Conceptos de eficacia terapéutica en psicoanálisis: una reseña histórica / Concepts of therapeutic effectiveness in psychoanalysis: a historical review

El autor parte de la base de que el conocimiento psicoanalítico del desarrollo y del proceso se ha expandido considerablemente durante las últimas décadas, y que durante este tiempo se ha desarrollado una competencia abierta de una variedad de teorías por el respaldo de la comunidad analítica. Desde esta perspectiva, el autor considera que es vital un mejor conocimiento de las fuentes de la acción terapéutica, como parte de la base científica de nuestro campo, de la cual dependen los avances futuros en la teoría y en la técnica. Este trabajo pone el énfasis en el cambio de visión desde los primeros días del análisis, cuando se buscaba un elemento terapéutico único para explicar sus efectos, hasta el presente, cuando vemos que el efecto terapéutico depende de múltiples procesos interactuantes, ninguno de los cuales puede asignarse una clara prioridad. Se postula que, en este estado científicamente deseable pero clínicamente problemático, existe la necesidad urgente de una mayor investigación por parte de los psicoanalistas, que requiere de cuidadosas descripciones del proceso analítico, especificaciones precisas de las hipótesis y sus predicciones clínicas, y de un buen diseño de investigación para poner a prueba estas predicciones (AU)

The author begins from the premise that psychoanalytic knowledge of development and process has broadened considerably over recent decades, and that during this time an open competition has flourished over a range of theories through the backing of the analytic community. From this standpoint, the author considers it vital to gain a greater understanding of the sources of therapeutic action, as part of the scientific basis of our field, upon which future advances in theory and technique depend. This paper highlights the change in perspective from the early days of analysis, where a unique therapeutic element was sought to explain its effects, up to the present, where we see that the therapeutic effect depends upon numerous interacting processes, none of which may be ascribed clear priority. The author postulates that in this scientifically desirable but clinically problematic state, there is an urgent need for greater investigation on the part of psychoanalysists, which calls for thorough descriptions of the analytic process, precise specifications of the hypotheses and their clinical predictions, and for a good research design to test these predictions (AU)

The advance of poststructuralism and its influence on family therapy.

Postmodernism began to influence family therapy very early in the 1980s with articles referencing postmodern ideas, focusing on meaning and multiplicity. With the appearance of narrative therapy on the scene in the 1990s there was a shift toward poststructural thinking, which refined the movement and politicized the clinical work. Even with a bit of a backlash, whether because this was a new idea or it somehow threatened a positivistic culture, a poststructural view has continued to have effects on family therapy. This article explores the variety of influences: the expansion of narrative ideas, the innovation of Madsen's collaborative helping, and also more nuanced effects. I argue that a poststructural view has effectively changed how many family therapists think and may also be subtly influencing how they might work.