ABSTRACT
Evidence-Based Psychological Treatments for Adults: A Selective Review. BACKGROUND: Psychological treatments have shown their efficacy, effectiveness, and efficiency in dealing with mental disorders. However, considering the scientific knowledge generated in recent years, in the Spanish context, there are no updating studies about empirically supported psychological treatments. The main goal was to carry out a selective review of the main empirically supported psychological treatments for mental disorders in adults. METHOD: Levels of evidence and degrees of recommendation were collected based on the criteria proposed by the Spanish National Health System (Clinical Practice Guidelines) for different psychological disorders. RESULTS: The results indicate that psychological treatments have empirical support for the approach to a wide range of psychological disorders. These levels of empirical evidence gathered range from low to high depending on the psychological disorder analysed. The review indicates the existence of certain fields of intervention that need further investigation. CONCLUSIONS: Based on this selective review, psychology professionals will be able to have rigorous, up-to-date information that allows them to make informed decisions when implementing empirically based psychotherapeutic procedures based on the characteristics of the people who require help.
Subject(s)
Mental Disorders , Adult , Humans , Mental Disorders/therapyABSTRACT
Se describe el caso clínico de un hombre de 38 años con trastorno adaptativo con ansiedad. La percepción de sobrecarga de trabajo le originó síntomas propios de ansiedad, sentimiento de incapacidad para resolver los problemas, para desconectar y para continuar en la situación presente, deterioro en la gestión de la rutina diaria y consumo excesivo de alcohol. Se aplicó la terapia cognitivo-conductual, un tratamiento multicomponente para reducir la ansiedad (psicoeducación, técnicas cognitivas y técnicas de desactivación fisiológica), un programa de bebida controlada para disminuir el consumo de alcohol y entrenamiento en solución de problemas y gestión del tiempo para disminuir la sobrecarga de trabajo y paliar el estrés. Tras el tratamiento, se observa una clara mejoría con descenso de su activación fisiológica, reducción significativa del número de anticipaciones ansiosas con respecto al entorno laboral y disminución de la conducta de consumo de alcohol. Se discuten los resultados de la intervención, que confirman la eficacia del tratamiento
The case of a thirty-eight-year-old man with an adjustment disorder together with anxiety is described. The perception of his work overload led to consequences such as symptoms of anxiety, perception of inability to solve problems, difficulty disconnecting, and continuing in the present situation. Another consequence was a deterioration in his daily routine, in addition to excessive drinking. Cognitive behavioral therapy, a multicomponent treatment for anxiety (psycho-education, cognitive techniques, and physiological techniques deactivation), was applied, together with controlling his drinking program as to reduce alcohol consumption, and training in problem solving and time management to reduce his work overload and eliminate stress. At the end of the treatment, there was an improvement with his physiological arousal, especially in the decrease of anxiety regarding working environment and resolved drinking behavior. Intervention results which confirm the effectiveness of treatment are discussed
Subject(s)
Humans , Male , Adult , Burnout, Professional/psychology , Adjustment Disorders/psychology , Cognitive Behavioral Therapy/methods , Anxiety Disorders/therapy , Workload/psychology , Alcohol Drinking/therapyABSTRACT
