Queridos Residentes, Cuidaos: una Guía Para Sobrevivir a la Psicología Clínica / Dear Trainees, Take Care of Yourselves: A Guide to Surviving Clinical Psychology

La residencia en psicología clínica es un proceso que pondrá al límite la capacidad de adaptación de los residentes,especialmente si no gozan de la supervisión y el soporte institucional adecuados. Conscientes de esta situación, estetrabajo pretende normalizar la complejidad que supone formarse como psicólogo clínico en España, poniendo unénfasis especial en los primeros pasos como residente en el Sistema Nacional de Salud y en los desafíos personalesque ello implica. Asimismo, persigue incrementar la sensibilidad sobre la necesidad de medidas que permitan a losresidentes sobrevivir a la psicología clínica. Por ende, se discute el estado del arte sobre el concepto de autocuidadodentro del campo de la psicología clínica y la psicoterapia desde la perspectiva de que especialistas mejor formadospodrán mejorar el Sistema Nacional de Salud y la atención a la salud mental de los más vulnerables.(AU)

The training system in clinical psychology in Spain is a process that will test the adaptability of trainees to thelimit, especially if they do not have adequate supervision and institutional support. Aware of this issue, this paperaims to normalize the complexity of training as a clinical psychologist in Spain, placing special emphasis on thefirst steps as a trainee in the National Health System and on the personal challenges involved. Moreover, it seeksto increase sensitivity and awareness about the importance of establishing measures that enable trainees to surviveclinical psychology. Therefore, the state of the art on the topic of self-care within the field of clinical psychologyand psychotherapy is discussed from the perspective that better trained specialists will improve the National HealthSystem and mental health care for the most vulnerable people.(AU)

Developing a smartphone App based on the Unified Protocol for the transdiagnostic treatment of emotional disorders: A qualitative analysis of users and professionals' perspectives.

Emotional Disorders have become the most prevalent mental disorders in the world. In relation to their high prevalence, mental health care from public health services faces major challenges. Consequently, finding solutions to deliver cost-effective evidence-based treatments has become a main goal of today's clinical psychology. Smartphone apps for mental health have emerged as a potential tool to deal with it. However, despite their effectiveness and advantages, several studies suggest the need to involve patients and professionals in the design of these apps from the first stage of the development process. Thus, this study aimed to identify, from both a group of users and professionals, the needs, opinions, expectations and design aspects of a future smartphone app based in the Unified Protocol (UP), that will allow to develop the subsequent technical work of the app engineers. Two focus groups were conducted, one with 7 professionals and the other with 9 users, both groups familiar with the UP. A thematic content analysis based in grounded theory was performed in order to define emergent categories of analysis derived from the interview data. The results revealed 8 common topics in both focus groups and 5 specific key topics were identified in the professionals' focus group. Of the total proposals, 93 % of the professionals' and 78 % of the users' are implemented in the preliminary version of the app.

[Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art].

Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art. BACKGROUND: The empirical evidence accumulated on the efficacy, effectiveness, and efficiency of psychotherapeutic treatments in children and adolescents calls for an update. The main goal of this paper objective was to carry out a selective review of empirically supported psychological treatments for a variety of common psychological disorders and problems in childhood and adolescence. METHOD: A review was carried out of the psychological treatments for different psychological disorders and problems in social-emotional or behavioral adjustment in the child-adolescent population according to the Spanish National Health System (Clinical Practice Guidelines) levels of evidence and degrees of recommendation. RESULTS: The findings suggest that psychological treatments have empirical support for addressing a wide range of psychological problems in these developmental stages. The degree of empirical support ranges from low to high depending on the phenomenon analyzed. The review suggests unequal progress in the different fields of intervention. CONCLUSIONS: From this update, psychologists will be able to make informed decisions when implementing those empirically supported treatments to address the problems that occur in childhood and adolescence.

