Informe de rotación electiva

El presente informe tiene como objetivo describir el proceso de rotación desarrollado en la Fundación Equipo de Terapia Cognitiva Infanto-juvenil (ETCI), durante el período comprendido entre el 3 de marzo al 28 de mayo de 2021. Se considera como punto de partida el proyecto presentado, y se abordarán los objetivos planteados, contemplando las actividades realizadas que contribuyeron al logro de los mismos. (AU)

Cross-country discrepancies on public understanding of stress concepts: evidence for stress-management psychoeducational programs.

BACKGROUND: Negative effects of stress have pose one of the major threats to the health and economic well being of individuals independently of age and cultural background. Nevertheless, the term "stress" has been globally used unlinked from scientificevidence-based meaning. The discrepancies between scientific and public stress knowledge are focus of concern and little is know about it. This is relevant since misconceptions about stress may influence the effects of stress-management psychoeducational programs and the development of best practices for interventions. The study aimed to analyze stress knowledge among the Canadian and Brazilian general public and to determine the extent to which scientific and popular views of stress differ between those countries. METHODS: We evaluated 1156 healthy participants between 18 and 88 years of age recruited from Canada (n = 502) and Brazil (n = 654). To assess stress knowledge, a questionnaire composed of questions regarding stress concepts ("stress is bad" versus "stress-free life is good") and factors capable of triggering the stress response ("novelty, unpredictability, low sense of control and social evaluative threat versus "time pressure,work overload, conflict, unbalance and children") was used. RESULTS: Both Canadian and Brazilian participants showed misconceptions about stress and the factors capable of triggering a stress response. However, the rate of misconceptions was higher in Brazil than in Canada (p < 0.05). CONCLUSION: These findings suggest a lack of public understanding of stress science and its variance according to a country's society. Psychoeducational programs and vulnerability of stress-related disorder are discussed.

The origins and professionalization of cognitive psychotherapy in Argentina.

The growing popularity of cognitive-behavioral therapy (CBT) has helped reshape the mental health scene in the city of Buenos Aires, historically the stronghold of psychoanalysis. In the early 1980s, CBT was infrequently used and sometimes overtly resisted in the field of mental health. Almost 3 decades later, the impact of CBT has increased dramatically in Argentina, not only in independent practice but also in the health system and in everyday life. This article aims to describe the process by which Argentine psychotherapists first adopted this new theoretical framework.

Implementation of evidence-based practices for children in four countries: a project of the World Psychiatric Association.

OBJECTIVE: The present study examined implementation issues in adopting cognitive-behavioral therapies in routine clinical settings in four countries reflecting diverse cultures, languages, settings, and traditions. METHOD: A Director's Systems Survey was administered prior to program implementation and one year later. Therapist ratings on attitudes about evidence-based practices and satisfaction were also gathered. RESULTS: All sites reported successful adoption of the program, although significant variations existed in fiscal support, family involvement, prior experience with cognitive-behavioral therapies, and plans for sustainability. Therapists' ratings indicated overall satisfaction with the implementation of the project. Findings from the Director's Systems Survey pointed to five factors facilitating implementation: 1) early adoption and guidance by innovative leaders (i.e., the Directors); 2) attention to the "fit" between the intervention model and local practices; 3) attention to front-end implementation processes (e.g., cultural adaptation, translation, training, fiscal issues); 4) attention to back-end processes early in the project (e.g., sustainability); and 5) establishing strong relationships with multiple stakeholders within the program setting. CONCLUSIONS: The implementation issues here mirror those identified in other studies of evidence-based practices uptake. Some of the obstacles to implementation of evidence-based practices may be generic, whereas issues such as the impact of political/economic instability, availability of translated materials, constitute unique stressors that differentially affect implementation efforts within specific countries.

Implementation of evidence-based practices for children in four countries: a project of the World Psychiatric Association / Implementação de práticas baseadas em evidências para o tratamento de crianças em quatro países: um projeto da Associação Mundial de Psiquiatria