BACKGROUND: Recent studies have compared the efficacy of cognitive intervention compared to behavioral techniques for the treatment of different disorders. In line with that work, the empirical study presented here examined the efficacy of Behavioral Activation (BA) and Cognitive Therapy (CT) on Negative Automatic Thoughts (PANs) elicited in situations generating anxiety. METHOD: Based on a sample of 42 students aged 18 to 21 who took the ISRA B, BADS and EROS, 18 subjects with the highest scores were selected and assigned at random to one of two experimental groups or to a control group. Experimental Group 1 was given intervention based on CT and Experimental Group 2 based on BA. Both interventions consisted of five 60-min sessions. RESULTS: Pre and post treatment measurement analyses reveal that both conditions effectively reduced the intensity of the anxiety response. However, BA was the only condition showing a significant reduction in ANTs. CONCLUSIONS: The results are discussed stressing the efficacy of BA in exclusively cognitive intervention
ANTECEDENTES: las intrusiones mentales (IM) constituyen la variante normativa de las obsesiones en el Trastorno Obsesivo-Compulsivo (TOC), las preocupaciones sobre defectos en el Trastorno Dismórfico Corporal (TDC), las imágenes sobre enfermedad en Hipocondría (TH), y pensamientos sobre alimentación en los Trastornos Alimentarios (TA). Nuestro objetivo es explorar, a nivel intra-sujeto, las relaciones entre la frecuencia y la molestia asociadas a las cuatro modalidades de IM. MÉTODO: 438 participantes (Medad = 29.84, DT = 11.41; 70,54% mujeres) completaron el Inventario de Pensamientos Intrusos Desagradables (INPIDES), que evalúa la presencia y molestia de IM con contenidos obsesivos, dismórficos, hipocondríacos y alimentarios. RESULTADOS: más del 76% de los participantes experimentaron las cuatro modalidades de IM. Las alimentarias fueron las más frecuentes pero las menos molestas, mientras que las hipocondríacas fueron las menos frecuentes pero las más molestas. La frecuencia y malestar de las cuatro IM correlacionaron entre sí. Las mujeres experimentaron las IM obsesivas, dismórficas y alimentarias más que los hombres. La edad se asoció negativamente con la frecuencia y el malestar de las IM. CONCLUSIÓN: las IM pueden ser una variable transdiagnóstica a trastornos como el TOC, el TDC, los TA y la Hipocondría, y ello puede contribuir a explicar las similitudes fenomenológicas entre estos trastornos
Subject(s)
Humans , Male , Female , Young Adult , Cognitive Behavioral Therapy/methods , Anxiety Disorders/therapy , Behavior Therapy/methods , Behavioral Symptoms/therapy , Treatment Outcome , Psychotherapy/methods , NegativismABSTRACT
BACKGROUND: Recent studies have compared the efficacy of cognitive intervention compared to behavioral techniques for the treatment of different disorders. In line with that work, the empirical study presented here examined the efficacy of Behavioral Activation (BA) and Cognitive Therapy (CT) on Negative Automatic Thoughts (PANs) elicited in situations generating anxiety. METHOD: Based on a sample of 42 students aged 18 to 21 who took the ISRA B, BADS and EROS, 18 subjects with the highest scores were selected and assigned at random to one of two experimental groups or to a control group. Experimental Group 1 was given intervention based on CT and Experimental Group 2 based on BA. Both interventions consisted of five 60-min sessions. RESULTS: Pre and post treatment measurement analyses reveal that both conditions effectively reduced the intensity of the anxiety response. However, BA was the only condition showing a significant reduction in ANTs. CONCLUSIONS: The results are discussed stressing the efficacy of BA in exclusively cognitive intervention.