[Evidence-Based Psychological Treatments for Adults: A Selective Review]

Evidence-Based Psychological Treatments for Adults: A Selective Review. BACKGROUND: Psychological treatments have shown their efficacy, effectiveness, and efficiency in dealing with mental disorders. However, considering the scientific knowledge generated in recent years, in the Spanish context, there are no updating studies about empirically supported psychological treatments. The main goal was to carry out a selective review of the main empirically supported psychological treatments for mental disorders in adults. METHOD: Levels of evidence and degrees of recommendation were collected based on the criteria proposed by the Spanish National Health System (Clinical Practice Guidelines) for different psychological disorders. RESULTS: The results indicate that psychological treatments have empirical support for the approach to a wide range of psychological disorders. These levels of empirical evidence gathered range from low to high depending on the psychological disorder analysed. The review indicates the existence of certain fields of intervention that need further investigation. CONCLUSIONS: Based on this selective review, psychology professionals will be able to have rigorous, up-to-date information that allows them to make informed decisions when implementing empirically based psychotherapeutic procedures based on the characteristics of the people who require help.

La psicología clínica ante la pandemia COVID-19 en España / No disponible

No disponible

Systematic Client Feedback: A naturalistic pilot study / Feedback sistemático del cliente: un estudio piloto naturalístico

INTRODUCTION: Routine outcome monitoring or systematic client feedback (SCF) continues to garner empirical support. The Partners for Change Outcome Management System (PCOMS) is one application of SCF with significant research support but no studies have been conducted in Spain. This investigation describes the effects of PCOMS in routine practice via a comparison to published PCOMS studies. MATERIAL AND METHODS: In a retrospective observational study, PCOMS was implemented with 42 clients treated in routine psychotherapy. Outcomes were measured by the Outcome Rating Scale (ORS) and descriptively compared to PCOMS studies included in a meta-analysis and a PCOMS benchmarking study regarding reliable and/or clinically significant change, no change, and deterioration. RESULTS: The current study achieved similar rates of reliable and clinically significant change (73.8%) to the benchmarking study (65.6%) and the RCTs (67.5%). Regarding no change rates, the current study (23.8%) mirrored results of the RCTs (25.6%) and was better than the benchmarking study (35.4%). The current study incurred a low 2.4% deterioration rate compared to a 10.7% and 7.0% rate of the benchmarking study and RCTs, respectively. CONCLUSIONS: While not without flaws, this pilot study offers some evidence that the improved outcomes associated with PCOMS may also occur in psychotherapy settings in Spain

INTRODUCCIÓN: La monitorización sistemática de resultados o recolección sistemática del feedback del cliente (SFC) continúa acumulando apoyo empírico. El Partners for Change Outcome Management System (PCOMS) es una aplicación de la SFC cuya eficacia no ha sido investigada en España. Este estudio describe los resultados tras implementar PCOMS en un contexto de práctica clínica rutinaria, y los compara con los estudios de referencia disponibles en la literatura especializada. MATERIAL Y MÉTODOS: En un estudio observacional retrospectivo, PCOMS se implementó con 42 clientes tratados en psicoterapia rutinaria. Los resultados se midieron mediante la Escala de Calificación de Resultados (SRO) y descriptivamente en comparación con los estudios de PCOMS incluidos en un metaanálisis y un estudio de evaluación comparativa de PCOMS con respecto a cambios confiables y/o clínicamente significativos, sin cambios y deterioro. RESULTADOS: Se encontraron tasas similares de cambio fiable y cambios clínicamente significativos (73.85) a las obtenidas en el estudio de referencia (65.6%) y ECA (67.5%). En cuanto a las tasas de ausencia de cambios, el presente estudio (23.8%) mostró los mismos resultados que los ECA (25.6%) y mejores que los del estudio de referencia (35.4%). La tasa de deterioro (2.4%) fue inferior al 10.7 y al 7.0% obtenidos en el estudio de referencia y en los ECA, respectivamente. CONCLUSIONES: Con algunas limitaciones que se describen, este estudio piloto ofrece evidencia preliminar de que la mejora de resultados asociada a PCOMS puede darse también en población española

Pericia, efectos del terapeuta y práctica deliberada: El ciclo de la excelencia / Expertise, therapist effects and deliberate practice: The cycle of excellence

