Capacitación no escolarizada en psicoterapia: problemas y perspectivas / Non-school training in psychotherapy: problems and perspectives

Introducción: la capacitación no escolarizada en psicoterapia se define como la enseñanza de esta intervención por fuera de los entornos clínicos universitarios y de la normativa de educación universitaria. Aunque esta forma de estudios es bastante aceptada por psiquiatras y otros profesionales de la salud mental, esta podría no garantizar una adecuada capacitación y certificación. La presente revisión describe las características de la capacitación no escolarizada en psicoterapia en el Perú y aborda los potenciales problemas con la capacitación y certificación. Método: se realiza un análisis de la capacitación no escolarizada de psicoterapia y se la compara con el modelo formativo en psicoterapia de la residencia de Psiquiatría. Resultados: la capacitación no escolarizada en psicoterapia es una modalidad válida de estudios. Sin embargo, su alcance académico y profesional debe ser mejor valorado ya que estos programas podrían no contar con los recursos para reemplazar la capacitación universitaria, y no cuentan con el valor legal para facultar el ejercicio profesional de la psicoterapia de acuerdo a las normativas actuales de la educación universitaria y de licenciamiento profesional. Conclusión: es necesario fortalecer la capacitación de psicoterapia en la residencia de Psiquiatría y la apertura de programas universitarios de postgrado (programas de especialización, maestría o doctorado) para que la capacitación y certificación de psicoterapia sigan los canales formativos y de licenciamiento profesional oficiales.

Introduction: non-school training in psychotherapy is defined as the teaching of this intervention outside of university clinical settings and university education regulations. Although this form of study is widely accepted by psychiatrists and other mental health professionals, it may not guarantee adequate training and certification. This review describes the characteristics of non-school training in psychotherapy in Peru and addresses possible problems with training and certification. Method: an analysis of the non-schooled psychotherapy training is carried out and compared with the training model in psychotherapy of the psychiatric residency. Results: non-school training in psychotherapy is a valid study modality. However, their academic and professional scope should be better valued since these programs may not have the resources to replace university training, and they do not have the legal value to license the professional practice of psychotherapy according to current regulations of college education and professional licensing. Conclusion: it is necessary to strengthen psychotherapy training in psychiatry residency and the opening of postgraduate university programs (specialization, master or doctorate programs) so that psychotherapy training and certification follow the official training and professional licensing channels.

Aprimoramento em grupoterapia: adaptação ao contexto on-line / Group therapy improvement: adaptation to the online context / Formación profesional en terapia de grupo: adaptación al contexto online

Este é um Relato de Experiência de Aprimoramento em Coordenação e Manejo de Grupos. A experiência ocorreu durante a pandemia da COVID-19, sendo assim, desafios e adaptações estiveram presentes na vida cotidiana e acadêmica. A adaptação do aprimoramento para a modalidade on-line e em contexto pandêmico, provocou questionamentos a respeito do êxito da tarefa. O emprego dos dispositivos on-line para o aprimoramento de grupoterapeutas é um campo relativamente novo, justificando a relevância deste trabalho. Foi utilizado Diário de Campo para a coleta de dados e optou-se pelo referencial teórico de Pichon-Rivière, e outros autores da Psicanálise das Configurações Vinculares que discutem a questão da virtualidade na atualidade. Entendemos que a adaptação ao modelo on-line possibilitou a continuidade das atividades grupais programadas e a existência de um espaço de formação, troca e suporte entre pares. O Grupo Psicanalítico de Reflexão foi fundamental neste contexto, favoreceu a aprendizagem e o desenvolvimento de competências, oportunizou a construção e fortalecimento de vínculos, estimulou a postura crítica e criativa diante dos desafios, limites e potencialidades da adaptação ao modelo on-line, além de acolher as experiências decorrentes dos aprimoramentos do estado de pandemia.

This is an Experience Report on the Improvement Group Coordination and Management. The Experience occurred during the COVID-19 pandemic; therefore, challenges and adaptations were present in daily and academic life. Questions about the success of the task were raised after the adaptation of the Group Therapy to the modality due to the pandemic context. The usage of online devices to enhance group therapists is a relatively new field, justifying the relevance of this work. Field Diary was used for data collection. We opted for the theoretical framework of Pichon-Rivière, and the Psychoanalysis of Binding Configurations' authors, who discuss the issue of virtuality today. We understand that the adaptation to the online model enabled the continuity of scheduled group activities and the existence of training spaces, exchanges, and support peers. The Psychoanalytic Reflection Group was fundamental in this context, it favored learning and the development of skills. It provided the opportunity to build, strengthen bonds, and encourage critical and creative stances in the face of the challenges, limits, and potentials of adapting to the online model; and welcomed the experiences of improvements resulting from the pandemic state.

