Skills training followed by either EMDR or narrative therapy for posttraumatic stress disorder in adult survivors of childhood abuse: a randomized controlled trial.

Background: Individuals suffering from PTSD following childhood abuse represent a large subgroup of patients attending mental health services. The aim of phase-based treatment is to tailor treatment to the specific needs to childhood abuse survivors with PTSD with a Skills Training in Affective and Interpersonal Regulation (STAIR) phase, in which emotion dysregulation and interpersonal problems are targeted, and a trauma-focused phase.Objective: The purpose of this study was to compare STAIR + Eye Movement Desensitization and Reprocessing (EMDR) vs. STAIR + Narrative Therapy (NT) as treatments for PTSD following childhood-onset trauma in a routine clinical setting.Method: Sixty-eight adults were randomly assigned to STAIR/EMDR (8 STAIR-sessions followed by 12 EMDR-sessions) or STAIR/NT (8 STAIR-sessions followed by 12 NT-sessions). Assessments took place at pre-treatment, after each treatment phase and at 3 and 12 months post-intervention follow-up. Primary outcomes were interviewer-rated and self-reported symptom levels of PTSD. Secondary outcomes included symptom levels of depression and disturbances in emotion regulation and interpersonal skills.Results: Multilevel analyses in the intent-to-treat sample indicated that patients in both treatments improved substantially on PTSD symptom severity (CAPS: d = 0.81 to 1.29; PDS: d = 1.68 to 2.15), as well as on symptom levels of depression, anxiety, emotion regulation, dissociation and interpersonal skills. Effects increased or were maintained until 12-month follow-up. At mid-treatment, after STAIR, patients in both treatments improved moderately on PTSD symptom severity (PDS: d = 1.68 to 2.15), as well as on symptom levels of depression (BDI: d = .32 to .31). Symptoms of anxiety, emotion dysregulation, interpersonal problems and dissociation were not decreased after STAIR. There were no significant differences between the two conditions on any outcome.Conclusion: PTSD in adult survivors of childhood interpersonal trauma can effectively be treated by phase-based interventions using either EMDR or NT in the trauma-processing phase.Trial registration: ClinicalTrials.gov identifier: NCT01443182..

The study directly compares Skills Training in Affective and Interpersonal Regulation (STAIR) followed by either EMDR or Narrative Therapy in the trauma-processing phase in routine clinical setting.The brief phase-based treatment was found to be effective in reducing both symptoms of PTSD as well as emotion regulation and interpersonal problems in survivors of childhood abuse.Posttraumatic Stress Disorder in adult survivors of childhood interpersonal trauma can effectively be treated by phase-based interventions using either EMDR or Narrative Therapy in the trauma-processing phase.

La terapia narrativa como intervención en jóvenes víctimas de abuso sexual infantil / Narrative therapy as an intervention in young victims of child sexual abuse

La terapia narrativa surge como una propuesta de intervención, debido a que este modelo permite que las personas puedan generar un proceso donde se desarrolle de manera integral lo que han padecido, y, de esa manera, poder resignificarlo; consiguientemente, cada paciente puede, así, superar la experiencia traumática (Ihl y Diaz, 2021). Método: Este trabajo de integración final de diseño teórico de revisión bibliográfica se propuso analizar la posible eficacia de la terapia narrativa como intervención clínica con jóvenes que han sido víctimas del abuso sexual infantil. Síntesis y conclusiones: La terapia narrativa propone un espacio respetuoso, flexible y de contención; se establece un entorno en el que el paciente tiene la oportunidad de contar su experiencia traumática, sin estar obligado a relatarla. Es decir, este abordaje no se enfoca en la exposición del trauma, ni exige que la persona relate la situación de abuso en un momento específico; la terapia narrativa propone trabajar con los efectos y las consecuencias del trauma AU

Narrative therapy emerges as an intervention proposal because this model allows people to generate a process where what they have suffered is developed in an integral way, and, in this way, to resignify it; consequently, each patient can thus overcome the traumatic experience (Ihl & Diaz, 2021). Method: This work offinal integration of theoretical design of bibliographic review was proposed to analyze the possible effectiveness of narrative therapy as a clinical intervention with young people who have been victims of child sexual abuse. Synthesis and conclusions: Narrative therapy proposes a respectful, flexible, and supportive space; an environment is established in which the patient has the opportunity to recount his traumatic experience, without being obliged to recount it. In other words, this approach does not focus on the exposure of the trauma, nor does it require the person to report the situation of abuse at a specific time; Narrative therapy proposes working with the effects and consequences of trauma AU

Education for peace and coexistence without violence. A proposal at the basic level from Narrative Therapy / Educación para la paz y convivencia sin violencia. una propuesta en el nivel básico desde la terapia narrativa

RESUMEN Este artículo contribuye a las investigaciones y propuestas de intervención cualitativas para mejorar la convivencia y fomentar la paz a través de una metodología emergente que muestra la terapia narrativa. Se partió de un diagnóstico realizado en una escuela primaria de la ciudad de Guadalajara (Jalisco) que cuenta con 340 alumnos, entre 6 y 12 años, donde se evidencia la violencia en dicho plantel, detectada mediante estadística simple, narrativas y dibujos. Efectuamos una propuesta de intervención a partir de un modelo que sugiere la terapia narrativa, denominado "el árbol de la vida", que permitió a niñas y niños tomar un sentido de pertenencia al convivir en paz, manifestando experiencias pedagógicas que promuevan el concepto de comunidad educativa incluyente con valores humanos y esperanzadora, tan necesaria en estos tiempos. El objetivo de esta investigación fue dar cuenta de que educar para la paz y la convivencia es una construcción que se realiza en nuestra vida cotidiana y que la escuela es un espacio ideal para tomar conciencia cultivar y crear desde temprana edad una sociedad constructora de culturas de paz.