La Práctica (Clínica) Basada en la Evidencia se define como la integración de la mejor investigación disponible con la pericia clínica y las características, preferencias y cultura del paciente. Del mismo modo, la variable terapeuta empieza a mostrar su influencia decisi-va en el resultado de los tratamientos psicológicos. En este trabajo se pone el énfasis en la figura del terapeuta en el contexto del pro-grama de formación PIR de especialistas en Psicología Clínica de nuestro Sistema Nacional de Salud. Se revisan los constructos pericia, efectos del terapeuta y se presenta la Práctica Deliberada como un sistema de entrenamiento que puede ayudar a mejorar los resultados de los clínicos y sus tratamientos. Se realizan recomendaciones concretas para mejorar el modelo de supervisión durante la residencia PIR y se discuten algunas de las implicaciones y limitaciones del estado actual de la cuestión

Evidence-based (clinical) practice is the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences. Similarly, the therapist factor is beginning to show its decisive influence on the outcome of psychological treatments. This paper emphasizes the therapist factor in the context of the PIR training program of Clinical Psychology specialists within our National Health System. Expertise and therapist effects are reviewed and deliberate practice is presented as a training system that can help clinical psychologists to improve their outcomes and treatments. Specific recommendations are made to improve the supervision model during PIR training and the implications and limitations of the topic are discussed

Monitorización sistemática y feedback en psicoterapia / Routine outcome monitoring and feedback in psychotherapy

En el campo de la investigación en psicoterapia existe una intensa dialéctica entre el enfoque centrado en los resultados y el enfoque centrado en el proceso psicoterapéutico. La Práctica Basada en la Evidencia integra ambas posturas junto a las características del paciente y la pericia de los clínicos. De este modo, las variables de proceso tienen una mayor visibilidad en la última década. En este trabajo se aborda una de ellas: la monitorización sistemática de resultados y el uso del feedback del paciente en psicoterapia. Se realiza una presentación del tema en nuestro entorno y se ilustra mediante la exposición de 5 casos clínicos. Se revisa el estatus empírico de la cuestión, sus principales virtudes y algunos inconvenientes para su generalización en la práctica clínica

There is a passionate dialectic between outcome-based and process-based psychotherapeutic approaches in the field of psychotherapy research. Evidence-based practice integrates both positions with patient characteristics and clinical expertise. Thus, process factors have had increased visibility over the past decade. This paper examines one of them: routine outcome monitoring and collecting patient feedback. The topic is presented in our context and it is illustrated by exposing five clinical cases. We review the empirical status on the topic and the main strengths and barriers for its generalization in clinical practice are discussed

El trastorno de personalidad por evitación: una propuesta de tratamiento especializado en la sanidad pública española / The avoidant personality disorder: A proposal for specialized treatment in the Spanish National Health System

El trastorno de la personalidad por evitación es un problema de salud mental común, heterogéneo y altamente incapacitante. Sin embargo, muy pocos trabajos se han centrado específicamente en su tratamiento y no se dispone de guías clínicas para su abordaje. En consecuencia, el principal objetivo de este trabajo es revisar la literatura disponible en este campo y presentar una propuesta de tratamiento especializado para pacientes con trastorno de la personalidad por evitación grave en la sanidad pública española. El programa Galatea es un tratamiento intensivo y prolongado que combina la terapia individual basada en la mentalización y la terapia metacognitiva interpersonal en grupo. Con el fin de ilustrar el tratamiento, se presenta un caso clínico tratado dentro del programa. Por último, se discuten las implicaciones asistenciales de Galatea en el tratamiento especializado del trastorno de la personalidad por evitación grave en el ámbito público

Avoidant personality disorder is a common, heterogeneous and disabling mental health problem. Despite this, few studies have specifically focused on avoidant personality disorder treatment, and clinical guidelines have not been developed. Therefore, the main purpose of this work is to critically review the available literature on this topic and propose a specialized treatment for patients with severe avoidant personality disorder in the Spanish National Health System. The Galatea program is an intensive and longer treatment that combines individual therapy based on Mentalization-Based Therapy and Metacognitive Interpersonal Group Therapy. In order to illustrate the treatment, a clinical case treated within the program is presented. Finally, Galatea's healthcare implications in the specialized treatment of severe avoidant personality disorder in the public mental health settings are discussed

The Effects of Metacognition-Oriented Social Skills Training on Psychosocial Outcome in Schizophrenia-Spectrum Disorders: A Randomized Controlled Trial.

