ABSTRACT
El objetivo de este artículo es analizar, desde una perspectiva intersubjetiva, los deseos predominantes en los relatos de un adolescente violento y su madre en una sesión vincular. El Algoritmo David Liberman-ADL es el método utilizado, focalizando en un aporte novedoso transmitido por Maldavsky que permite una diferenciación entre los relatos centrados en terceros y los relatos centrados en el propio narrador. En relación con la intersubjetividad, el análisis de los deseos en una sesión vincular permitió detectar que en el vínculo que han podido establecer el adolescente y su madre a lo largo de su vida predominan situaciones de carencia y de vulnerabilidad psicosocial que se manifiesta en un conflicto patógeno en relación con la endogamia-exogamia ante la imposibilidad del logro psíquico del desasimiento de la autoridad parental. El adolescente realiza una salida fallida de su casa a través de conductas agresivas hacia sus pares en un contexto de riesgo, lo cual retroalimenta el temor materno e intensifica el control hacia su hijo. Si bien se observa que la madre intenta ejercer un rol adecuado, aún no puede preguntarse por el deseo de su hijo que se manifiesta en esa actitud oscilante entre abúlica y agresiva AU
The objective of this article is to analyze, from an intersubjective perspective, the predominant desires within the narratives of a violent teenager and his mother during a therapeutic session. The David Liberman Algorithm (ADL) is the method employed, focusing on a novel contribution introduced by Maldavsky that enables differentiation between narratives centered on third parties and those centered on the narrator themself. In the context of intersubjectivity, the analysisof desires within this therapeutic session reveals that the relationship between the adolescent and his mother has been marked by situations of deficiency and psychosocial vulnerability throughout their lives. This is manifested in a pathogenic conflict related to endogamy-exogamy concerning the unattainable psychological detachment from parental authority. The adolescent attempts an unsuccessful departure from his home through aggressive behavior towards peers in a high-risk environment, which, in turn, exacerbates his mother's fears and intensifies her control over her son. Although it is evident that the mother is trying to assume an appropriate role, she is still unable to explore her son's desires, as demonstrated by his oscillation between apathy andaggression AU
Subject(s)
Humans , Male , Female , Adolescent , Violence/psychology , Psychology, Adolescent , Psychoanalysis , Psychotherapy/methods , Personal Narratives as TopicABSTRACT
Punishing, minimizing, ignoring, or becoming distressed when dealing with children's negative emotions may favor the emergence or worsen behavior problems during childhood. This study examined the effects of the intervention program Vivendo Emoções [Experiencing Emotions] on maternal reactions to children's emotions and children's internalizing and externalizing problems. Thirty-two mothers of children aged between three and eight participated and were assigned to an intervention (n = 16) or a comparison (n = 16) group. The intervention was implemented in eight sessions intended to promote the mothers' strategies to identify and regulate their children's negative emotions and enable the children to improve emotional competence. The mothers completed the CCNES to report their reactions to children's emotional expressions and the CBCL to report internalizing and externalizing problems on pretest and posttest. The results reveal that mothers in the intervention group reported fewer unsupportive reactions on posttest than mothers in the comparison group. This finding shows the potential of such interventions to decrease unsupportive maternal reactions. Additionally, children in the intervention group presented more frequent somatic complaints than those in the comparison group on posttest. A potential explanation is that the mothers were more prepared to encourage their children to report negative emotions associated with bodily sensations.
Castigar, minimizar, ignorar o manifestar malestar ante la expresión de emociones negativas de los niños puede favorecer la aparición o el empeoramiento de problemas de comportamiento en la infancia. Este estudio examinó los efectos del programa de intervención Viviendo Emociones, focado en la socialización emocional de los niños, en las reacciones maternas a las emociones y en los problemas internalizantes y externalizantes de los niños. Participaron 32 madres de niños entre tres y ocho años, divididas en los grupos intervención (n = 16) y comparación (n = 16). El Viviendo Emociones se realizó en ocho sesiones y busca promover estrategias para identificar y regular las emociones negativas expresadas por los niños para que ellos amplíen su competencia emocional. En el pre-test y post-test, las madres respondieron el CCNES para reportar sus reacciones ante las expresiones emocionales de sus hijos y el CBCL para reportar problemas internalizantes y externalizantes. Los resultados revelaron que las madres en el grupo de intervención reportaron menos reacciones de no apoyo que las madres en el grupo comparación en el post-test. Ese hallazgo resalta el potencial de intervenciones de esta naturaleza para reducir las reacciones maternas de no apoyo. Adicionalmente, los niños del grupo intervención presentaron más quejas somáticas que los niños del grupo comparación en el post-test. Una explicación potencial es que las madres estaban más preparadas para alentar a los niños a reportar emociones negativas asociadas a sensaciones corporales.