OBJETIVE: The present study examined implementation issues in adopting cognitive-behavioral therapies in routine clinical settings in four countries reflecting diverse cultures, languages, settings, and traditions. METHOD: A Director's Systems Survey was administered prior to program implementation and one year later. Therapist ratings on attitudes about evidence-based practices and satisfaction were also gathered. RESULTS: All sites reported successful adoption of the program, although significant variations existed in fiscal support, family involvement, prior experience with cognitive-behavioral therapies, and plans for sustainability. Therapists' ratings indicated overall satisfaction with the implementation of the project. Findings from the Director's Systems Survey pointed to five factors facilitating implementation: 1) early adoption and guidance by innovative leaders (i.e., the Directors); 2) attention to the "fit" between the intervention model and local practices; 3) attention to front-end implementation processes (e.g., cultural adaptation, translation, training, fiscal issues); 4) attention to back-end processes early in the project (e.g., sustainability); and 5) establishing strong relationships with multiple stakeholders within the program setting. CONCLUSIONS: The implementation issues here mirror those identified in other studies of evidence-based practices uptake. Some of the obstacles to implementation of evidence-based practices may be generic, whereas issues such as the impact of political/economic instability, availability of translated materials, constitute unique stressors that differentially affect implementation efforts within specific countries.

OBJETIVO: Este estudo visa a examinar problemas na implementação de técnicas psicoterápicas cognitivo-comportamentais em ambientes clínicos de atendimento primário em quatro países que refletem diversas culturas, línguas, ambientes e tradições. MÉTODO: Uma pesquisa foi aplicada aos diretores de Sistemas Clínicos antes da implementação do programa e um ano após. Também foram coletados dados sobre como os terapeutas avaliavam as ações relativas à prática baseada em evidências e qual seu grau de satisfação com essa prática. RESULTADOS: Todos os locais de implementação relataram a adoção bem sucedida do programa, ainda que com significativas variações no apoio fiscal, envolvimento familiar, experiência prévia com terapias cognitivo-comportamentais e planos de sustentação em longo prazo. As avaliações dos terapeutas indicaram uma satisfação generalizada com a implementação do projeto. Achados da pesquisa com os diretores dos Sistemas Clínicos apontaram cinco fatores que facilitaram a implementação: 1) rápida adoção e orientação por líderes inovadores (i.e., os diretores); 2) atenção à adequação entre o modelo de intervenção e as práticas locais; 3) atenção desde o início à relação entre os processos de implementação e os usuários finais (e.g., adaptação cultural, tradução, treinamento, problemas fiscais); 4) atenção precoce aos processos de retaguarda do projeto (e.g., sustentação); e 5) estabelecimento de relações estreitas com múltiplos financiadores da instalação do programa. CONCLUSÕES: Os problemas de implementação encontrados neste estudo se assemelham aos identificados em outros estudos sobre a aquisição de práticas baseadas em evidência. Alguns dos obstáculos para a implementação de práticas baseadas em evidência podem ser generalizados, ao passo que problemas como o impacto da instabilidade político-econômica e disponibilidade de materiais traduzidos constituem estressores peculiares que afetam de forma diferenciada os esforços de implementação em cada país.

Reducing health disparities through culturally sensitive treatment for HIV+ adults in Haiti.

There is a critical need to deliver empirically validated interventions to underserved populations. Haiti, the country most heavily affected by the AIDS epidemic in the Caribbean, accounts for approximately 50% of all cases in the region. Poverty, disparities in access to healthcare, and socio-political instability are among the reasons why the country has been ravaged by the disease. Ongoing projects in Haiti have shown that integrated prevention and care in resource poor settings are feasible and can be successful, as evidenced by a 50% drop in incidence among pregnant women since 1993. The AIDS prevention program has embarked on a comprehensive effort to culturally adapt a cognitive-behavioral stress management program for Haitian HIV+ individuals. The purpose of the program is to improve adherence to antiretroviral medication, reduce transmission to uninfected partners, and improve coping. This comprehensive approach is necessary to ensure the validity of the cross-cultural adaptation of this intervention.

Increasing access to preventive health care through cultural adaptation of effective HIV prevention interventions: a brief report from the HIV prevention in Haitian youths study.

This article describes an HIV prevention study among Haitian youths, based on the cultural adaptation of a cognitive behavioral HIV risk reduction intervention entitled "Becoming a Responsible Teen." The aim of the parent study is to evaluate whether the BART intervention is more effective than a control condition in reducing HIV risk behavior in the target population. The project explores how self-efficacy, behavioral intentions, social factors and acculturation influence the risk behavior of Haitian American adolescents. This community based translation of a risk reduction intervention, previously found to be effective in other populations, can serve as a model for reducing health disparities in a vulnerable adolescent population that lacks access to preventive health care. The purpose of this paper is to present preliminary data from the pre-assessment phase of the intervention, which enabled the project to incorporate health disparity issues with this population and address barriers to health care access.