Este es un informe de Experiencia de Formación Profesional en la Coordinación y Gestión de Grupos. En el año de esta experiencia ocurrió la pandemia del COVID-19, desafíos y adaptaciones se hicieron presentes en la vida cotidiana y académica. La adaptación de la formación a la modalidad en línea y el contexto de pandemia, planteó interrogantes sobre el éxito de la tarea. El uso de dispositivos en línea para la formación de terapeutas grupales es un campo relativamente nuevo, que justifica la relevancia de este trabajo. Se utilizó Diario de Campo para recoger datos. Optamos por el marco teórico de Pichon-Rivière y autores del Psicoanálisis de las Configuraciones Vinculantes que discuten el tema de la virtualidad en la actualidad. Entendemos que la adaptación al modelo en línea permitió la continuidad de las actividades grupales programadas y la existencia de un espacio de formación, intercambio y apoyo entre pares. El Grupo de Reflexión Psicoanalítica fue fundamental en este contexto, favoreció el aprendizaje y el desarrollo de habilidades, brindó la oportunidad de construir y fortalecer lazos, estimuló una actitud crítica y creativa frente a los desafíos, límites y potencialidades de la adaptación al modelo en línea y acogió las experiencias de la formación derivadas del estado de pandemia.

Emoções vivenciadas pelos psicoterapeutas-aprendizes nos serviços-escolas: uma leitura psicanalítica / Emociones vivenciadas por los psicoterapeutas-aprendices em las escuelas-clínicas: una lectura psicanalítica / Emotions experienced by apprentice psychotherapists at school-clinics: a psychoanalytic reading

RESUMO Os atendimentos clínicos realizados nos serviços-escolas são permeados por uma série de experiências emocionais vivenciadas pela díade psicoterapeuta-aprendiz/paciente. Diante das diversas nuances da clínica psicanalítica, o psicoterapeuta-aprendiz vivencia experiências que refletem em sua subjetividade. Este estudo teve como objetivo investigar as vivências emocionais dos estudantes de graduação em psicologia durante os estágios em clínica psicanalítica e analisar as emoções percebidas em si mesmos pelos psicoterapeutas-aprendizes nos atendimentos em psicoterapia psicanalítica. Trata-se de um estudo clínico-qualitativo, utilizando-se o referencial teórico psicanalítico. Participaram 27 estudantes de psicologia, que realizavam atendimentos nos serviços-escolas de quatro Instituições de Ensino Superior. A coleta de dados foi realizada através de entrevistas semidirigidas, as quais foram submetidas à análise de conteúdo. Nos resultados observou-se a presença das vivências de ansiedade, medo, insegurança e nervosismo, presentes no processo psicoterapêutico. A identificação com as vivências emocionais dos pacientes e as dúvidas referentes à percepção das próprias emoções, foram importantes aspectos encontrados neste estudo. Tais resultados podem contribuir para a reflexão sobre a vivência desta experiência para o psicoterapeuta-aprendiz, a fim de melhor prepará-lo para os desafios da prática clínica psicanalítica.

RESUMEN Los atendimientos clínicos realizados en las escuelas clínicas están impregnados por una serie de experiencias emocionales vivenciadas por la díada psicoterapeuta-aprendiz / paciente. Ante los diversos matices de la clínica psicoanalítica, el psicoterapeuta-aprendiz vivencia experiencias que reflejan en su subjetividad. Este estudio tuvo como objetivo investigar las vivencias emocionales de los estudiantes de graduación en psicología durante las etapas en clínica psicoanalítica y analizar las emociones percibidas en sí mismos por los psicoterapeutas-aprendices en las atenciones en psicoterapia psicoanalítica. Se trata de un estudio clínico-cualitativo, utilizando el referencial teórico psicoanalítico. Participaron veintisiete estudiantes de psicología, que realizaban atendimientos en las escuelas clínicas de cuatro Instituciones de Enseñanza Superior. La recolección de datos fue realizada a través de entrevistas semidirigidas las cuales fueron sometidas a análisis de contenido. En los resultados se observó la presencia de las vivencias de ansiedad, miedo, inseguridad y nerviosismo, presentes en el proceso psicoterapéutico. La identificación con las vivencias emocionales de los pacientes y las dudas referentes a la percepción de las propias emociones, fueron importantes aspectos encontrados en este estudio. Tales resultados pueden contribuir a la reflexión sobre la vivencia de esta experiencia para el psicoterapeuta-aprendiz, a fin de prepararlo mejor para los desafíos de la práctica clínica psicoanalítica.