Punir, minimizar, ignorar ou manifestar desconforto diante da expressão de emoções negativas dos filhos pode favorecer o surgimento ou agravamento dos problemas de comportamento na infância. Este estudo examinou os efeitos do programa de intervenção, Vivendo Emoções, com foco na socialização emocional infantil, sobre as reações maternas às emoções dos filhos e os problemas internalizantes e externalizantes das crianças. Participaram 32 mães de crianças entre três e oito anos, divididas em grupo intervenção (n = 16) e comparação (n = 16). O Vivendo Emoções foi realizado em oito sessões e busca promover estratégias para identificação e regulação das emoções negativas expressas pelos filhos de forma que a criança amplie sua competência emocional. No pré-teste e no pós-teste, as mães responderam a CCNES para informar suas reações às expressões emocionais nos filhos e o CBCL para relatar problemas internalizantes e externalizantes. Os resultados revelaram que as mães do grupo intervenção relataram menos reações não apoiadoras do que as mães do grupo comparação no pós-teste. Esse achado evidencia o potencial de intervenções dessa natureza para reduzir reações maternas não apoiadoras. Adicionalmente, as crianças do grupo intervenção apresentaram mais queixas somáticas do que as crianças do grupo comparação no pós-teste. Uma explicação potencial é que as mães estivessem mais preparadas para encorajar as crianças a relatar emoções negativas associadas a sensações corporais.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Socialization , Child Behavior/psychology , Emotions/physiology , Problem Behavior/psychology , Mothers/psychology , Parent-Child Relations , Psychotherapy/methods , Checklist , Sociodemographic Factors , Maternal Behavior/physiologyABSTRACT
RESUMEN: Es sabido que, tanto psicólogos como psiquiatras infantiles, poseen escasa capacitación y formación en el área de lingüística, lo que sin duda tiene gran relevancia en la salud mental infantil. Consecuentemente, una mayor especialización en los aspectos evolutivos del lenguaje infantil, podría favorecer la eficacia en la psicoterapia con niñas y niños, potenciando las técnicas clásicamente utilizadas en setting, como lo son el juego y las actividades plásticas. Así, con mayor conocimiento en psicolingüística y pragmática, profesionales de la salud mental incrementarían su batería de herramientas prácticas para una efectiva comunicación momento a momento en el espacio terapéutico con el/la paciente. Esto no sólo ampliaría el uso de la psicolingüística infantil más allá del diagnóstico de los trastornos del lenguaje, sino que también contribuiría a converger los conocimientos teórico-prácticos para potenciar el trabajo psicológico con infancia, mediante una comunicación más efectiva del adulto con el/la niña/o.
ABSTRACT It is known that both child psychologists and psychiatrists have little training in linguistics, which undoubtedly has great relevance in children's mental health. A greater specialization in the evolutionary aspects of children's language could improve the effectiveness in psychotherapy, enhancing the techniques classically used in setting, such as games and artistic activities. Thus, with greater knowledge in psycholinguistics and pragmatics, mental health professionals could increase their battery of practical tools for effective moment-by-moment communication with the patient. This would expand the use of child psycholinguistics not only for the diagnosis of language disorders, but also contribute to converge theoretical and practical knowledge achieving a more effective communication between the adult and the child.
Subject(s)
Humans , Child , Psycholinguistics , Psychotherapy/methods , Child LanguageABSTRACT
Schizencephaly is an extremely rare developmental birth defect or malformation characterized by abnormal clefts in the cerebral hemispheres of the brain, extending from the cortex to the ventricles, which may be unilateral or bilateral. This case report describes the general characteristics of a psychological home care program, reporting the main theoretical and technical elements in a 12-years-old case of type II Schizencephaly. The aims of the psychological home treatment were acceptance of the new treatment reality, a reduction in aggression and anxiety, and psychological support for the patient and family. In the psychological home care, patient's awareness of illness was developed, along with family orientation, psychoeducation, relaxation techniques, and cognitive distraction. It can be observed that a significant improvement in the affective and emotional state was achieved within the patient's clinical framework.
A esquizencefalia é um defeito ou malformação congênita do desenvolvimento extremamente raro, caracterizado por fendas anormais nos hemisférios cerebrais, estendendo-se do córtex aos ventrículos, que podem ser unilaterais ou bilaterais. Este relato de caso descreve as características gerais de um programa de atenção psicológica domiciliar, relatando os principais elementos teóricos e técnicos de um paciente de 12 anos de idade com esquizencefalia tipo II. Os objetivos do tratamento psicológico domiciliar eram a aceitação da nova realidade do tratamento, a redução da agressividade e da ansiedade e o apoio psicológico ao paciente e à família. No atendimento psicológico domiciliar, a consciência do paciente sobre a doença foi desenvolvida, juntamente com a orientação familiar, psicoeducação, técnicas de relaxamento e distração cognitiva. Pode-se observar que houve melhora significativa do estado afetivo e emocional no quadro clínico do paciente.