A pilot study of the effects of metacognition-oriented social skills training (MOSST) on social functioning in patients with schizophrenia spectrum disorders (SSDs) reported promising results. The main purpose of the current trial was to compare the effectiveness and potential benefits of MOSST vs conventional social skills training (SST). Single-blind randomized controlled trial with 2 groups of patients aged 18-65 with SSDs on partial hospitalization. Participants were randomly assigned (1:1) to receive 16 group sessions with MOSST or conventional SST, both in addition to standard care, over 4 months, with a 6-month follow-up. Psychosocial functioning, metacognition, and symptom outcomes were measured by blind assessors. Statistical analyses used mixed models to estimate treatment effects in each postrandomization time point. Thirty-six patients were randomly assigned to the MOSST group and 33 patients to the conventional SST group. Between-group differences were significant in favor of MOSST on Social and Occupational Functioning Assessment Scale (SOFAS) and Personal and Social Performance Scale (PSP) total scores at post-treatment and follow-up. Concerning PSP subscales, there were significant between-group differences in favor of MOSST at follow-up on socially useful activities, personal and social relationships, and disturbing and aggressive behaviors. Metacognition only improved following MOSST group. For people with SDDs, MOSST appears to have short- and long-term beneficial effects on social functioning and symptoms. Further studies are required to replicate the current results in other samples.

Del libro blanco del título de grado en psicología al negocio de la desesperación: análisis cuantitativo de los estudios de psicología en España durante la década 2005-2015 / From the white paper on the qualification of the degree in psychology to the business of desperation: a quantitative analysis of psychology studies in spain over the decade of 2005-2015

El proceso de convergencia con el Espacio Europeo de Educación Superior motivó la publicación del Libro Blanco del Título de Grado en Psicología (ANECA, 2005) donde se desglosa un análisis de la situación de los estudios de Psicología en España y se enumera una serie de recomendaciones para adecuar la titulación a los requisitos europeos. El presente trabajo pretende, diez años después, analizar el grado de implementación de las medidas y propuestas incluidas en el Libro Blanco, así como presentar modelos pronósticos en base a las tendencias observadas mediante análisis de series temporales. Los resultados muestran un incremento progresivo y constante de la oferta formativa, del número de nuevos centros donde se imparte el Grado de Psicología así como de otros indicadores estrechamente relacionados con dicho crecimiento. Por último, se discuten los posibles motivos y se reflexiona sobre el impacto en la precariedad laboral, las elevadas tasas de desempleo y las consecuencias nocivas para un modelo sostenible de la profesión

The process of convergence with the European Higher Education Area led to the publication of the White Paper on the qualification of the Degree in Psychology (ANECA, 2005) in which an extensive analysis was carried out of the situation of university studies in psychology in Spain and guidelines were produced to adapt the degree to the European requirements. Ten years later, the present paper aims to analyze the implementation rate of the guidelines included in the White Paper, as well as to develop prognostic models based on the trends observed using time series analyses. The results show a constant and progressive increase in the educational training offered, the number of new faculties, and other closely associated indicators related to this growth. Different explanations and reasons for these results are discussed. We also reflect on the detrimental impact on job security amongst psychologists, the high unemployment rates, and the negative consequences for a sustainable model of professional development

Entrenamiento en habilidades sociales orientado a la metacognición (MOSST): marco teórico, metodología de trabajo y descripción del tratamiento para pacientes con esquizofrenia / Metacognition-Oriented Social Skills Training (MOSST): theoretical framework, working methodology and treatment description for patients with schizophrenia