ABSTRACT This article supports qualitative research and intervention proposals to improve coexistence and promote peace through an emerging methodology that shows narrative therapy. It was based on a diagnosis made in a primary school in the city of Guadalajara, Jalisco, which has 340 students, between 6 and 12 years old, where violence is evidenced in said campus, detected through simple statistics, narratives and drawings. We made an intervention proposal based on a model that suggests narrative therapy called "the tree of life" that allowed girls and boys to take a sense of belonging by living together in peace, manifesting pedagogical experiences that promote the concept of an inclusive educational community with human and hopeful values, so necessary in these times. The objective of this research was to realize that educating for peace and coexistence is a construction that takes place in our daily lives and that the school is an ideal space, to become aware of cultivating and creating from an early age, a construction society of cultures of peace.

The couple's tree of life: Promoting and protecting relational identity.

We present The Couple's Tree of Life (CTOL) as a new collective narrative methodology to strengthen couple relationships and prevent conflicts. The CTOL, based on the tree of life methodology (Ncube & Denborough, Tree of Life, mainstreaming psychosocial care and support: a manual for facilitators, REPSSI, 2007), aims to reinforce the identity and strengths of the couple. We explain the CTOL implementation process and illustrate it step by step with a group of 14 adult heterosexual Caucasian couples who belonged to Protestant churches in Madrid (Spain). As a way to assess its usefulness before applying the CTOL to other groups of couples, we conducted a pre-post evaluation using the Dyadic Adjustment Scale of Spanier(1976). We found an improvement in dyadic adjustment, quality, understanding of, and satisfaction with, the relationship. The results, though not generalizable at this stage, suggest that the CTOL could reinforce the couple's identity while maintaining individual identities. We also discuss the possible applications of couples therapy.

Presentamos El árbol de la vida de la pareja (CTOL, por sus siglas en inglés) como una nueva metodología narrativa colectiva, con el fin de fortalecer las relaciones de pareja y para la prevención de conflictos. El CTOL, basado en la metodología del árbol de la vida (Ncube & Denborough, Tree of Life, mainstreaming psychosocial care and support: a manual for facilitators, REPSSI, 2007), tiene como finalidad reforzar la identidad y las fortalezas de la pareja. Explicamos el proceso de implementación del CTOL y lo ejemplificamos paso a paso con un grupo de 14 parejas heterosexuales caucásicas adultas que pertenecían a iglesias protestantes en Madrid (España). Como forma de evaluar su utilidad antes de aplicar el CTOL a otros grupos de parejas, realizamos una evaluación previa y posterior utilizando la Escala de Ajuste Diádico de Spanier (1976). Hallamos una mejora en el ajuste diádico, en la calidad, en la comprensión de la relación y en la satisfacción con esta. Los resultados, aunque no son generalizables en esta etapa, sugieren que el árbol de la vida de la pareja podría reforzar la identidad de la pareja y a la vez mantener las identidades individuales. También explicamos las posibles aplicaciones a la terapia de pareja.

A randomized controlled trial evaluating the effectiveness of narrative therapy on resilience of orphaned and abandoned children fostered in SOS children's village.

Background: Narrative Therapy is an efficacious treatment approach widely practiced for various psychological conditions. However, few studies have examined its effectiveness on resilience, a robust determinant of one's mental health, and there has been no randomized controlled trial in sub-Saharan Africa.Objective: This study sought to evaluate the efficacy of narrative therapy for the resilience of orphaned and abandoned children in Rwanda.Method: This study was a 'parallel randomized controlled trial' in which participants (n = 72) were recruited from SOS Children's Village. Half of the participants (n = 36) were randomly allocated to the intervention group and the rest to the delayed narrative therapy group. For the intervention group, children attended ten sessions (55 min each) over 2.5 months. Data were collected using the Child and Youth Resilience Measure (CYRM) and analyzed using mixed ANOVA within SPSS version 28.Result: The results from ANOVA indicated a significant main effect of time and group for resilience total scores. Of interest, there was a significant time by group interaction effect for resilience. Pairwise comparison analyses within-group showed a significant increase in resilience in the intervention group, and the effect size was relatively large in this group.Conclusion: Our findings highlight the notable efficacy of narrative therapy for children's resilience in the intervention group. Therefore, health professionals and organizations working with orphaned and abandoned children will apply narrative therapy to strengthen their resilience and improve mental health.Trial registration: Pan African Clinical Trial Registry identifier: PACTR202107499406828..

The effect size of narrative therapy for resilience was relatively large in the intervention group.Narrative therapy is an efficacious approach for resilience elevation in orphaned and abandoned children.Close attention should be paid to the implementation of narrative therapy for strengthening children's resilience as an everyday tool in foster care.

