ABSTRACT
Antecedentes: En el contexto terapéutico de pacientes con anorexia nerviosa, es relevante el establecimiento de la alianza terapéutica (AT). Objetivo: Describir los aspectos identificados como facilitadores del logro de una AT positiva desde la perspectiva de pacientes con anorexia nerviosa y sus respectivas terapeutas. Método: Estudio exploratorio, descriptivo-relacional realizado con metodología cualitativa, cuyo análisis de datos se basó en la Grounded Theory, incluyéndose a dos pacientes anorécticas con sus respectivas terapeutas. Resultados: Las pacientes y sus terapeutas valoraron los siguientes parámetros, respectivamente: 1. Ambiente emocional: la incondicionalidad, el interés genuino y la confianza versus el no enjuiciamiento y mayor disponibilidad; 2. Conductas y actitudes deseables (en la terapeuta): flexibilidad, libertad para hablar y la disponibilidad, (en las pacientes): la necesidad de cambiar y tener recursos; 3. Técnicas valoradas: terapia centrada en recursos (o capacidades), co-participación con el tratamiento, conocer testimonios de otras pacientes, hablar libremente con empatía, chequear constantemente el tratamiento y responsabilizar a la paciente de su terapia. Surge un modelo de facilitadores de la AT que incluye subsistema paciente, subsistema terapeuta, atmósfera relacional y espacio terapéutico con sus características particulares. Conclusiones: La generación de una buena AT es un factor destacable en el éxito del proceso terapéutico que implica una relación consciente y una aceptación recíproca, integrada por las influencias de la díada terapeuta/paciente.
Background: The settlement of a therapeutic alliance (TA) is relevant within the therapeutic context of patients suffering from anorexia nervosa. Objective: To describe the aspects identified as facilitators in order to achieve a positive therapeutic alliance from the perspective of anorexic patients and their a positive therapeutic alliance from the perspective of anorexic patients and their therapists. Method: It was an exploratory, relational-descriptive and qualitative study and its data analysis was based in the Grounded Theory, including two anorectic patients and their in the Grounded Theory, including two anorectic patients and their therapists. Results: Both, patients and therapists valued the following parameters, respectively: 1. Emotional environment: unconditional genuine interest and confidence versus non judgment and higher availability; 2. Desirable behaviors and attitudes (in the therapist): flexibility, freedom of speech and availability, (in patients): to change and to have resources; 3. Valued techniques: centered in resources, co-participation in the treatment, to know testimonies of other patients versus focalization in skills, emphatic freedom of speech, to check the treatment constantly and to make the patient responsible of her therapy. A model of TA facilitators emerges that includes patient subsystem, therapist subsystem, relational atmosphere and therapeutic space with their particular characteristics. Conclusions: The generation of a good TA is a remarkable factor in the success of the therapeutic process that implies a conscious relationship and a reciprocal acceptation integrated by the influences of the therapist/patient dyad.
Subject(s)
Humans , Adult , Female , Young Adult , Anorexia Nervosa/psychology , Anorexia Nervosa/therapy , Professional-Patient Relations , Cooperative Behavior , Emotions , Environment , Feeding and Eating Disorders/psychology , Feeding and Eating Disorders/therapyABSTRACT
Este estudio pretendió comprender las vivencias subjetivas de adolescentes chilenos con obesidad, respecto a su tratamiento para adelgazar. Se empleó una metodología cualitativa y se realizó un diseno descriptivo. La muestra quedó constituida por nueve participantes entre 13 y 18 anos. Los datos se recogieron con entrevistas focalizadas y se analizaron según los principios de la Grounded Theory. Los resultados indican que para los participantes es importante contar con un tratamiento multidisciplinario en donde también reciban el apoyo del entorno para su realización. La motivación intrínseca para generar el cambio se sindica como relevante y toma gran importancia, sentir que es posible llevar a cabo el tratamiento y ver los efectos positivos de éste. En cuanto a los conflictos que presentan en su realización, se senala la falta de constancia, las dificultades para cambiar hábitos y el ambiente externo, cuando éste no ayuda a mantener el tratamiento.
The objective of this study was to understand the subjective experiences of Chilean adolescents with obesity, regarding their treatment to lose weight. A qualitative methodology and descriptive design was performed. The sample was formed by nine participants between 13 and 18 years old. The data was collected through focused interviews and was analyzed according to the principles of Grounded Theory. Results indicate thatfor participants is important to have a multidisciplinary treatment with environment support to fulfill its realization. Intrinsic motivation to create change is as relevant and feeling that it is possible to carry out the treatment and see the positive effects of it, takes great relevance. As for the conflicts that occur in their implementation, important points are the lack of consistency, difficulty of changing habits and the external environment, when it does not help to maintain treatment.
