Cost-effectiveness and cost-utility study of a psychoeducational group intervention for people with depression and physical comorbidity in primary care.

OBJECTIVE: To evaluate the cost-effectiveness and cost-utility of a psychoeducational group intervention led by primary care (PC) nurses in relation to customary care to prevent the depression and improve quality of life in patients with physical comorbidity. DESIGN: Economic evaluation based on data from randomized, multicenter clinical trial with blind response variables and a one-year follow-up, carried in the context of the PSICODEP study. LOCATION: 7 PC teams from Catalonia. PARTICIPANTS: >50 year-old patients with depression and some physical comorbidity: diabetes mellitus type 2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma. INTERVENTION: 12 psychoeducational group sessions, 1 per week, led by 2 PC nurses with prior training. MEASUREMENTS: Effectiveness: depression-free days (DFD) calculated from the BDI-II and quality-adjusted life years (QALYs) from the Euroqol-5D. Direct costs: PC visits, mental health, emergencies and hospitalizations, drugs. Indirect costs: days of temporary disability (TD). The incremental cost-effectiveness ratios (ICER), cost-effectiveness (ΔCost/ΔDLD) and cost-utility (ΔCost/ΔQALY) were estimated. RESULTS: The study includes 380 patients (intervention group [IG] = 204; control group [CG] = 176). 81.6% women; mean age 68.4 (SD = 8.8). The IG had a higher mean cost of visits, less of hospitalizations and less TD than the CG. The difference in costs between the IG and the CG was -357.95€ (95% CI: -2026.96 to 1311.06) at one year of follow-up. There was a mean of 11.95 (95% CI: -15.98 to 39.88) more DFD in the IG than in the CG. QALYs were similar (difference -0.01, 95% CI -0.04 to 0.05). The ICERs were 29.95€/DLD and 35,795€/QALY. CONCLUSIONS: Psychoeducational intervention is associated with an improvement in DFD, as well as a reduction in costs at 12 months, although not significantly. QALYs were very similar between groups.

BLAME-LESS STUDY: a two-arm randomized controlled trial evaluating the effects of an online psychoeducation programme for adolescents who have experienced physical/sexual violence or sexual abuse. Rationale, study design, and methods.

Background: Victims of physical/sexual violence or sexual abuse commonly experience defense responses that result in feelings of guilt and shame. Although trauma-focused interventions are effective in treating post-traumatic stress disorder symptoms, the presence of trauma-related shame and guilt can potentially hinder the process of disclosure during treatment, thus diminishing their overall effectiveness. It is hypothesized that providing psychoeducation about common defense responses will reduce feelings of shame and guilt, thereby increasing receptivity to trauma-focused treatment.Objective: This paper describes the rationale, study design, and methods of the BLAME-LESS study. The effects of a brief online psychoeducation program will be compared with a waiting-list control group. The intervention aims to reduce feelings of trauma-related shame and guilt that adolescents experience regarding their own defense responses during and after physical/sexual violence or sexual abuse.Methods: Adolescents (12 - 18 years old) with a history of physical/sexual violence or sexual abuse who suffer from trauma-related feelings of shame and guilt can participate in the study. The study follows a two-arm RCT that includes 34 participants. The primary outcomes includes trauma-related feelings of shame and guilt. The secondary outcomes includes PTSD symptoms, anxiety and depression symptoms, traumatic cognitions, readiness to disclose details of memories of the trauma, and motivation to engage in trauma-focused therapy. Assessments take place after screening, at baseline, two weeks after allocation to the intervention or waiting-list, and, only for the waiting-list participants, seven weeks after allocation to the intervention.Conclusions: There is a need for treatment approaches that target trauma-related feelings of shame and guilt. A recently developed brief online psychoeducation program on defense responses during and after trauma offers victims of physical/sexual violence or sexual abuse a free and accessible way to obtain reliable and valid information. The proposed RCT will evaluate the effectiveness of this online psychoeducation program.Trial Registration: Request is pending.

Some defense responses to physical/sexual violence or sexual abuse, such as tonic immobility and appeasement behaviour, are common but unknown and raise feelings of shame and guilt.BLAME-LESS (In Dutch: On(t)schuldig) is a newly developed online psychoeducation programme that aims to reduce feelings of trauma-related shame and guilt. This programme includes explanatory animations, in-depth interviews with experts and victims, and written information accompanied by case reports.The proposed study examines the effectiveness of the brief online psychoeducation programme BLAME-LESS in a well-controlled study.

Programas de intervención para mejorar la convivencia escolar: una revisión sistemática / Intervention programs to improve school coexistence: a systematic review

El estudio de la convivencia escolar es cada vez más recurrente en los últimos años por la aparición de múltiples problemas asociados a esta. La ausencia de evidencia respecto al efecto de los programas de intervención hace necesaria una revisión de literatura internacional sobre la eficiencia de los programas de intervención para mejorar la convivencia escolar. Para el desarrollo de este estudio se ha utilizado la guía de declaración PRISMA para revisiones sistemáticas, se realizó la búsqueda en cinco bases de datos SCOPUS, WEB OF SCIENCE, SCIELO, REDALYC y PUBMED en diciembre de 2022. Los resultados encontraron 365 artículos, y tras aplicar los criterios de elegibilidad se incluyeron 27 publicaciones, de las que el 88.90% fueron estudios cuasiexperimentales y se aplicó como instrumento principal el Cuestionario de Violencia Escolar (CUVE). En los estudios se analizaron los aspectos conductuales, bullying, problemas de comportamiento y habilidades sociales. Los programas de intervención más utilizados fueron de inteligencia emocional, educación deportiva, de convivencia, enfoque múltiple y psicoeducación. La revisión concluyó que los programas de inteligencia emocional y educación deportiva son aquellos con mayor evidencia de eficiencia para mejorar la convivencia escolar; sin embargo, aún con lo descrito, los resultados no son muy concluyentes y se debe seguir con esta línea de investigación. (AU)

