Epistemología, historia y fundamentos de la Terapia Breve Estratégica. El Modelo de Giorgio Nardone / Epistemology, history and foundations of Brief Strategic Therapy. Giorgio Nardone´s Mode

La terapia breve estratégica modelo evolucionado de Giorgio Nardone, está considerada en la actualidad como una psicoterapia que evidencia una alta eficacia y eficiencia, en una variedad de trastornos emocionales. En este artículo se presenta la historia y los fundamentos epistemológicos de la terapia breve estratégica, fundamentadas en el pensamiento sistémico, la cibernética, la teoría general de los sistemas y el constructivismo. Se analiza la evolución y desarrollo histórico desde el Mental Research Institute en Palo Alto hasta la creación del Centro en Arezzo Italia. Se presentan las bases teóricas de la terapia breve estratégica centrada en el presente y en las soluciones, partiendo de la premisa de que los intentos de solución mantienen el problema y planteando que desde la lógica estratégica siempre la solución se adapta al problema y a su objeto de estudio.(AU)

Giorgio Nardone's evolved model of brief strategic therapy is a psychotherapy that is currently considered to demonstrate high efficacy and efficiency for a variety of emotional disorders. This article presents the history and epistemological foundations of brief strategic therapy, based on systems thinking, cybernetics, general systems theory, and constructivism. The evolution and historical development are analyzed, from the Mental Research Institute in Palo Alto to the creation of the Strategic Therapy Center in Arezzo Italy. The theoretical foundations of brief strategic therapy focused on the present and solutions are presented, starting from the premise that attempts at solution actually maintain the problem and proposing that based on strategic logic the solution always adapts to the problem and its object of study.(AU)

Eficacia de los tratamientos psicológicos para los comportamientos autolesivos suicidas y no suicidas en adolescentes / Efficacy of psychological treatments for suicidal and non-suicidal self-injurious behaviors in adolescents

Los comportamientos autolesivos y suicidas en adolescentes, por su creciente prevalencia como por sus fatales consecuencias, son en nuestrosdías un problema de salud pública que requiere de intervenciones eficaces. Con el objetivo de dilucidar los tratamientos psicológicos que, hasta lafecha, mejor funcionan para reducir o eliminar estos comportamientos, se realizó una revisión de estudios de metaanálisis y revisiones sistemáticasen las bases de datos PsycArticles, PsycInfo y MEDLINE. Los criterios de elegibilidad establecidos permitieron la selección final de 10 registros.Los resultados mostraron una elevada heterogeneidad y un alcance limitado de los tratamientos psicológicos con tamaños del efecto de pequeñosa moderados tanto para las conductas autolesivas, como para la ideación suicida, la suicidabilidad y especialmente para la intención suicida. Estosefectos tendían a debilitarse o desaparecer en el medio y largo plazo. La Terapia Dialéctica Conductual (TDC) resultó ser comparativamente la quemejores resultados obtuvo de las intervenciones analizadas. El alcance restringido de los resultados y las importantes limitaciones metodológicashalladas alertan de la necesidad de más investigación, así como del futuro diseño de intervenciones específicas para este tipo de problemas. (AU)

Self-injurious and suicidal behaviors in adolescents are nowadays a public health problem that requires effective interventions. In order to elucidate the psychological treatments that, to date,work best to reduce or eliminate these behaviors, a review of meta-analysis and systematic reviews was carried out in the PsycArticles, PsycInfo andMEDLINE databases. The established eligibility criteria allowed the final selection of 10 records. The results showed high heterogeneity and poorresults for the psychological treatments with small to moderate effect sizes for self-injurious behaviors, suicidal ideation, suicidality and especiallyfor suicidal attempts. These effects tended to weaken or disappear in the medium to long term. Dialectical Behavior Therapy (DBT) proved to becomparatively the best performing of the interventions analyzed. The limited scope of the results and the important methodological limitations alertus to the need for further research and the future design of specific interventions for this type of problems. (AU)

Effectiveness of psychological treatments for depression in childhood and adolescence: A review of reviews / Eficacia de los tratamientos psicológicos para depresión en la infancia y la adolescencia: Una revisión de revisiones