ABSTRACT The psychotherapeutic clinic services in the school-clinics are permeated by a series of emotional experiences lived by the apprentice psychotherapist/patient dyad. In the light of the various nuances of the psychoanalytic practice, the apprentice psychotherapist goes through experiences that reflect on his subjectivity. This study aimed to investigate the emotional experiences of undergraduate psychology students during their stages in school-clinics and to analyze the emotions perceived in themselves in the attendance in psychoanalytic psychotherapy. This is a clinical-qualitative study using the psychoanalytic theoretical framework. Twenty-seven psychology students participated in this study who attended the school-clinics of four Higher Education Institutions. Data collection was carried out through semi-structured interviews, which were submitted to content analysis. The results showed the presence of anxiety, fear, insecurity and nervousness feelings in the psychotherapeutic process. Identification with the emotional experiences of patients and doubts regarding the perception of their own emotions were essential aspects found in this study. Such results may contribute to the reflection on the experience of the apprentice psychotherapist to better prepare him for the challenges of psychoanalytic clinical practice.

El uso de series de televisión para la formación de competencias en Psicoterapia / The use of television series in the formation of psychotherapeutic competences

Introducción: La formación de competencias en Psicoterapia es una tarea difícil, que exige continuamente la evaluación de nuevos métodos que complementen los tradicionales. Objetivo: Evaluar el uso de series de televisión en la formación de competencias para identificar y modelar procedimientos psicoterapéuticos como alternativa a los métodos tradicionales. Métodos: Estudio de caso (n = 24) en el contexto de un diplomado de intervención clínica psicodinámica: grupo experimental (n = 12) y grupo de control (n = 12). En el grupo experimental se usaron, como complemento, series de televisión relacionadas con la Psicoterapia, editadas en fragmentos con entradas diferenciadas por marcadores asociados a conceptos clave. Resultados: El uso de tecnologías audiovisuales en la formación de competencias terapéuticas, como complemento a la enseñanza tradicional, no pareció modificar las habilidades teóricas de los alumnos; sin embargo, favoreció los resultados en las evaluaciones de competencias prácticas en Psicoterapia. También mejoró la visión de proceso y la capacidad para evaluar situaciones; desarrolló capacidades para la aplicación oportuna de herramientas terapéuticas; diversificó el repertorio conductual ante situaciones inesperadas; y pareció mejorar la disposición afectiva para enfrentar los primeros casos. Conclusiones: La incorporación de series de televisión como complemento didáctico en un programa de Psicoterapia parece mejorar la efectividad del proceso enseñanza-aprendizaje. El estudio también sugiere que el uso de este tipo de herramientas técnicas de la tecnología de la información, como un método complementario, favorecerá la preparación emocional de los profesionales en formación para trabajar con los primeros pacientes de Salud Mental; sin embargo, esta hipótesis deberá corroborarse en futuras investigaciones que incluyan una muestra mayor(AU)

Introduction: The formation of psychotherapy competences is a difficult task, which demands permanent assessment of new methods complementing the traditional ones. Objective: To assess the use of television series in the formation of competences to identify and model psychotherapeutic procedures, as an alternative over traditional methods. Methods: Case study, with n=24, carried out in the context of a diploma course in Clinical Psychodynamic Intervention. There was an experimental group (n=12) and a control group (n = 12). In the experimental group, television series related to psychotherapy were used as complementary ones, edited in fragments with entries differentiated by markers associated with key concepts. Results: The use of audiovisual technologies in the formation of therapeutic competences, as a complement to traditional teaching, did not seem to modify the theoretical abilities of the students; however, it favored the outcomes in the assessment of practical psychotherapeutic competencies. It also improved process vision and the ability to assess situations, developed capacities for timely application of therapeutic tools, diversified the behavioral repertoire in unexpected situations, and seemed to improve affective disposition to face the first cases. Conclusions: The incorporation of television series as a didactic complement in a psychotherapy program seems to improve the effectiveness of the teaching-learning process. The study also suggests that the use of this type of technical information technology tools, as a complementary method, will favor the emotional preparation of professionals under training to work with their first mental health patients; however, this hypothesis should be corroborated in future research including a larger sample(AU)

Os bastidores da psicoterapia: descrição de sentidos e a supervisão clínica na abordagem fenomenológica humanista / The backstage of psychotherapy: sense's description and clinical supervision in the humanist phenomenological approach / Los bastidores de psicoterapia: descripción de sentidos y la supervisión clínica en el enfoque fenomenológico humanista