The study of school coexistence is increasingly recurrent in recent years due to the appearance of multiple problems associated with it, the absence of evidence regarding the effect of intervention programs led to formulating as an objective the review of existing international literature on the efficiency of intervention programs to improve school coexistence. For the development of the study, the PRISMA declaration guide for systematic reviews was used, searches were carried out in five databases SCOPUS, WEB OF SCIENCE, SCIELO, REDALYC and PUBMED in December 2022 by combining keywords and descriptors. The results of the systematization found 365 articles, after applying the eligibility criteria, 27 publications were included, where 88.90% were quasi-experimental studies and the School Violence Questionnaire (CUVE) was applied as the main instrument, in the studies the aspects were analyzed. behavioral problems, bullying, behavior problems and social skills. The most used intervention programs were emotional intelligence, sports education, coexistence, multiple approach and psychoeducation. The review concluded that emotional intelligence and sports education programs are those with the greatest evidence of efficiency in improving school life; however, even with what has been described, the results are not very conclusive, and this line of research should be continued. (AU)

Intervenciones psicoeducativas sobre salud mental con adolescentes en contextos escolares: una revisión sistemática / Psychoeducational interventions on mental health with adolescents in scholar contexts: a systematic review

La adolescencia es una etapa de transición en la que pueden aparecer dificultades a nivel personal, académico, familiar y social. Se estima que el 20% de adolescentes se enfrentará a algún problema de salud mental. El objetivo de este trabajo es realizar una revisión sistemática sobre intervenciones psicoeducativas para la prevención y/o la promoción de la salud mental en adolescentes dentro del contexto escolar. Para ello, se ha realizado una búsqueda en las bases de datos Web of Science, Scopus y PsycInfo, en la que se han identificado inicialmente 105 artículos, y se han seleccionado 11 estudios sobre programas psicoeducativos que reunían los criterios de inclusión. Tras esta revisión, se puede afirmar que la mayoría de intervenciones psicoeducativas analizadas son efectivas en la promoción del conocimiento de salud mental, la reducción del estigma y la adquisición de estrategias y habilidades con adolescentes. (AU)

Adolescence is a critical life phase during which people are faced with important decisions at the personal, academic, familial, and social level, what often comes with many difficulties. It is estimated that around 20% of adolescents will experience mental health difficulties. This study reviews psychoeducational interventions aimed at the prevention and promotion of adolescents’ mental health within the school context. A systematic search was conducted in Web of Science, Scopus and PsycInfo, through which 105 articles were identified and 11 were selected according to the inclusion criteria. After reviewing the main aspects of each program, it can be concluded that, overall, psychoeducational interventions are effective. These interventions promote mental health knowledge, reduce associated stigmas, and provide useful strategies for navigating problems. (AU)

Protocol for evaluation of effects of a psychoeducational trauma-informed intervention directed at schools.

Background: Adverse childhood experiences (ACE) can have negative effects on cognitive, social and emotion regulation abilities, which can threaten the child's school integration and capacity to learn. While steady relations to sensitive, understanding adults may moderate these negative outcomes, the difficulties of children with ACEs pose a major challenge for teachers, whose insufficient preparation may lead to career attrition.Objective: Psychoeducational trauma-informed care (TIC) interventions targeting teachers may strengthen teacher preparation and buffer the deleterious outcomes of ACEs, yet the evidence-base for these interventions is limited. Importantly, while minority groups are overrepresented among those with ACEs and additionally risk exposure to ethno-racial trauma, TIC interventions lack a social disadvantage/discrimination perspective. The Present trial addresses these issues.Method: The study protocol employs a quasi-experimental design for assessing effects of a psychoeducational TIC intervention carried out in Swedish schools by Save the Children, Sweden (SCS). We compare, for the first time, an intervention group (N = 160) and a control group (N = 160) over time (pre-intervention, immediately after, 6 and 12 months post-intervention), assessing teacher stress, compassion fatigue, self-efficacy and trauma-informed knowledge. We monitor teacher attitudes and attributions of students' academic weaknesses and behavioural and mental difficulties. The trial is preregistered (DOI:10.17605/OSF.IO/V7SH8).Results: We hope that the mitigating effects of the SCS-TIC school intervention may be independent of social category, and that the trial will additionally generate knowledge of how providers and recipients of TIC may respond to it differently depending on their social and cultural identities. As school-based TIC practices and interventions are expansively relied on as means of preventing teacher burnout and career attrition, and buffering negative consequences of ACEs for children, establishing their effects with methodological robustness is important and timely.Conclusion: Such knowledge may be used to tailor and target interventions to specific populations, while ensuring maximum effectiveness.

Psychoeducational trauma-informed care interventions targeting teachers may strengthen teacher preparation and buffer the negative outcomes of adverse childhood experiences.The evidence based for these interventions is insufficient, while potential interactions with the teachers' and children's social identities are unexplored.Our quasi-experimental, longitudinal, preregistered trial will address these knowledge gaps and increase the knowledge for targeted intervention.

Efectos de la educación emocional en el duelo por la pérdida de un ser querido en la infancia y la adolescencia: una revisión sistemática guiada por las directrices PRISMA / Effects of grief education programs in children and adolescents facing the loss of a loved one: a prisma-driven systematic review

Introducción: Diferentes estudios surgidos desde el año 2020 indican que 5,2 millones de niños y niñas han perdido al menos un progenitor o cuidador como consecuencia de la pandemia de COVID-19. Estos datos ponen de manifiesto la importancia de educar en el duelo a los niños y adolescentes y protegerlos de posibles complicaciones en la elaboración del duelo.Objetivo: Analizar si hasta el momento se han realizado investigaciones que avalúen los efectos de los programas de educación emocional en la elaboración del duelo por la pérdida de un ser querido.Método: Se ha realizado una revisión sistemática siguiendo las directrices PRISMA que ha permitido identificar 8 estudios localizados en las bases de datos PsycInfo, Pubmed, ERIC y Dialnet que cumplían con los criterios de inclusión. Resultados y conclusiones: Los resultados indican que la educación emocional sí influye en la relación que los niños y adolescentes establecen con el duelo, la pérdida y la muerte. Asimismo, la falta de claridad en algunos resultados y el uso de instrumentos no específicos para avaluar el duelo, hace que estos deban ser valorados con precaución y hace aconsejable más investigación que supere las limitaciones de la actual.(AU)

Introduction: Several studies published since 2020 claim that about 5.2 million children have lost at least one parent or parental figure to COVID-19. These data support the importance of grief psychoeducation with children and adolescents as this may be an effective intervention to protect them from eventual complications, such as prolonged grief disorder, posttraumatic stress disorder, or others. Aim: To analyse whether research has been conducted up to date on the effects of grief psychoeducation or emotional education programs on grief processes following the death of a parent or another loved one in children and adolescents. Materials and Methods: A PRISMA-driven systematic review has been carried out using databases PsycInfo, Pubmed, ERIC and Dialnet. 8 studies meeting all inclusion criteria have been identified and analysed.Results and conclusions: Results suggest that emotional education significantly impacts grieving processes in children and adolescents, besides shaping their relationships with bereavement, loss and death. Nonetheless, some of the located study results lack clarity and many studies did not use specific instruments to evaluate grief. This calls for prudence when interpreting positive results and encourages future research that hopefully overcomes limitations identified in previous studies.(AU)

Mindfulness-based cognitive therapy versus psychoeducational intervention in bipolar outpatients: Results from a randomized controlled trial.