Los déficits en el funcionamiento social son un síntoma característico de la esquizofrenia y han sido ampliamente descritos en la literatura. Como resultado, el entrenamiento en habilidades sociales (EHS) se considera una parte esencial del tratamiento integral para la esquizofrenia y su inclusión se recomienda en diversas guías clínicas internacionales del trastorno. Sin embargo, diferentes estudios han revelado que los programas actuales de EHS tienen un efecto limitado en cuanto a sus beneficios potenciales sobre el funcionamiento psicosocial cotidiano de los pacientes. El presente trabajo tiene por objetivo presentar un nuevo marco de intervención que integra el entrenamiento metacognitivo y el EHS para pacientes con esquizofrenia: el entrenamiento en habilidades sociales orientado a la metacognición (MOSST). La justificación teórica de MOSST se sustenta en los recientes hallazgos que sugieren el papel central de los déficits metacognitivos en el funcionamiento psicosocial de estos pacientes. Por este motivo, MOSST pretende no solo entrenar las habilidades interpersonales sino también mejorar la comprensión de los estados mentales propios y ajenos, así como la relación entre estos y el comportamiento social efectivo. Para facilitar la descripción de MOSST, su implementación se ilustra a través de un paciente con esquizofrenia que finalizó con éxito el programa completo. Por último, se discuten las implicaciones clínicas de los resultados disponibles hasta la fecha con MOSST, sus limitaciones y las direcciones futuras de investigación

Metacognition-oriented Social Skills Training (MOSST): Theoretical Framework, Working Methodology and Treatment Description for Patients with Schizophrenia. The presence of social deficits in schizophrenia has been widely described in literature as well as the negative impact of these deficits on psychosocial functioning. As a result, social skills training (SST) has emerged as a well-validated intervention that is recommended in several treatment guidelines for schizophrenia. However, different studies have found that the effects and generalizability of current SST programmes are limited regarding the potential benefits on daily psychosocial functioning of these patients. This paper aims to describe a newly developed intervention model that integrates metacognitive remediation into SST for patients affected by schizophrenia: metacognition-oriented social skills training (MOSST). Theoretical model of MOSST is based on recent findings suggesting the central role of metacognitive deficits to successful psychosocial functioning in schizophrenia. Thereby, MOSST focuses not only on train interpersonal skills but also on improving the understanding of one's own mental states and those of the others as well as the connection between mental states and effective social behaviour. In order to facilitate the treatment description, a case report of an adult diagnosed by schizophrenia who successfully completed the programme is presented. Finally, clinical implications and limitations of available evidence on MOSST are discussed, and future research directions with this programme are pointed out

En busca de nuestra mejor versión: pericia y excelencia en Psicología Clínica / Searching for our best version: Expertise and excellence in Clinical Psychology

La pericia y la excelencia en Psicología Clínica están siendo objeto de renovado interés en el panorama internacional. Cómo hacen su trabajo los psicólogos clínicos, respecto a qué tratamientos psicológicos aplican, explica gran parte de la variabilidad de los resultados al finalizar el tratamiento. La evidencia relativa a los efectos de la pericia es contradictoria; en gran parte, debido a la ausencia de una definición operativa de consenso. La presente revisión narrativa opinática analiza el estado de la cuestión, presenta una propuesta de definición y busca estimular el debate para que académicos y clínicos contemplen la pericia como una variable clave de la efectividad de los tratamientos. Finalmente, se reflexiona sobre el modelo formativo en Psicología Clínica de nuestro entorno y la forma de sistematizar el entrenamiento y la supervisión promoviendo la excelencia en el desempeño clínico a lo largo de todo el ciclo profesional

Expertise and excellence in Clinical Psychology are receiving renewed interest in the international scene. How clinical psychologists do their work, depending on which psychological treatments they apply, explains a large amount of the variability in treatment outcomes. Evidence concerning the expertise effects is largely contradictory owing to the absence of an operational consensus definition. The present opinative narrative review attempts to analyze the literature on the topic, proposes a definition and pursues to stimulate the debate among academics and clinicians to consider the expertise as a key variable in treatment effectiveness. The Spanish training model in Clinical Psychology is discussed, aiming to systematize the training and supervision in order to promote excellence in clinical performance throughout the professional cycle

A pilot study on feasibility, acceptance and effectiveness of metacognitive-oriented social skills training in schizophrenia.