A psicoterapia é um campo científico que se aprimora de maneira contínua, especialmente pelas atuais demandas que requerem a garantia do protagonismo e a autonomia aos usuários de saúde mental. Nesse contexto, a supervisão clínica e os instrumentos construídos a partir dela aparecem como um importante fator no processo de qualificar a prática e formar novos terapeutas. O presente estudo tem por objetivo geral analisar os relatos descritivos produzidos para a supervisão de estágio, que incluem os apontamentos da supervisora, e são tomados como versões de sentido, com o intuito específico de dar visibilidade ao processo de formação do(a) futuro terapeuta. Para tanto, inspira-se no método fenomenológico com fundamento qualitativo e descritivo, que destaca a dimensão compreensiva, intersubjetiva e intencional entre consciência e mundo vivido. O corpus de análise constituiu-se de vinte e um relatórios de descrição dos sentidos no encontro psicoterapêutico com um único paciente, durante o ano de 2017. Foram selecionados três encontros psicoterapêuticos para análise das versões de sentido neste ensaio, a partir dos critérios temporal e longitudinal, procurando dar visibilidade ao processo clínico, às intervenções terapêuticas gestadas no encontro entre psicoterapeuta-paciente-descrição de sentidos-supervisão, e seu impacto na formação clínica. Há, por fim, a ressonância de novas maneiras de existir para ambos, paciente e terapeuta.

Psychotherapy is a research field in continuous improvement, mostly due to the current requiring demands on protagonism guarantee and autonomy to mental health users of the tool. In this context, clinical supervision and the instruments that have been built from it represent an important factor to the process of qualifying the practice and training new therapists. The present study aims to analyse the produced descriptive internship reports, including the supervision notes, which are taken as sense's versions, in order to draw visibility to the process of preparing future therapists. Therefore, there has been inspired by phenomenological method on a qualitative and descriptive basis in order to characterize a comprehensive, intersubjective and intentional understanding between consciousness and the living world. The corpus of the analysis consisted of twenty-one patients' sense description reports produced along individual counselling sessions during 2017. Three psychotherapeutics meetings were selected for analysis of the sense's versions in this study, based on the temporal and longitudinal criteria, in order to provide visibility to the clinical process, as well as to the therapeutic interventions generated during the sessions, embracing therapist-patient-sense description-supervision, and their impacts on clinical training. Last, there has been observed a resonance of new ways of existing, sprouting for both patient and therapist.

La psicoterapia es un campo científico que se perfecciona de manera continua, especialmente por las actuales demandas que requieren la garantía del protagonismo y la autonomía a los usuarios de salud mental. En ese contexto, la supervisión clínica y los instrumentos construidos a partir de ella aparecen como un importante factor en el proceso de calificar la práctica y formar nuevos terapeutas. El presente estudio tiene por objetivo general analizar los relatos descriptivos producidos para la supervisión de prácticas, que incluyen los apuntes de la supervisora, y se toman como versiones de sentido, con el propósito específico de dar visibilidad al proceso de formación del futuro terapeuta. Para ello, se inspiró en el método fenomenológico con fundamento cualitativo y descriptivo, que destaca la dimensión comprensiva, intersubjetiva e intencional entre conciencia y mundo vivido. El corpus de análisis se constituyó de veintiún informes de descripción de los sentidos en el encuentro psicoterapéutico con un solo paciente durante el año 2017. Se seleccionaron tres reuniones psicoterapéuticas para análisis de las versiones de sentido en esta prueba, en base a los criterios temporales y longitudinales se busca dar visibilidad al proceso clínico, a las intervenciones terapéuticas gestadas en el encuentro entre terapeutapaciente-descripción de sentidossupervisión, y su impacto en la formación clínica. Hay, por fin, la resonancia de nuevas maneras de existir, brotando para ambos, paciente y terapeuta.

Brief training in psychological assessment and interventions skills for cancer care staff: a mixed methods evaluation of deliberate practice techniques.