INTRODUCTION: Few controlled trials have assessed the impact of Mindfulness Based Cognitive Therapy (MBCT) on symptoms and functioning in bipolar disorder (BD). This study aims to evaluate the effectiveness of MBCT adjunctive group treatment. MATERIAL AND METHODS: Randomized, prospective, multicenter, single-blinded trial that included BP-outpatients with subthreshold depressive symptoms. Participants were randomly assigned to three arms: treatment as usual (TAU); TAU plus psychoeducation; and TAU plus MBCT. Primary outcome was change in Hamilton-D score; secondary endpoints were change in anxiety, hypo/mania symptoms and functional improvement. Patients were assessed at baseline (V1), 8 weeks (V2) and 6 months (V3). Main hypothesis was that adjunctive MBCT would improve depressive symptoms more than psychoeducation. RESULTS: Eighty-four participants were recruited (MBCT=40, Psychoeducation=34, TAU=10). Depressive symptoms improved in the three arms between V1 and V2 (p<0.0001), and between V1 and V3 (p<0.0001), and did not change between V2 and V3. At V3 no significant differences between groups were found. There were no significant differences in other measures either. CONCLUSIONS: In our BD population we did not find superiority of adjunctive MBCT over adjunctive Psychoeducation or TAU on subsyndromal depressive symptoms; neither on anxiety, hypo/mania, relapses, or functioning.

Acompanhamento psicoeducacional online: a experiência de um grupo de autoapoio para mulheres com fibromialgia / Online psychoeducational accompaniment: the experience of a self-support group for women with fibromyalgia / Seguimiento psicoeducativo online: la experiencia de un grupo de autoapoyo para mujeres con fibromialgia

A fibromialgia (FM) chama a atenção por ser uma síndrome que causa uma dor crônica ao indivíduo, além de não ter sua fisiopatologia definida e está presente em 2,5% da população brasileira . O objetivo deste trabalho é discutir sobre o papel e o apoio da psicoeducação junto as mulheres com fibromialgia. Trata-se de um relato de experiência de estágio Supervisionado em Saúde Mental/Projeto de extensão realizado no formato on-line, via plataforma Google Meet. O suporte foi construído através dos encontros semanais entre estagiárias de psicologia e profissionais de diferentes subáreas da saúde como reumatologia, educação física, fisioterapia e nutrição, bem como da cocriação ocorrida na troca de saberes e experiências entre as participantes e profissionais. Destacamos que os encontros configuraram-se com momentos informativos e também psicoterapêuticos embasados na Gestalt-terapia. Dentro desta área do conhecimento, foi possível promover para as participantes do grupo informações de grande relevância, que muitas não teriam condições de adquirir sem a mediação do grupo.

Fibromyalgia (FM) draws attention for being a syndrome that causes chronic pain to the individual, besides not having its pathophysiology defined and is present in 2.5% of the Brazilian population. The objective of this paper is to discuss the role and support of psychoeducation for women with fibromyalgia. This is an experience report of the Supervised Internship in Mental Health/Extension Project conducted online, via the Google Meet platform. The support was built through weekly meetings between trainees of psychology and professionals from different subareas of health as rheumatology, physical education, physiotherapy and nutrition, as well as the co-creation occurred in the exchange of knowledge and experiences between participants and professionals. We emphasize that the meetings consisted of informative and psychotherapeutic moments based on Gestalt-therapy. Within this area of knowledge, it was possible to provide the group participants with information of great relevance, which many of them would not have been able to acquire without the mediation of the group. KEYWORDS: Fibromyalgia; Support Group; Psychoeducation.

La fibromialgia (FM) llama la atención por ser un síndrome que causa dolor crónico al individuo, además de no tener su fisiopatología definida y está presente en el 2,5% de la población brasileña. El objetivo de este trabajo es discutir el papel y el apoyo de la psicoeducación con mujeres con fibromialgia. Se trata de un informe de experiencia de Prácticas Supervisadas en Salud Mental/Proyecto de Extensión realizado en línea, a través de la plataforma Google Meet. El apoyo se construyó a través de reuniones semanales entre estudiantes de psicología y profesionales de diferentes subáreas de la salud como reumatología, educación física, fisioterapia y nutrición, así como la co- creación se produjo en el intercambio de conocimientos y experiencias entre los participantes y profesionales. Destacamos que los encuentros se configuraron con momentos informativos y también psicoterapéuticos basados en la terapia Gestalt. Dentro de esta área de conocimiento, fue posible promover a los participantes del grupo informaciones de gran relevancia, que muchos de ellos no habrían podido adquirir sin la mediación del grupo.

Material psicoeducativo sobre transtorno do déficit de atenção e hiperatividade: avaliação docente / Psychoeducational material about attention deficit hyperactivity disorder: teachers evaluation / Material psicoeducativo sobre el trastorno por déficit de atención e hiperactividad: evaluación docente

O presente estudo objetivou desenvolver e avaliar um material psicoeducativo sobre Transtorno do Déficit de Atenção e Hiperatividade (TDAH) destinado a professores em escolas públicas e privadas. Utilizou-se um protocolo de avaliação para materiais educativos, respondido por 40 professoras de escolas da região metropolitana de Porto Alegre e Vale do Caí, no estado do Rio Grande do Sul (Brasil). Considerou-se a compreensão, a linguagem, a opinião quanto ao estímulo à aprendizagem e os conhecimentos prévios das professoras sobre TDAH. Os resultados da análise de conteúdo e da estatística descritiva indicaram que o material apresentava conteúdo e linguagem adequados, contendo informações que auxiliavam na compreensão e trabalho docente com crianças com o diagnóstico. A versão final do material contemplou as sugestões de aprimoramento advindas dos profissionais.

