La terapia narrativa como intervención en jóvenes víctimas de abuso sexual infantil / Narrative therapy as an intervention in young victims of child sexual abuse

La terapia narrativa surge como una propuesta de intervención, debido a que este modelo permite que las personas puedan generar un proceso donde se desarrolle de manera integral lo que han padecido, y, de esa manera, poder resignificarlo; consiguientemente, cada paciente puede, así, superar la experiencia traumática (Ihl y Diaz, 2021). Método: Este trabajo de integración final de diseño teórico de revisión bibliográfica se propuso analizar la posible eficacia de la terapia narrativa como intervención clínica con jóvenes que han sido víctimas del abuso sexual infantil. Síntesis y conclusiones: La terapia narrativa propone un espacio respetuoso, flexible y de contención; se establece un entorno en el que el paciente tiene la oportunidad de contar su experiencia traumática, sin estar obligado a relatarla. Es decir, este abordaje no se enfoca en la exposición del trauma, ni exige que la persona relate la situación de abuso en un momento específico; la terapia narrativa propone trabajar con los efectos y las consecuencias del trauma AU

Narrative therapy emerges as an intervention proposal because this model allows people to generate a process where what they have suffered is developed in an integral way, and, in this way, to resignify it; consequently, each patient can thus overcome the traumatic experience (Ihl & Diaz, 2021). Method: This work offinal integration of theoretical design of bibliographic review was proposed to analyze the possible effectiveness of narrative therapy as a clinical intervention with young people who have been victims of child sexual abuse. Synthesis and conclusions: Narrative therapy proposes a respectful, flexible, and supportive space; an environment is established in which the patient has the opportunity to recount his traumatic experience, without being obliged to recount it. In other words, this approach does not focus on the exposure of the trauma, nor does it require the person to report the situation of abuse at a specific time; Narrative therapy proposes working with the effects and consequences of trauma AU

Repercussions of family violence: oral history of adolescents.

OBJECTIVE: To know the repercussions of the experience of family violence from the oral history of adolescents. METHOD: Qualitative study based on the Oral History method, conducted from interviews with adolescents enrolled in a public school in Salvador, State of Bahia, Brazil. The data were systematized according to the thematic analysis and supported by theoretical references on family violence and adolescence. RESULTS: Family violence implies physical illness associated with the damage caused by physical aggression and somatization of violent events, as well as compromising mental health, provoking feelings of deep sadness, self-injury behavior and suicidal ideation. All of these factors impair interpersonal relationships, school performance, as well as making them more vulnerable to alcohol intake. FINAL CONSIDERATIONS: The study indicates signs suggestive of grievance, from which the professionals should proceed the investigation in order to refute or confirm the experience of the phenomenon, as well as intervene in the cases.

Repercussions of family violence: oral history of adolescents / Repercusiones de la violencia intrafamiliar: historias orales de adolescentes / Repercussões da violência intrafamiliar: história oral de adolescentes

ABSTRACT Objective: To know the repercussions of the experience of family violence from the oral history of adolescents. Method: Qualitative study based on the Oral History method, conducted from interviews with adolescents enrolled in a public school in Salvador, State of Bahia, Brazil. The data were systematized according to the thematic analysis and supported by theoretical references on family violence and adolescence. Results: Family violence implies physical illness associated with the damage caused by physical aggression and somatization of violent events, as well as compromising mental health, provoking feelings of deep sadness, self-injury behavior and suicidal ideation. All of these factors impair interpersonal relationships, school performance, as well as making them more vulnerable to alcohol intake. Final Considerations: The study indicates signs suggestive of grievance, from which the professionals should proceed the investigation in order to refute or confirm the experience of the phenomenon, as well as intervene in the cases.

