Therapist's interventions immediately after exceeding the client's therapeutic zone of proximal development: A comparative case study.

OBJECTIVE: When therapists' proposals are too demanding exceeding clients' readiness to move into change, clients may resist advancing. We aimed to understand how a therapist behaved immediately after the client resisted advancing into change within Cognitive-Behavioral Therapy. METHODS: We analyzed a recovered and an unrecovered case, both with Major Depression, and followed by the same therapist. Through the Therapeutic Collaboration Coding System, we analyzed 407 exchanges of interest. RESULTS: In both cases, clients resisted more in advancing at intermediate sessions, mainly by the therapist's challenges to raise insight and debate cognitive beliefs in the recovered case, and to seek experiential meanings in the unrecovered case. Immediately after clients resisted advancing, the therapist tended to insist on challenging them in the same direction. In the recovered case, the therapist did so continually throughout the therapy, sometimes balancing between insisting or stepping back. In the unrecovered case, the therapist insisted on challenging, but mostly at the final session. Occasionally, the therapist insisted on challenging, and clients resisted over consecutive exchanges. CONCLUSION: Our results reinforce that to enact progress and change clients need to be pushed into change, however it requires therapists' skillful assessment of clients' tolerance to move in time.

Tradução para portuguêse validação cultural da Empowerment Assessment Rating Scale / Translation to Portuguese and cultural validation of the Empowerment Assessment Rating Scale

Introduction: To assess the level of community empowerment, Laverack proposes an instrument called the Empowerment Assessment Rating Scale (EARS), which has nine assessment domains related to community empowerment. Objectives: Translate to Portuguese and culturally validate the EARS for an ACeS community, a hospital community, a business community, and a school community. A review of the Portuguese translation was developed, a review group was set up to analyze the resulting document, by consensus a new scale called the Escala de Avaliação do Empoderamento Comunitário (EAvEC) was developed, and the retroversion was developed. Same review group conducted a new evaluation of the resulting version, comparing them with the original in English. The study was carried out at a Hospital in the Azores Archipelago, three Health Centers Organizations in the North of Portugal, an Education-oriented Company in Greater Porto and a School Community in Mozambique, where the focus group scale was applied based on a problematic chosen for intervention. Results: EVaEC retained the nine evaluation domains of the original scale and its translated version did not change after its cultural adaptation. The level of community empowerment was identified in each of the communities, analyzed in the form of a radar chart, with the clustered image of all domains. Discussion / Conclusions: EVaEC is a useful tool for community intervention and is being used to assess community empowerment in the MAIEC project of theCentre for Interdisciplinary Research in Health at Universidade Católica Portuguesa

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Therapist's actions after therapeutic collaboration breaks: a single case study.

Aim: This study analyzes how a therapist contributed to therapeutic collaboration reestablishment by describing his actions after therapeutic collaboration breaks in a recovered completer clinical case. Method: Data was collected from a narrative therapy case with the diagnosis of depression spanning 19 sessions. We identified sequences in which therapeutic collaboration breaks were re-established (or not) through the Therapeutic Collaboration Coding System. We analyzed the therapist's actions after the therapeutic collaboration breaks through Conversation Analysis. Results: Typically, the therapist maintained the action that preceded the therapeutic collaboration break. When he did so by proposing a new meaning to the client's experience or by highlighting the client's agency, the therapeutic collaboration was usually re-established; however, when he did so by guiding or making exploratory questions to deepen the client's experience, the therapeutic collaboration was usually not re-established. When the therapist retreated from his previous action, the therapeutic collaboration tended to be re-established, mainly when he reflected the client's previous turn. Conclusion: This study suggests that more important than maintaining or retreating from the previous action is how the therapist does so. The therapist's actions of acknowledging the client's experience and agency contributed to therapeutic collaboration reestablishment.