The present study aimed to develop and evaluate psychoeducational material on Attention Deficit Hyperactivity Disorder (ADHD) for teachers in public and private schools. An evaluation protocol for educational materials was used and answered by 40 teachers from schools in the metropolitan region of Porto Alegre and Vale do Caí (RS, Brazil). The understanding, the language, the opinion regarding the stimulus to learning and the teachers' previous knowledge about ADHD were considered. The results of content analysis and descriptive statistics indicated that the material had adequate content and language, containing information that improved the of understanding the teaching work with children withal diagnosis. The final version of the material included suggestions for improvement from professionals.

El presente estudio tuvo como objetivo desarrollar y evaluar un material psicoeducativo sobre el Trastorno por Déficit de Atención con Hiperactividad (TDAH) para docentes de escuelas públicas y privadas. Se utilizó un protocolo de evaluación de materiales educativos, respondido por 40 docentes de la región metropolitana de Porto Alegre y Vale do Caí (RS). Se consideró la comprensión, el lenguaje, la opinión sobre el estímulo al aprendizaje y los conocimientos previos de los docentes sobre el TDAH. Los resultados del análisis de contenido y la estadística descriptiva indicaron que el material tenía contenido y lenguaje adecuados, conteniendo información que ayudó en la comprensión y enseñanza con los niños con el diagnóstico. La versión final del material incluyó sugerencias de mejora por parte de los profesionales.

De las enfermedades terminales a la infertilidad; convergencias y desencuentros / From Terminal Illnesses to Infertility: Convergences and Disagreements

El presente estudio intenta delinear un paralelismo entre la infertilidad y el cáncer a partir de la contrastación de la bibliografía disponible con la serie New Amsterdam, a la vez que pretende responder a los siguientes interrogantes: ¿qué puntos en común tienen ambas enfermedades? ¿en qué se diferencian? ¿qué rol podemos adoptar desde la psicología y desde la comunidad? Siguiendo esta línea, se encontró que ambas ponen en funcionamiento mecanismos de afrontamiento ya que son enfermedades crónicas que disparan un gran impacto emocional y cambios en la cotidianeidad. Asimismo, la infertilidad se diferencia del cáncer en que no presenta dolor asociado, no hay amenaza hacia la supervivencia y tampoco afecta a la funcionalidad de ningún órgano (Antequera et al, 2008). Estos resultados llevan a plantear una equivalencia en las intervenciones, principalmente psicoeducativas, que pueden ser aplicadas tanto por profesionales de la salud como por miembros de la comunidad, y que redundarían en: mayor adherencia al tratamiento, un rol más activo por parte del paciente en la toma de decisiones, un mayor sentimiento de control sobre su propia vida, entre otras

This study aims to outline a parallelism between infertility and cancer based on the comparison of the available bibliography with the New Amsterdam series, while attempting to answer the following questions: what points do both diseases have in common? What is the difference between them? What role can we adopt from psychology and the community? Following this line, it was found that both put coping mechanisms into operation since they are chronic diseases that trigger a great emotional impact and changes in daily life. Likewise, infertility differs from cancer in that it does not present associated pain, there is no threat to survival and it does not affect the functionality of any organ (Antequera et al, 2008). These results lead to propose an equivalence in interventions, mainly psychoeducational, which can be applied both by health professionals and by members of the community, and which would result in: greater adherence to treatment, a more active role from the patient in decision-making, a greater feeling of control over their own life, among others

Psychoeducational Interventions in Children and Adolescents with Type-1 Diabetes: A Systematic Review / Las intervenciones psicoeducativas en los menores y adolescentes con diabetes tipo 1: una revisión sistemática

The effectiveness of psychoeducational interventions in children and adolescents with type 1 diabetes is unclear. A systematic review was developed in accordance with PRISMA. Relevant databases (Pubmed, Cochrane, PsycINFO, and PsyARTICLES) were analyzed. Articles of the last decade with type 1 diabetes population between 6 and 18 years participating in psychoeducational interventions were the inclusion criteria. Twenty studies were reviewed, and improvements were found in glycosylated hemoglobin, diabetes knowledge, and psychosocial variables. The results support the positive effect of these interventions. The characteristics that seem to be behind the success of these interventions are the design appropriate to the characteristics of the population, the participation of psychologist and educators, the continuity of the program over time, and the use of digital tools and interaction strategies. Further studies need to be carried out and replicated in different groups of children and adolescents.

Hay dudas acerca de la efectividad de las intervenciones psicoeducativas en menores y adolescentes con diabetes tipo 1, motivo por el cual se realizó una revisión sistemática de acuerdo con el protocolo PRISMA. Se analizaron distintas bases de datos (Pubmed, Cochrane, PsycINFO y PsyARTICLES) con los siguientes criterios de inclusión: artículos de los últimos diez años, con población con diabetes tipo 1 de edades comprendidas entre los 6 y 18 años que hubieran participado en cualquier intervención psicoeducativa. Se revisaron 20 estudios y los resultados mostraron una mejora en la hemoglobina glicosilada, en el conocimiento de la enfermedad y en algunas variables psicosociales tras estas intervenciones. Las características que parecen estar detrás del éxito de estas intervenciones psicoeducativas son el diseño adecuado a las características de la población, la participación de profesionales de la psicología y de la educación, la continuidad del programa en el tiempo y el uso de herramientas digitales y otras estrategias de interacción. Se destaca la necesidad de realizar más estudios y que sean replicados en diferentes grupos de menores y adolescentes.