RESUMEN Objetivo: Conocer las repercusiones derivadas de la violencia intrafamiliar a partir de historias orales de adolescentes. Método: Se trata de una investigación cualitativa basada en el método de la Historia Oral, realizada mediante entrevistas a alumnos adolescentes de una escuela pública de Salvador, Bahía, Brasil. Se sistematizaron los datos según el análisis temático con respaldo en referenciales teóricos sobre violencia intrafamiliar y adolescencia. Resultados: La violencia intrafamiliar trae como consecuencia enfermedades asociadas a la agresión física padecida, somatizando el penoso evento y comprometiendo la salud mental, ya que suscita sentimientos de profunda tristeza, comportamiento de autolesión e ideas suicidas. Todos estos factores perjudican las relaciones interpersonales, el rendimiento escolar y propician el uso del alcohol. Consideraciones Finales: El estudio señala la existencia del agravio, a partir del cual los profesionales deben realizar investigaciones en el sentido de refutar o confirmar la vivencia del fenómeno e intervenir en los casos.

RESUMO Objetivo: Conhecer as repercussões da vivência de violência intrafamiliar a partir da história oral de adolescentes. Método: Pesquisa qualitativa, fundamentada no método da História Oral, realizada a partir de entrevistas com adolescentes matriculadas(os) em uma escola pública de Salvador, Bahia, Brasil. Os dados foram sistematizados conforme a análise temática e respaldados em referenciais teóricos sobre violência intrafamiliar e adolescência. Resultados: A violência intrafamiliar implica adoecimento físico associado aos danos decorrentes da agressão física e à somatização do evento violento, bem como compromete a saúde mental, suscitando sentimentos de tristeza profunda, comportamento de autolesão e ideação suicida. Todos esses fatores prejudicam as relações interpessoais, o desempenho escolar, bem como vulnerabiliza para o uso de álcool. Considerações Finais: O estudo aponta sinais sugestivos do agravo, a partir dos quais os profissionais deverão proceder a investigação no sentido de refutar ou confirmar a vivência do fenômeno, bem como intervir diante dos casos.

Is Narrative Cognitive Therapy as Effective as Cognitive Behavior Therapy in the Treatment for Depression in Young Adults?

This study aimed to compare the effectiveness of narrative cognitive therapy (NCT) and cognitive behavior therapy (CBT) in the improvement of perception of quality of life in young adults with depression at 12-month follow-up. This was a randomized clinical trial conducted using seven sessions of NCT or CBT. Quality of life was measured using the Medical Outcomes Survey Short-Form General Health Survey. The sample included 97 patients. Considering only completers to be samples, CBT was more effective than NCT for improvement of physical functioning (p = 0.031), vitality (p = 0.013), and mental health (p = 0.002) at 12-month follow-up. However, in the intention-to-treat analysis, we found no difference between groups. Regardless of model, we found a significant improvement in all domains from baseline to postintervention and 6- and 12-month follow-ups, except for the bodily pain domain. In conclusion, both models were effective in the improvement of perception of quality of life.

Debriefing interventions for the prevention of psychological trauma in women following childbirth.