Depression in childhood and adolescence is a public health problem due to its high prevalence and the impact it has in the individual development. There is clear evidence of the efficacy of Interpersonal Therapy (IPT) and Cognitive-Behavioural Therapy (CBT) in the treatment of depression in children and adolescents; however, recent reviews and meta-analyses provide new perspectives for treatment. The purpose of this workis to synthesize the bibliography available through a systematic review of systematic reviews and meta-analysis that summarizes in a comprehensive way the evidence of the last two decades on the effectiveness of psychological interventions for infant-juvenile depression. A systematicreview of systematic reviews and meta-analyses was performed. A search was conducted in the Web of Science and Scopus databases. Eightrecords met the inclusion criteria, 2 were analysed in their entirety and from the remaining 6 the information needed for independent analysis wasextracted. Seven different psychotherapies were studied: CBT and IPT were the most studied (n=7; 87.5%), followed by family therapy (n=5;62.5%), psychodynamic therapy (n=3; 37.5%), behavioural therapy (n=3; 37.5%), computerised CBT (n=2; 25%), problem-solving therapy (n=1;12.5%) and supportive therapy (n=1; 12.5%). IPT and CBT were shown to be effective in the treatment of adolescent depression. Half of thereviews (n=4; 50%) had a low methodological quality and the other half (n=4; 50%) were classified as critically low. In general, psychologicalinterventions for child and adolescent depression produce significant, but modest effects. Specifically, IPT and CBT can be considered the maintreatment alternatives for adolescent depression. There is insufficient data of specific psychological treatment for children diagnosed with a depressive disorder. ... (AU)

La depresión infanto-juvenil es un problema de salud pública por su elevada prevalencia y el impacto que tiene en el desarrollo del individuo. Aunque existe una sólidaevidencia sobre la eficacia de la psicoterapia interpersonal y la terapia cognitivo-conductual (TCC) en el tratamiento de la depresión en niños yadolescentes, recientes revisiones y meta-análisis aportan nuevas perspectivas de tratamiento. La finalidad de este trabajo es sintetizar la bibliografía disponible mediante una revisión sistemática de revisiones sistemáticas y meta-análisis que resuma de manera integral la evidencia de lasúltimas dos décadas sobre la eficacia de las intervenciones psicológicas para la depresión infanto-juvenil. Se realizó una revisión sistemática derevisiones sistemáticas y meta-análisis. Se llevó a cabo una búsqueda en las bases de datos Web of Science y Scopus. Ocho registros cumplieron los criterios de inclusión, 2 se analizaron en su totalidad y de los 6 restantes se extrajo la información necesaria para ser analizada independientemente. Se estudiaron siete psicoterapias distintas: la TCC y la terapia interpersonal fueron las más estudiadas (n=7; 87,5%), seguidas porla terapia familiar (n=5; 62,5%), la terapia psicodinámica (n=3; 37,5%), la terapia conductual (n=3; 37,5%), la TCC informatizada (n=2; 25%), laterapia de resolución de problemas (n=1; 12,5%) y la terapia de apoyo (n=1; 12,5%). La terapia interpersonal y la TCC demostraron ser efectivas en el tratamiento de la depresión adolescente. La mitad de las revisiones (n=4; 50%) presentaron una calidad metodológica baja y la otramitad (n=4; 50%) se clasificó como críticamente baja. Las intervenciones psicológicas para la depresión infanto-juvenil, en general, producenefectos significativos, pero modestos. De forma específica, la terapia interpersonal y la TCC pueden considerarse las principales alternativas detratamiento para la depresión adolescente. ...(AU)

How effective are psychological treatments for internet gaming disorder? An umbrella review / ¿Qué eficacia tienen los tratamientos psicológicos para el trastorno de juego por internet? Una revisión de revisiones

Behavioural addictions such as Internet addiction (IA) and, more specifically, Internet gaming disorder (IGD) or video game addiction, have increased their prevalence in recent years in the child and adolescent population. The aim of the present study was to review and synthesise the existingevidence on the effectiveness of psychological treatments for addressing this addiction, as well as to compare them with other types of treatment. Tothis end, an in-depth search for systematic reviews and meta-analyses was carried out across different databases (WOS, Scopus, PubmMed, Cochrane), inclusion and exclusion criteria were set, and guidelines for the search strategy were defined, as well as the study selection method. A totalof 14 reviews and meta-analyses were reviewed. The results showed that cognitive behavioural therapy (CBT) was the most studied psychologicaltreatment, consistently showing effectiveness in reducing the symptoms and severity of IA/IGD. Furthermore, CBT appeared to be more effectivewhen combined with other types of treatment such as pharmacological treatment. It is concluded that there is a need to investigate the effectivenessof psychological treatments for IA/IGD separately in order to provide appropriate interventions to reduce the severity of addiction and improve thequality of life and well-being of children and adolescents. (AU)

