Epistemología, historia y fundamentos de la Terapia Breve Estratégica. El Modelo de Giorgio Nardone / Epistemology, history and foundations of Brief Strategic Therapy. Giorgio Nardone´s Mode

La terapia breve estratégica modelo evolucionado de Giorgio Nardone, está considerada en la actualidad como una psicoterapia que evidencia una alta eficacia y eficiencia, en una variedad de trastornos emocionales. En este artículo se presenta la historia y los fundamentos epistemológicos de la terapia breve estratégica, fundamentadas en el pensamiento sistémico, la cibernética, la teoría general de los sistemas y el constructivismo. Se analiza la evolución y desarrollo histórico desde el Mental Research Institute en Palo Alto hasta la creación del Centro en Arezzo Italia. Se presentan las bases teóricas de la terapia breve estratégica centrada en el presente y en las soluciones, partiendo de la premisa de que los intentos de solución mantienen el problema y planteando que desde la lógica estratégica siempre la solución se adapta al problema y a su objeto de estudio.(AU)

Giorgio Nardone's evolved model of brief strategic therapy is a psychotherapy that is currently considered to demonstrate high efficacy and efficiency for a variety of emotional disorders. This article presents the history and epistemological foundations of brief strategic therapy, based on systems thinking, cybernetics, general systems theory, and constructivism. The evolution and historical development are analyzed, from the Mental Research Institute in Palo Alto to the creation of the Strategic Therapy Center in Arezzo Italy. The theoretical foundations of brief strategic therapy focused on the present and solutions are presented, starting from the premise that attempts at solution actually maintain the problem and proposing that based on strategic logic the solution always adapts to the problem and its object of study.(AU)

Psicoterapia breve dinámica y su aplicación en pacientes con trastorno mental severo en una unidad de alta dependencia psiquiátrica / Brief dynamic psychotherapy and its application in patients with severe mental disorder in a high dependency psychiatric unit

El objetivo de este artículo es hacer una revisión de las principales características de la teoría y la técnica de la Psicoterapia Breve Psicoanalítica: conceptos básicos, historia,origen, diferentes definiciones, objetivos, indicaciones y contraindicaciones, así como lasmodificaciones en la técnica con sus característicaspropias y definitorias. Se muestrasu aplicabilidad y utilidad en una Unidad deAlta Dependencia Psiquiátrica (UADP), conresultados efectivos y eficientes en un entornoestructurado en el que paralelo a la psicoterapia,cada uno de los miembros de la Unidadejerce una función terapéutica necesariaen pacientes con un Trastorno Mental Severo.Por último se expone una experiencia en psicoterapia dinámica breve en nuestra UADP. (AU)

The goal of this article is to review the main characteristics of the theory and technique of Brief Psychoanalytic Psychotherapy: basic concepts, history, origin, different definitions, objectives, indications and contraindications,as well as the modificationsin the technique with its own and definingcharacteristics. Its applicability and usefulnessin a Highly Dependent Psychiatric Unitis shown, with effective and efficient resultsin a structured environment, in which, in parallelto psychotherapy, each one of the Unitmembers exercises a necessary therapeuticfunction in patients with a severe mental disorder.Finally, an experience in brief dynamicpsychotherapy in our UADP is exposed. (AU)

Short-term psychodynamic psychotherapy: a brief history.

OBJECTIVE: To discuss the development and rationale for different models of short-term psychodynamic psychotherapy. CONCLUSION: There are a variety of historical reasons for the current climate of short-term dynamic therapies that can help inform upon their application and future directions.

The early history of ideas on brief interventions for alcohol.

AIMS: This study explores the early development of brief interventions for alcohol using a history of ideas approach with a particular focus on intervention content. METHODS: The source publications of the key primary studies published from approximately 1962 to 1992 were examined, followed by a brief review of the earliest reviews in this field. These studies were placed in the context of developments in alcohol research and in public health. RESULTS: After early pioneering work on brief interventions, further advances were not made until thinking about alcohol problems and their treatment, most notably on controlled drinking, along with wider changes in public health, created new conditions for progress. There was then a golden era of rapid advance in the late 1980s and early 1990s, when preventing the development of problem drinking became important for public health reasons, in addition to helping already problematic drinkers. Many research challenges identified at that time remain to be met. The content of brief interventions changed over the period of study, although not in ways well informed by research advances, and there were also obvious continuities, with a renewed emphasis on the facilitation of self-change being one important consequence of the development of internet applications. CONCLUSIONS: Ideas about brief interventions have changed in important ways. Brief interventions have been studied with different populations of drinkers, with aims embracing both individual and population-level perspectives, and without well-specified contents. The brief intervention field is an appropriate target for further historical investigations, which may help thinking about addressing alcohol and other problems.