BACKGROUND: Childbirth is a complex life event that can be associated with both positive and negative psychological responses. When giving birth is experienced as particularly traumatic this can have a negative impact on a woman's postnatal emotional well-being. There has been an increasing focus on women's psychological trauma symptoms following childbirth, including the relatively rare phenomenon of post-traumatic stress disorder (PTSD), and the benefit of debriefing interventions to prevent this. In this review we examined the evidence for debriefing as a preventative intervention for psychological trauma following childbirth. OBJECTIVES: To assess the effects of debriefing interventions compared with standard postnatal care for the prevention of psychological trauma in women following childbirth. SEARCH METHODS: The trials registers of the Cochrane Depression, Anxiety and Neurosis Group (CCDANCTR-References and CCDANCTR-Studies) and the Cochrane Pregnancy and Childbirth Group were searched up to 4 March 2015. These registers include relevant randomised controlled trials from the following bibliographic databases: the Cochrane Library (all years to date), MEDLINE (1950 to date), EMBASE (1974 to date), and PsycINFO (1967 to date). Additional searches were conducted in CENTRAL, MEDLINE, EMBASE, PsycINFO, and Maternity and Infant Care. The reference lists of all included studies were checked for additional published reports and citations of unpublished research. Experts in the field were contacted. SELECTION CRITERIA: We included randomised controlled trials (RCTs) and quasi-randomised trials comparing postnatal debriefing interventions with standard postnatal care for the prevention of psychological trauma of women following childbirth. The intervention consisted of at least one debriefing intervention session, which had the purpose of allowing women to describe their experience and to normalise their emotional reaction to that experience. DATA COLLECTION AND ANALYSIS: Three authors independently assessed trial quality and extracted data. Meta-analysis was conducted where there were more than two trials examining the same outcomes. MAIN RESULTS: We included seven trials (eight articles) from three countries (UK, Australia and Sweden) that fulfilled the inclusion criteria. The number of women contributing data to each outcome varied from 102 to 1745. Methodological quality was variable and most of the studies were of low quality. The quality of evidence for the prevalence of psychological trauma (primary outcome) and the prevalence of depression symptoms was rated low or very low, based on few studies (ranging from a single study to three studies) with high risk of bias in main domains such as performance bias, random sequence generation, allocation concealment and incomplete outcome data. The quality of evidence for the remaining outcomes (that is prevalence of anxiety, prevalence of fear of childbirth, prevalence of general psychological morbidity, health service utilization and attrition from treatment) was not assessed as data were not available.Among women who had a high level of obstetric intervention during labour and birth, we found no difference between standard postnatal care with debriefing and standard postnatal care without debriefing on psychological trauma symptoms within three months postpartum (RR 0.61; 95% CI 0.28 to 1.31; n = 425) or at three to six months postpartum (RR 0.62; 95% CI 0.27 to 1.42; n = 246). The results were based on two trials, respectively. Among women who experienced a distressing or traumatic birth, there was no evidence of an effect of psychological debriefing on the prevention of PTSD (measured by the MINI-PTSD) at four to six weeks postpartum (RR 1.15; 95% CI 0.66 to 2.01; n = 102) or at six months (RR 0.35; 95% CI 0.10 to 1.23; n = 103). The results were based on one small trial. One trial involving low-risk women who delivered healthy infants at or near term reported no significant difference between the intervention group and the control group in the proportion of women who met the diagnostic criteria for psychological trauma during the year following childbirth (RR 1.06; 95% CI 0.88 to 1.28; n = 1745). We did not find any information about attrition rates. AUTHORS' CONCLUSIONS: We did not find any high quality evidence to inform practice, with substantial heterogeneity being found between the studies conducted to date. There is little or no evidence to support either a positive or adverse effect of psychological debriefing for the prevention of psychological trauma in women following childbirth. There is no evidence to support routine debriefing for women who perceive giving birth as psychologically traumatic.Future research should provide greater detail of the outcome measures used, and with scales for measuring psychological trauma validated against clinical diagnostic interviews. High rates of obstetric intervention in some birth settings may mean that women require improved emotional care from health professionals to reduce the risk of childbirth being experienced as traumatic. As all included trials excluded women unable to communicate in the native language of the study setting, there is no information on the response of these women to psychological debriefing. No included studies were conducted in low or middle-income countries.

[Contributions by integrative community therapy to users of Psychosocial Care Centers (CAPS) and family members: thematic oral history]. / Contribuições da terapia comunitária integrativa para usuários dos Centros de Atenção Psicossocial (CAPS): do isolamento à sociabilidade libertadora.