Las adicciones conductualescomo la adicción a internet (IA) y, concretamente, el trastorno de juego por internet (IGD) o adicción a videojuegos, han aumentado su prevalenciaen los últimos años en población infanto-juvenil. El objetivo del presente estudio fue realizar una revisión de revisiones para agrupar y sintetizar laevidencia existente acerca de la efectividad de los tratamientos psicológicos para abordar este tipo de adición, así como compararlos con otrostipos de tratamiento. Para ello, se realizó una búsqueda exhaustiva de revisiones sistemáticas y/o meta-análisis en diferentes bases de datos (WOS,Scopus, PubmMed, Cochrane), se establecieron los criterios de inclusión y exclusión, y se definió la estrategia de búsqueda, así como el método deselección de los estudios. En total se revisaron 14 revisiones y meta-análisis. Los resultaron evidenciaron que la terapia cognitivo-conductual (TCC)fue el tratamiento psicológico más estudiado, mostrando consistentemente efectividad para reducir los síntomas y la severidad de IA/IGD. Además,la TCC parece ser más efectiva cuando se combinaba con otros tipos de tratamiento como el farmacológico. Se concluye la necesidad de investigarla efectividad de los tratamientos psicológicos para IA/IGD de manera diferenciada con el objetivo de establecer intervenciones adecuadas quepermitan reducir la gravedad de la adicción y mejorar el bienestar y la calidad de vida de los niños y adolescentes. (AU)

Natural language processing for cognitive therapy: Extracting schemas from thought records.

The cognitive approach to psychotherapy aims to change patients' maladaptive schemas, that is, overly negative views on themselves, the world, or the future. To obtain awareness of these views, they record their thought processes in situations that caused pathogenic emotional responses. The schemas underlying such thought records have, thus far, been largely manually identified. Using recent advances in natural language processing, we take this one step further by automatically extracting schemas from thought records. To this end, we asked 320 healthy participants on Amazon Mechanical Turk to each complete five thought records consisting of several utterances reflecting cognitive processes. Agreement between two raters on manually scoring the utterances with respect to how much they reflect each schema was substantial (Cohen's κ = 0.79). Natural language processing software pretrained on all English Wikipedia articles from 2014 (GLoVE embeddings) was used to represent words and utterances, which were then mapped to schemas using k-nearest neighbors algorithms, support vector machines, and recurrent neural networks. For the more frequently occurring schemas, all algorithms were able to leverage linguistic patterns. For example, the scores assigned to the Competence schema by the algorithms correlated with the manually assigned scores with Spearman correlations ranging between 0.64 and 0.76. For six of the nine schemas, a set of recurrent neural networks trained separately for each of the schemas outperformed the other algorithms. We present our results here as a benchmark solution, since we conducted this research to explore the possibility of automatically processing qualitative mental health data and did not aim to achieve optimal performance with any of the explored models. The dataset of 1600 thought records comprising 5747 utterances is published together with this article for researchers and machine learning enthusiasts to improve upon our outcomes. Based on our promising results, we see further opportunities for using free-text input and subsequent natural language processing in other common therapeutic tools, such as ecological momentary assessments, automated case conceptualizations, and, more generally, as an alternative to mental health scales.

Desafíos asociados al estudio de psicoterapeutas expertos / Challenges related to the study of psychotherapy experts

El estudio de expertise psicoterapéutica podría contribuir a la comprensión de los efectos del terapeuta sobre el cambio y a la mejora de los métodos de entrenamiento de terapeutas. Sin embargo, este tipo de estudios presenta una serie de problemáticas que limitan su avance. Dentro de éstas es posible identificar desafíos en cuanto a su relevancia, delimitación conceptual, fundamentación teórica-empírica, diseños investigativos y consecuencias políticas de sus resultados. El objetivo del presente artículo es presentar tales desafíos y proponer lineamientos para poder sobrellevarlos en investigaciones futuras. (AU)

The study of psychotherapeutic expertise could contribute to the understanding of therapist effects as well as to the improvement of methods of therapist training. However, there are several problems in this field that limit its progress, for example, its relevance, conceptual delimitation, theoretical-empirical foundation, research designs, and the political consequences of the results. The aim of this article is to describe these challenges and propose guidelines to overcome them in future research. (AU)

Re-evaluating randomized clinical trials of psychological interventions: Impact of response shift on the interpretation of trial results.