Subject(s)
Anxiety/psychology , Anxiety/therapy , Cognitive Behavioral Therapy , Thinking , Adolescent , Anxiety/etiology , Female , Humans , Male , Young AdultABSTRACT
El artículo presenta información sobre una modalidad de dependencia emocional para la que se acuña el término 'Síndrome de Fortunata'- que designa un tipo de relaciones afectivas que determinadas mujeres desarrollan repetidamente hacia hombres casados. En el síndrome son identificables varios patrones de conducta y varias actitudes características, como la fuerte y duradera dependencia emocional y la fidelidad hacia ese hombre, la ambivalencia de sentimientos hacia la pareja oficial (rencor por la creencia de que le ha arrebatado algo propio, pero también deseos de ser ella, de emularla o, incluso, de llevarse bien), el cuestionamiento de la validez de la unión del hombre con la otra mujer y la fantasía reiterada de que las circunstancias cambiarán y ambos acabarán juntos. Además de delimitar e ilustrar este tipo de relaciones, sus peculiaridades y sus diferencias respecto de otras situaciones con las que podría confundirse, se hipotetizan algunas posibles causas de esta forma de dependencia emocional y se presentan varias estrategias para ayudar a las mujeres que quieren terminar con esta modalidad de vinculación afectiva
This paper presents information about a form of emotional dependency, for which the term 'Fortunata syndrome' has been coined, designating a type of affective relationship that some women develop repeatedly with married men. Several patterns of behaviour and repeated attitudes can be identified in this syndrome, such us the strong and lasting emotional dependency and loyalty to the man, the ambivalence of feelings towards the official partner (resentment due to the belief that the partner has taken something which belongs to them, but also the desire to be her, to imitate her or even to get along with her), the questioning of the validity of the union of man with the other woman and repeated fantasies that their circumstances will change and they will end up together. In addition to defining and illustrating these relationships, their idiosyncrasies and their differences with regards to other situations with which they could be confused, we hypothesise some possible causes of this form of emotional dependence and we present several strategies to help women who wish to put an end to this form of affective linkage
Subject(s)
Female , Humans , Male , Medicine in Literature , Expressed Emotion/physiology , Dependency, Psychological , Codependency, Psychological/physiology , Emotions/physiology , Psychotherapy/methods , Psychotherapy/trends , Extramarital Relations/psychology , Marriage/psychology , Affective Symptoms/psychology , Psychology, Clinical/methods , Psychology, Clinical/organization & administration , Object Attachment , Psychoanalysis/methods , Psychoanalysis/trendsABSTRACT
BACKGROUND: This article presents a description of the Integrative Behavioral Couple Therapy (IBCT), and puts forwards its contributions, its techniques and progress, the research data on its usefulness compared to traditional behavioral couple therapy, and explains basically its articulation in third-wave behavior therapies using the concepts of functionality, rule-governed/contingency-shaped behavior and acceptance. METHOD: A theoretical review of the main IBCT bibliography was carried out. RESULTS: The review shows that this intervention model includes innovative intervention strategies (to promote acceptance and tolerance) that join the already well-known behavioral couple therapy techniques (behavior exchange, communication training and couple problem solving), substantially modifying the therapy. Furthermore, it incorporates useful orientation for especially difficult problems in couples (such as infidelity and substance use, abuse and dependence situations). CONCLUSIONS: After this analysis, IBCT is revealed as a new intervention, the scope of which is still spreading among professionals. The acceptance concept, one of the core elements of third-wave therapies, has been fruitfully included in behavioral couple therapy through the IBCT
ANTECEDENTES: este artículo presenta una descripción de la Terapia Integral Conductual de Pareja (TICP); se enumeran sus aportaciones, sus técnicas y su curso; se ofrecen datos de investigación respecto a su utilidad comparada con la terapia de pareja conductual tradicional y se explica su articulación en las terapias de tercera generación a través de los conceptos de funcionalidad, aceptación y conducta gobernada por reglas/moldeada por contingencias. MÉTODO: se efectuó una revisión teórica en la bibliografía más importante de la TICP. RESULTADOS: la revisión ha revelado que este modelo de intervención incluye novedosas estrategias de intervención (para el fomento de la aceptación y la tolerancia) que se unen a las ya conocidas de la terapia de pareja conductual (intercambio de reforzadores, entrenamientos en comunicación y resolución de problemas), de forma que modifica sustantivamente la terapia; además, incorpora orientaciones útiles para problemas especialmente difíciles de las parejas (como infidelidades y situaciones de consumo de sustancias, maltrato y dependencia). CONCLUSIONES: la TICP se presenta como una intervención nueva y cuyo alcance está aún por divulgarse. El concepto de aceptación, uno de los elementos nucleares de la tercera generación, se ha incorporado fructíferamente a la terapia de pareja a través de la TICP