The aim of this study was to analyze contributions by integrative community therapy to behavior changes in users of Psychosocial Care Centers (CAPS). This was a comprehensive-interpretative study with a qualitative approach, based on thematic oral history. The study site was the Caminhar Center in João Pessoa, Paraíba State, Brazil. The study material was produced with interviews conducted with six subjects and was discussed using thematic analysis as proposed by Minayo, providing the basis for two major thematic lines: integrative community therapy as a liberating praxis and changes that make the difference. The subjects' stories revealed significant changes in the personal, professional, and community fields, based on their inclusion in the integrative community therapy circles, a strategy that promoted the recovery of processes of natural socialization that constitute human life. The use of integrative community therapy was clearly related to proposals for the participants' psychosocial integration and rehabilitation.

Contribuições da terapia comunitária integrativa para usuários dos Centros de Atenção Psicossocial (CAPS): do isolamento à sociabilidade libertadora / Contributions by integrative community therapy to users of Psychosocial Care Centers (CAPS) and family members: thematic oral history / Las contribuciones de la terapia comunitaria a los usuarios de los Centros de Atención Psicosocial (CAPS): del aislamiento a la sociabilidad libertadora

O objetivo deste estudo foi analisar as contribuições da terapia comunitária integrativa considerando as mudanças de comportamentos de usuários de um Centros de Atenção Psicossocial (CAPS). Trata-se de uma pesquisa compreensivo-interpretativa de abordagem qualitativa, onde se utilizou a história oral temática. O cenário da investigação foi o CAPS Caminhar, localizado na cidade de João Pessoa, Paraíba, Brasil. O material empírico foi produzido a partir de entrevistas realizadas com seis colaboradores, e o produto desse material foi discutido com base na análise temática proposta por Minayo, que subsidiou a construção de dois grandes eixos temáticos: A terapia comunitária integrativa como práxis libertadora e mudanças que fazem a diferença. As histórias dos colaboradores revelaram que ocorreram mudanças significativas nos campos pessoal, profissional e comunitário, a partir da inserção deles nas rodas de terapia comunitária integrativa, pois se verificou que tal estratégia promoveu a recuperação dos processos de socialização natural que constituem a vida humana. Ficou claro que o uso da terapia comunitária integrativa está relacionado a propostas de inclusão e reabilitação psicossocial de seus participantes.

The aim of this study was to analyze contributions by integrative community therapy to behavior changes in users of Psychosocial Care Centers (CAPS). This was a comprehensive-interpretative study with a qualitative approach, based on thematic oral history. The study site was the Caminhar Center in João Pessoa, Paraíba State, Brazil. The study material was produced with interviews conducted with six subjects and was discussed using thematic analysis as proposed by Minayo, providing the basis for two major thematic lines: integrative community therapy as a liberating praxis and changes that make the difference. The subjects' stories revealed significant changes in the personal, professional, and community fields, based on their inclusion in the integrative community therapy circles, a strategy that promoted the recovery of processes of natural socialization that constitute human life. The use of integrative community therapy was clearly related to proposals for the participants' psychosocial integration and rehabilitation.

El objetivo de este estudio fue analizar las contribuciones de la terapia comunitaria en relación con los cambios en el comportamiento de los usuarios de un Centro de Atención Psicosocial (CAPS). Se trata de un enfoque cualitativo de investigación interpretativa global, en el que se utilizó un conjunto de historias orales temáticas. El centro de la investigación fue el CAPS Caminhar, ubicado en la ciudad de João Pessoa, Paraíba, Brasil. Los datos empíricos fueron obtenidos de entrevistas con seis empleados y el producto de este material se discutió sobre la base del análisis temático propuesto por Minayo, que promovió la construcción de dos grandes temas: terapia comunitaria como praxis liberadora y los cambios que marcan la diferencia. Las historias de los empleados revelaron que se produjeron cambios significativos en los ámbitos personales, profesionales y de la comunidad en la que se encuentran, además de en las sesiones de terapia comunitaria, ya que se comprobó que dicha estrategia promueve la recuperación de los procesos de socialización naturales que constituyen la vida humana. Estaba claro que el uso de las terapias comunitarias está relacionado con las propuestas para la inclusión y la rehabilitación.