Terapia narrativa e neuroplasticidade: pensando suas conexões / Narrative therapy, neuroplasticity and their connections

Foi investigado, nesse artigo, a forma com que a terapia narrativa, a partir da construção de histórias alternativas, pode estimular a plasticidade neuronal, promovendo mudanças psicológicas e comportamentais. Realizou-se uma revisão bibliográfica para analisar as contribuições teóricas e práticas da relação entre histórias alternativas e a neuroplasticidade. Foi observado que esta interface tem sido pouco estudada enquanto tema unificado. Na terapia narrativa o terapeuta ajuda o paciente a olhar detalhes até então não percebidos de sua história, trazendo novos estímulos e permitindo ao paciente recontar repetidas vezes sua própria história alternativa. Isso contribui para uma ressignificação de sua história e o desenvolvimento de novos pensamentos e sentimentos, que resultarão em novos comportamentos. A vivência desse processo, ativa a neuroplasticidade do cérebro e cria novas conexões neuronais, gerando mudanças saudáveis e funcionais na vida do paciente.

This work investigates how narrative therapy can stimulate neuroplasticity, with basis on the construction of alternative histories, thus promoting psychological and behavioral changes. A literature review was carried out to analyze the contribution, theoretical and practical, arising from the relationship between neuroplasticity and alternative histories. It was noticed that this interface has been little studied as a unified theme. In narrative therapy, the therapist helps the patient to look at details of his/her history so far unnoticed, bringing new stimuli and allowing the patient to recall his/her alternative history, over and over again. This contributes to a resignification of his/her history and the development of new thoughts and feelings, which will result in behavioral changes. The experience of the process of creating and recalling such alternative history, activates brain’s neuroplasticity, establishing new neural connections and contributing to healthy and functional changes in the patient's life.

Mindfulness and Embodiment in Family Therapy: Overview, Nuances, and Clinical Applications in Poststructural Practices.

This paper discusses the inclusion of ideas from mindfulness, embodiment, and associated brain research in poststructural family therapies. Connecting research and practice across diverse fields is presented as enriching therapeutic work, increasing clinical effectiveness, and broadening options for families seeking our assistance. Ways of incorporating mindfulness and embodiment are described and offer distinctively novel practices not typically used in traditional forms of poststructural therapies. These innovative practices are illustrated by clinical work with a mother and her five-year- daughter who survived a dangerous health crisis and an extremely painful hospitalization. Therapeutic work with this family exemplifies how traumatic experiences are not always accessible through linguistic means alone. Working with interpersonal mind-body practices can uniquely contribute to relaxing the sympathetic nervous system and activating the social engagement branch of the parasympathetic nervous system. The inclusion of such practices can provide valuable opportunities to facilitate the emergence of preferred experiences of self for all family members.

Este artículo trata de la inclusión de las ideas de conciencia plena y personificación, y de la investigación neurológica asociada en las terapias familiares posestructurales. La conexión de la investigación y la práctica entre áreas diversas se presenta como un trabajo terapéutico enriquecedor que aumenta la eficacia clínica y amplía las opciones para las familias que buscan nuestra asistencia. Se describen las maneras de incorporar la conciencia plena y la personificación y se ofrecen prácticas distintivamente innovadoras que normalmente no se usan en las formas tradicionales de las terapias posestructurales. Estas prácticas innovadoras se ilustran mediante el trabajo clínico con una madre y su hija de cinco años que sobrevivieron a una emergencia de salud peligrosa y a una hospitalización sumamente dolorosa. El trabajo terapéutico con esta familia ejemplifica cómo no siempre es posible acceder a las experiencias traumáticas por medios lingüísticos solamente. El trabajo con prácticas interpersonales centradas en el cuerpo y la mente puede contribuir de manera única a relajar el sistema nervioso simpático y a activar la rama de la participación social del sistema nervioso parasimpático. La inclusión de dichas prácticas puede brindar oportunidades valiosas de facilitar el surgimiento de experiencias preferidas del yo para todos los miembros de la familia.

Constructing We-ness: A Communal Coping Intervention for Couples Facing Chronic Illness.

Communal coping occurs when relationship partners view a stressful health problem as "ours," rather than yours or mine, and take collaborative action to deal with it. Although research employing linguistic (we-talk) and other measures of communal coping demonstrates relevance to a variety of chronic illnesses, the literature offers little about how clinicians can actively promote we-ness and teamwork to help patients and their partners achieve the health benefits this appears to confer. This paper highlights clinical and supporting scientific features of a narrative intervention designed to foster communal coping by couples in which one partner has a chronic illness. The illustrative illness is diabetes, but with modification the protocol is suitable for other chronic conditions as well. Grounded in systemic and narrative models of problem maintenance and change, the communal coping intervention represents a distillation of research and clinical experience with family consultation over several decades. In contrast to more directive and educational approaches, the intervention consists entirely of questions, with no direct suggestions or instruction about how patients, partners, or couples should change. These questions comprise 8 sequential modules (Coping Challenges, Trajectory and Focus, Illness as External Invader, You as a Couple, Past Teamwork in Overcoming Adversity, Present and Future Teamwork, Obstacles to Teamwork, and Wrap-Up), described here in manual-like detail.

