a most effective alternative intervention especially for elderly at minimizing these above outcomes. Therefore, the present study assessed the effect of RGT on depression, self-esteem and loneliness among elderly women residing in old age home.Methods: Quantitative Research approach and quasi- experimental design was adopted. A total of 50 elderly women aged ³60yrs residing in Nirmal Hriday, Missionaries of charity old age home, Bhubaneswar were selected for experimental (N=25) and control (N=25) group by using purposive sampling. Baseline data were collected by using Socio demographic data Performa, Geriatric depression scale, Rosenberg self-esteem scale and UCLA loneliness scale after getting written informed consent from each participant. Total 3 biweekly reminiscence sessions for 45 minutes was held by dividing the experimental group into 4 groups.Results: Analysis revealed that after RGT, the experimental group showed that level of depression was decreased (before intervention 10.08±1.41 and after intervention 6.36±1.38), self-esteem was improved (before intervention 23.4±2.69 and after intervention 29.56±2.58) and loneliness was reduced (before intervention 36.92±4.57 and after intervention 20.96±5.09) significantly. There was a statistically significant difference found in depression, self-esteem and loneliness scores among experimental group as compared to control group (p<0.0001).Conclusions: On the findings of the study it was concluded that RGT yielded positive effects among elderly women residing in old age home.

Efficacy of pilates based group therapy on fatigue and quality of life in brain tumor survivors – A randomized control trial

Introduction: Fatigue is one of the most common problems experienced by the cancer patients. It is a normal and necessary instrument of physiologic self-regulation and protects the body from exaggerated or harmful efforts. It becomes pathologic when it appears during normal activities and does not improve after rest. It is one of the prevalent symptoms of the patients receiving radiation therapy, cytotoxic chemotherapy or biological response modifiers. Fatigue is inversely associated with activity level and functional capacity. Aim: To evaluate the effectiveness of the pilates based group therapy on the reduction of the levels of fatigue, symptom burden and the improvement in the domain the global functioning, functional component of the EORTC QLQ C30. Materials and methods: Interventional experimental Randomized control trial was used in this study. The study included brain tumor survivors both genders (male and female) with age group ranging from 18 – 65 and completion of the treatment with surgery, radiotherapy, chemotherapy with or without current hormone treatment and overall kps score >70 were randomly allocated into two groups. Group A and Group B. Group A performed pilates exercises and Group B performed conventional therapy which includes ROM exercises and strengthening exercises to the upper limb, lower limb back and both the groups advised walking for 15 min daily. Sathish Kumar Jakkula, Sai Gayathri Mangavelli, Vani Reddy Manchi, Amita Samal, K. Sukavya Reddy. Efficacy of pilates based group therapy on fatigue and quality of life in brain tumor survivors – A randomized control trial. IAIM, 2019; 6(10): 74-81. Page 75 Results: The experimental group A performing a pilates exercises showed statistically significant improvement in the reduction of the fatigue levels and the symptom burden and improvement in the global functioning and functional components of the EORTC QLQ C30 Questionnaire with the probability of <0.005. Conclusion: Pilates based group therapy found to be effective in reducing fatigue levels and symptom burden there by improving the quality of life in brain tumor survivors according to the statistical data available.

Effect of group attribution training combined with clozapine on negative symptoms and quality of life in refractory schizophrenia patients / 中华行为医学与脑科学杂志

Objective To investigate the effect of attributional retraining group therapy ( ARGT) combined with closabine on the negative symptoms and quality of life in refractory schizophrenia patients. Methods The refractory schizophrenia patients were divided into ARGT combined with clozapine therapy group(study group,n=56) and clozapine alone group(control group,n=54). The positive and negative syn-drome scale( PANSS) was used to assess the symptoms of all patients at baseline and 8 weeks later. The quality of life(QOL) of the patients was assessed by GQOLI-74 at baseline and 8 weeks after treatment. The side effects were evaluated by treatment emergent symptom scale(TESS) before and after treatment. SPSS18. 0 was used for statistical analysis. Results At baseline,there was no significant difference in PANSS score between the two groups. After 8 weeks,the total score of PANSS (79. 41±11. 64) and the score of negative symptoms (28. 68 ±2. 74) in the study group were lower that those of control group(83. 06±11. 58,30. 61± 2. 12),and the differences were statistically significant(t=7. 68,7. 10,both P<0. 05). The scores of positive symptoms,cognitive symptoms,emotional symptoms and aggression symptoms in the study group had no sta- tistical differences compared with the control group (all P>0. 05). There were no significant differences in the scores of material life,mental health,physical health and social function between the two groups at base-line (P>0. 05). After 8 weeks,the total score of GQOLI- 74 (206. 37±14. 37),material life score (48. 69± 6. 35),body health score ( 52. 83± 7. 32),mental health score ( 51. 66 ± 4. 63) and social function score (53. 62± 6. 17) of the study group were higher than those of control group((182. 00± 12. 56),( 44. 62± 6. 11),(48. 52±5. 52),(45. 26±4. 66),(46. 18±5. 32))(t=4. 67,5. 26,3. 26,4. 92,3. 25,all P<0. 05). There was no significant difference in TESS score between the two groups(P<0. 05). Conclusion ARGT combined with clozapine can improve the negative symptoms and the quality of life of patients with refractory schizophrenia.