BACKGROUND: Effectiveness of psychological treatment is often assessed using patient-reported health evaluations. However, comparison of such scores over time can be hampered due to a change in the meaning of self-evaluations, called 'response shift'. Insight into the occurrence of response shift seems especially relevant in the context of psychological interventions, as they often purposefully intend to change patients' frames of reference. AIMS: The overall aim is to gain insight into the general relevance of response shift for psychological health intervention research. Specifically, the aim is to re-analyse data of published randomized controlled trials (RCTs) investigating the effectiveness of psychological interventions targeting different health aspects, to assess (1) the occurrence of response shift, (2) the impact of response shift on interpretation of treatment effectiveness, and (3) the predictive role of clinical and background variables for detected response shift. METHOD: We re-analysed data from RCTs on guided internet delivered cognitive behavioural treatment (CBT) for insomnia in the general population with and without elevated depressive symptoms, an RCT on meaning-centred group psychotherapy targeting personal meaning for cancer survivors, and an RCT on internet-based CBT treatment for persons with diabetes with elevated depressive symptoms. Structural equation modelling was used to test the three objectives. RESULTS: We found indications of response shift in the intervention groups of all analysed datasets. However, results were mixed, as response shift was also indicated in some of the control groups, albeit to a lesser extent or in opposite direction. Overall, the detected response shifts only marginally impacted trial results. Relations with selected clinical and background variables helped the interpretation of detected effects and their possible mechanisms. CONCLUSION: This study showed that response shift effects can occur as a result of psychological health interventions. Response shift did not influence the overall interpretation of trial results, but provide insight into differential treatment effectiveness for specific symptoms and/or domains that can be clinically meaningful.

El deseo del analista en la experiencia del análisis

Reflexión sobre los deseos del analista basada en los aportes de Jacques Lacan, partiendo de la concepción del psicoanálisis como praxis, y del inconsciente como concepto fundamental de la misma, y concibiéndolo como articulador de estas cuestiones.

Mitos e tabus sobre o cuidado em saúde mental

Webnário "Campanha Janeiro Branco" 26/01 - 16 horas Mediadora: Cristina Vasconcelos – Psicóloga Convidadas: Luzieta Martins – Psicóloga - Hospital Gurupi/SES Luciana Sant’ana – Medica - CAPS/Araguaína Lyana Rocha – Psicóloga - Hospital Augustinópolis/SES #vemprasaudemental​ #todostemdireitoasaudemental​ #quemcuidadamentecuidadavida

Psychotherapy at a Distance.

The 2020 COVID-19 pandemic has abruptly overwhelmed normal life. Beyond the fear and fatality of the virus itself comes a likely wave of psychiatric disorders. Simultaneously, social distancing has changed overnight how psychiatrists and other mental health professionals must treat patients. Telepsychotherapy, until now a promising but niche treatment, has suddenly become treatment as usual. This article briefly reviews the limited clinical evidence supporting different modes of telepsychotherapy, then focuses on how remote therapy affects clinicians and their patients.

Using computerized text analysis to examine associations between linguistic features and clients' distress during psychotherapy.

Raw linguistic data within psychotherapy sessions may provide important information about clients' progress and well-being. In the current study, computerized text analytic techniques were applied to examine whether linguistic features were associated with clients' experiences of distress within and between clients and whether changes in linguistic features were associated with changes in treatment outcome. Transcripts of 729 psychotherapy sessions from 58 clients treated by 52 therapists were analyzed. Prior to each session, clients reported their distress level. Linguistic features were extracted automatically by using natural language parser for first-person singular identification and using positive and negative emotion words lexicon. The association between linguistic features and levels of distress was examined using multilevel models. At the within-client level, fewer first-person singular words, fewer negative emotional words and more positive emotional words were associated with lower distress in the same session; and fewer negative emotion words were associated with lower next session distress (rather small f2 effect sizes = 0.011 < f2 < 0.022). At the between-client level, only first session use of positive emotion words was associated with first session distress (ηp2 effect size = 0.08). A drop in the use of first-person singular words was associated with improved outcome from pre- to posttreatment (small ηp2 effect size = 0.05). The findings provide preliminary support for the association between clients' linguistic features and their fluctuating experience of distress. They point to the potential value of computerized linguistic measures to track therapeutic outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

DNA methylation and psychotherapy response in trauma-exposed men with appetitive aggression.