OBJECTIVE: Unaddressed anxiety and depression is common among cancer patients and has significant adverse consequences. Cancer staff training is recommended for psychological assessment and interventions to address depression and anxiety, to increase access to psycho-social oncology care. However, psychological skills training has a poor track-record for improving clinical effectiveness. "Deliberate practice", receiving feedback on therapeutic micro-skills and rehearsing modifications, can enhance clinical effectiveness. This study applied deliberate practice to maximise benefits of brief psychological skills training for cancer care staff. METHODS: Seventeen one-day training workshops were provided to 263 cancer care staff, aiming to improve confidence in assessing anxiety and depression, and delivering problem-solving therapy. Training used deliberate practice methods at the expense of didactic lecturing. Staff confidence was assessed in key teaching domains using pre-post confidence ratings. Anonymous comments from 152 training attendees were examined using thematic analysis. RESULTS: One-day psychological skills training significantly improved cancer staff confidence in assessment of anxiety and depression, and delivery of brief psychological interventions. Thematic analysis indicated that focusing on practical skills was valued by participants and contributed to staff commitments to change practice. However, some participants felt the one-day training was over-filled and would be better delivered over more days. CONCLUSIONS: Similar results can be achieved by providing psychological skills training on a single-day, as compared to an established five-day programme, by abbreviating didactic teaching and focusing time on deliberate practice of skills. Training may increase the likelihood of changes in practice, but more training time may be required for maximum benefit.

El autocuidado como un componente de la salud mental del psicólogo desde una perspectiva biopsicosocial / Self-care as a component of the psychologist's mental health from a biopsychosocial perspective

El presente artículo pretende describir la importancia de la competencia del autocuidado en la salud mental de los profesionales de psicología, desde una perspectiva biopsicosocial, reflexionando acerca de cómo la personalidad, la construcción social y la praxis influyen en el autocuidado. La revisión teórica se hizo a partir de un enfoque cualitativo, desde la perspectiva hermenéutica; múltiples autores continúan apuntando a lo vital que resulta ser el desarrollo de habilidades adquiridas en el ejercicio académico de la formación de los futuros psicólogos; sin embargo, es en el ejercicio profesional donde se adquieren no sólo las destrezas, sino las herramientas integradoras frente a lo que el quehacer profesional requiere, una vez se inicia en el trabajo de campo. Se infiere, entonces, a modo de conclusión, que el psicólogo tiene la responsabilidad de asumir el autocuidado como una competencia, en pro de su bienestar y su ejercicio profesional; tarea que no podrá ser asumida en la coparticipación de las diversas agremiaciones en pro de la salud mental y el autocuidado.

This article aims to describe the importance of self-care competence in the mental health of psychology professionals from a biopsychosocial perspective, reflecting on how personality, social construction and praxis influence self-care. The theoretical revision was made from a qualitative approach, from the hermeneutical perspective; multiple authors continue to point to how vital it is to develop skills acquired in the academic exercise of training future psychologists; However, it is in the professional practice where not only the skills but the integrating tools are acquired, compared to what the professional task requires once it begins in the field work; it is inferred then from the conclusions that the psychologist is responsible for assuming self-care as a competence for their well-being and professional practice; a task that cannot be assumed in the co-participation of the various associations in favor of mental health and self-care.

[Analysis of the German state medical examination regarding psychiatrically relevant topics]. / Staatsexamensanalyse hinsichtlich psychiatrisch relevanter Themen.

BACKGROUND: The second part of the state medical examination is an essential part of medical education in Germany. From 2006 until 2013, the second and third parts of the licensing examination were combined, thus earning this examination the reputation of being notoriously difficult to pass. The aim of this exploratory study was to examine psychiatric and psychotherapeutic questions in the written part of the second examination. OBJECTIVES: This study analyzed the proportion of psychiatric and psychotherapeutic questions in the written part of the second leg of the German state medical examination. In a second step, a more detailed analysis aimed to identify more specific subject areas and to allocate diagnoses according to ICD-10, allowing a detailed overview of the presence of psychiatric topics. MATERIAL AND METHODS: A total of 8 examinations from fall 2010 up to spring 2014 a were included in the analysis. Every examination comprised 320 questions, thus a total of 2560 questions were analyzed. All questions pertaining to psychiatric or psychotherapeutic topics were included. Questions were categorized according to a predefined set of subject areas and an ICD-10 diagnosis. RESULTS: Out of the total of 2560 questions analyzed, 166 were categorized as being in psychiatry or psychotherapy, with each examination comprising an average of 20.75 (SD = 5.80) relevant questions. Most questions were allocated to the subject area of pharmacology (n = 53), followed by psychopathologic assessment (n = 27) and psychotherapy (n = 12). Sorted according to ICD-10 criteria, most questions could be assigned to the F3 category, the affective disorders group (21.9 %, n = 35). CONCLUSION: In comparison to the actual strain placed on the healthcare system, the results indicate an underrepresentation of psychiatric disorders in the second part of the German state medical examination. The distribution of specific disorders mirrors the actual distribution at least in part; however, certain practically relevant disorders are severely underrepresented.