El afrontamiento comunitario ocurre cuando las parejas de una relación ven un problema de salud estresante como nuestro, en lugar de tuyo o mío, y toman medidas colaborativas para resolverlo. Aunque las investigaciones que emplean medidas lingüísticas (uso de nosotros al hablar) y otras medidas de afrontamiento comunitario demuestran relevancia para diversas enfermedades crónicas, la bibliografía ofrece poco sobre cómo los profesionales clínicos pueden promover activamente la nostredad y el trabajo en equipo para ayudar a los pacientes y a sus parejas a obtener los beneficios de salud que esto parece conceder. Este artículo destaca las características científicas clínicas y respaldatorias de una intervención narrativa diseñada para fomentar el afrontamiento comunitario por parte de parejas en las cuales uno de sus integrantes tiene una enfermedad crónica. La enfermedad que se ejemplifica es la diabetes, pero con modificaciones, el protocolo es apropiado para otras enfermedades crónicas también. Basada en modelos sistémicos y narrativos de mantenimiento de problemas y de cambio, la intervención de afrontamiento comunitario representa una síntesis de la investigación y la experiencia clínica con consultas de familias durante varias décadas. En contraste con enfoques más autoritarios y educativos, la intervención consiste totalmente en preguntas, sin sugerencias directas ni órdenes sobre cómo los pacientes, las integrantes de la pareja o las parejas deben cambiar. Estas preguntas están compuestas por ocho módulos correlativos (Las dificultades del afrontamiento, La trayectoria y el enfoque, La enfermedad como invasor externo, Ustedes como pareja, El trabajo previo en equipo a la hora de superar la adversidad, El trabajo en equipo presente y futuro, Los obstáculos para el trabajo en equipo, y Conclusión), descritos aquí en detalle al estilo de un manual.

El construccionismo social en la conducta suicida: conversaciones narrativas con estudiantes universitarios / Social constructionism in suicidal behavior: narrative conversations with college students

En este artículo presentamos los resultados de una investigación que tuvo como objetivo com-prender los significados que los estudiantes de la Universidad Católica Luis Amigó de Manizales (Colombia) les dan a sus experiencias relacionales, en el contexto familiar y social, identifican-do aquellos aspectos de las relaciones que pueden ser factores protectores del riesgo suicida. Es una investigación de corte cualitativo con un diseño hermenéutico, siendo la narrativa la es-trategia para la producción dialógica. Tomamos como categorías de análisis los significados atribuidos a las relaciones con la familia, con los amigos y en el propio contexto investigativo. Encontramos que son factores protectores del riesgo suicida: la aceptación, la confianza y la posibilidad de ser auténtico y de expresarse libremente. Consideramos el potencial preventivo de las conversaciones narrativas basadas en el reconocimiento y el diálogo en las relaciones in-terpersonales. (AU)

In this paper we present the results of a research that aimed to understand the meanings that the students of the Luis Amigó Catholic University of Manizales (Colombia) give to their rela-tional experiences, in the familiar and social contexts, identifying those aspects of the rela-tionships that can be protective factors for suicide risk. It is a qualitative research with a hermeneutic design, being narrative approach the strategy for dialogic production. We took as categories of analysis the meanings attributed to relationships with family, friends, partners and in the research context itself. We found that acceptance, trust, the possibility of being authentic and of expressing oneself freely are protective factors for suicidal risk. Finally, we acknowledge the preventive potential of narrative conversations based on recognition and dia-logue in interpersonal relationships. (AU)

Maternidad e identidad materna: deconstrucción terapéutica de narrativas / Maternity and maternal identity: therapeutic deconstruction of narratives

La identidad se construye en la infancia mediante la interacción entre el sujeto y el ambiente, y se va transformando a lo largo de la vida en función de las experiencias del individuo, las relaciones interpersonales y los discursos culturales predominantes. Históricamente, un constructo de repercusión fundamental en la generación de la identidad ha sido el concepto binario de género masculino/femenino, que suponía la asignación de roles sociales diferenciados a hombres y mujeres. En la mujer, la maternidad implica el nacimiento de una nueva identidad a menudo ligada a narrativas rígidas respecto a la “buena madre,” heredadas de los modelos de socialización tradicionales y patriarcales, que entran en conflicto con otros discursos de realización personal. Las dificultades para adecuar las propias decisiones a la narrativa de la “buena madre” generan síntomas de ansiedad, impotencia y frustración en las mujeres, y han propiciado un importante debate social con opiniones encontradas respecto a los modelos de crianza y cuidados de los hijos. En esta revisión, se propone una guía de exploración y abordaje terapéutico narrativo para ayudar a las mujeres que atendemos en la consulta a cuestionar los discursos sociales que les provocan malestar emocional y validar su toma de decisiones respecto a las distintas formas de crianza y maternidad. (AU)

Identity is built during childhood through the interaction of subjects with their environment and circumstances, and is subsequently modified during their lifetime depending on their different individual experiences, the interpersonal relationships they establish, and the predominant cultural discourse. Historically, we can define the binary concept of “gender”, male/female, as a fundamental factor of identity building that assigns very different social roles to different individuals depending on them being categorized as male or female. To women, maternity implies the birth of a new identity, which is traditionally linked to fairly strong pre-established cultural narratives about what a “good mother” is. This is, in turn, related to the traditional patterns of socialisation, which may spark a conflict against other cultural discourses centred around personal fulfilment. The difficulties that arise when trying to accommodate their self-decisions to the “good mother” narrative may generate anxiety symptoms, a sense of helplessness, and frustration among women. This struggle has propitiated and encouraged an important social debate with very opposing views about child rearing, nurturing, and care. In this revision paper, we propose a guide for exploration and management based on narrative therapy to help women we assist in our medical practice to question the social discourses that generate such emotional uneasiness and to validate their own decisions regarding the different approaches to child-bearing and rearing. (AU)

Efeito da terapia de reminiscência na população geriátrica: Scoping review / Effects of reminiscence therapy on the geriatric population: Scoping review / Efecto de la terapia de reminiscencia en la población geriátrica: Scoping Review