Subject(s)
Humans , Female , Child , Psychotherapy/methods , Schizencephaly/diagnosis , Schizencephaly/therapy , Home Care Services , Patient Care Team , Professional-Family Relations , Relaxation Therapy , Treatment OutcomeABSTRACT
Therapeutic Assessment is a model of psychological evaluation that adopts a collaborative approach and a semi-structured systematization to the extent that it has well-defined steps. Considering its intervention nature, Therapeutic Assessment seeks to bring about positive changes in the lives of clients and/or people close to them. The present study aimed to evaluate how the Therapeutic Assessment process presented therapeutic consequences, using the case study as a research method. The description of the results was based on the assistance of a client using the Therapeutic Assessment model. The findings corroborate the hypotheses related to the therapeutic benefits of the Therapeutic Assessment, providing the clients with increased self-knowledge and self-reflection and changes in the way they deal with difficult situations. We conclude that more research on Therapeutic Assessment should be developed to verify other possible benefits of the model. (Au)
A Avaliação Terapêutica é um modelo de avaliação psicológica que adota uma abordagem colaborativa e uma sistematização semiestruturada na medida em que possui etapas bem definidas. Considerando seu caráter interventivo, a Avaliação Terapêutica busca proporcionar mudanças positivas na vida dos clientes e/ou de pessoas próximas a ele. O presente estudo objetivou avaliar de que maneira o processo de Avaliação Terapêutica apresentou consequências terapêuticas, utilizando-se o estudo de caso como método de investigação. A descrição dos resultados orientou-se por meio do atendimento de uma cliente utilizando o modelo de Avaliação Terapêutica. Os achados corroboram com as hipóteses relacionadas aos benefícios terapêuticos da Avaliação Terapêutica, possibilitando à cliente aumento do autoconhecimento e da autorreflexão e mudanças na sua maneira de lidar com situações difíceis. Conclui-se que mais pesquisas sobre Avaliação Terapêutica devem ser desenvolvidas para se verificar outros possíveis benefícios do modelo. (AU)
La Evaluación Terapéutica es un modelo de evaluación psicológica que adopta un enfoque colaborativo y una sistematización semiestructura, visto que cuenta con etapas bien definidas. Considerando su carácter intervencionista, la Evaluación Terapéutica busca proporcionar cambios positivos en la vida de los clientes y/o de personas cercanas a él. El presente estudio objetivó evaluar de qué manera el proceso de Evaluación Terapéutica presenta consecuencias terapéuticas, utilizando el estudio de caso como método de investigación. La descripción de los resultados se orientó por la atención de una cliente, utilizando el modelo de Evaluación Terapéutica. Los hallazgos corroboran con las hipótesis relacionadas con los beneficios terapéuticos de la Evaluación Terapéutica, posibilitando al cliente el aumento del autoconocimiento, de la autorreflexión y cambios en su manera de lidiar con situaciones difíciles. Se concluye que se deben desarrollar más investigaciones sobre Evaluación Terapéutica para verificar otros posibles beneficios del modelo. (AU)
Subject(s)
Humans , Female , Middle Aged , Psychotherapy/methods , Therapeutics/methods , Self Concept , Projective TechniquesABSTRACT
A autora busca descrever alguns aspectos associados aos impasses presentes nas primeiras entrevistas clínicas realizadas pelo analista com o paciente. A princípio, faz uma breve exposição sobre as entrevistas iniciais. Em seguida, apresenta questões acerca das defesas que os pacientes podem vir a manifestar nesses primeiros contatos. Para pensar sobre tais mecanismos defensivos, explora os conceitos de implicação e reserva do agente cuidador, propostos por Luís Claudio Figueiredo, além de concepções de Thomas Ogden que possibilitam refletir sobre o contato vivo com os pacientes. Na sequência, aborda esses entraves ou dificuldades com que se defrontam os analistas nos primeiros encontros no contexto da pandemia e dos atendimentos online engendrados por essa nova circunstância, imposta a todos.
This article seeks to describe some aspects associated with the impasses present in the first clinical interviews conducted by the analyst with the patient. Initially, a brief explanation about the initial interviews is carried out. Then, questions regarding the defenses that may be manifested by patients in these first contacts are posed. In order to think about such defensive mechanisms, the concepts of implication and reserve of the caregiver agent, proposed by Luís Claudio Figueiredo, are explored, in addition to the statements of Thomas Ogden that enable us to think about the vivid contact with patients. Further on, these same obstacles or difficulties with which analysts are faced in these first encounters are also specifically addressed in the context of the pandemic and the online care engendered by this new circumstance imposed on everyone.
Este artículo describe aspectos relacionados a los obstáculos presentes en las primeras entrevistas clínicas realizadas por el analista con el paciente. En primer lugar, se describen, en resumen, las entrevistas iniciales. Luego, se plantean preguntas sobre las defensas que pueden manifestar los pacientes en estos primeros contactos. Para pensar en los mecanismos defensivos, se exploran los conceptos de implicación y reserva del agente cuidador. Estos conceptos, propuestos por Luís Claudio Figueiredo, además las declaraciones de Thomas Ogden, nos permiten pensar en el contacto vivo con los pacientes. En un segundo momento, estos mismos obstáculos, dificultades a los que se enfrentan los analistas en estos primeros encuentros, también se abordan específicamente en el contexto de la pandemia y la atención en línea que genera esta nueva circunstancia que se impone a todos.
