Insight in terms of Behavior in the Clinical Context: Transfer and Rule-governed Behavior / El insight desde el análisis de la conducta: la transferencia y la conducta gobernada por reglas

A redefinition of insight-type events is presented, an initial attempt to view insight in terms of behavior analysis in the clinical context and relevant variables are suggested for their study. This definition assumes the insight as a novel behavior that involves the search for solutions to psychological problems. Solving a problem is discovering an effective behavior pattern, based on the creation of verbal rules that help the client to reach the solution. In this problem-solving process, a new behavior emerges, explained through the solution of a transfer task. The theoretical proposal exposed allows a better understanding of this phenomenon, overcoming the problems of mentalist conceptions about the term of insight, and contributes to a better understanding of some relevant elements of change process. (AU)

Se presenta una redefinición del evento tipo insight, un intento inicial por explicar el insight en términos del análisis de la conducta en el contexto clínico, así como la propuesta de variables relevantes para su estudio. Esta definición asume el insight como una conducta novedosa que involucra la búsqueda de soluciones a problemas de carácter psicológico. Resolver un problema es descubrir un patrón de conducta efectivo, a partir de la creación de reglas verbales que ayudan al cliente a llegar a la solución. En este proceso de resolución de problemas, emerge una conducta novedosa explicada a través de la solución de una tarea de transferencia. La propuesta teórica expuesta permite una mejor comprensión del fenómeno, superando los problemas de concepciones mentalistas y contribuye a un mejor entendimiento de elementos relevantes del proceso de cambio. (AU)

Verbal Behavior Analysis of Expert and Inexperienced Therapists Applying the Socratic Method.

The Socratic method, as an eminently verbal procedure, will be analyzed from a behavioral perspective in order to clarify how verbal conditioning works within. This work compares the verbalizations that expert and inexperienced therapists emit during Socratic method to find out which and why certain therapist verbalizations are most successful in changing client responses. The sample consisted of 113 Socratic method fragments from 18 cases, analyzed by observational methodology. The expert therapists had more than 6 years of experience, the inexperienced less than 2. Experts had fewer failure Socratic method fragments, but there were no differences in successful ones. The way of questioning had a different pattern: Inexperienced therapists suggested more the response, experts used more didactic verbalizations; also, experts used the aversive component more and contingently. The creation of guidelines based on functional description of verbal interaction and the need for novice psychologists training are some implications of these results.

Verbal Behavior Analysis of Expert and Inexperienced Therapists Applying the Socratic Method

The Socratic method, as an eminently verbal procedure, will be analyzed from a behavioral perspective in order to clarify how verbal conditioning works within. This work compares the verbalizations that expert and inexperienced therapists emit during Socratic method to find out which and why certain therapist verbalizations are most successful in changing client responses. The sample consisted of 113 Socratic method fragments from 18 cases, analyzed by observational methodology. The expert therapists had more than 6 years of experience, the inexperienced less than 2. Experts had fewer failure Socratic method fragments, but there were no differences in successful ones. The way of questioning had a different pattern: Inexperienced therapists suggested more the response, experts used more didactic verbalizations; also, experts used the aversive component more and contingently. The creation of guidelines based on functional description of verbal interaction and the need for novice psychologists training are some implications of these results. (AU)

Toward an experimental analysis of verbal shaping in psychotherapy.

AbstractObjective. Some authors have suggested that verbal shaping is an active component in cognitive restructuring. The goal of the current study was to provide experimental evidence in support of the shaping hypothesis. METHOD: Three consecutively admitted adults with symptoms of anxiety and depression participated in the study. Participants underwent baseline, treatment comparison, crossover, and follow-up phases as part of an experimental single-case study. We selected two target irrational beliefs and praised either the client's approximations to a terminal (more adaptive) class of verbalizations (differential reinforcement of approximations) or just the terminal class of verbalizations (terminal reinforcement). RESULTS: Irrational beliefs exposed to differential reinforcement of approximations was a more effective approach to reducing irrational beliefs. CONCLUSION: The study provides experimental evidence in support of the verbal shaping hypothesis. Our findings suggest that it may be possible to enhance clinical outcomes by actively engaging in verbal shaping during client-therapist verbal interaction.

What works in the Socratic debate? An analysis of verbal behaviour interaction during cognitive restructuring.