Mindfulness Component in a Dialectical Behavioural Therapy Group Intervention for Family Members of Borderline Personality Disorder Patients / Mindfulness en una Intervención Grupal de Terapia Dialéctica Conductual para Familiares de Pacientes con Trastorno Límite de la Personalidad

Background: Family members of people with borderline personality disorder (BPD) are seriously affected by the disease and it is common for them to ask for professional help. The main objective of this study is to assess, in an open clinical trial, a treatment protocol based on Dialectical Behaviour Therapy (DBT) strategies for relatives of individuals with BPD, compared to the same protocol plus a mindfulness component (DBT-M). Method: The interventions were conducted in a sample of 108 relatives of 83 patients diagnosed with BPD from a Specialized Unit for Personality Disorders. Relatives and patients completed the assessment protocol before and after the intervention. Results: Significant improvements in almost all the relevant variables tested were observed after the treatment in both the relatives and the patients. However, there were only statistically significant differences between the groups in the negative attitude towards the illness, where relatives in the DBT-M condition showed greater improvement than those in the DBT condition. Conclusions: The results indicate that the intervention helps both patients and relatives to improve on key issues. It is essential to consider and offer support to the families of people with severe psychological disorders.(AU)

Antecedentes: Los familiares de las personas con trastorno límite de la personalidad (TLP) son unos de los grandes afectados por el trastorno, y resulta frecuente que soliciten ayuda profesional. El objetivo estudio es evaluar un protocolo de tratamiento basado en estrategias de Terapia Dialéctica Conductual (DBT) para familiares de personas con TLP, en comparación con el mismo protocolo más un componente de mindfulness (DBT-M). Método: Las intervenciones se realizaron en una Unidad Especializada en Trastornos de la Personalidad, en una muestra 108 familiares de 83 pacientes diagnosticados de TLP. Familiares y pacientes completaron el protocolo de evaluación antes y después de la intervención. Resultados: Se observan mejoras significativas tanto en los familiares como en los pacientes tras el tratamiento, en casi todas las variables relevantes. Sin embargo, sólo hubo diferencias estadísticamente significativas entre las dos condiciones en la actitud negativa hacia la enfermedad, donde los familiares en la condición DBT-M mostraron una mejoría mayor que los de la condición DBT. Conclusiones: Los resultados indican que la intervención ayuda, tanto a los pacientes como a los familiares, a mejorar en aspectos clave. Resulta fundamental tener en cuenta y ofrecer apoyo a los familiares de personas con trastornos psicológicos graves.(AU)

Adesão de mães de bebês prematuros com indicadores clínicos de saúde emocional à grupos psicoeducativos / Adherence of mothers of premature babies with clinical indicators of emotional health to psychoeducational groups / Adhesión de madres de prematuros con indicadores clínicos de salud emocional a grupos psicoeducativos

Diversos fatores podem interferir na saúde emocional materna e, dentre eles, o nascimento prematuro do bebê. Este estudo pretendeu: a) descrever e comparar a saúde emocional de mães de bebês prematuros que aderiram ou não a grupos psicoeducativos, com indicadores clínicos de ansiedade, estresse e depressão pós-parto e, b) identificar quais variáveis sociodemográficas influenciaram a saúde emocional das participantes de cada um dos grupos. A amostra foi composta por 42 mães de bebês prematuros que apresentaram indicadores clínicos de saúde emocional, que foi avaliada por meio de inventários de estresse, ansiedade e depressão. Elas compuseram dois grupos: 22 mães que participaram dos grupos e 20 que não participaram. Não foram observadas diferenças significativas entre as variáveis sociodemográficas e nem entre os indicadores de saúde emocional entre os dois grupos. Todavia, é importante identificar os indicadores emocionais clínicos de mães de bebês e oferecer intervenções para minimizá-los, enquanto medidas preventivas de saúde mental da população feminina e, consequentemente, infantil.

Several factors can interfere in maternal emotional health and, among them, the premature birth of the baby. This study aimed: a) to describe and compare the emotional health of mothers of premature babies who joined or not to psychoeducational groups, with clinical indicators of anxiety, stress and postpartum depression and, b) identify which sociodemographic variables influenced the emotional health of participants in each of the groups. The sample consisted of 42 mothers who presented clinical indicators of emotional health, which was assessed through inventories of stress, anxiety and depression. They composed two groups: 22 mothers who participated in the groups and 20 who did not. No significant differences were observed between sociodemographic variables or between emotional health indicators between the two groups. However, it is important to identify the clinical emotional indicators of mothers of premature babies and offer interventions to minimize them, as preventive measures for mental health in the female population and, consequently, in children.

Varios factores pueden interferir con la salud emocional materna y, entre ellos, el nacimiento prematuro del bebé. Este estudio tuvo como objetivo: a) describir y comparar la salud emocional de madres de bebés prematuros que ingresaron o no a grupos psicoeducativos, con indicadores clínicos de ansiedad, estrés y depresión posparto y, b) identificar qué variables sociodemográficas influyeron en la salud emocional de las madres en cada uno de los grupos. La muestra estuvo conformada por 42 madres de bebés prematuros que presentaron indicadores clínicos de salud emocional, la cual fue evaluada a través de inventarios de estrés, ansiedad y depresión. Compusieron dos grupos: 22 madres que participaron en los grupos y 20 que no. No se observaron diferencias significativas entre variables sociodemográficas ni entre indicadores de salud emocional entre los dos grupos. Sin embargo, es importante identificar los indicadores clínicos emocionales de las madres de bebés prematuros y ofrecer intervenciones para minimizarlos, como medidas preventivas para la salud mental de la población femenina y, en consecuencia, de los niños.

Escola de pais do Brasil: prevenção e promoção de práticas parentais positivas / Parents school of Brazil: prevention and promotion of positive parenting practices / Escuela de padres en Brasil: prevención y promoción de prácticas de crianza positivas

RESUMO A Escola de Pais do Brasil (EPB) realiza o Círculo de Debates, trabalho preventivo realizado com pais e cuidadores, em parceria com prefeituras e escolas das regiões dos municípios em que possuem seccionais. Esta pesquisa teve como objetivo descrever e analisar o Círculo de Debates através de um estudo observacional, com observação participante e registro em diário de campo, que resultou em análise temática e criação de três categorias mutuamente excludentes: prevenção, cotidiano dos pais/mães e valores e limites na educação. Apresenta ainda uma categoria transversal: a psicoeducação. Pela análise, o trabalho do Círculo de Debates da EPB foi considerado psicoeducativo, de prevenção e promoção de práticas parentais positivas.

ABSTRACT The Parent's School of Brazil (EPB) conducts the Debate Circle, preventive work with parents, mothers, and caregivers, in partnership with city halls and schools in the regions of the counties in which they have sections. This study sought to describe and analyze the Debate Circles through an observational study, with participant observation and the use of a field diary. Analyses were conducted via thematic analysis and three mutually exclusive categories were generated: prevention, parents' daily life and values, and limits in education. It also presents a transversal category: psychoeducation. According to the analysis, the work of the EPB Debate Circle was considered psychoeducative for the prevention and promotion of positive parenting practices.