Cet article cherche à décrire certains aspects associés aux impasses présentes dans les premiers entretiens cliniques menés par l'analyste, avec le patient. Dans un premier temps, un bref exposé sur ces premiers entretiens est effectué. Ensuite, des questions sont posées sur les défenses que peuvent manifester les patients lors de ces premiers contacts. Et pour réfléchir encore à de tels mécanismes défensifs, les notions d'implication et de réserve de l'agent soignant, proposées par Luís Claudio Figueiredo, sont explorées, en plus des propos de Thomas Ogden, qui permettent de penser le contact en direct avec les patients. Dans un second moment, ces mêmes obstacles ou difficultés rencontrés par les analystes lors de ces premières rencontres sont aussi spécifiquement abordés dans le contexte de la pandémie et des soins en ligne engendrés par cette nouvelle circonstance imposée à tout le monde.
Subject(s)
Humans , Psychoanalysis/methods , Psychotherapy/methods , Telemedicine/methods , PandemicsABSTRACT
Resumo Este trabalho faz parte de uma pesquisa maior, na qual se procura compreender como a somaterapia de Roberto Freire surgiu e se desenvolveu a partir da contracultura dos anos 1970. Abordam-se a criação e o desenvolvimento inicial da somaterapia, partindo do que se compreende ser um "mito de criação": uma narrativa ordenada e coerente que explica o surgimento da terapia e que aparece, de forma recorrente, com poucas alterações. Analisam-se, ainda, narrativas posteriores a esse período que remetem ao processo de nomeação da somaterapia. Nesta análise, são encontrados conflitos de dados e incongruências que indicam a complexidade desses processos e o esforço dos autores no sentido de ordenação e legitimação da técnica terapêutica.
Abstract This work is part of a larger survey on how Roberto Freire's somatherapy emerged and developed from the counterculture of the 1970s, addressing the creation and initial development of somatherapy, starting from what is understood to be a "creation myth," an orderly and coherent narrative explaining the emergence of this therapy that is frequently repeated with few changes. Later narratives referring to the process of naming somatherapy are also examined, revealing inconsistencies and conflicts in the data that indicate the complexity of these processes and the authors' efforts to add order and legitimacy to this therapeutic technique.
Subject(s)
Humans , History, 20th Century , Psychotherapy/history , Psychotherapy/methods , HistoryABSTRACT
Abstract Systematic case studies are often placed at the low end of evidence-based practice (EBP) due to lack of critical appraisal. This paper seeks to attend to this research gap by introducing a novel Case Study Evaluation-tool (CaSE). First, issues around knowledge generation and validity are assessed in both EBP and practice-based evidence (PBE) paradigms. Although systematic case studies are more aligned with PBE paradigm, the paper argues for a complimentary, third way approach between the two paradigms and their 'exemplary' methodologies: case studies and randomised controlled trials (RCTs). Second, the paper argues that all forms of research can produce 'valid evidence' but the validity itself needs to be assessed against each specific research method and purpose. Existing appraisal tools for qualitative research (JBI, CASP, ETQS) are shown to have limited relevance for the appraisal of systematic case studies through a comparative tool assessment. Third, the paper develops purpose-oriented evaluation criteria for systematic case studies through CaSE Checklist for Essential Components in Systematic Case Studies and CaSE Purpose-based Evaluative Framework for Systematic Case Studies. The checklist approach aids reviewers in assessing the presence or absence of essential case study components (internal validity). The framework approach aims to assess the effectiveness of each case against its set out research objectives and aims (external validity), based on different systematic case study purposes in psychotherapy. Finally, the paper demonstrates the application of the tool with a case example and notes further research trajectories for the development of CaSE tool.
Subject(s)
Psychotherapy/methods , Evaluation Studies as Topic , Evidence-Based Practice/methods , Qualitative ResearchABSTRACT
Resumo O Ensaio Clínico Aleatorizado (ECA) é considerado o tipo de desenho metodológico com maior poder de verificação da eficácia das psicoterapias. Entretanto, especialmente a partir da segunda metade do século XX, muitas críticas direcionadas às concepções epistemológicas subjacentes às ditas "ciências duras" atingiram também, no âmbito das ciências da saúde, os estudos que adotavam esse desenho. Este artigo é uma reflexão crítica sobre algumas das objeções feitas aos ECAs, avaliando de que maneira e até que ponto estes poderiam se configurar como estratégia válida de investigação científica no contexto crítico apontado. Conclui-se que o ECA pode e deve ser utilizado - desde que em contexto crítico - por seu valor pragmático, enquanto produtor de predições e intervenções capazes de solucionar problemas clínicos, inevitavelmente definidos e estabelecidos a partir do ponto de vista particular de uma comunidade.
Abstract The randomized controlled clinical trial (RCT) is considered the type of methodological design with the greatest power to verify the efficacy of psychotherapies. However, especially from the second half of the twentieth century, many criticisms directed at the epistemological conceptions underlying the so-called "hard sciences" have also affected the studies that adopted this design. This article is a critical reflection on some of the objections made to randomized clinical trials, evaluating how and to what extent these trials could be configured as a valid scientific research strategy in this critical context. We concluded that the RCT should be used - as long as it is performed in a critical context - due to its pragmatic value, as a producer of predictions and interventions capable of solving clinical problems, inevitably defined and established from the particular point of view of a community.