Exposure to violence can lead to appetitive aggression (AA), the positive feeling and fascination associated with violence, and posttraumatic stress disorder (PTSD), characterised by hyperarousal, reexperience and feelings of ongoing threat. Psychotherapeutic interventions may act via DNA methylation, an environmentally sensitive epigenetic mechanism that can influence gene expression. We investigated epigenetic signatures of psychotherapy for PTSD and AA symptoms in South African men with chronic trauma exposure. Participants were assigned to one of three groups: narrative exposure therapy for forensic offender rehabilitation (FORNET), cognitive behavioural therapy or waiting list control (n = 9-10/group). Participants provided saliva and completed the Appetitive Aggression Scale and PTSD Symptom Severity Index at baseline, 8-month and 16-month follow-up. The relationship, over time, between methylation in 22 gene promoter region sites, symptom scores, and treatment was assessed using linear mixed models. Compared to baseline, PTSD and AA symptom severity were significantly reduced at 8 and 16 months, respectively, in the FORNET group. Increased methylation of genes implicated in dopaminergic neurotransmission (NR4A2) and synaptic plasticity (AUTS2) was associated with reduced PTSD symptom severity in participants receiving FORNET. Analyses across participants revealed a proportional relationship between AA and methylation of TFAM, a gene involved in mitochondrial biosynthesis.

Psychotherapy via the Internet: What Programs Do Psychotherapists Use, How Well-Informed Do They Feel, and What Are Their Wishes for Continuous Education?

The outbreak of the COVID-19 pandemic has caused changes in the provision of psychotherapy around the world. The common format of delivering in-person psychotherapy is replaced by psychotherapy via the Internet to a great extent. This study examined how well Austrian psychotherapists feel informed about the use of the Internet in psychotherapy, where additional information needs exist, and which software is used. A link to an online survey was sent to all psychotherapists providing a valid email address in the official list of licensed psychotherapists at the start of the COVID-19 lockdown in Austria. A total of 1547 people took part in the survey. The results show that psychotherapy via the Internet was primarily offered via Skype and Zoom during the COVID-19 pandemic and that the majority of the therapists felt well-informed about psychotherapy via the Internet; however, several therapists stated that they wish to have further information on data protection and security. Overall, the study shows that Austrian psychotherapists coped well with the rapid change from the provision of psychotherapy through personal contact to psychotherapy via the Internet. Security and data protection aspects of therapy via the Internet should be addressed in training and further education of psychotherapists. As this study was conducted online, it might have caused some respondent bias towards a higher participation of psychotherapists with higher preference for new technologies.

The Use of New Digital Information and Communication Technologies in Psychological Counseling during the COVID-19 Pandemic.

The use of digital information and communication technologies (ICTs) has enabled many professionals to continue to provide their services during the COVID-19 pandemic. However, little is known about the adoption of ICTs by psychologists and the impact of such technologies on their practice. This study aimed to explore psychologists' practices related with the use of ICTs before and during the COVID-19 lockdown, to identify the main changes that the pandemic has brought and the impact that such changes have had on their practice with clients, and also identify the factors that potentially have affected such changes. The Portuguese Psychologists Association announced the study, and 108 psychologists responded to an online survey during the mandatory lockdown. The results showed that these professionals continued to provide their services due to having adopted ICTs. Comparing with face-to-face interventions, psychologists recognized that additional precautions/knowledge were needed to use such technologies. Despite the challenges identified, they described the experience with the use of ICTs as positive, meeting clients' adherence, and yielding positive results. Psychologists with the most years of professional experience maintained their services the most, but those with average experience showed the most favorable attitudes toward the use of technologies and web-based interventions.

Existential positive psychology and integrative meaning therapy.

The unprecedented changes in our society because of COVID-19 and the fourth industrial revolution (4IR) shows that our healthcare system and the medical approach to psychotherapy can no longer meet the mental health needs of society. This paper first described the negative impact of COVID-19 and 4IR on our mental health. Then, following a brief critique of the medical model, this paper proposes that the future of psychotherapy needs to be based on the more inclusive and integrative framework of existential positive psychology (PP 2.0), which emphasizes flourishing through suffering. Finally, the paper emphasizes Viktor Frankl's cure and Wong's integrative meaning therapy. It concludes that integrative meaning therapy represents the future of psychotherapy, because it is situated in the area of interactions of at least three traditions: Clinical psychology, existential psychology, and positive psychology. This integrative model is holistic, recognising humans as bio-psycho-social-spiritual beings and considers several theoretical perspectives in both diagnosis and treatment.