CONTEXTO: A Terapia da Reminiscência (TR) tem vindo a ser utilizada com o objetivo de promover o bem-estar, a cognição e o humor. A população geriátrica tem habitualmente associadas patologias como demência e/ou depressão e é frequentemente alvo de TR. Contudo, uma pesquisa preliminar revelou que os dados relativos aos efeitos desta terapia e a forma como esta deve ser implementada, encontram-se dispersos na literatura sendo difícil a sua apreciação. Por conseguinte decidiu-se realizar uma scoping review com a seguinte questão de investigação: “Qual o efeito da terapia da reminiscência na população geriátrica?”. OBJETIVO(S): Mapear a evidência científica acerca dos efeitos da TR na população geriátrica. MÉTODOS: Scoping Review orientada pela metodologia proposta pelo Joana Briggs Institute. Entre 1 e 17 de junho de 2018, foram pesquisados os descritores “reminiscence therapy”, “reminiscence” e “life review” nas plataformas EBSCO, B-on, e nas bases de dados PubMed e SciELO. A seleção dos artigos foi realizada de acordo com critérios pré-definidos: idade dos participantes superior a 65 anos, aplicação de TR, artigos gratuitos e disponíveis em texto integral em Português, Espanhol e Inglês. RESULTADOS: Foram analisados 4 artigos num total de 73. A TR produz efeitos na redução da sintomatologia depressiva e na sobrecarga dos cuidadores, no comportamento, desempenho cognitivo e no bem-estar. CONCLUSÕES: Existe pouca evidência científica que comprove os efeitos da TR na população geriátrica, e a forma como esta deve ser implementada, pelo que é necessário desenvolver estudos longitudinais com amostras significativas, por forma a melhor compreender o efeito da TR.

BACKGROUND: Reminiscence Therapy (RT) has been used to promote well-being, cognition and mood improvement.The geriatric population is usually associated with pathologies such as dementia and/or depression and is often targeted for RT. However, preliminary research has shown that data regarding the effects of this therapy and how it should be implemented are scattered in the literature. Therefore, we decided to carry out a scoping review with the following research question: “What is the effect of reminiscence therapy on the geriatric population?” AIM To map the scientific evidence about the effects of the RT in the geriatric population. METHODS: A Scoping Review guided by the methodology proposed by the Joanna Briggs Institute. From the first of June to the 17th of 2018,we search for the "reminiscence therapy", "reminiscence" and "life review" descriptors in the EBSCO and B-on platforms, at PubMed and SciELO databases. The papers were selected according to predefined criteria such as participants' age of over 65 years, participants submitted to RT, papers with free full text in Portuguese, Spanish and English. RESULTS: 4 articles were selected and analyzed from a total of 73. The RT produces effects on the reduction of depressive symptoms and caregivers' overload, behavior, cognition, and well-being. CONCLUSIONS:There is a lack of evidence to substantiate the effect of the RT on the geriatric population, as well as how it should be applied. Therefore, further longitudinal studies with significant samples are necessary to better understand the effect of RT in the geriatric population.

CONTEXTO: La Terapia de la Reminiscencia (TR) ha sido utilizada con el objetivo de promover el bienestar, la cognición y el humor.La población generalmente está asociada a la demencia y depresión y está frecuentemente sometida a RT. Una investigación preliminar reveló que los datos sobre los efectos de esta terapia y cómo debe implementarse están dispersos en la literatura y son difíciles de evaluar. Consiguiente, se decidió realizar una scoping review con la siguiente pregunta de einvestigación: “Cuál es el efecto de la terapia de reminiscencia en la población geriátrica?” OBJETIVO(S): Mapear la evidencia sobre los efectos de la TR en la población geriátrica. METODOLOGÍA: Scoping Review usando la metodología propuesta por el Instituto Joanna Briggs. Entre el 1 y el 17 de junio de 2018, se usaron los descriptores "reminiscence therapy", "reminiscence" y "life review" en las plataformas EBSCO y B-on, en las bases PubMed y SciELO. La selección de artículos se llevó a cabo de acuerdo con criterios previamente definidos: edad de los participantes superior a 65 años, participantes se sometieron a la TR, y artículos disponibles en texto completo en portugués, español e inglés. RESULTADOS: Se analizaron 4 artículos de un total de 73. La TR produce efectos en la reducción de la sintomatología depresiva y sobrecarga de los cuidadores, en el comportamiento, cognición y el bienestar. CONCLUSIONES: Hay poca evidencia científica que demuestre los efectos de la TR en la geriátrica y de cómo debe ser implementada. Consiguiente es necesario realizar más estudios longitudinales y con muestras significativas para comprender mejor el efecto de la TR.

Outsider Witness Groups as a Means of Professional Growth in Family Therapy Training: An Exploratory Qualitative Study.

This exploratory qualitative study examines the experiences and meanings associated with family therapy trainees' participation in the narrative practice of Outsider Witness Groups (OWG). At the Barcai Institute in Tel Aviv, we incorporate OWGs into our live clinical supervision courses. In some sessions, we offer the families undergoing therapy the opportunity to listen to the reflections of the group of trainees regarding what they witnessed during the session. Twenty-nine family therapy trainees participated in the study in five focus group interviews. Analysis of the interviews yielded four core themes regarding the trainees' experiences: (i) Exploring the stance of the therapist; (ii) The art of listening; (iii) Reflection on hierarchy and boundary setting; and (iv) Negotiating self-disclosure. The findings indicate that family therapy trainees stand to benefit significantly in their professional journey, development, and growth from integrating OWG practices into their training. OWG fosters the development of critical reflectivity in trainees, including the deconstruction of common and taken-for-granted assumptions. It also fosters practices related to family therapy, and perhaps also to therapy in general. The findings also suggest that taking part in OWGs during training may contribute to family therapy trainees' development of critical reflectivity as a means of introducing a more critical and political approach to therapy and developing their own preferred stories as therapists.