Résumé L'essai clinique randomisé est considéré comme le type de conception méthodologique ayant le plus puissant pour vérifier l'efficacité des psychothérapies. Cependant, surtout depuis la seconde moitié du XXe siècle, de nombreuses critiques adressées aux conceptions épistémologiques qui sous-tendent les sciences dites « dures ¼ ont également affecté, dans le cadre des sciences de la santé, les études qui ont adopté cette conception. Cet article est une réflexion critique sur certaines des objections faites aux essais cliniques randomisés, évaluant comment et dans quelle mesure ceux-ci pourraient être configurés comme une stratégie valide de recherche scientifique dans le contexte critique signalé. On en conclu que l'ECA peut et doit être utilisé - à condition que ce soit dans un contexte critique - pour sa valeur pragmatique, en tant que producteur de prédictions et d'interventions capables de résoudre des problèmes cliniques, inévitablement définies et établies du point de vue particulier d'une communauté.
Resumen El ensayo clínico aleatorizado (ECA) se considera el tipo de diseño metodológico con mayor poder para verificar la eficacia de las psicoterapias. Sin embargo, especialmente desde la segunda mitad del siglo XX, muchas críticas dirigidas a las concepciones epistemológicas subyacentes a las llamadas "ciencias duras" también han afectado, dentro del alcance de las ciencias de la salud, los estudios que adoptan este diseño. Este artículo es una reflexión crítica sobre algunas de las objeciones hechas a los ECA, evaluando cómo y en qué medida podrían configurarse como una estrategia de investigación científica válida en este contexto crítico. Se concluye que el ECA puede y debe usarse, siempre y cuando se encuentre en un contexto crítico, por su valor pragmático como productor de predicciones e intervenciones capaces de resolver los problemas clínicos inevitablemente definidos y establecidos desde el punto de vista particular de una comunidade.
Subject(s)
Psychotherapy/methods , Behaviorism , Efficacy , Knowledge , Evidence-Based Practice , JudgmentABSTRACT
Los trastornos del ánimo (uni o bipolares) constituyen un significativo problema de salud pública, tanto por su alta prevalencia como por el elevado índice de discapacidad que generan. El presente artículo aborda el problema de la resistencia a tratamiento como también las estrategias y guías clínicas para el manejo de los cuadros de mayor complejidad. Se analizan los aportes de la terapia farmacológica, de la psicoterapia y de las terapias somáticas no farmacológicas, intentando un enfoque integrativo. El equipo multidisciplinario de la Unidad de Trastornos del Ánimo del Departamento de Psiquiatría de Clínica Las Condes busca aplicar un modelo integrativo con una mirada amplia, con el objetivo de encontrar el mejor manejo para cada paciente, orientado no solo a la remisión sintomática sino también a la recuperación funcional (autonomía, calidad de vínculos, etc.), para incidir de este modo en la calidad de vida global de los pacientes.
Affective disorders (uni or bipolar) represent a significant public health issue, due both to its high prevalence as well as the high index of disability that they generate. This article addresses the problem of treatment resistance, as well the use of clinical guidelines and strategies for the treatment of more complex cases. We analyze the contributions of pharmacological treatments, psychotherapy and non-pharmacological somatic therapies, from an integrative point of view. The multidisciplinary team of Mood Disorders Unit at Clínica Las Condes Psychiatry Department seeks to apply a broad-view integrative model with the aim of finding the better management strategy for each patient. Our objectives are both symptomatic remission and functional recovery (autonomy, quality of affective bonds, etc.), in order to make a difference on the patients' overall quality of life.