Subject(s)
Humans , Male , Female , Couples Therapy/education , Couples Therapy/ethics , /analysis , /ethics , Spouse Abuse/diagnosis , Spouse Abuse/prevention & control , Couples Therapy/instrumentation , Couples Therapy , /methods , /prevention & control , Spouse Abuse/history , Spouse Abuse/psychology , Spouse Abuse/therapyABSTRACT
BACKGROUND: This article presents a description of the Integrative Behavioral Couple Therapy (IBCT), and puts forwards its contributions, its techniques and progress, the research data on its usefulness compared to traditional behavioral couple therapy, and explains basically its articulation in third-wave behavior therapies using the concepts of functionality, rule-governed/contingency-shaped behavior and acceptance. METHOD: A theoretical review of the main IBCT bibliography was carried out. RESULTS: The review shows that this intervention model includes innovative intervention strategies (to promote acceptance and tolerance) that join the already well-known behavioral couple therapy techniques (behavior exchange, communication training and couple problem solving), substantially modifying the therapy. Furthermore, it incorporates useful orientation for especially difficult problems in couples (such as infidelity and substance use, abuse and dependence situations). CONCLUSIONS: After this analysis, IBCT is revealed as a new intervention, the scope of which is still spreading among professionals. The acceptance concept, one of the core elements of third-wave therapies, has been fruitfully included in behavioral couple therapy through the IBCT.
Subject(s)
Couples Therapy/methods , Female , Humans , Interpersonal Relations , Interview, Psychological , Male , Problem Solving , Psychological Distance , Spain , Spouses/psychologyABSTRACT
Se presenta el tratamiento de un sujeto varón de 44 años con síntomas de depresión. La intervención se organizó a partir del análisis propuesto por la Activación Conductual (AC), que contempla algunos tipos de depresión como formas elaboradas de evitación. Entre los componentes del tratamiento se incluyó la recuperación de tareas abandonadas, el replanteamiento de nuevos objetivos vitales, la extinción de conductas de evitación, la programación horaria y la recuperación de obligaciones domésticas, laborales y sociales. Después de siete meses de intervención se apreciaron cambios significativos en las medidas pretratamiento (BDI-II, AAQ, ATQ, EROS y BADS), así como en el número y el tipo de actividades desarrolladas. Tras este tiempo el cuadro depresivo podía considerarse remitido y el paciente había recuperado un trabajo productivo. Los beneficios terapéuticos se mantuvieron durante los siguientes cinco meses de seguimiento. A pesar de la gravedad del cuadro, el sujeto no deseaba tomar medicación antidepresiva, por lo que ésta no se empleó en ningún momento. Los buenos resultados obtenidos no obstante esta circunstancia y la duración relativamente breve de la intervención suponen un aval importante para el modelo de terapia propuesto por la AC para este tipo de casos (AU)
Treatment for a 44-year-old man with depressive symtomatology is set out. The intervention proposed was based on the behavioral activation (BA) analysis, that sees some types of depression as elaborated avoidance modalities. Treatment components included recuperation of tasks that had previously been given up, reconsideration of life goals, ending of avoidance behaviors, time scheduling and reengagement with housework, labour duties and social responsibilities. After seven months of treatment remarkable changes appeared in the pre-treatment measures (BDI-II, AAQ, ATQ, EROS, and BADS), as well as in the number and kind of activities carried out. Depression was in full remission and the patient had regained a state of productive work. Follow-up showed that therapeutic benefits persisted for the next five months. In spite of the severity of the set of symptoms, the patient did not want to take antidepressant medication, and so it was never used. The good outcomes obtained in spite of this circumstance and despite the relatively short length of time of intervention strongly support the model proposed by BA for these kinds of cases (AU)
Subject(s)