BACKGROUND: In preparation for a randomized controlled trial, a pilot study was conducted to investigate the feasibility, acceptability and effectiveness of a psychotherapy group based on metacognitive-oriented social skills training (MOSST). METHODS: Twelve outpatients with schizophrenia were offered 16 group-sessions of MOSST. Effect sizes were calculated for changes from baseline to treatment end for both psychosocial functioning and metacognitive abilities measured by the Personal and Social Performance Scale (PSP) and the Metacognition Assessment Scale-Abbreviated (MAS-A) respectively. RESULTS AND DISCUSSION: Ten patients finished the full treatment protocol and nonsignificant moderate effect sizes were obtained on PSP and MAS-A scores. To date, this is the first study in Spain to suggest that outpatients with schizophrenia will accept metacognitive therapy for social skills training and evidence improvements in psychosocial functioning and metacognition. CONCLUSION: Despite limitations inherent in a pilot study, including a small sample size and the absence of a control group, sufficient evidence of effectiveness was found to warrant further investigation. TRIAL REGISTRATION: ISRCTN10917911 . Retrospectively registered 30 November 2016.

Nuevas controversias en psicología sanitaria: un análisis libre de ruido / New controversies in Health Psychology: A noise free analysis

Durante los últimos años hemos asistido a la regulación del ejercicio sanitario de la Psicología. Nuevas figuras profesionales, como el Psicólogo General Sanitario, precipitan la confusión en competencias respecto a otras profesiones ya existentes en el ámbito, como el Psicólogo especialista en Psicología Clínica. Esta circunstancia ha motivado conflictos e incluso difusión de información distorsionada (o ruido) desde los sectores académico y colegial. El presente trabajo intenta realizar un análisis, libre de ruido, de las controversias actuales no resueltas que afectarán de forma inminente a la evolución de la Psicología Sanitaria. Entre ellas, los límites entre ambas profesiones, su articulación dentro del ámbito sanitario, la acreditación de nuevas especialidades sanitarias y la regulación del Grado en Psicología. Más allá del ruido generado desde intereses particulares, este trabajo pretende analizar las opciones, oportunidades y consecuencias de la toma de decisiones respecto a estas cuestiones aún inconclusas. Finalmente, se apuesta por el debate abierto y transparente entre todas las partes de la Psicología, como única solución a la encrucijada actual de la disciplina

Practice in health related issues in psychology has been increasingly regulated over the past few years in Spain. New professional profiles such as General Health Psychologist have caused confusion over skills and competences with other existing professionals such as Clinical Psychologists. This circumstance has sometimes caused conflicts among psychology professionals due to misinformation (noise) from academic and professional bodies (COP) over recent legal discussions. Our manuscript tries to carry out a noiseless analysis of the current unresolved controversies surrounding psychology in the health sector that would inevitably affect the development of psychology in this area in Spain. Issues such as the boundaries between both professions, their role and functions in the health sector, the accreditation of new health specialties and the regulation of the Psychology Degree arise. Leaving aside the noise generated by particular interests, this article tries to analyze the options, opportunities and consequences of decision making about these yet to be solved matters. Finally, we encourage all psychology sectors to engage in an open and transparent debate as the only way to achieve a real solution for the critical position of psychology in Spain

Expectations among patients and health professionals regarding Web-based interventions for depression in primary care: a qualitative study.

