Therapeutic Alliance in Online and Face-to-face Psychological Treatment: Comparative Study.

BACKGROUND: Since the COVID-19 pandemic, the number of online mental health treatments have grown exponentially. Additionally, it seems inevitable that this technical resource is here to stay at health centers. However, there is still very little scholarly literature published on this topic, and therefore, the impact of the changes that have had to be dealt with in this regard has not been studied. OBJECTIVE: This study aims to evaluate the differences in the establishment of the therapeutic alliance (TA) based on the intervention modality (online or face-to-face), the type of attachment, and diagnosis. METHODS: A total of 291 subjects participated in the study, 149 (51.2%) of whom were men and 142 were (48.8%) women between the ages of 18 and 30 years. The instruments used were sociodemographic data, SOFTA-o (System for Observing Family Therapeutic Alliances-observational), and Relationship Questionnaire. RESULTS: The results show that the treatments conducted face-to-face obtain significantly better scores in the creation of the TA than those conducted online (t=-42.045, df=289, P<.001). The same holds true with attachment, in that users with secure attachment show a better TA than those with insecure attachment (t=6.068, P<.001,), although there were no significant differences with the diagnosis (F=4.566, P=.44), age (r=0.02, P=.70), and sex (t=0.217, P=.33). CONCLUSIONS: We believe that professionals are not yet prepared to conduct remote treatment with a degree of efficacy similar to that of face-to-face. It is essential for professionals to receive training in this new technical resource and to understand and incorporate the variants it entails into their daily practice.

A Psychoanalytical Perspective on the Co-therapeutic Relationship With a Group of Siblings of Children With Autism: An Observational Study of Communicative Behavior Patterns.

A child diagnosed with autism may have a negative psychological and behavioral impact on their siblings, whose participation in a group with children in the same situation is a preventive measure. Our group study was conducted by two therapists (T1 and T2) assigned to co-therapy (CT) work. Both therapists shared the theoretical bases and understanding of the group and the needs of the individual subjects, and complemented each other in terms of the direction of their interventions, given that shared impressions and continuous exchanges that integrate countertransference aspects are essential to successful co-therapy. The objectives of this study were as follows: (a) to detect patterns of clarification, confrontation, and interpretation interventions by T1 and T2 in the group; and (b) to detect patterns of clarification, confrontation and interpretation interventions considering T1 and T2 as the only focal subject of the CT. Design was mixed-methods based on systematic observation, for which we developed a qualitative ad hoc instrument that combined a field format and a categorizing system. Interobserver agreement was analyzed quantitatively using Cohen's kappa and Krippendorf's canonical concordance. Once data reliability was confirmed, lag sequential analysis using GSEQ5 software was performed to search for behavior patterns. The results show (a) different behavior patterns in the clarification, confrontation, and interpretation interventions by T1 and T2; and (b) different behavior patterns when T1 and T2 are considered as the focal subject (CT). Our study offers a new perspective on the impact of therapist interventions on participants in this kind of group.

Investigar la comunicación en el grupo: el desarrollo de un instrumento observacional para un grupo de hermanos de niños con TEA / Researching communication within the group: development of an observational tool for a group of siblings of children with ASD

Partiendo del estudio de un grupo de hermanos de niños con TEA, este artículo tiene como principal objetivo, resaltar la importancia del acercamiento entre la práctica clínica y la investigación. Se registraron siete sesiones en video para hacer un estudio con metodología observacional. El proceso de elaboración del instrumento observacional ad hoc fue estructurado tras la revisión de tesis doctorales basadas en experiencias de grupos desde la perspectiva psicoanalítica (Arias, 2004; Roustan, 2010; Vaimberg, 2010) (AU)

Based on the study of a group of siblings of autistic children, this article has a main objective: to highlight the importance of rapprochement between clinical practice and research. Seven sessions were recorded in video to study with observational methodology. The process of developing ad hoc observational instrument was structured following the revision of doctoral thesis based on experiences of groups from a psychoanalytic perspective (AU)

Estudio de la calidad de vida en pacientes con psicosis incipiente / Study of the quality of life of patients in early psichosis

Introducción: La descripción de las características de personas diagnosticadas de Estado Mental de Alto Riesgo (EMAR), que son susceptibles de convertirse en un Primer Episodio Psicótico (PEP), es el primer paso para la prevención primaria y secundaria efectuada en los servicios de nuestro sistema sociosanitario. Material: 23 pacientes diagnosticados de EMAR y otros 23 de PEP que han sido atendidos en el Equipo de Atención Precoz a Pacientes en riesgo de Psicosis (EAPPP) de Barcelona, durante el período 2006-2011. Método: Estudio transversal descriptivo para determinar la percepción subjetiva de la calidad de vida, condiciones psicosociales y clínicas de pacientes según presenten un EMAR o un PEP. Resultados: Se observa que los pacientes con EMAR y PEP tienen una percepción subjetiva de la calidad de vida y un Funcionamiento Global (GAF) similar, a pesar de obtener puntuaciones diferentes en la escala PANSS. Conclusiones: A la vista de los resultados, es importante diagnosticar a las personas que presentan un EMAR, cuyas características psicosociales son similares a las que presentan un PEP, para así evitar una posible evolución hacia un trastorno psicótico (AU)

The description of the characteristics of persons diagnosed with Ultra High Risk (UHR) of psychosis, which are likely to become a First Episode of Psychosis (FEP), is the first step primary and secondary prevention made in our health service system. Material: 23 patients diagnosed EMAR and 23 of PEP who have been treated in the Early Care Team for Patients at risk of psychosis (EAPPP) of Barcelona, between the years 2006-2011. Method: Descriptive cross-sectional study to determine the subjective perception of quality of life, psychosocial and clinical conditions of patients by presenting At-Risk Mental State of psychosis (EMAR) or a First Episode of Psychosis (PEP). Results: Patients with EMAR and PEP have a subjective perception of quality of life and a similar Global Functioning despite getting different scores on the PANSS scale. Conclusions: It is important to diagnose people with EMAR, whose psycho-social characteristics are similar to PEP, in order to avoid a possible evolution towards a psychotic disorder (AU)