[Dissemination of psychotherapy modules for traumatized refugees : Experience gained from trauma work in crisis and conflict regions]. / Dissemination psychotherapeutischer Module für traumatisierte Geflüchtete : Erkenntnisse aus der Traumaarbeit in Krisen- und Kriegsregionen.

With each additional accumulative exposure to severe and traumatic stressors, the likelihood of developing mental health problems and physical diseases increases. Displaced individuals have usually experienced a number of serious threats to health due to organized violence in their home country or attacks during the flight. Frequently, domestic violence adds additional strain to the stressors experienced. The resulting impairments in psychosocial functioning reduce the resources needed for social adjustment and integration. Social exclusion then in turn often further aggravates the existing mental health complications. For the treatment of trauma spectrum disorders, different evidence-based psychotherapies are available. In high-income countries, trained and licensed psychotherapists are typically in positions to apply such interventions; however, even an advanced system with a high capacity, such as the psychotherapeutic care offered in Germany, severely struggles to manage the demands associated with the rapid addition of hundreds of thousands of displaced people. Germany's mental healthcare system at present lacks the resources, both human and technological, to effectively manage the present demands. Systematic scientific studies in resource-poor regions of war and conflict have demonstrated that the dissemination of effective treatment to local personnel, even with limited training, results in substantial improvements in the mental health challenges within the community: Organized as a cascade model, members of the refugee community learn to identify weakened fellow citizens requiring in-depth diagnostic interviews. Educated, bilingual individuals acquainted with their country's healthcare system (e. g. nurses, teachers and social workers) receive training to conduct structured interviews and evidence-based interventions under the supervision of centrally organized licensed psychotherapists. More complex cases are referred to local psychotherapists, psychiatrists or specialized treatment centers. These humanitarian efforts are based on the convention for the protection of human rights and secure the safety, freedom and dignity of these persons.

Clinical errors as a lack of context responsiveness.

Although standardized treatments have the potential to decrease clinical errors, within-session responsiveness is complicated and complementary frameworks may be needed to foster enhanced responsiveness in the context of evidence-based treatments. Recent efforts have targeted the enhancement of flexibility and responsiveness in the delivery of manualized treatments, including the development of transdiagnostic treatments (i.e., protocols that are designed to be used across different diagnoses) intended to tailor intervention principles to the needs of individual patients. Context-Responsive Psychotherapy Integration (Constantino, Boswell, Bernecker, & Castonguay, 2013) offers an if-then framework that supports the utilization of evidence-based clinical strategies in response to the identification of specific process markers. Failure to identify or appropriately respond to such markers may result in negative therapeutic process as well as outcomes. This case study uses the context-response psychotherapy integration framework to understand critical moments of clinical decision-making through examining an individual treatment case that unilaterally terminated after seven sessions of transdiagnostic treatment. This illustrative empirical case analysis focuses on three potential clinical errors, as indicated by a lack of responsiveness to three candidate process markers: (a) low outcome expectations, (b) self-strivings, and (c) outcome monitoring. For each clinical error, alternative clinical strategies are discussed.

"Melanoma: Questions and Answers." Development and evaluation of a psycho-educational resource for people with a history of melanoma.

PURPOSE: People with melanoma often report pervasive fears about cancer recurrence, unmet information needs, and difficulties accessing psychological care. Interventions addressing the supportive care needs of people with melanoma are rare, and needs are often overlooked. The study evaluated a newly developed, evidence-based, psycho-educational resource for people with melanoma. METHODS: The evaluation study comprised three groups: adults at high risk of new primary disease due to multiple previous melanomas or one melanoma and dysplastic nevus syndrome (DNS), adults at moderate risk due to one previous melanoma and no DNS, and health professionals involved in melanoma care. Participants evaluated a 68-page psycho-educational booklet, Melanoma: Questions and Answers, developed by a multidisciplinary team in accordance with published evidence, clinical guidelines, and intervention development frameworks. The booklet comprised seven modules featuring information on melanoma diagnosis, treatment, prognosis, and ongoing clinical management; risk factors and the role of genetic counseling services for melanoma; psycho-education on emotional, behavioral, and cognitive responses to melanoma, including psycho-education on fear of cancer recurrence; description of healthy coping responses; a suite of tailored tools to support skin self-examination, doctor-patient communication, and identification of the signs and symptoms of anxiety and depression; a list of community-based services and resources; and tools to support melanoma-related record keeping and monitoring. Resource acceptability, relevance, quality, dissemination preferences, emotional responses, unmet information needs, and demographic characteristics were assessed. RESULTS: Nineteen melanoma survivors (response rate 50 %) and 10 health professionals (response rate 83 %) evaluated the resource. Responses were overwhelmingly positive; the booklet was thoroughly read and highly rated in terms of quality and quantity of information, utility of health education tools, and capacity to address unmet needs. Ninety-five percent of melanoma survivors would recommend the booklet to others. Most preferred a paper-based format, provided by their treating doctor at diagnosis. CONCLUSIONS: Melanoma: Questions and Answers was feasible and acceptable and demonstrated a strong capacity to address the information and psycho-educational needs of people with melanoma at low fiscal cost.

