Analysis of the role of motivating operations in the therapeutic verbal interaction / Análisis del rol de las operaciones motivadoras en la interacción verbal terapéutica

El concepto de operación motivadora (OM) ayuda a suplir los problemas de la noción tradicional de motivación en el estudio del proceso terapéutico. En este trabajo, se analizó el rol de tres tipos de verbalizaciones del terapeuta con una función de OM y se comprobó su relación con el comportamiento verbal de los clientes. Para tal propósito, se observaron grabaciones de 40 sesiones de terapia pertenecientes a 9 casos diferentes. El Sistema ACOVEO fue el sistema de categorías empleado para identificar las categorías OM con información clínica, OM con consecuencias y OM con emparejamiento. El SISC-CVC fue aquel utilizado para identificar las verbalizaciones de las clientes codificadas como Acuerdo y Desacuerdo. Se llevaron a cabo análisis secuenciales para comprobar la relación entre las diferentes OMs entre ellas y con el acuerdo del cliente. Los resultados mostraron que las diferentes OMs fueron emitidas en bloque y que cuando la categoría OM con información clínica se emitía con OM con consecuencias o con OM con emparejamiento se encontraba una mayor asociación con la categoría de Acuerdo (r = 2.47; r = 1.86) que con la de Desacuerdo (r = -.53; r = -.36). Estos resultados destacan la importancia de la emisión de OMs que asocian de manera directa el comportamiento del cliente con eventos con un componente elicitador, ofreciendo estrategias más eficaces para los terapeutas.(AU)

The concept of motivating operation(MO) helps to overcome both theoretical and practical problems of the traditional notion of motivation in the study of the therapeutic process. In this research, the role of three types of therapists’ verbalizations with an MO functionwas analyzed, in addition to their association with clients’ verbal behavior. For this purpose, recordings of 40 clinical sessions belonging to 9 different cases were ob-served. The ACOVEO System was the observational category system used to identify the therapists’ verbal MOs coded as MO with clinical information, MO with consequences, andMO with pairings. The SISC-CVC was the one used to identify clients’ verbalizations coded as Agreementand Disagreement. Se-quential analyses were performed to test the relation between the three dif-ferent types of MOs with themselves, as well as with clients’ concurrence. Results showed that the different MOs were emitted in chunks and when MO with clinical information was uttered either with MO with consequences or MO with pairingsthere was a greater association with Agreement(r = 2.47; r = 1.86) rather than with Disagreement (r = -.53;r = -.36). These findings high-light the importance of the emission of MOs that associate directly events with an eliciting component with clients’ behavior, giving more efficacious strategies to the therapists.(AU)

Eficiencia de las terapias: ¿un paso más allá de la eficacia? Análisis crítico del modelo cognitivo-conductual / Efficiency of therapies: A step beyond effectiveness? Critical analysis of the cognitive-behavioral model

La proliferación de la investigación de resultados ha colocado al modelo cognitivo-conductual como la terapia de elección para la mayoría de problemas psicológicos. Este tipo de investigación deja a un lado el análisis de los procesos de cambio conductual que subyacen al éxito de las diferentes técnicas de tratamiento, ya no sería importante saber qué es lo que hace que una técnica funcione siempre que ésta sea eficaz. Como consecuencia, el modelo cognitivo-conductual ha perdido la reflexión teórica y la fundamentación experimental que caracterizaba a la modificación de conducta sobre la cual se sustentaba en sus orígenes. Desde nuestra perspectiva, la investigación de procesos sería un paso previo necesario a la investigación de resultados de forma que los primeros puedan explicar cómo y por qué funcionan los tratamientos psicológicos, evitando así que el clínico se limite a aplicar procedimientos descritos en manuales protocolizad

The proliferation of outcome research has placed the cognitive-behavioral model as the therapy of choice for most psychological problems. This type of research leaves aside the analysis of behavioral change processes that underlie the success of different treatments techniques. Therefore, it would no longer be important to know what is that makes a technique works as long as it gives the expected results. Consequently, the cognitive-behavioral model has lost the theoretical reflection and the experimental foundation that characterized the modification of behavior on which it was based on its origins. From our perspective, process research would be a necessary preliminary step to outcome research so that it could explain how and why psychological treatments work, avoiding that the clinician simply applies the procedures described in the standardized manuals

Study Protocol on Ecological Momentary Assessment of Health-Related Quality of Life Using a Smartphone Application.

Health-Related Quality of Life (HRQoL) is a construct of increasing importance in modern healthcare, and has typically been assessed using retrospective instruments. While such measures have been shown to have predictive utility for clinical outcomes, several cognitive biases associated with human recall and current mood state may undermine their validity and reliability. Retrospective tools can be further criticized for their lack of ecology, as individuals are usually assessed in less natural settings such as hospitals and health centers, and may be obliged to spend time and money traveling to receive assessment. Ecological momentary assessment (EMA) is an alternative, as mobile assessment using mobile health (mHealth) technology has the potential to minimize biases and overcome many of these limitations. Employing an EMA methodology, we will use a smartphone application to collect data on real-time HRQoL, with an adapted version of the widely used WHOQOL-BREF questionnaire. We aim to recruit a total of 450 healthy participants. Participants will be prompted by the application to report their real-time HRQoL over 2 weeks together with information on mood and current activities. At the end of 2 weeks, they will complete a retrospective assessment of their HRQoL and they will provide information about their sleep quality and perceived stress. The psychometric properties of real-time HRQoL will be assessed, including analysis of the factorial structure, reliability and validity of the measure, and compared with retrospective HRQoL responses for the same 2-week testing period. Further, we aim to identify factors associated with real-time HRQoL (e.g., mood, activities), the feasibility of the application, and within- and between-person variability in real-time HRQoL. We expect real-time HRQoL to have adequate validity and reliability, and positive responses on the feasibility of using a smartphone application for routine HRQoL assessment. The direct comparison of real-time and retrospective measures in this study will provide important novel insight into the efficacy of mHealth applications for HRQoL assessment. If shown to be valid, reliable and feasible for the collection of HRQoL data, mHealth applications may have future potential for facilitating clinical assessment, patient-physician communication, and monitoring individual HRQoL over course of treatment.