Intensive short-term dynamic psychotherapy: a systematic review and meta-analysis of outcome research.

Habib Davanloo has spent his career developing and teaching methods to accelerate dynamic psychotherapy, including his technique of intensive short-term dynamic psychotherapy (ISTDP). Over the past 20 years, outcome studies using this treatment have been conducted and published. We performed a systematic review of the literature to obtain studies presenting ISTDP outcome data. We found 21 studies (10 controlled, and 11 uncontrolled) reporting the effects of ISTDP in patients with mood, anxiety, personality, and somatic disorders. Using the random-effects model, we performed meta-analyses including 13 of these studies and found pre- to post-treatment effect sizes (Cohen's d) ranging from 0.84 (interpersonal problems) to 1.51 (depression). Post-treatment to follow-up effect sizes suggested that these gains were maintained at follow-up. Based on post-treatment effect sizes, ISTDP was significantly more efficacious than control conditions (d = 1.18; general psychopathology measures). Study quality was highly variable, and there was significant heterogeneity in some analyses. Eight studies using various measures suggested ISTDP was cost-effective. Within limitations of study methodologies, this evidence supports the application of ISTDP across a broad range of populations. Further rigorous and targeted research into this method is warranted.

Time is of the essence: A selective review of the fall and rise of brief therapy research.

For compelling reasons of equity and the advance of public health, brief psychotherapy has become the dominant format in both practice and research. One consequence of this is the apparent decline of a distinct stream of brief therapy research. However, much of the agenda formerly identified with that research stream is of increasing importance to the field. Time is indeed of the essence in current psychotherapy research. For example, factors conducive to the time efficiency of brief psychodynamic therapy have been described recently. The important question 'How much therapy is enough?' has been addressed by studies inspired by the dose-response analysis of Howard and colleagues. The value of ultra-brief interventions has been examined. These issues are considered in a selective review, drawing in particular on the work of the Sheffield/Leeds psychotherapy of depression research group. This research treats the number of treatment sessions as an independent variable, thereby providing a causal analysis of the dose-response relationship over a range from two to 16 sessions, illuminated by a comparative analysis of change processes in treatments of different durations. Its results enable some specification of the extent and nature of incremental benefit derived from additional sessions in the psychotherapy of depression.

[Interpersonal psychotherapy (IPT) of depression: an overview of the psychiatric historical background and clinical practice of IPT]. / Die Interpersonelle Psychotherapie (IPT) in der Depressionsbehandlung: ein Uberblick über den psychiatriegeschichtlichen Hintergrund und die psychotherapeutische Praxis der IPT.

Among the forms of short-term psychotherapies for the treatment of depression, IPT (16 - 20 sessions) by Klerman u. Mitarb. is meanwhile one of the most well known and clinically practiced approaches. IPT has also been carefully controlled in a variety of studies proving efficacy. Interpersonal psychotherapy is based on the ideas of the interpersonal school of psychiatry. The hypothesis is that psychiatric illnesses and here depression develop in an interpersonal context. Life problems may contribute to onset and potentially chronicity of (current) depression and vice versa. By enhancing interpersonal functioning of the depressed patient IPT initiates the reduction of depressive symptomatology and helps solving of current life problems as dual goal of therapy.

Evolução das psicoterapias breves / Evolution in the brief psychotherapies

Este artigo evoca o nascimento, a evolução das psicoterapias breves e os problemas que a corrente breve coloca em comparação à cura psicanalítica clássica. Fazemos em seguida algumas considerações sobre a variedade das técnicas utilizadas e sua ligação com a relação terapêutica antes de introduzir os princípios fundamentais sobre os quais se fundamenta nossa atividade terapêutica em Lausanne, a saber o estudo da relação entre enquadre terapêutico e relação terapêutica. Explicamos, em algumas palavras, porque fomos levados a mudar a técnica ativa, comumente utilizada em psicoterapia breve, pela noção da atividade de pensamento. Dois aspectos de nossa atividade terapêutica são evocados: a investigação psicodinâmica breve e a psicoterapia breve da inspiração psicanalítica propriamente dita(AU)

La terapia breve de resolución de problemas y sus ventajas para la unidad de medicina conductual en un hospital general / The brief therapy of problem resolution and its advantages for behavioral medicine unit at a general hospital