Community-based intervention for depression management at the primary care level in Ha Nam Province, Vietnam: a cluster-randomised controlled trial.

OBJECTIVE: To evaluate the effectiveness of an intervention including psychoeducation and yoga for depression management at the primary healthcare level in one district in the Hà Nam province, Vietnam. METHOD: The Patient Health Questionnaire-9 (PHQ-9) was used for depression screening and follow-up. Screened patients were further diagnosed with the Mini-International Neuropsychiatric Diagnostic Interview, by a trained general doctor. A linear regression model, adjusted for age, gender and baseline PHQ-9 score was used to assess whether the intervention leads to decreased depression severity compared to standard care in the control communes. RESULTS: Both groups had similar PHQ-9 scores at baseline. The intervention group had on average significantly lower PHQ-9 scores after the intervention than the control group. Almost half of the patients in the intervention group recovered from depression, whereas nobody did in the control group. CONCLUSION: The results indicate that the intervention can be more effective than standard care in treating depression. The mean change of the PHQ-9 score after the intervention is deemed to be of clinical relevance.

Impact of education on clinicians' attitudes to exposure therapy for eating disorders.

It is well established that clinicians use exposure therapy far less often than the evidence would suggest is justified. This shortfall has been explained as being at least partly a result of clinicians' beliefs and attitudes about exposure and their trait anxiety. Recent studies have shown that attitudes to exposure therapy for anxiety disorders can be improved through a simple educational approach. This study aimed to determine whether a similar educational approach can improve therapists' attitudes to exposure therapy for the eating disorders, and whether clinician's pre-intervention characteristics influenced the impact of the training. Thirty-four eating disorder clinicians (30 female, four male; mean age = 39.0 years; 85.3% Caucasian) attended a 90-min didactic teaching session on the subject of the use of exposure in treatment of eating disorders. Their attitudes to exposure therapy were measured before and after the workshop, in a within-subject design. The outcome was a substantial improvement in attitudes, with a strong effect size (Cohen's d = 1.68) that was comparable to the outcome of a similar intervention among clinicians working with anxiety disorders. The improvement was not related to clinicians' anxiety levels, but was greater among those whose attitudes were more negative at the outset of the teaching. While this finding needs to be tested for long-term maintenance and its relationship to change in clinical practice, it adds to the evidence that a simple educational intervention is sufficient to result in substantial improvement in clinicians' attitudes to exposure therapy.

Rational for Conducting PTSD Research and Challenges of Recruiting and Training Volunteers to Screen and Treat PTSD among the Nepal 2015 Earthquake Survivors.

Post-traumatic Stress Disorder (PTSD) is common psychiatric morbidity among earthquake survivors, and if untreated people suffer from it for years. Government of Nepal and NGOs provided various short-term mental health services to the victims of the 2015 earthquake in Nepal, but there was no plan or provision for long-term mental health problems. The prevalence of PTSD following natural disasters depends on various local factors requiring understanding and further investigation before identifying affordable evidence based interventions. This paper discusses the need for PTSD research among the survivors of the 2015 earthquake in Nepal, and describes the challenges and difficulties of recruiting and training PTSD volunteers.

Pesquisa empírica em psicoterapia psicanalítica: contribuição para a formação teórico-clínica de psicoterapeutas / Empirical research in psychoanalytic psychotherapy: contribution for the theoretical-clinical training of psychotherapists

O artigo apresenta breve histórico do desenvolvimento da teoria e da técnica da psicoterapia psicanalítica. Também diferencia duas modalidades de pesquisa empírica em psicoterapia: processo e resultado de tratamento. Destaca a pouca quantidade de pesquisas, no Brasil, sobre a temática, o que atesta a ausência de tradição de estudos desse caráter e a distância entre clínicos e pesquisadores. Salienta que a pesquisa de processo é uma possibilidade de aproximação entre essas áreas. Os autores consideram necessários e relevantes os esforços para unir clínicos e pesquisadores na pesquisa empírica em psicoterapia, e sugerem a inserção da pesquisa na formação do psicoterapeuta como possibilidade de aproximação de clínicos e pesquisadores e, assim, de redução dessa lacuna.(AU)