Therapeutic collaboration and significant event to the client´s change: a systematic review

This study presents a systematic review of literature on research focused in significant events in psychotherapy and their relation with collaborative nature process between therapist and client. Researchers argue that attention to significant events can be effectively an important strategy to improve the understanding of how change process occurs in psychotherapy. Moreover, the therapeutic collaboration as a central dimension of alliance has been consistently associated with therapeutic change. This study aimed to understand how these two research topics have been addressed in conjunction by psychotherapy researchers. Medline and PubMed Resources Guide, Scielo, Web of Science, Scopus, PsycINFO, EBSCO and OVID electronic databases was searched between the years 2000 and 2015, with keywords such as therapeutic alliance or collaboration, and significant events, helpful aspects, important moments, or episodes, and process or outcomes, with all possible combinations of derivatives. Regarding the results of this review, we found only four qualitative studies that meet the inclusion criteria. These studies had different aims and used different methodologies to collect and to analyze the significant events. The analysis of these studies suggest a need for further investigations aiming to do microanalysis the interactive and relational processes occurring within the significant events in psychotherapy (AU)

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Evaluation of liquid biphasic Granada medium and instant liquid biphasic Granada medium for group B streptococcus detection.

INTRODUCTION: Group B streptococci (GBS) are transmitted from the mother to the newborn. Prevention of neonatal infection is achieved by intrapartum prophylaxis given to mothers colonized with GBS at 35 to 37 weeks of pregnancy. MATERIALS AND METHODS: Liquid biphasic Granada medium (LB) and instant liquid biphasic Granada medium (ILB) were evaluated for GBS detection. Vaginal swabs obtained from 300 women were inoculated onto LB or ILB, or onto Todd-Hewitt broth and analyzed with the ATB system (comparison method). RESULTS: Prevalence of GBS was 20% (61/300). LB and Todd-Hewitt with ATB detected GBS in 20% of women, and ILB in 19% of women. No growth was observed at four hours in any of the media studied. At 10 h and 14 h, identification of GBS was possible in 43/300 (14%) and 53/300 (18%) of ILB cultures, respectively, and in 32/300 (11%) and 46/300 (15%) of LB cultures. CONCLUSION: All the media used are suitable for GBS detection. The majority of GBS were identified in ILB and LB cultures at 10 h and 14 h.

Evaluation of liquid biphasic Granada medium and instant liquid biphasic Granada medium for group B streptococcus detection

Introduction. Group B streptococci (GBS) are transmitted from the mother to the newborn. Prevention of neonatal infection is achieved by intrapartum prophylaxis given to mothers colonized with GBS at 35 to 37 weeks of pregnancy. Materials and methods. Liquid biphasic Granada medium (LB) and instant liquid biphasic Granada medium (ILB) were evaluated for GBS detection. Vaginal swabs obtained from 300 women were inoculated onto LB or ILB, or onto Todd-Hewitt broth and analyzed with the ATB system (comparison method). Results. Prevalence of GBS was 20% (61/300). LB and Todd-Hewitt with ATB detected GBS in 20% of women, and ILB in 19% of women. No growth was observed at four hours in any of the media studied. At 10 h and 14 h, identification of GBS was possible in 43/300 (14%) and 53/300 (18%) of ILB cultures, respectively, and in 32/300 (11%) and 46/300 (15%) of LB cultures. Conclusion. All the media used are suitable for GBS detection. The majority of GBS were identified in ILB and LB cultures at 10 h and 14 h (AU)

Introducción Los estreptococos del grupo B (SGB) se transmiten de la madre al recién nacido. La prevención de la infección neonatal se logra mediante la profilaxis intraparto de las madres colonizadas por SGB en las semanas 35 a 37 de gestación. Materiales y métodos Se ha evaluado el uso del medio Granada líquido bifásico (LB) y del medio Granada líquidobifásico instantáneo (LBI) para la detección de SGB. Se tomaron muestras vaginales con torunda de 300 mujeres, se inocularon las torundas en LB, LBI o en caldo Todd-Hewitt, y se analizaron los resultados con el sistema ATB (método de comparación). Resultados La prevalencia de SGB fue del 20% (61/300). Los medios LB y Todd-Hewitt con ATB detectaron SGB en el 20% de mujeres, y el medio LBI en el 19%. No se observó crecimiento a las 4 h en ninguno de los medios estudiados. A las 10 y 14 h se pudo identificar SGB en 43/300 (14%) y en 53/300 (18%) de los cultivos en LBI, respectivamente, y en 32/300 (11%) y en 46/300 (15%) de los cultivos en LB. Conclusión Todos los medios usados son adecuados para la detección de SGB. La mayoría de SGB se identificaron en LBI y en LB a las 10 y a las 14 (AU)