Se presenta el método de psicoterapia conocido como terapia breve de resolución de problemas. Se hace una reseña histórica de la aparición del enfoque, para luego mencionar sus principales premisas teóricas, destacando la originalidad de éstas en comparación con otros métodos terapeúticos. también se describe muy sintéticamente el modo como opera el terapeuta en este enfoque, ilustrando con ejemplos basados en casos clínicos tópicos. Finalmente se dan a conocer las principales ventajas que ofrece el modelo en cuanto a la atención psicológica y psiquiátrica que pueda brindar una unidad de salud mental de un hospital. Entre ellas se señala: su brevedad, su amplia aplicabilidad a toda clase de problemas, la posibilidad de coordinar acciones en distintos niveles de la organización hospitalaria y otras. Se postula que el modelo de la terapia breve de resolución de problemas es particularmente apto para ser adoptado como principal método de atención en una unidad de medicina o de salud mental en un hospital general

Play interview therapy: its history, theory and practice--a fifty year retrospective account.

The method of the play interview offers the fearful child an opportunity to express himself by speaking for a series of dolls representing siblings, parents, teachers or himself. It is not the child who is aggressive, fearful, jealous or desires the parent's affection, but the doll. In this manner, the child learns to make connections between his fears and his unacceptable "bad" thoughts, feelings or wishes. Improvement occurs after several play interviews.

[Brief analytic psychotherapies. I. Historical and conceptual foundations]. / Les psychothérapies analytiques brèves. I. Fondements historiques et conceptuels.

From a pragmatic standpoint where the essential aim lies in the therapeutic efficacy within a relatively short duration, brief dynamic psychotherapies have progressively emerged from the psychoanalytic trend, which they come from. Yet, they are unambiguously connected with psychoanalysis in so far they use its theoretical frame as well as some of its technical aspects, particularly transference interpretation.

[Short-term psychotherapy]. / Les psychothérapies brèves.

Short-term psychotherapy is characterized by a reduction in the number of interviews as compared with the conventional methods and by more limited therapeutic objectives. It is still based on psychoanalysis, but the setting and problematics are different. Interviews take place face to face and include a so-called focalization. The results, on the whole, are interesting. Short-term psychotherapy constitutes a more expeditious approach making the best possible use of available resources.

Short-term dynamic psychotherapy: its history, its impact and its future.

Short-term dynamic psychotherapy is successful for the healthier patient, but also for the individual with severe and chronic problems. The author surveys the history of brief intervention since Freud. Despite favorable outcomes, there has been a lack of interest for short-term dynamic therapy. Analysts, emphasizing on long-term analysis, failed to distinguish between developing theory and treatment. Since the mid-fifties interest for short-term techniques has increased. Research is resulting in criteria for selection and outcome. Utilized are active techniques, as transference interpretation, in dealing with specified foci. Successful outcome is obtained in oedipal problems, grief reactions, obessive compulsive illnesses, multiple phobias and some boderline disorders. In future, research is necessary on differentiation between patients, on comparison between treatment methods, and on technical factors, next to education and training.

Psicoterapia psicodinámica breve en la década del ochenta / Short-psychodinamic psychotherapy on the eighties.

La psicoterapia es como el mítico Janus, tiene dos caras, la mágico-religiosa y la científica. Este trabajo enfoca una forma de psicoterapia científica que tendrá, junto con otras psicoterapias de corta duración, preponderancia en la década de los años ochenta. La discusión empieza con las contribuciones de Freud, Rank, Ferenczi, French y Alexander y termina con los estudios metodológicos de Malan, Sifneos, Mann y Davanloo. Discute el proceso de selección y la técnica a la luz de cambios recientes en actitud, percepción y expectativa no sólo de pacientes sino también de agencias reguladoras y de grupos profesionales organizados. Finalmente señala la similitud y las diferencias con otros tratamientos de corta y larga duración.

Short-term dynamic psychotherapy.

Short-term dynamic psychotherapy is rooted in psychoanalytic theory. The author traces the historical background of brief psychotherapy, focusing on the contributions of Freud, Ferenczi, Rank, and Alexander and French, and then presents a synthesis of contemporary views. Selection criteria for patients who can benefit from short-term therapy, and the techniques used, are discussed. Similarities to and differences from crisis intervention techniques are pointed out. The trend of the future can be expected to be toward shorter-term therapies, but given the present state of psychiatric knowledge, long-term therapy will still be necessary for many patients.