The article presents a brief historical development of theory and technique of psychoanalysis and psychotherapy. It also distinguishes two kinds of empirical research in psychotherapy: process and results of treatment. It highlights the small amount of research in this field in Brazil. That shows a lack of tradition of studies like this and a gap between clinicians and researchers. It points out that process research is a possibility of interlocution between these areas. The authors emphasize that efforts become necessary and relevant to unite clinicians and researchers work, and suggest research as a discipline in psychotherapy training as a possible approach between clinicians and researchers and thus reduce this gap.(AU)

Ainda o futuro das psicoterapias - 2015 e além? / Still the future of psychotherapies - 2015 and beyond?

Discutem-se as perspectivas futuras das psicoterapias a partir de "previsões" levantadas por trabalhos publicados em 1987, 1999 e revisitados em 2014. Indica-se que a principal evolução das técnicas psicoterápicas, nestes últimos 30 anos, foi sua maturidade científica em termos de um consistente corpo de pesquisas atestando sua eficácia e efetividade em diversos quadros psiquiátricos. Apesar desse cenário mais favorável, discutem-se algumas das razões de por que as psicoterapias parecem ainda estar na defensiva em relação ao uso de psicofármacos e outras intervenções não psicológicas, e se conclui sugerindo a criação de uma entidade nacional e independente de psicoterapeutas, que possa normatizar e fiscalizar mais adequadamente suas funções, treinamento, educação contínua e políticas públicas adequadas.(AU)

Psychotherapies future perspectives are discussed, considering earlier "predicitions" from papers published in 1987, 1999, and a 2014 presentation. It is emphasized the main evolution of psychotherapeutics techniques in the last 30 years, namely their scientific maturity, obtained through a consistent body of evidences of their efficacy and effectiveness in diverse psychiatric pathologies. But in spite of this more favourable scenario, it seems that the psychotherapies remain in a defensive position vis a vis psychopharmacologic and other non-psychological interventions. One of the paper conclusions is a suggestion to join efforts to build a National (Brazilian) and Independent Psychotherapy Association, to provide norms, rules, training, and accreditation, as well as public policies, for the profession of Psychotherapist.(AU)

Instrumento de apoio para a primeira entrevista em psicoterapia cognitivo-comportamental / Instrument of support to the first interview in cognitive-behavioral psychotherapy / Instrumento de apoyo a la primera entrevista en psicoterapia cognitivo-conductual

A primeira entrevista em psicoterapia é, usualmente, vivenciada com grande ansiedade por estagiários de Psicologia. Visando facilitar essa transição profissional e colaborar para a formação de terapeutas iniciantes, este artigo tem por objetivo apresentar um instrumento para uso por estagiários de Psicoterapia Cognitivo-Comportamental na primeira sessão individual. O instrumento é apresentado na forma de uma lista de checagem, contendo aspectos a serem abordados no decorrer da sessão, além de questões abertas sobre a vivência emocional e autoavaliação do desempenho na sessão. São discutidos achados de pesquisa em psicoterapia que fundamentam o instrumento. Adicionalmente, são sugeridos estudos para avaliação de seu potencial didático na formação de psicoterapeutas.

The first interview in psychotherapy is usually experienced with great anxiety by psychology undergraduate trainees. In search of making easier that professional transition and collaborate for the professional training of beginners therapists, this paper has the aim to present an instrument for use by trainees in the first session of Cognitive Behavioral Psychotherapy. The instrument is presented in the format of a checklist, consisting of features to be addressed during the session, besides open questions about the emotional experience and evaluation of the own performance. Research findings in the psychotherapy field which provide the basis for the instrument are discussed. Additionally, further studies are recommended in order to evaluate its didactic potential in the psychotherapy training.

La primera entrevista en psicoterapia es, generalmente, vivida con gran ansiedad por los alumnos de Psicología en prácticas. Con la finalidad de facilitar esta transición profesional y colaborar con la formación de nuevos terapeutas, este artículo tiene como objetivo presentar una herramienta para la primera sesión individual de los alumnos de Psicoterapia Cognitivo-Conductual. El instrumento se presenta en forma de una lista de verificación que contiene los aspectos a tratar durante la sesión, además de preguntas abiertas acerca de la experiencia emocional y una auto-evaluación de su desempeño en la sesión. Se discuten los hallazgos de investigaciones en psicoterapia que fundamentan el instrumento. Adicionalmente, se sugieren estudios para evaluar su potencial educativo en la formación de psicoterapeutas.