ABSTRACT
Objective: Routine outcome monitoring benefits treatment by identifying potential no change and deterioration. The present study compared two methods of identifying early change and their ability to predict negative outcomes on self-report symptom and wellbeing measures. Method: 1467 voluntary day patients participated in a 10-day group Cognitive Behaviour Therapy (CBT) program and completed the symptom and wellbeing measures daily. Early change, as defined by (a) the clinical significance method and (b) longitudinal modelling, was compared on each measure. Results: Early change, as defined by the simpler clinical significance method, was superior at predicting negative outcomes than longitudinal modelling. The longitudinal modelling method failed to detect a group of deteriorated patients, and agreement between the early change methods and the final unchanged outcome was higher for the clinical significance method. Conclusions: Therapists could use the clinical significance early change method during treatment to alert them of patients at risk for negative outcomes, which in turn could allow therapists to prevent those negative outcomes from occurring.
Subject(s)
Cognitive Behavioral Therapy , Outcome Assessment, Health Care/methods , Personal Satisfaction , Self Report , Adult , Female , Humans , Longitudinal Studies , Male , Models, TheoreticalABSTRACT
Este estudo teve por objetivo avaliar a efetividade de um grupo terapêutico fundamentado na Terapia Cognitivo-Comportamental no atendimento à pessoa com transtorno de ansiedade na rede de atenção primária à saúde. Doze mulheres, de 20 a 49 anos, iniciaram o tratamento e 11 o concluíram três meses após o início da intervenção. Os dados foram coletados por meio do Inventário de Ansiedade de Beck e da Escala de Ansiedade de Hamilton. Análises estatísticas fundamentadas no método proposto por Jacobson e Truax (JT), o qual apresentou resultados confiáveis com todos os respectivos parâmetros, revelaram que a maioria das participantes apresentou mudança positiva e confiável após a intervenção. Diante disso, conclui-se que a utilização de ambos os instrumentos facilitou o manejo e a estruturação das atividades do grupo terapêutico, uma vez que os resultados proporcionaram um diagnóstico situacional. Outro ponto a ser destacado diz respeito à confiabilidade dos resultados obtida a partir do Método JT com todos os respectivos parâmetros.
This study aimed to evaluate the effectiveness of a therapeutic group based on Cognitive-Behavioral Therapy in the care of the person with anxiety disorder in the primary health care network. 12 women aged 20 to 49 years started treatment and 11 completed it three months after the beginning of the intervention. Data were collected using the Beck Anxiety Inventory and the Hamilton Anxiety Scale. Statistical analyses based on the method proposed by Jacobson and Truax (JT) revealed that the most part of the participants presented a reliable positive change after the intervention. Therefore, it was concluded that the use of both instruments proved to be a facilitator of the management and structuring of the activities of the therapeutic group since the results provided a situational diagnosis. Another point to be highlighted concerns about the reliability of the results obtained from the JT Method with all the respective parameters.
Este estudio tuvo como objetivo evaluar la efectividad de un grupo terapéutico basado en la Terapia Cognitivo-Comportamental en el cuidado de la persona con trastorno de ansiedad en la red de atención primaria. 12 mujeres de 20 a 49 años comenzaron el tratamiento y 11 la completaron tres meses después del inicio de la intervención. Los datos fueron recolectados utilizando el Inventario Beck de Ansiedad y la Escala de Ansiedad de Hamilton. Los análisis estadísticos basados en el método propuesto por Jacobson y Truax (JT) revelaron que la mayor parte de los participantes presentaron un cambio positivo confiable después de la intervención. Por lo tanto, se concluyó que el uso de ambos instrumentos resultó ser un facilitador de la gestión y estructuración de las actividades del grupo terapéutico, ya que los resultados proporcionaron un diagnóstico situacional. Otro punto a destacar se refiere a la fiabilidad de los resultados obtenidos del Método JT con todos los parámetros respectivos.
Subject(s)
Humans , Female , Adult , Middle Aged , Psychotherapy, Group , Mental Health , Clinical RelevanceABSTRACT
La prevención de los trastornos alimentarios es considerada por los psicólogos de la salud como una tarea prioritaria a cubrir. De acuerdo con esta idea se propuso analizar y evaluar la eficacia de dos programas de intervención basados en distintas estrategias. La muestra no probabilística estuvo formada por 58 estudiantes, con edad promedio de 13.43, (DE=1.14). Las participantes se asignaron al azar a dos distintos programas de prevención selectiva: Psicoeducación (n=28; x̅ de edad=13.46, DE=1.17) y Realidad Virtual Reforzada (n=30; x̅ de edad=13.40, DE=1.13). Los resultados muestran que no se detectaron diferencias entre los programas. Al evaluar el efecto de los dos programas por separado (prestest-postest) se obtuvieron resultados positivos y estadísticamente significativos (p < .001) en variables asociadas con imagen corporal y conductas alimentarias de riesgo. Además se observó una disminución importante en el porcentaje de participantes que se ubicaban en riesgo (significancia clínica) como producto de los programas. Estos hallazgos son alentadores debido a la importancia implicada en la disminución de factores de riesgo y el efecto que tiene en la salud de las adolescentes.
The prevention of eating disorders is considered, mainly by psychologists of health, a priority task to cover. In accord to this idea it was decided to analyze and evaluate the effectiveness of two intervention programs based in different strategies. The nonrandom sample consisted of n=58 students with a mean age of x̅ =13.43 (SD=1.14), which were randomly assigned to two different selective prevention programs: Psychoeducation (n = 28; age of x̅ =13.46, SD=1.17) and Virtual reality Reinforced (n=30; age of x̅ =13.40, SD=1.13). The results showed no differences between programs. However, when each was evaluated (pretest / postest) results were positive and statistically significant (p < .001) in those variables associated with body image and disordered eating. In addition there was a significant decrease in the percentage of participants who were placed at risk (clinical significance) as a result of the preventive programs. These findings are encouraging because of the importance involved in reducing risk factors and the effect it has on the health of adolescents.