Subject(s)
Humans , Practice Guidelines as Topic , Mood Disorders/therapy , Psychotherapy/methods , Bipolar Disorder/therapy , Remission Induction , Mood Disorders/drug therapy , Recovery of Function , Depression/therapy , Antidepressive Agents/therapeutic useSubject(s)
Humans , Cognitive Behavioral Therapy/methods , Hypochondriasis/therapy , Anxiety Disorders/therapy , Psychotherapy/methods , Sweden , Randomized Controlled Trials as Topic , Treatment Outcome , Remote Consultation/statistics & numerical data , Distance Counseling/statistics & numerical data , Hypochondriasis/pathology , Antidepressive Agents/therapeutic useSubject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Anxiety/therapy , Stress Disorders, Post-Traumatic/therapy , Depression/therapy , Intimate Partner Violence/psychology , Anxiety/diagnosis , Patient Dropouts , Psychotherapy/methods , Quality of Life , Safety , Stress Disorders, Post-Traumatic/psychology , Randomized Controlled Trials as Topic , Meta-Analysis as Topic , Self Efficacy , Depression/diagnosis , Systematic Reviews as TopicABSTRACT
Abstract Background Alexithymia is reported to be a risk factor for depression. Psychotherapy is efficient for treatment of depression. Yet, the effect of psychotherapies on alexithymia is poorly understood. Objectives We aimed to compare Cognitive Behavioral Therapy (CBT), Existential Psychotherapy (ExP) and Supportive Counseling (SUP) for therapeutic efficacy and effect on alexithymia in depression. Methods There were 22 patients for each patient group. Sessions were performed as eight consecutive weekly and following two monthly boosters. Sixty six healthy controls were added. Prior to the sessions, patients received Sociodemographic Data Form, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-1), Hamilton Depression Rating Scale (HDRS) and 20-item Toronto Alexithymia Scale (TAS-20). The control group received Sociodemographic Data Form, SCID-1 and TAS-20. Patients additionally received HDRS and TAS-20 after their weekly and booster sessions. Results Patients' mean TAS-20 score was greater than of controls, however, it did not have a significant change throughout the study. Mean HDRS scores of ExP and CBT groups were lower than SUP group at the end. Discussion Alexithymia did not improve with psychotherapy. The exception was effect of ExP on externally oriented thinking. Psychotherapies all improved depression. CBT and ExP were more helpful than SUP.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Psychotherapy/methods , Cognitive Behavioral Therapy , Counseling/methods , Affective Symptoms/therapy , Depression/therapy , Psychiatric Status Rating Scales , Treatment Outcome , Affective Symptoms/complications , Depression/etiology , Mental Status ScheduleABSTRACT
Resumen Se analizan las aportaciones de distintas autoras feministas/psicoanalistas con el fin de sustentar que la perspectiva de género aplicada a un proceso psicoterapéutico de orientación psicoanalítica no sólo es viable, sino deseable. La intención es no sólo aplicarla a sujetos que manifiesten algún conflicto con su identidad de género, su orientación sexual, su expresión de género o algún otro aspecto relacionado con el ejercicio de su sexualidad, sino demostrar que dicha perspectiva puede aplicarse a los procesos psicoterapéuticos de todo sujeto, ya que se considera que ejerce efectos terapéuticos y que fortalece el proceso mismo. La elección de autoras del continente americano, latinoamericanas en su mayoría, permite hacer un ejercicio de revisión del psicoanálisis contemporáneo, de forma contextualizada, y reconoce el vínculo imperdible entre psicoanálisis y estudios de género.
Resumo Diferentes aportes de autoras feministas/psicanalistas são analisados com o fim de sustentar que a perspectiva de gênero aplicada num processo de psicoterapia de orientação psicanalítica é não só viável, como desejável. A intenção é não aplica-la somente a sujeitos que possam manifestar algum conflito com sua identidade de gênero, sua orientação sexual, sua expressão de gênero ou algum outro aspecto relacionado com o exercício da sua sexualidade, mas demostrar que tal perspectiva pode se aplicar a todos os processos psicoterapêuticos, já que ditos processos exercem efeitos terapêuticos e, mais ainda, fortalecem o processo em si mesmo. A eleição das autoras do continente americano, latino-americanas na sua maioria, permite fazer um exercício de revisão da psicanálise contemporânea, de forma contextualizada, e reconhece o vínculo iniludível entre a psicanálise e os estudos de gênero.
Abstract In this article, the input of several feminist/psychoanalyst authors is analyzed in order to support that gender perspective applied to a therapy process is not only viable, but desirable. It looks into the general application of this perspective and not only to subjects manifesting an open conflict with their gender identity, the expression of their gender or any other aspect related to the exercise of their sexuality. It demonstrates that such an approach can be applied to any psychotherapeutic process, considering that it enforces therapeutic effects and fortifies the process itself. By choosing authors from the American continent, mostly Latin American, this exercise enables a review of contemporary psychoanalysis in the Latin American context and recognizes the unavoidable link between psychoanalysis and gender studies.
Subject(s)
Humans , Psychoanalytic Therapy/methods , Sexual Behavior , Sexuality/psychology , Gender Perspective , Gender Identity , Psychotherapy/methods , Social Construction of GenderABSTRACT
Background Affordable interventions to improve metabolic control of Type 2-Diabetes Mellitus are increasingly necessary. Aim To review systematically the existing literature on the effects of psychological interventions on Type-2 Diabetes Mellitus compensation. Material and Methods We performed a systematic literature review and meta-analysis on the effectiveness of psychological interventions implemented for Type-2 Diabetes Mellitus patients. Research included the following electronic databases: PubMed, Bireme, Web of Science, SciELO, Embase, EBSCOhost, SCOPUS, Psychology Database. Results Most studies showed a decrease in the level of glycated hemoglobin after interventions, which applied different initiatives complementary to standard medical treatment. Mainly, these interventions encompassed training for self-monitoring and control of diabetes based on cognitive behavioral psychology, counseling, self-assessment and physical-spiritual work based on transpersonal psychology. Conclusions Psychological tools could be an adjunct to the standard medical treatment for patients with Type-2 Diabetes Mellitus, reducing glycated hemoglobin levels and improving self-regulation, disease awareness and adherence from the self-efficacy perception perspective.