RESUMEN La Escuela de Padres de Brasil (EPB) realiza el Círculo de Debate, trabajo preventivo con padres, madres y cuidadores, en alianza con ayuntamientos y escuelas de las regiones de los municipios en los que tiene secciones. Este estudio buscó describir y analizar los Círculos de Debate a través de un estudio observacional, con observación participante y el uso de diario de campo, que da como resultado el análisis temático y la creación de tres categorías mutuamente excluyentes: prevención, vida cotidiana de los padres y valores y límites en la educación. También presenta una categoría transversal: psicoeducación. Según el análisis, el trabajo del Círculo de Debate EPB se consideró psicoeducativo, para la prevención y promoción de prácticas parentales positivas.

Evaluación de los niveles de sobrecarga en cuidadores primarios de personas con esquizofrenia a través de un programa de psicoeducación / Assessment of overload levels in primary caregivers of people with schizophrenia through a psychoeducation program

A partir del año 2012 el Hospital Psiquiátrico San Lázaro cierra el servicio de hospitalización. La propuesta de esta institución fue implementar un programa de psicoeducación dirigida a la familia para el manejo de los pacientes con trastornos mentales. La participación de los cuidadores primarios en el manejo de pacientes con trastornos mentales crónicos, incluida la esquizofrenia; sin embargo, visibilizó diversos niveles de sobrecarga. Objetivo: Determinar los niveles de sobrecarga en cuidadores primarios, y los efectos atribuibles al Programa de Clínica de Apoyo a Familiares de Personas con Esquizofrenia. Materiales y Métodos: Se diseñó un estudio de evaluación pre y post intervención, en 108 expedientes seleccionados para extraer las variables socio demográficas disponibles y los puntajes de sobrecarga obtenidos con la Escala de Sobrecarga del Cuidador de Zarit. Se describieron los resultados y se analizaron mediante el test de McNemar. Resultados: La mayoría de cuidadores fueron mujeres 67,5 %. El parentesco más frecuente fue el de padres con 44,4 % seguido de hermanos 25,9 %. El rango de edad más común fue el de 51- 60 años. El 71,1 % de los cuidadores presentaron algún tipo de sobrecarga. Para la evaluación de los cambios en los niveles de sobrecarga pre y post intervención se aplicó la prueba de McNemar, cuyo resultado fue de 27,4 mostrando diferencia significativa con valor de p <0,005. Conclusión: La intervención con cuidadores primarios, mediante programas psicoeducativos puede ser una opción viable para reducir los niveles de sobrecarga en familiares de personas con esquizofrenia(AU)

As of 2012, the San Lázaro Psychiatric Hospital closes the hospitalization service. The proposal of this institution was to implement a psychoeducation program aimed at the family for the management of patients with mental disorders. The involvement of primary caregivers in the management of patients with chronic mental disorders, including schizophrenia; however, it made visible various levels of overload. Objective: To determine the levels of burden in primary caregivers, and the effects attributable to the Program of Support Clinic for Family Members of People with Schizophrenia. Methods: A pre and post intervention evaluation study was designed in 108 selected files to extract the available socio-demographic variables and the burden scores obtained with the Zarit Caregiver Burden Scale. The results were described and analyzed using the McNemar test. Results: The majority of caregivers were women, 67.5%. The most frequent relationship was that of parents with 44.4% followed by siblings 25.9%. The most common age range was 51-60 years. 71.1% of the caregivers presented some type of overload. McNemar's test was applied to assess the changes in the levels of pre- and post-intervention overload, the result of which was 27.4, showing a significant difference with a p value <0.005. Conclusion: Intervention with primary caregivers, through psychoeducational programs, may be a viable option to reduce the levels of burden in relatives of people with schizophrenia

Becoming what you are seeking: Building Relational Self-Awareness in emerging adults.

Emerging adults are attempting to navigate a rapidly shifting and immensely complicated landscape of modern love, often without meaningful sex and relationship education. Although individually oriented relationship education programs for emerging adults make a difference in the knowledge, attitudes, and beliefs of the recipients (Simpson et al., Journal of Youth and Adolescence, 2018, 47, 477) and most emerging adults report they yearn for relationship education (Weissbourd et al., The talk: How adults can promote young people's healthy relationships and prevent misogyny and sexual harassment, 2017), these programs are not widely available. Educators who are working with emerging adults in a classroom or psychoeducational setting are well-positioned to help emerging adults identify and enact healthy and purposeful relational and sexual choices. The first part of the paper orients readers to the "topography" of the modern love landscape by describing four macro cultural themes that impact the intimate lives of emerging adults. The second part of the paper introduces relationship educators to Relational Self-Awareness (Solomon, Loving Bravely: 20 lessons of self-discovery to help you get the love you want, New Harbinger, 2017), an integrative approach to helping emerging adults understand the self-in-relationship. Each of the five pillars of Relational Self-Awareness is defined and operationalized, and specific recommendations are provided for how educators can integrate these pillars into their existing curricula. Clinical implications and future directions are offered.

Los adultos emergentes están intentando orientarse ante un panorama de amor moderno rápidamente cambiante e inmensamente complicado, generalmente sin sexo significativo ni educación sobre las relaciones. Aunque los programas de educación sobre las relaciones para adultos emergentes con orientación individual marcan una diferencia en el conocimiento, las actitudes y las creencias de los destinatarios (Simpson et al., 2018), y la mayoría de los adultos emergentes informan que desean recibir educación sobre las relaciones (Weissbourd et al., 2017), estos programas no son ampliamente accesibles. Los educadores que trabajan con adultos emergentes en un aula o en un entorno psicoeducativo están bien posicionados para ayudarlos a identificar y a adoptar elecciones sexuales y relacionales saludables y significativas. La primera parte del artículo guía a los lectores por la "topografía" del panorama del amor moderno mediante la descripción de cuatro temas macroculturales que repercuten en las vidas íntimas de los adultos emergentes. En la segunda parte del artículo se presenta la autoconciencia relacional (Solomon, 2017) a los educadores sobre relaciones, un enfoque integrador para ayudar a los adultos emergentes a comprender el yo en las relaciones. Se definen y se operacionalizan cada uno de los cinco pilares de la autoconciencia relacional, y se dan recomendaciones específicas sobre cómo los educadores pueden integrar estos pilares en sus planes de estudio existentes. Se comentan las consecuencias clínicas y las futuras direcciones del estudio.