BACKGROUND: Cognitive restructuring is one of the most complex application procedures in psychotherapy. It is widely used by psychologists from different orientations. However, the guidelines on how to apply it do not usually have empirical evidence and there is a lack of knowledge about the mechanisms of change that explain it. AIMS: The analysis of verbalizations that therapists emit during the Socratic method could help to better understand the functioning and strategies of effective debates. METHOD: In this study, specific verbal interaction sequences were analysed using observational methodology. The sample consisted of 113 Socratic questioning fragments belonging to 18 clinical cases, treated by behavioural therapists. RESULTS: Among other findings, it was found that using questioning together with certain previous verbalizations directed the client's response more effectively and those successful debates were characterized by using the aversive component in a frequent and contingent way. CONCLUSION: This study shows the most effective way to establish such an interaction in the Socratic method (following a style closer to Ellis's argumentative debate), which entails relevant practical applications in therapy.

Applying cognitive restructuring in therapy: The clinical reality in Spain.

Cognitive restructuring is one of the most widely used techniques among psychologists of different orientations. However, there is a lack of clarity in what concerns its precise definition, functioning, effectiveness, and components. OBJECTIVE: To obtain precise information on how psychotherapists use cognitive restructuring in their clinical practice in Spain. METHOD: A survey study was conducted following a descriptive quantitative methodology, with a cross-sectional design and a non-random sampling method. Three hundred and twenty psychotherapists responded to a questionnaire, created ad hoc, on cognitive restructuring. RESULTS: Cognitive restructuring is widely used by therapists with different levels of experience, training, and following different psychotherapeutic approaches. Furthermore, it is applied to address a wide variety of psychological problems. There exist relevant differences in the use of the technique depending on the therapists' level of experience. CONCLUSIONS: This study has shown, for the first time, how cognitive restructuring is applied in daily clinical practice. The main implications of these results are discussed, and new lines of inquiry are proposed. Clinical or methodological significance of this article: This study has contributed to bringing the clinical reality of cognitive restructuring closer to the scientific community, by identifying which of the elements and procedures that are taught or researched are actually applied in daily practice.

Rule Emission: A Possible Variable for Improved Therapeutic Practice.

It has been suggested that achieving greater effectiveness in psychotherapeutic treatment requires analyzing what therapists actually do and say, how they do this and when it is done. Based on this approach, in this study we focused on the rules emitted by therapists, since providing rules is thought to be of fundamental importance in promoting effective and efficient clinical change. Specifically, we sought to determine whether the experience level of therapists and the brevity of therapy would be related to patterns of therapist rule emission as categorized by the Category System of Rules emitted by the Therapist (SISC-RULES-T) (Vargas-de la Cruz & Pardo-Cebrián, 2014). Greater therapist experience and shorter therapy duration were found to be reliably predictive of more rule emissions across most rule categories (Z values between: Z = -3.68 and Z = -2.05; p values: p < .05 and p < .001). These variables were also predictive of more emissions of rules that specified all three operant contingency elements (situation, behavior, and consequence) rather than fewer elements (Z = -2.59, p < .05; Z = -2.26, p < .05). In the expert therapists and therapist with shorter cases, there was a nonsignificant tendency for the emission of general and conceptual rules to increase over sessions whereas emissions of concrete and particular rules tended to decrease; the explicitness of the three contingency elements also tended to decrease as treatment progressed. These findings may help to identify verbal characteristics of therapists that could lead to improved therapeutic practice.

Rule emission: a possible variable for improved therapeutic practice

It has been suggested that achieving greater effectiveness in psychotherapeutic treatment requires analyzing what therapists actually do and say, how they do this and when it is done. Based on this approach, in this study we focused on the rules emitted by therapists, since providing rules is thought to be of fundamental importance in promoting effective and efficient clinical change. Specifically, we sought to determine whether the experience level of therapists and the brevity of therapy would be related to patterns of therapist rule emission as categorized by the Category System of Rules emitted by the Therapist (SISC-RULES-T) (Vargas-de la Cruz & Pardo-Cebrián, 2014). Greater therapist experience and shorter therapy duration were found to be reliably predictive of more rule emissions across most rule categories (Z values between: Z = -3.68 and Z = -2.05; p values: p < .05 and p < .001). These variables were also predictive of more emissions of rules that specified all three operant contingency elements (situation, behavior, and consequence) rather than fewer elements (Z = -2.59, p < .05; Z = -2.26, p < .05). In the expert therapists and therapist with shorter cases, there was a nonsignificant tendency for the emission of general and conceptual rules to increase over sessions whereas emissions of concrete and particular rules tended to decrease; the explicitness of the three contingency elements also tended to decrease as treatment progressed. These findings may help to identify verbal characteristics of therapists that could lead to improved therapeutic practice