Subject(s)
Humans , Psychotherapy/methods , Diabetes Mellitus, Type 2/psychology , Diabetes Mellitus, Type 2/therapyABSTRACT
Abstract Introduction Preeclampsia is a serious complication during pregnancy that not only influences maternal and fetal physical health, but also has maternal mental health outcomes such as anxiety. Prenatal anxiety has negative short- and long-term effects on pre- and postpartum maternal mental health, delivery, and mental health in subsequent pregnancies. Objective To investigate the effectiveness of individual psycho-educational counseling on anxiety in pregnant women with preeclampsia. Methods This was a randomized, intervention-controlled study involving two governmental hospitals in the municipality of Sirjan, Kerman, from January 30 2017 to March 31 2017. A total of 44 pregnant women with preeclampsia were assessed. The women were randomized into two groups: control (n=22) and intervention (n=22). The intervention consisted of two sessions of individual psycho-educational counseling. The level of anxiety was measured using the Spielberger State-Trait Anxiety Inventory (STAI) as pretest before the first session and as posttest after the second session during the hospitalization period. Results There was a significant reduction in the anxiety level after the counselling sessions in the intervention group (p<0.005). In addition, there was a slight increase in the anxiety level in the control group after the study. Conclusion According to the results, psycho-educational counseling can significantly reduce the anxiety level in pregnant women with preeclampsia. Therefore, it is recommended that healthcare providers provide this type of therapeutic intervention for pregnant women after hospitalization, in order to reduce their anxiety level and its subsequent negative outcomes. Clinical trial registration: IRCT2017082029817N3.
Resumo Introdução A pré-eclâmpsia é uma complicação séria durante a gravidez que não apenas influencia a saúde física da mãe e do feto, mas também tem consequências para a saúde mental materna, por exemplo ansiedade. A ansiedade pré-natal tem efeitos negativos e de longo prazo sobre a saúde mental da mãe antes e após o parto, sobre o parto, assim como sobre a saúde mental em gestações subsequentes. Objetivo Investigar a eficácia do aconselhamento psicoeducacional individual com relação aos níveis de ansiedade em gestantes com pré-eclâmpsia. Métodos Este foi um estudo randomizado, controlado, que envolveu dois hospitais governamentais na cidade de Sirjan, Kerman, de 30 de janeiro de 2017 a 31 de março de 2017. Um total de 42 gestantes com pré-eclâmpsia foram avaliadas. As mulheres foram randomicamente divididas em dois grupos: controle (n=22) e intervenção (n=22). A intervenção consistiu de duas sessões de aconselhamento psicoeducacional individual. O nível de ansiedade foi medido usando-se o Spielberger State-Trait Anxiety Inventory (STAI) antes da primeira sessão (pré-teste) e após a segunda seção (pós-teste), durante o período de hospitalização. Resultados Houve uma redução significativa no nível de ansiedade após as sessões de aconselhamento no grupo intervenção (p<0,005). Além disso, houve um discreto aumento no nível de ansiedade no grupo controle após o estudo. Conclusão De acordo com os resultados deste estudo, o aconselhamento psicoeducacional pode reduzir de forma significativa o nível de ansiedade em gestantes com pré-eclâmpsia. Assim, recomenda-se que os profissionais de saúde ofereçam esse tipo de intervenção terapêutica para gestantes após a hospitalização, a fim de reduzir o nível de ansiedade e seus desfechos negativos. Registro do ensaio clínico: IRCT2017082029817N3.
Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Young Adult , Anxiety Disorders/therapy , Pre-Eclampsia/psychology , Psychotherapy/methods , Patient Education as Topic/methods , Counseling/methods , Anxiety Disorders/etiology , Prenatal Care , Treatment Outcome , Middle AgedABSTRACT
Resumen Investigaciones recientes en psicoterapia muestran que el estudio de la interacción psicoterapéutica al centrar su atención en la conversación de interlocutores, entrega señales que permiten analizar el cambio terapéutico. El propósito del presente estudio de caso es analizar el movimiento de una Estructura de Intercambios Terapéuticos en la conversación de procesos psicoterapéuticos completos de adolescentes depresivos con intento de suicidio en contexto hospitalario. Se analizó el uso del tiempo de los intercambios comunicacionales entre terapeuta y paciente durante las sesiones, que fueron segmentadas en inicio, desarrollo y cierre. Los resultados muestran que los intercambios se producen según su utilidad en la psicoterapia y que su ocupación es sensible y ajustada al trabajo y objetivos terapéuticos que van surgiendo en la interacción. Adicionalmente se identificaron intercambios que son funcionales al inicio, desarrollo y cierre de cada sesión, y otros que deben utilizarse con cautela por parte del psicoterapeuta. La investigación verifico que el psicoterapeuta debe saber cuál, cuándo y cómo utilizar la Estructura de Intercambios Terapéuticos.
Abstract Recent research in psychotherapy shows that the study of psychotherapeutic interaction by focusing attention on the conversation of interlocutors, provides signals to analyze the therapeutic change. The purpose of the present case study is to understand the movement of a Therapeutic Exchange Structure in the conversation of complete psychotherapeutic processes of depressed adolescents with attempted suicide in a hospital context, analyzing the use of the time of the exchanges in the sessions, which were segmented in start, development and closure. The results show that the exchanges are managed according to their usefulness in psychotherapy that their occupation is sensitive and adjusted to the work and therapeutic objectives that arise in the interaction. In addition, there would be exchanges that are functional at the beginning, development and closure of each session, and others that should be used with caution. The psychotherapist must know what, when and how to use the Structure of Therapeutic Exchanges.