Subject(s)
Therapeutics/psychology , Adolescent , Obesity/psychologyABSTRACT
Background: In Chile, there has been an increase in suicide rates from 1.1 to 2.6 per 100,000 among adolescents aged 10 to 14 years and from 4.4 to 8.9 per 100,000 among those aged 15 to 19 years Aim: To identify protective factors for suicidal ideation according to parenting styles, as described by Barber et al. Material and Methods: The relation between suicidal ideation and parenting styles was assessed in a random sample of 2,346 Chilean school attending adolescents aged 13 to 20 years old (59% women) from three cities: Antofagasta (Northern Chile, II Region), Santiago (Central, Metropolitan Region) and Concepción (Southern, VIII Region). Participants were tested with the Chilean adaptation of the Cross National Adolescents Program (CNAP) Plus questionnaire developed by Barber et al. The relation between suicidal ideation and parenting styles was assessed using regression analyses. Results: Correlations between suicidal ideation and parenting styles were mostly significant, yet weak. High odds ratios were observed among parents who had a strong psychological control, inconsistent control, lack of expression of affection and covered marital hostility. Conclusions: High adolescent self-esteem, a good relationship with parents, psychological parental autonomy, expression of physical affection, social support and paternal monitoring were protective factors against suicidal ideation.
Subject(s)
Adolescent , Female , Humans , Male , Young Adult , Parent-Child Relations , Parenting , Personal Autonomy , Self Concept , Social Support , Suicidal Ideation , Chile , Logistic Models , Odds Ratio , Suicide/prevention & control , Time FactorsABSTRACT
Se presenta un consenso de expertos sobre "La Espiritualidad y Religiosidad como Factor Protector en Mujeres Depresivas con Riesgo Suicida", que se obtuvo utilizando una metodología Delphi. Sus resultados se han organizado en cinco áreas enfocadas en aspectos referentes al diseño de una intervención espiritual/religiosa: a) encuadre; b) características yformación del interventor, c) elementos a resguardar, d) contenidos y e) fases. Se concluye que los aspectos espirituales y religiosos deben considerarse en cada caso, y que un acompañamiento en pacientes creyentes puede mejorar su evolución y prevenir nuevos episodios de de riesgo suicida. En algunos casos la religiosidad pudiera aumentar los montos de culpa, aumentando la severidad y complejidad del cuadro clínico.
This document presents the expert consensus produced by a working meeting in Santiago de Chile during 2010 about "The Spirituality and Religiosity as a protective factor in depressive women with Suicidal Risk". The consensus followed the steps suggested by Delphi methodology. Its results are organized in five areas referent to spiritual/religious interventions: a) setting, b) counselor training, c) elements, d) subjects covered, e) stages. The experts consulted concluded that spiritual and religious aspects need to be considerate in each case, and that in believers can improve progress and prevent relapses at suicidal risk. However in some cases religious can increase the amounts offault, amplifying the severity and complicating the evolution.
Subject(s)
Humans , Female , Religion , Suicide, Attempted , Risk , Spirituality , DepressionABSTRACT
BACKGROUND: In Chile, there has been an increase in suicide rates from 1.1 to 2.6 per 100,000 among adolescents aged 10 to 14 years and from 4.4 to 8.9 per 100,000 among those aged 15 to 19 years AIM: To identify protective factors for suicidal ideation according to parenting styles, as described by Barber et al. MATERIAL AND METHODS: The relation between suicidal ideation and parenting styles was assessed in a random sample of 2,346 Chilean school attending adolescents aged 13 to 20 years old (59% women) from three cities: Antofagasta (Northern Chile, II Region), Santiago (Central, Metropolitan Region) and Concepción (Southern, VIII Region). Participants were tested with the Chilean adaptation of the Cross National Adolescents Program (CNAP) Plus questionnaire developed by Barber et al. The relation between suicidal ideation and parenting styles was assessed using regression analyses. RESULTS: Correlations between suicidal ideation and parenting styles were mostly significant, yet weak. High odds ratios were observed among parents who had a strong psychological control, inconsistent control, lack of expression of affection and covered marital hostility. CONCLUSIONS: High adolescent self-esteem, a good relationship with parents, psychological parental autonomy, expression of physical affection, social support and paternal monitoring were protective factors against suicidal ideation.