Humans , Male , Adult , Cognitive Behavioral Therapy/methods , Depressive Disorder/therapy , Evaluation of Results of Therapeutic Interventions , Activities of Daily LivingABSTRACT
En este artículo se repasan las técnicas de tres de las terapias de tercera generación conductual (Terapia de Aceptación y Compromiso, Psicoterapia Analítico Funcional y Terapia Conductual Dialéctica) para reflexionar sobre el tipo de destrezas que el terapeuta debe desarrollar si pretende lograr una actuación competente al practicarlas. Este examen lleva a distinguir entre: (1) habilidades de escucha y discriminación de respuesta; (2) habilidades de fluidez, repertorio y competencia verbal; (3) habilidades de ejecución motora; (4) habilidades de imaginación-creatividad; (5) habilidades de conexión-empatía; y (6) otras habilidades (trabajo en grupo entre terapeutas, meditación, atención plena, etc.). Un análisis de estas destrezas permite concluir que los nuevos desarrollos parten de las tradicionales habilidades del terapeuta cognitivo-conductual pero replanteadas y con formas decididamente más elaboradas. Por otro lado, se revela que las competencias habitualmente entrenadas en la licenciatura, así como las que pueden derivarse exclusivamente de la lectura de los textos en que se divulgan estas terapias, resultan limitadas para un trabajo eficaz dentro de estos nuevos modelos. En conclusión, se propone la implementación de una formación práctica o procedimental a través de talleres, materiales audio-visuales y supervisión de casos (AU)
In this paper, the techniques of three of the third-wave of behavioral therapy reviewed Acceptance and Commitment Therapy, Functional Analytical Psychotherapy and Dialectic Behavioral Therapy). We reflect on the type of skills that the therapist must develop in order to guarantee a competent performance when practicing. A distinction is made between: (1) listening and answer discrimination skills; (2) fluidity, variety and verbal competence skills; (3) motor skills; (4) imagination-creativity skills; (5) empathy skills; and (6) other skills e.g., working in groups of therapist, meditation, mindfulness, etc. An analysis of these skills let us conclude that the new developments start from cognitive-behavioral therapy traditional skills but are reframed and elaborated in new ways. On the other hand, we found that the skills more commonly trained during the degree, as well as those that can be obtained from reading the texts in which these therapies are explained, are scarce for an effective work within these new models. Finally, we propose the improvement of practical training through workshops, audio-visual resources and case supervision (AU)
Subject(s)
Humans , Behavior Therapy/methods , Psychotherapy/methods , Mental Disorders/therapy , EffectivenessABSTRACT
En los últimos años, muchos clínicos observan con interés el desarrollo de los tratamientos eficaces. Su divulgación supone una considerable garantía para los pacientes y es el mejor aval social para la profesión; sin embargo, para los terapeutas también acarrea una serie de presiones que raramente son expuestas en los manuales y artículos científicos. El profesional que actúa con la premisa de "la técnica es lo importante y eficaz", puede atribuir a su falta de destreza con ella una evolución inesperada, el fracaso de la terapia o los abandonos. Convencidos del poder transformacional de determinados procedimientos, se puede olvidar que casi siempre es más sencillo y eficaz tratar de cambiar el entorno que altera al sujeto que lograr -sin cambios en ese medio- que se auto-controle, se relaje, vea las cosas de otra manera o, por último, admita su situación. Llevadas las cosas al extremo, aparece el peligro de establecer una relación exclusiva entre tratamiento y técnica, lo que supone una vulneración de los principios de la evaluación e intervención psicológica
During the last few years many practitioners have been observing with interest the development of effective treatments. Circulation of such treatments is a guarantee for patients and a social support for the profession. Nevertheless, it results in pressure for therapists which is seldom addressed in literature: Professionals whose practice premise is "technique is what matters" may put down to his/her lack of skillfulness an unexpected course of treatment, therapy failure or patient withdrawal from treatment. Persuaded of the transformational power of certain procedures, they may forget that most times it is easier and more effective to change subject environment than to make him/her self-control, relax, change the way they look things and finally accept his/her situation. Carrying the matter so far, the danger of establishing a unique relationship between treatment and technique may arise, thus meaning a violation of principIes of psychological assessment and intervention