BACKGROUND: One-quarter of the world's population will suffer from depression symptoms at some point in their lives. Mental health services in developed countries are overburdened. Therefore, cost-effective interventions that provide mental health care solutions such as Web-based psychotherapy programs have been proposed. OBJECTIVE: The intent of the study was to identify expectations regarding Web-based psychotherapy for the treatment of depression in primary care among patients and health professionals that might facilitate or hinder its effects. METHODS: The expectations of untreated patients and health professionals were examined by means of interviews and focus groups. There were 43 participants (20 patients with mild and moderate levels of depression, 11 primary care physicians, and 12 managers; 22 of them for interviews and 21 for groups). A thematic content analysis from the grounded theory for interviews, and an analysis of the discursive positions of participants based on the sociological model for groups were performed. Interpretations were achieved by agreement between three independent analysts. RESULTS: All participants showed a good general acceptance of Web-based psychotherapy, appreciating possible advantages and improvements. Patients, physicians, and managers shared the same conceptualization of their expectations, although highlighting different aspects. Patients focused on the need for individualized and personalized interaction, while professionals highlighted the need for the standardization of the program. Physicians were concerned with extra workload, while managers were worried about optimizing cost-effectiveness. CONCLUSIONS: Expectations of the different participants can conflict with each other. Finding a balanced position among them is needed if we are to harmoniously implement effective Web-based interventions for depression in routine clinical practice.

Psicología Sanitaria: en busca de identidad / Psychology: in search of identity

Este trabajo continúa el debate iniciado en números anteriores (Carrobles, 2012, 2013; Sánchez Reales, Prado Abril y Aldaz Armendáriz, 2013) a raíz de la creación de la nueva profesión de Psicólogo General Sanitario. Reflexionamos sobre los itinerarios curriculares que capacitan profesionalmente en el ámbito de la Psicología Sanitaria, considerando la narrativa que ha acompañado este proceso y su repercusión en la configuración de las identidades profesionales de la Psicología Sanitaria. Enfatizamos la importancia de los aspectos históricos, contextuales y legislativos y profundizamos sobre el estatus actual de la Psicología Clínica en el Sistema Nacional de Salud, destacando las oportunidades actuales que permiten la construcción de un itinerario formativo y profesional coherente de Psicología Sanitaria

This paper follows the discussion started in previous issues (Carrobles, 2012, 013; Sánchez Reales, Prado Abril & Aldaz Armendáriz, 2013) following thecreation of the new General Health Psychologist profession. We reflect on curricular itineraries and professional training in the field of Health Psychology, considering the narrative that has accompanied this process and its impact in shaping professional identities of Health Psychology. We emphasize the importance of the historical, contextual and legislative aspects and we deepen on the current status of Clinical Psychology in the National Health System, highlighting current opportunities that allow the construction of a coherent professional training itinerary on Health Psychology

Coping with stress and types of burnout: explanatory power of different coping strategies.

BACKGROUND: Burnout occurs when professionals use ineffective coping strategies to try to protect themselves from work-related stress. The dimensions of 'overload', 'lack of development' and 'neglect', belonging to the 'frenetic', 'under-challenged' and 'worn-out' subtypes, respectively, comprise a brief typological definition of burnout. The aim of the present study was to estimate the explanatory power of the different coping strategies on the development of burnout subtypes. METHODS: This was a cross-sectional survey with a random sample of university employees, stratified by occupation (n = 429). Multivariate linear regression models were constructed between the 'Burnout Clinical Subtypes Questionnaire', with its three dimensions -overload, lack of development and neglect- as dependent variables, and the 'Coping Orientation for Problem Experiences', with its fifteen dimensions, as independent variables. Adjusted multiple determination coefficients and beta coefficients were calculated to evaluate and compare the explanatory capacity of the different coping strategies. RESULTS: The 'Coping Orientation for Problem Experiences' subscales together explained 15% of the 'overload' (p<0.001), 9% of the 'lack of development' (p<0.001), and 21% of the 'neglect' (p<0.001). 'Overload' was mainly explained by 'venting of emotions' (Beta = 0.34; p<0.001); 'lack of development' by 'cognitive avoidance' (Beta = 0.21; p<0.001); and 'neglect' by 'behavioural disengagement' (Beta = 0.40; p<0.001). Other interesting associations were observed. CONCLUSIONS: These findings further our understanding of the way in which the effectiveness of interventions for burnout may be improved, by influencing new treatments and preventive programmes using features of the strategies for handling stress in the workplace.