ABSTRACT
Dog-assisted therapy (DAT) has shown benefits in people with mental health disorders. A child psychiatric day hospital would be a suitable setting to implement DAT and evaluate the benefits in a pediatric population. METHODS: Mixed methods research in a naturalistic setting was considered in this pre-post quantitative study including 23 children under 13 treated in a day hospital over 2 years. Quantitative analysis included the number of emotional and behavioral outbursts and attendance rate and self-control and social impairment questionnaires completed by family members and therapists. In the qualitative study, the experiences of 12 mental health professionals involved in DAT were documented through semi-structured interviews. RESULTS: On DAT days, there were fewer emotional and behavioral outbursts and higher attendance. Significant differences were obtained between pre- and post-test scores on the SCRS and the SRS-2 completed by the therapists, while no significant differences were obtained on the questionnaires completed by the parents. Observations based on the qualitative study were as follows: (1) DAT improves emotional self-regulation; (2) DAT could facilitate the work of therapists in day hospitals; (3) health professionals displayed uncertainty due to a lack of familiarity with DAT. CONCLUSIONS: DAT improved emotional self-regulation, attendance rate and self-control and social response in children with mental disorders attending a day hospital.
ABSTRACT
INTRODUCCIÓN: El síndrome alcohólico fetal y los trastornos del espectro alcohólico fetal (TEAF) resultan de la exposición intrauterina al alcohol, y son las causas no heredables más comunes de discapacidad intelectual. Entre personas diagnosticadas de TEAF se ha identificado una mayor prevalencia de alteraciones físicas, cognitivas y conductuales, y mayor psicopatología en el niño, afectando a variables del temperamento que dificultan la creación de un vínculo seguro. Los niños con trastorno del vínculo presentan alteraciones conductuales, emocionales y de interacción social que aparecen asociados a la exposición de un patrón de cuidado caracterizado por negligencia, carencia social o maltrato durante la primera infancia. OBJETIVO: El objetivo del presente trabajo es aportar información sobre los trastornos del vínculo en población diagnosticada de un TEAF, a través de la revisión de la literatura existente y la presentación de dos casos clínicos. Por último, discutiremos sobre la intervención psicoterapéutica en este perfil clínico. MÉTODO: Estudio de casos clínicos, de dos niños con diagnóstico de TEAF y Trastorno del vínculo, atendidos en nuestro servicio de Psiquiatría y Psicología infanto-juvenil del Hospital Clínic de Barcelona. RESULTADO: Se expondrán las características clínicas y la evolución de los casos durante el tratamiento. CONCLUSIONES: Se propone un diagnóstico temprano y una intervención centrada en el vínculo que garantice un cuidador constante y sensible, involucrado emocionalmente y afectivamente disponible, y a partir de esta intervención, trabajar la sintomatología comórbida. No es posible generalizar los resultados debido a las limitaciones en la revisión y el número de casos
INTRODUCTION: Fetal alcohol syndrome and fetal alcohol spectrum disorders (FASD) result from intrauterine exposure to alcohol, and are the most common non-heritable causes of intellectual disability. Among people diagnosed with FASD, a higher prevalence of physical, cognitive and behavioral disorders, as well as more psychopathology have been identified in the child, affecting temperament variables that make it difficult to create a secure attachment. Children with attachment disorders show behavioral, emotional and social interaction problems that appear associated with exposure to patterns of care characterized by neglect, social deprivation or abuse during early childhood. OBJECTIVE: The aim of this work is to review the relationship between FASD and attachment disorders, through the review of the existing literature and the presentation of two clinical cases. Finally, we will discuss about the psychotherapeutic intervention in this clinical profile. METHOD: Clinical case study of 2 children with a diagnosis of FASD and attachment disorder, treated in our Child and Adolescent Clinical Psychiatry and Psychology Service at Hospital Clínic in Barcelona. RESULTS: The clinical characteristics and the evolution of the cases during the treatment will be presented. CONCLUSIONS: An early diagnosis and an intervention focused on attachment is proposed, providing a constant and sensitive caregiver, emotionally involved and affectively available, and after this, facilitate the work of comorbid symptoms. The results cannot be generalized due to review limitations and the number of cases