Psicoeducação sobre violência e mindfulness para mulheres com histórico de violência: um estudo de caso / Psychoeducation on violence and mindfulness for women with a history of violence: a case study

A violência por parceiros íntimos (VPI) consiste em um problema de saúde pública e de violação dos direitos humanos das mulheres que pode ser prevenida. As intervenções devem ter ações para minimizar o impacto do abuso sofrido e fortalecer a vítima, para que ela consiga interromper o ciclo de violência. Este estudo de caso teve como objetivo analisar a viabilidade de uma intervenção baseada em dois elementos: psicoeducação sobre VPI e mindfulness.Uma mulher (43 anos) vítima de violência física e psicológica do seu ex-parceiro e de seu parceiro atual participou de 12 sessões psicoterapêuticas: 4 sessões de psicoeducação em VPI e 8 sessões de treinamento em mindfulness. Todo o conteúdo das sessões foram transcritos e analisados qualitativamente. Ademais, a participante respondeu as escalas Beck de ansiedade e depressão e a Escala Filadélfia de Mindfulness - EFM para os níveis de atenção à experiência no momento em diferentes momentos da intervenção. Os dados obtidos nos instrumentos indicaram diminuição dos sintomas de ansiedade e depressão, aumento no escore de aceitação das experiências e dimininuição do awareness. Conclui-se que tal intervenção se mostra viável por possibilitar diminuição de sintomas e maior consciência e reflexão a respeito de seus relacionamentos íntimos, e o desenvolvimento de uma atitude de não julgamento, de abertura e compaixão relacionada à experiência presente.(AU)

Intimate partner violence (IPV) is a public health problem and a violation of women´s rights that can be prevented. Interventions must minimize the impact of the abuse suffered by women and strengthen her in order to interrupt the cycle of violence. This case study aimed to analyze the feasibility of an intervention based on two elements: psychoeducation on IPV and mindfulness. A woman (43 years old), victim of physcial and psychological violence from her former and ex-partner, participated in 12 psychological sessions: 4 sessions of psychoeducation on IPV and 8 sessions on mindfulness training. The entire content of the sessions were transcribed and analyzed qualitatively. In addition, the participant answered the Beck anxiety and depression scales and the Philadelphia Mindfulness Scale-EFM at different times of the intervention. The data obtained indicated a decrease in the symptoms of anxiety and depression, an increase in the score of acceptance of the experiences and a decrease in awareness (EFM). It is concluded that such intervention is considered feasible because it decreased symptons and allowed a greater awareness and reflection of the participant regarding their intimate relationships, and the development of an attitude of non-judgment, openness and compassion related to the present experience.(AU)

La violencia de pareja (VPI) es un problema de salud pública y una violación de los derechos humanos de las mujeres que puede prevenirse. Las intervenciones deben minimizar el impacto del abuso sufrido y fortalecer a la víctima, para interrumpir el ciclo de violencia. Este estudio de caso tuvo como objetivo analizar la viabilidad de una intervención basada en dos elementos: psicoeducación sobre VPI y mindfulness. Una mujer (43 años) víctima de violencia física y psicológica por parte de su ex pareja y su pareja actual participó en 12 sesiones psicoterapéutico: 4 sesiones de psicoeducación en VPI y 8 sesiones de mindfulness. Todo el contenido de las sesiones se transcribió y analizó cualitativamente. Además, el participante respondió las escalas de ansiedad y depresión de Beck y la Escala de atención plena de Filadelfia - EFM. Los datos obtenidos indicaron una disminución en los síntomas de ansiedad y depresión, un aumento en el puntaje de aceptación de las experiencias y una disminución en la conciencia. Se concluye que dicha intervención es factible porque permite la diminuición de los sintomas y una mayor conciencia y reflexión del participante con respecto a sus relaciones íntimas, y el desarrollo de una actitud de no juicio, apertura y compasión relacionada con la experiencia actual.(AU)

Resultados de una intervención psicoeducativa interdisciplinar con EMDR en pacientes con fibromialgia: experiencia de un centro privado / Results of an interdisciplinary psychoeducational intervention with EMDR in patients with fibromyalgia: a private center experience

Objetivo: Evaluar los efectos de un protocolo multidisciplinario (psicología, reumatología, medicina del deporte, unidad del sueño y nutrición) en pacientes con fibromialgia. Materiales y métodos: Se evaluaron los cambios en el estado de ansiedad (objetivo principal), la intensidad del dolor, su repercusión sobre las actividades cotidianas y su limitación subjetiva in situ. El abordaje psicológico incluyó un proceso psicoeducativo como marco general y técnicas de desensibilización y reprocesamiento con movimientos oculares (EMDR) como instrumento de regulación emocional. Se utilizó un diseño intrasujeto con medidas pre y postestudio, cuyos instrumentos fueron el inventario de ansiedad rasgo (STAI), la dimensión dolor del WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), un test específico de repercusión del dolor en la vida cotidiana (diseñado a propósito) y una escala subjetiva in situ de la intensidad de dolor (escala de Thierry). La utilización de prácticas EMDR (música bilateral y maniobra del abrazo-mariposa o similar) y el grado de satisfacción de las pacientes se valoraron en términos porcentuales al final del estudio. Resultados: Un total de 56 mujeres con una edad media de 51 (± 10) años y edades comprendidas entre los 30 a 73 años fueron estudiadas. Las participantes se distribuyeron desde el año 2016 hasta 2020 en 8 grupos sucesivos de no más de 10 integrantes cada uno. Cada grupo recibió 10 sesiones (una por semana) de una hora y media de duración que se distribuyeron en 6 sesiones de psicología y 1 sesión de reumatología, medicina del deporte, unidad del sueño y nutrición. Los resultados mostraron efectos positivos significativos después del programa, con mejoras post intervención en el estado de ansiedad rasgo (p = 0,0000/p < 0,005) (d = 0,427) intensidad del dolor (p = 0,0003) (d = 0,344), repercusión del dolor (p = 0,0000/p < 0,005)...(AU)