Este estudio exploratorio cualitativo analiza las experiencias y los significados asociados con la participación de practicantes de terapia familiar en la práctica narrativa con grupos de testigos externos (OWG; White, 2007). En el Barcai Institute de Tel Aviv, incorporamos grupos de testigos externos en nuestros cursos de supervisión clínica en vivo. En algunas sesiones, ofrecemos a las familias que están en terapia la oportunidad de escuchar las reflexiones del grupo de practicantes con respecto a lo que observaron durante la sesión. Veintinueve practicantes de terapia familiar participaron en el estudio en cinco entrevistas de grupos focales. Los análisis de las entrevistas arrojaron cuatro temas principales relativos a las experiencias de los practicantes: (a) el análisis de la postura del terapeuta; (b) el arte de escuchar; (c) la reflexión sobre la jerarquía y la fijación de límites; y (d) la negociación de la autorrevelación. Los resultados indican que los practicantes de terapia familiar salen ganando considerablemente en su recorrido, desarrollo y crecimiento profesional como consecuencia de la integración de las prácticas de grupos de testigos externos en su formación. Los grupos de testigos externos fomentan el desarrollo de la reflexividad crítica en los practicantes, incluida la deconstrucción de los supuestos comunes y dados por sentado. También promueven las prácticas relacionadas con la terapia familiar, y quizá también con la terapia en general. Los resultados también sugieren que formar parte de los grupos de testigos externos durante la formación puede contribuir al desarrollo de la reflexividad crítica de los practicantes de terapia familiar como forma de incorporar un enfoque más crítico y político de la terapia y desarrollar sus propias historias preferidas como terapeutas.

Efetividade na adesão a reabilitação auditiva em crianças: Grupo de Adesão Familiar e terapia inicial / Effectiveness in adherence to auditory rehabilitation in children: Family adherence group and initial therapy / Eficacia em la adherencia a la rehabilitación auditiva em niños: Grupo de la família adhesión y la terapia inicial

Introdução: O diagnóstico precoce da deficiência auditiva em crianças e a intervenção são determinantes para o desenvolvimento. Uso do AASI; expectativas dos familiares e sua implicação com o tratamento são fatores importantes para o prognóstico. Objetivo: O objetivo foi verificar a efetividade da adesão à reabilitação auditiva, a consistência de uso do AASI, a participação nas terapias e nos grupo na fase inicial do processo terapêutico (ADAPTI), num serviço da Rede Municipal de Saúde de São Paulo. Método: A pesquisa foi realizada em crianças com deficiência auditiva atendidas em um serviço da Rede Municipal, seus responsáveis e terapeutas. Este estudo teve caráter descritivo quanti/qualitativo. Caracterizamos os sujeitos do ponto de vista demográfico, audiológico, da consistência de uso do AASI e da efetividade na adesão. Resultados: As 25 crianças foram organizadas em cinco grupos. Dessas, 13 eram do gênero feminino e 12 do masculino. Vinte e quatro tinham perda auditiva sensorioneural. Uma tinha perda condutiva com AASI adaptado com vibrador ósseo. Dez tinham suspeita/presença de outros comprometimentos. Os classificamos conforme o desfecho do ADAPTI. Diferentes prognósticos interferiram nas orientações, desinteressando os pais com demandas diferentes. Discussão: O grupo de Apoio Familiar (GrAF) foi um facilitador no processo. Grupos mais homogêneos levam maior empatia entre os participantes e maior probabilidade de adesão. A distância e o SII 65 dB são fatores que parecem afetar a adesão. Conclusão: Grupos homogêneos propiciaram maior adesão; As atividades propiciaram discussões que promovem adesão ao tratamento; O GrAF foi considerado um facilitador. A distância e o SII 65 dB parecem afetar a adesão.

Introduction: Early diagnosis of hearing loss in children and intervention, are determinants for the development. Use of hearing aids; Family members' expectations and their implication with treatment are important factors for the prognosis. Objective: This study verified the effectiveness of adherence to rehabilitation, the consistency of the use of hearing aids, participation in the therapies and in the initial phase of the therapeutic process (ADAPTI), in a Municipal Health Service of São Paulo. Method: The research was carried out with hearing impaired children attending a Municipal Health Service, their parents and therapists. This study was quanti/qualitative. We characterize the patients from a demographic, audiological point of view, the consistency of the use of the hearing aids and the effectiveness of adherence. Results: The 25 children were organized into five groups. Of these, 13 were female and 12 male. Twenty four had sensorineural hearing loss. One had conductive loss and the hearing aids were adapted with bone vibrator. Ten had suspicion/presence of other compromises. We classified them according to the ADAPTI outcome. Different prognoses interfered in the orientations, disinterested parents with different demands. Discussion: The group was a facilitator in the process. More homogenous groups lead to greater empathy among participants and greater likelihood of adherence. Distance and SII 65 dB are factors that appear to affect adherence. Conclusion: Homogeneous groups provided greater adhesion; the activities provided discussions that promote adherence to treatment; the group was considered a facilitator. The distance and SII 65 dB seem to affect adhesion.