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Estudio Epidemiológico sobre cefaleas en población universitaria española / Epidemiological study of headache in Spanish university population

Resumen Las cefaleas representan un problema socio-sanitario de grandes dimensiones dada su elevada prevalencia a nivel mundial y las importantes implicaciones que tiene en la calidad de vida. El estrés es un factor esencial en el desarrollo y mantenimiento de las cefaleas, problema que se presenta con frecuencia en estudiantes universitarios. En este estudio se analizan la prevalencia, frecuencia, duración, intensidad, diagnóstico, medicación y distribución de las cefaleas así como otras características epidemiológicas relacionadas con la incapacidad percibida y las estrategias de afrontamiento. Una muestra de 458 participantes compuesta por 306 estudiantes de la Universidad Autónoma de Madrid (UAM) y 152 personas ajenas a dicha universidad, completaron la Encuesta epidemiológica de cefaleas online, creada ad hoc para este estudio. Se encontró un elevado porcentaje de personas que presentan cefaleas frecuentemente (entre 5 y 20 veces al mes) y no están diagnosticadas (63,2%). Se comparan los resultados con datos obtenidos en otras poblaciones y se discute su impacto e implicaciones. Se resalta la necesidad de implementar programas de prevención y tratamiento psicológicos y multidisciplinares.

Abstract Headaches represent a major socio-sanitary problem due to its high global prevalence and the important implications that they have on quality of life. Stress is an essential factor in the development and maintenance of headaches, a problem frequently encountered in university students. This study analyzes the prevalence, frequency, duration, intensity, diagnosis, medication and distribution of headaches as well as other epidemiological characteristics related to perceived disability and coping strategies. A sample of 458 participants formed by 306 students from the Autonoma University of Madrid (UAM) and 152 people not related to that university completed the "Online Headaches Epidemiological Inquest" created ad hoc for this study. We found a high percentage of people who presented headaches frequently (between 5 and 20 times per month) and were not diagnosed (63.2%). The results are compared with data obtained from other populations and their impact and implications are discussed. The need to implement psychological and multidisciplinary prevention and treatment programs is highlighted.

Las verbalizaciones tipo regla del terapeuta a lo largo del proceso clínico / The Therapist's rule-like Verbalizations throughout the Clinical Process

RESUMEN Se ha reconocido la importancia de las reglas del cliente para explicar un problema psicológico y para lograr superarlo. Sin embargo, no se ha incidido en el papel que podrían tener las reglas del terapeuta en el proceso clínico. Como un primer paso para poder dar una respuesta al respecto, en este estudio realizamos un análisis morfológico de las verbalizaciones en forma de regla emitidas por el terapeuta a lo largo del proceso clínico con el fin de identificar un patrón de emisión de este tipo de verbalizaciones que cambie de acuerdo con los distintos momentos de la terapia. Se analizaron las verbalizaciones en forma de regla emitidas por 9 terapeutas a lo largo de 19 casos clínicos (92 sesiones). Las verbalizaciones se codificaron de acuerdo con un Sistema de Categorización de las Reglas del Terapeuta (SISC-REGLAS-T). Los resultados mostraron diferencias entre el tipo de verbalizaciones en forma de regla y el objetivo que el terapeuta persigue alcanzar en los distintos momentos de la terapia. Estos resultados pueden ayudar a comprender cómo el terapeuta utiliza las verbalizaciones en forma de reglas, lo que contribuye al esclarecimiento del papel de las reglas que emite el terapeuta para conseguir el cambio clínico.

ABSTRACT It has been pointed out the importance of the rules to explain and to treat psychological problems. However it hasn't emphasize the role that the therapist's rules could have in clinical process. As a first step to give an answer, we realize a morphological analysis of verbalization- like-rule emitted by the therapist throughout the clinical process with the aim to identify a patron of emission of this kind of verbalization that changes according to different moments of therapy. This study analyzed the verbalization-like-rules emitted by 9 therapists over 19 clinical cases (92 sessions). The verbalizations were coded according to a system of categorization of the Rules Therapist (SISC-RULES-T). The results showed differences between the type of verbalizations-like-rules and target the therapist aims to achieve at different times of therapy. These results may help to understand how the therapist uses this kind of verbalizations, helping to clarify the functional role of rules issued by the therapist for clinical change.