Subject(s)
Humans , Female , Adolescent , Physician-Patient Relations , Psychotherapy/methods , Suicide/prevention & control , Depression/therapy , Suicide, Attempted/prevention & control , HospitalsABSTRACT
ABSTRACT BACKGROUND: Irritable bowel syndrome (IBS) is a clinical disorder associated with high socioeconomic burden. Despite its importance, management of IBS remains difficult and several interventions have been hypothesized as beneficial for this condition. This study identified and summarized all Cochrane systematic reviews (SRs) about the effects of interventions for managing IBS patients. DESIGN AND SETTING: Review of systematic reviews, carried out in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP). METHODS: Review of Cochrane SRs addressing interventions for IBS. RESULTS: We included six SRs assessing acupuncture, bulking agents, antispasmodics, antidepressants, herbal medicines, homeopathy, hypnotherapy and psychological therapy for IBS. The certainty of evidence ranged from unknown to moderate, mainly due to imprecision in the estimates and high risk of bias from the primary studies included. There was moderate certainty of evidence that acupuncture had no important benefit regarding improvement of symptoms and quality of life, compared with sham acupuncture. There was also very low certainty of evidence that homeopathic asafoetida, used alone or in association with nux, was better than placebo regarding self-reported overall improvement. CONCLUSION: There was moderate certainty of evidence that acupuncture had no important benefit regarding improvement of symptoms and quality of life. Further well-designed and well-conducted randomized clinical trials are needed in order to reduce the uncertainties regarding the most commonly used interventions for patients with IBS.
Subject(s)
Humans , Disease Management , Irritable Bowel Syndrome/therapy , Systematic Reviews as Topic , Psychotherapy/methods , Treatment Outcome , Evidence-Based Medicine , Irritable Bowel Syndrome/psychologyABSTRACT
O artigo apresentado tem como objetivo o estudo histórico do uso da hipnose, compreendida como prática clínica, na Clínica Psiquiátrica da Faculdade de Medicina da Universidade de São Paulo, entre os anos de 1930-1970. A transição da psiquiatria paulista nesse período, quando se deu a mudança das atividades do Hospital do Juqueri para a Faculdade de Medicina-USP, apoiou-se decisivamente no poder simbólico do discurso psiquiátrico, que tomou o axioma "ser científico" como filtro valorativo para apreciar ou depreciar determinadas práticas. Exemplarmente, a hipnose permaneceu imune ao crivo "científico" desses mesmos psiquiatras, que a adotavam como prática clínica sem submetê-la ao mesmo escrutínio aplicado a outras práticas, especialmente a psicoterapia psicanalítica. Por meio de documentos produzidos na época analisada, busca-se identificar o teor desses discursos psiquiátricos, imbuídos de sua dimensão considerada científica, redundando como estratégia de manutenção ou não de certas práticas, como foi o da hipnose.
The objective of this study was to analyze the history of the use of hypnosis, as a clinical practice, in the Psychiatric Clinic of the School of Medicine, at the University of São Paulo (USP), between 1930 and 1970. There was a transition in psychiatry in São Paulo in this period, when the activities of the Juqueri Hospital were transferred to the School of Medicine at USP. This was decisively supported on the symbolic power of the psychiatric speech, which took over the axiom "scientific being" as an evaluative filter to appreciate or depreciate certain practices. Hypnosis remained immune to the "scientific" sieve of the same psychiatrists who adopted it as a clinical practice without submitting it to the same scrutiny applied to other practices, especially psychotherapy and psychoanalysis. By means of documents produced in the analyzed period, the authors aimed at identifying the thrust of these psychiatric speeches, pervaded with their so-called scientific dimension, which culminated in a strategy to either keep or not keep certain practices, such as hypnosis.
El objetivo del artículo presentado es el estudio histórico del uso de la hipnosis, entendida como práctica clínica, en la Clínica Psiquiátrica de la Facultad de Medicina de la Universidad de São Paulo entre los años de 1930-1970. La transición de la psiquiatría de São Paulo en ese período cuando hubo el cambio de las actividades del hospital de Juqueri para la Facultad de Medicina-USP, se apoyó decisivamente en el poder simbólico del discurso psiquiátrico que asumió el axioma de "ser científico" como filtro de valor para apreciar o despreciar determinadas prácticas. Ejemplarmente, la hipnosis permaneció inmune al filtro "científico" de esos mismos psiquiatras que la adoptaban como práctica clínica sin someterla al mismo escrutinio aplicado a otras prácticas, especialmente a la psicoterapia psicoanalítica. Por medio de documentos producidos en la época analizada se busca identificar el tenor de esos discursos psiquiátricos, imbuidos de su dimensión considerada científica, resultando como estrategia de mantenimiento o no de determinadas prácticas, como fue la hipnosis.