Introducción: El diagnóstico precoz de lahipoacusia y la intervención son cruciales para el desarrollo. El uso de audífonos; expectativas de la familia y su relación com tratamento son factores importantes para el pronóstico. Objetivo: Verificar la eficacia de la adherencia a la rehabilitación auditiva, el uso de la audición, la participación em la terapia y el grupo al inicio del processo terapéutico (ADAPTI), um servicio de la ciudad de San Pablo de la Salud. Método: El estudio se llevó a cabo em niños com audición asistió a unservicio de la red municipal, sus agentes y los terapeutas. Este estúdio fue cuantitativo/cualitativo. Los sujetos em el punto de vista audiológico demográfica, el uso de la audicióncoherencia y laeficacia de lasayudas de miembros. Resultados: 25 niños se organizaronen cinco grupos. 13 eranmujeres y 12 hombres. 24 tenían una pérdida auditiva neurosensorial. Una perdida conductora con vibrador óseo. Diez habían sospechado/presencia de otros compromisos. Los clasificamos como el resultado de ADAPTI. Diferentes prognósticos han interferido em las directrices, los padres con diferentes demandas. Discusión: El grupo fue un facilitador em el proceso. Grupos más homogéneos tienen una mayor empatía entre los participantes y los más propensos a unirse. La distancia y el SII 65 dB son factores que parecen afectar e lcumplimiento. Conclusión: grupos homogéneos, mostró una mayor adherencia; Las actividades se hanllevado a buenas discusiones; El grupo fue considerado un facilitador. La distancia y el SII 65 dB parecenafectar el cumplimiento.

Michel Foucault e a revolução narrativa em psicopatologia e psicoterapia: ser-em-estórias entre pathos e poiesis / Michel Foucault and the narrative revolution in psychopathology and psychotherapy: Being-in-stories between pathos and poiesis / Michel Foucault et la révolution narrative en psychopathologie et psychothérapie: être-dans-des-histoires entre pathos et poiesis / Michel Foucault y la revolución narrativa en psicopatología y psicoterapia: ser-en-historias entre pathos y poiesis

O modelo narrativo em psicopatologia e psicoterapia, com dinamismo crescente desde a proposta inicial de White e Epston (1990), afirma-se como crítica "discursiva" não somente das categorias de diagnóstico psicopatológico, mas também da assimetria cognitiva e prática na relação psicoterapêutica. Neste artigo, examinamos os fundamentos epistemológicos desse modelo, recorrendo a Michel Foucault para examinar os processos simbólicos de criação narrativa da subjetividade.

The narrative model in psychopathology and psychotherapy, increasing dynamic since the initial proposal of White and Epston (1990), reaffirms itself as a "discursive" critique of psychopathological diagnosis categories, as well as of cognitive and practical asymmetry within the psychotherapeutical relationship. In this paper, we examine the epistemological foundations of this model, turning to Michel Foucault to examine the symbolic processes inherent to the narrative creation of subjectivity.

Le modèle narratif de la psychopathologie et de la psychothérapie, dont le dynamisme s'intensifie depuis White et Epston (1990), s'affirme comme une critique discursive des catégories de diagnostic psychopathologique, ainsi que de l'asymétrie cognitive et de la pratique du rapport psychothérapeutique. Cet article examine les fondements épistémologiques de ce modèle et analyse, avec Michel Foucault, les processus symboliques de la création narrative de la subjectivité.

El modelo narrativo en psicopatología y psicoterapia, con dinamismo creciente a partir de la propuesta inicial de White & Epston (1990), se presenta como crítica discursiva, no sólo de las categorías de diagnóstico psicopatológico, sino también de la asimetría cognitiva y de la práctica en la relación psicoterapéutica. En este artículo, se examinan los fundamentos epistemológicos de este modelo, recurriendo a Michel Foucault los procesos simbólicos de creación narrativa de la subjetividad.

Das narrative Modell der Psychopathologie und Psychotherapie, dessen Dynamik seit White und Epston (1990) zugenommen hat, versteht sich als 'diskursive' Kritik der diagnostischen Kategorien von psychischen Störungen, sowie der kognitiven und praktischen Asymmetrie der therapeutischen Beziehung. In diesem Artikel untersuchen wir die Grundlagen dieses Modells und analysieren, unter Bezugnahme von Michel Foucaults Theorie, die symbolischen Prozesse der narrativen Schaffung von Subjektivität.

Narrative Therapy's Relational Understanding of Identity.

We describe how we think of identity as relational, distributed, performed, and fluid, and we illustrate the use of this conceptualization within a narrative worldview. Drawing on the work of Michael White, we describe how this relational view of identity leads to therapeutic responses that give value to interconnection across multiple contexts and that focus on becoming rather than on being. We show how a narrative worldview helps focus on the relational, co-evolving perspective that was the basis of our early attraction to family therapy. We offer detailed examples from our work of practices that help us stay firmly situated in a relational worldview that is counter to the pervasive influence of individualism in our contemporary culture.

Creating a Space for Acknowledgment and Generativity in Reflective Group Supervision.

Small group supervision is a powerful venue for generative conversations because of the multiplicity of perspectives available and the potential for an appreciative audience to a practitioner's work. At the same time, the well-intentioned reflections by a few practitioners in a room can inadvertently duplicate normative discourses that circulate in the wider culture and the profession. This article explores the use of narrative practices for benefiting from the advantages of group supervision while mindful of the vulnerability that comes with sharing one's work among colleagues. The reflective group supervision processes described were modified from the work of Tom Andersen and Michael White to provide a venue that encourages the creative multiplicity of group conversation while discouraging unhelpful discourses which constrain generative conversation.

Couples Work in Cultural Context: Te Ao Maori and Poststucturalist Practices Informing Counselor Training in Aotearoa New Zealand.