Objective: To evaluate the effects of a multidisciplinary protocol (psychology, rheumatology, sports medicine, sleep unit and nutrition) in patients with fibromyalgia. Material and methods: Changes in the state of anxiety (main objective), intensity of pain, its impact on daily activities and "in situ" subjective limitations, were evaluated. The psychological approach included a psychoeducational process as a general framework and eye movement desensitization and reprocessing techniques (EMDR) as an instrument of emotional regulation. An intra-subject design was used with pre and post-study measurements whose instruments were the trait anxiety inventory (STAI), the WOMAC pain dimension (Western Ontario and McMaster Universities Osteoarthritis Index), a specific test measuring the impact of pain on daily life activities (designed on purpose) and a subjective "in situ" scale of pain intensity (Thierry scale). The use of EMDR practices (bilateral music, the butterfly-hug manoeuvre or similar) and the degree of patient satisfaction were assessed in percentage terms at the end of the study. Results: A total of 56 women with a mean age of 51 (± 10) years and aged between 30 to 73 years were studied. The participants were distributed from 2016 to 2020 in 8 successive groups of no more than 10 members per group. Each group received 10 sessions (one per week) lasting an hour and a half that were divided into 6 sessions of psychology and 1 session of rheumatology, sports medicine, sleep unit and nutrition. The results showed significant positive effects after the program, with post-intervention improvements in the state of trait anxiety (p = 0.0000/p < 0.005) (d = 0.427) intensity of pain (p = 0.0003) (d = 0.344), impact of pain on daily activities (p = 0.0000/p < 0.005) (d = 0.486) and in the subjective sensation of pain intensity (no patients exhibiting "very significant pain"). At the end of the study, 46 patients (83 %) had adopted EMDR...(AU)

Intervenção para mães com depressão pós-parto: protocolos de psicoeducação e treino para reconhecimento de emoção / Intervention for mothers with postpartum depression: psychoeducation and training for emotion recognition protocols / Intervención para madres con depresión posparto: protocolos de psicoeducación y capacitación para el reconocimiento de la emoción

A Depressão Pós-Parto Materna (DPP) é uma condição clínica que acarreta efeitos negativos na saúde da mãe, do bebê, e na relação entre ambos. Intervenções neste contexto devem ser adaptadas à realidade, a fim de diminuir os impactos no desenvolvimento infantil e na saúde materna. O objetivo deste estudo foi a construção de um protocolo de psicoeducação e a elaboração de um treinamento de reconhecimento de emoções. O método se constituiu de quatro etapas: revisão da literatura, proposta preliminar, análise de especialistas e estudo piloto. A psicoeducação foi guiada por sete cartilhas com temáticas típicas do desenvolvimento, e o treinamento de reconhecimento de emoções foi composto por um protocolo de atendimento para mães com DPP e seus bebês, com o objetivo de trabalhar questões relativas ao processamento de faces materno e viés atencional. Os resultados demonstraram que as duas propostas de protocolo de intervenção se mostraram de fácil compreensão para os sujeitos avaliados.

Postpartum Maternal Depression (PPD) is a clinical condition that has negative effects on the health of the mother, the baby and the relationship between both. Interventions in this context must be adapted to reality in order to reduce the impacts on child development and maternal health. The aim of this study was to build a psychoeducational protocol and to develop an emotion recognition training. The method consisted of four stages: literature review, preliminary proposal, expert analysis and pilot study. Psychoeducation was guided by seven booklets with themes typical of development, and the emotion recognition training consisted of a care protocol for mothers with PPD and their babies, with the objective of working on issues related to the processing of maternal faces and attentional bias. The results showed that the two intervention protocol proposals proved to be easy to understand for the evaluated subjects.

La depresión materna posparto (DPP) es una condición clínica que tiene efectos negativos en la salud de la madre, el bebé y la relación entre ambos. Las intervenciones en este contexto deben adaptarse a la realidad para reducir los impactos sobre el desarrollo infantil y la salud materna. El objetivo de este estudio fue construir un protocolo psicoeducativo y desarrollar un entrenamiento de reconocimiento de emociones. El método consistió en cuatro etapas: revisión de la literatura, propuesta preliminar, análisis de expertos y estudio piloto. La psicoeducación se guió por siete cartillas con temas típicos del desarrollo, y el entrenamiento de reconocimiento de emociones consistió en un protocolo de atención para madres con DPP y sus bebés, con el objetivo de trabajar en temas relacionados con el procesamiento de rostros maternos y sesgos atencionales. Los resultados mostraron que las dos propuestas de protocolo de intervención demostraron ser de fácil comprensión para los sujetos evaluados.

Rehabilitación psicosocial e intervención familiar en personas con trastorno dual / Psychosocial rehabilitation and family intervention for people with dual disorders

En el trastorno dual confluyen dos trastornos graves y crónicos que aún hoy son un desafío a las redes de atención sanitaria y social. En ese contexto las familias desempeñan un papel importante en el mantenimiento de estas personas en la comunidad. El trastorno dual se asocia con una serie de efectos negativos sobre el entorno familiar, con mayor carga de cuidados y conflictos. Para este artículo, se han revisado cuatro modelos de intervención familiar en el trastorno dual. Conclusiones. La intervención familiar ha demostrado ser un importante elemento del tratamiento del trastorno dual. Los cuatro programas de intervención presentados coinciden en unos componentes comunes: intervención uni/multi familiar, bases teóricas de los modelos de probada eficacia, psicoeducación, entrenamiento en comunicación, resolución de problemas y la entrevista motivacional transversal a todo el programa. Aun así persisten áreas que no mejoran y los resultados no son concluyentes, por lo que es necesario seguir buscando fórmulas que apunten hacia recursos terapéuticos más flexibles según las necesidades y circunstancias de cada una de estas personas. (AU)

In dual disorder, two serious and chronic disorders converge that are still a challenge to health and social care networks. In this context, families play an important role in keeping these people included in the community. Dual disorder is associated with a series of negative effects on the family environment, with a greater burden of care and conflict. For this article, four models of family intervention in dual disorder have been reviewed. Conclusions. Family intervention has proven to be an important element of dual disorder treatment. The four intervention programs presented coincide in share some common components: single / multi-family intervention, theoretical bases of the models of with proven efficacy, psychoeducation, communication training, problem solving, and the motivational interview across the entire program. Even so, some areas still persist without improvements and areas that do not improve persist and the results are not conclusive, so it is necessary to continue looking for formulas that point towards more flexible therapeutic resources according to the needs and circumstances of each of these people. (AU)