This article outlines key themes that appear in the teaching of poststructuralist ideas and practices for couples counseling within the Postgraduate Diploma in Counseling Program at Unitec Institute of Technology in Auckland, New Zealand, and it explores the congruence of this pedagogical approach with Maori (indigenous) understandings of relationality, collaboration, and partnership. The diploma program's curriculum includes narrative therapy and relational language-making. Themes explored in this article include: understanding (heterosexual) couple relationships as contextualized entities, deconstructing dominant discourses of coupledom, and the positioning of counselors/teachers as nonexpert. Taking each theme in turn, the authors, one of them Maori and two Pakeha (European), articulate points of alignment with Maori cultural concepts and practices.

Cultural Studies Methodologies and Narrative Family Therapy: Therapeutic Conversations About Pop Culture.

Therapists recognize that popular media culture is an influential force that shapes identities and relationships in contemporary society. Indeed, people have serious relationships with the commodities and practices that emerge from pop culture. However, they often lack the conceptual and conversational resources to engage meaningfully with clients about pop culture's influence in their lives. Cultural studies is introduced as an interdisciplinary approach that provides frameworks for both theory and practice that position therapists and clients to critically examine the role of pop culture in their lives. Cultural studies and narrative therapy are discussed as praxis allies that share a populist political intention and counter-hegemonic discursive practices. The integration of cultural studies methodologies into narrative therapy practice with a parent and her teenage daughter is illustrated through a case vignette.

Contos e terapia narrativa: possibilitando novas conversas / Tales and narrative therapy: making new conversations possible

Este artigo tem por objetivo apresentar uma experiência posta em prática pela terapeuta ao utilizar um conto de sua própria autoria no atendimento clínico com a Terapia Narrativa. Por meio dessa ferramenta, foi observada a possibilidade de favorecer a externalização e as conversas de reautoria através da reflexão sobre questões e dilemas vividos pelos personagens da ficção. De forma leve e lúdica a conversa se desenvolve orientada pela imaginação e pela ressonância com a historia de vida do cliente. São apresentados dois casos clínicos em que foram abordados o mesmo conto de minha autoria, a saber “O Passarinho e a Gaiola”.(AU)

This paper aims at describing the experience that was employed by the therapist, who used a tale of her own in her clinical practice with the help of Narrative Therapy. Using this tool, it was possible to favor externalization and conversations of re-authoring as the client reflected on the issues and dilemmas the fictional characters had to deal with. Playfully and smoothly, the conversation develops guided by imagination and by the resonance the story finds in the client’s own life. Here, we present two clinical cases which counted on the help of a tale I wrote myself – “The Bird and the Cage”.(AU)

Experiencia de hipertensión arterial en la relación paciente, familia y contexto de ayuda / Experience of arterial hypertension in the patient-family relationship in a care context

Objetivo Comprender la forma como se configura narrativa y conversacionalmente la experiencia de hipertensión arterial en la relación que establecen paciente, familia, médicos, e investigadores interventores y su reconfiguración en contextos de ayuda que faciliten la emergencia de relatos generadores de bienestar. Metodología Investigación cualitativa, con diseño narrativo-conversacional, reflexivo y contextual. Participaron un paciente con diagnóstico de hipertensión arterial, su familia, una psicóloga y dos médicos. Los métodos de construcción de la información fueron: encuentros conversacionales dialógicos y revisión de literatura. Para la interpretación de los resultados se utilizaron los análisis narrativo y conversacional. Resultados En la construcción de la experiencia de hipertensión arterial no se tienen en cuenta aspectos importantes como: la solicitud de escucha, la demanda de vinculación afectiva, la vivencia de enfermedad y en este caso la vejez, en relación con la vida cotidiana. En este contexto, se configuran formas de relación que facilitan que los acontecimientos asociados a la enfermedad sean vividos desde el malestar o sufrimiento. La conversación generativa con todos los actores, posibilita la construcción de espacios dialógicos-reflexivos que brindan la oportunidad de reconfigurar las relaciones y la experiencia. Conclusiones La construcción de contextos de ayuda en los que es posible hablar y escuchar acerca de los aspectos que evitan las familias y que no escuchan los médicos, facilita la reconfiguración de la experiencia de enfermedad.(AU)

Objective To understand how the narrative and conversational experience of arterial hypertension is configured in the relationships established among patients, family members, physicians and researchers-auditors, placing the illness in a care context to facilitate the dissemination of wellbeing narratives. Method Qualitative research with reflective and contextual conversational-narrative design, which involveda patient diagnosed with hypertension, his family and two doctors. The methods of constructing information was semi structured interviews, reflective observation and literature review. The systematization of information was carried out using frameworks designed for that purpose. For the interpretation of results, narrative and conversational analyses were used. Results In the process of constructing the experience of hypertension by family members or the physician, important aspects are not taken into account such as: the listening request, a demand for bonding, the experience of illness and in this case, the daily experience of old age. In this context, these kinds of relationships can lead to discomfort and suffering in the patient's experience of the illness. The conversation generated by all stakeholders enables the construction of dialogic-reflexive spaces that provide an opportunity to reshape relationships and experience of illness Conclusions The construction of contexts of care where one can talk and hear about issues without families and doctors facilitates the reconfiguration of the experience of illness, allowing for the inclusion of family and physicians in the generation of conversational-narrative positions. This implies personal and collective agency in order to mobilize and organize the resources they have, consistent with the patient's age and diagnosis.(AU)