Efficacy of Early Intervention Programmes: Systematic Review and Meta-analysis / Eficacia de los programas de atención temprana: revisión sistemática y metaanálisis

Background: Early childhood intervention is a form of intervention aimed at children to overcome difficulties in different areas of their development after birth. There are multiple early intervention programmes, but only a few studies assess their efficacy using data. Objective: A systematic review and meta-analysis of early intervention programmes was carried out. Method: Inclusion criteria were considered to be empirical studies, with outcome data on children between 0 and 6 years of age with various developmental problems. The review was conducted in nine databases. Results: Of the total number of studies from 2000 to 2021 in English and Spanish, 40 studies were included that looked at the efficacy of the programmes. Of these, 19 used comparisons with a control group, and 13 used single-subject designs, as well as other designs. The programmes were very diverse, mostly based on behavioural procedures, and aimed at promoting the development of specific areas. The quality of the studies is medium-high. The meta-analysis included 18 studies with a mean effect size d = 0.45 (CI = 0.18, 0.67), with high sample heterogeneity and low study selection bias. Conclusions: Early childhood interventions have a medium and positive efficacy on the skills and abilities of children with developmental problems. The limitations of the reviewed studies are discussed, as well as the need for well-defined programmes, long-term measurements, and comparisons of different types of programmes among them. (AU)

Antecedentes: La atención temprana es una forma de intervención dirigida a niños y niñas para intentar superar las dificultades en distintas áreas de su desarrollo tras el nacimiento. Existen múltiples programas, pero pocos estudios comparando con datos su eficacia. Objetivo: Se ha realizado una revisión sistemática y un metaanálisis de los programas de atención temprana. Método: Como criterios de inclusión se consideró que fuesen estudios empíricos con resultados sobre niños con diversos problemas de desarrollo entre 0 y 6 años. La revisión se realizó con nueve bases de datos. Resultados: Del total de estudios desde 2000 a 2021 en español e inglés se incluyeron 40 estudios que permitían ver la eficacia de los programas. De ellos 19 utilizaron comparaciones frente a un grupo control y 13 con diseños de caso único, además de otros diseños. Los programas de atención temprana fueron muy diversos, en su mayoría basados en procedimientos conductuales y dirigidos a impulsar el desarrollo de áreas específicas. La calidad de los estudios es media-alta. En el metaanálisis se incluyeron 18 estudios con un tamaño del efecto medio, d = 0.45 (CI = 0.18, 0.67), con gran heterogeneidad de las muestras y poco sesgo en la selección de estudios. Conclusiones: Los programas de atención temprana presentan una eficacia media y positiva con respecto a las habilidades y capacidades de los niños y niñas con problemas de desarrollo. Se comentan las limitaciones de los estudios revisados y la necesidad utilizar programas bien definidos, mediciones a largo plazo y comparaciones de diversos tipos de programas entre sí. (AU)

Validación y propiedades psicométricas del “Cuestionario de valores de vida” (VLQ) para población española / Validation and psychometric properties of the "Life Values Questionnaire" (VLQ) for the Spanish population

El objetivo de este trabajo es presentar la adaptación española del “Cuestionario de valores de vida” (VLQ; Wilson et al., 2010), aportando datos sobre sus propiedades psicométricas. Se aplicó el cuestionario a 531 participantes de entre 18 y 70 años (M= 28,73), siendo el 70% mujeres universitarias. El análisis factorial exploratorio mostró tres factores principales: comunidad, cercanía y obligaciones, cuyos niveles de consistencia interna fueron de 0,70, 0,71 y 0,68, respectivamente, mientras que para la puntuación total fue de 0,71 que resultaron similares a los del original. En cuanto a la validez concurrente, el VLQ mostró correlaciones moderadas con el “Cuestionario de valores personales” (Schwartz, 1992) (r= 0,47) y con el “Cuestionario de instantánea vital” (Ruiz-García et al., 2021; Tsai et al., 2023) (r= 0,65). Se discute la utilidad del VLQ para evaluar y hacer seguimiento a los procesos clave involucrados en los cambios clínicos, así como para mejorar y evaluar los valores personales íntimamente relacionados con la calidad de vida, el sentido de la vida y el bienestar de la comunidad. (AU)

Enhancing students' well-being with a unified approach based on contextual behavioural science: A randomised experimental school-based intervention.

A new generation of interventions has begun to move towards principles of acceptance that deal with the context and function of psychological events. The aim of this paper is to analyse the effectiveness of a brief contextual behavioural intervention to improve the psychological well-being of secondary school students. This intervention represents a unified model with key processes based on contextual behavioural science, including Acceptance and Commitment Therapy (ACT) and Functional Analytic Psychotherapy (FAP). We conducted an intervention with 94 students (age range 17-19 years), randomly assigned to an experimental group (n = 50) or control group (n = 44). Participants took a pretest and post-test of distress, life satisfaction, psychological flexibility and mindfulness. The intervention consisted of three sessions of 1 h each. The results showed significant differences between the groups in distress and significant differences for the interaction (group × pre-post) in all the other variables. The intervention had greater benefits for girls than for boys. These results may provide a breakthrough, thus leading to a process of evidence-based therapies, which would be responsible for inducing psychological improvements in brief periods, in a population with an increasing risk of distress.

Programa de intervención breve basado en las terapias contextuales para mejorar el bienestar psicológico en el entorno organizacional / Brief intervention programme based on contextual therapies to improve psychological well-being at the workplace

Introducción y objetivos: Este estudio examina la eficiencia y efectividad de un programa breve, basado en las dos terapias contextuales más representativa, para mejorar la salud general, y el bienestar laboral de los empleados/as de una cooperativa agrícola. La evaluación pretest se realizó con 25 empleados de la misma empresa, de los cuales 15 cumplieron con los criterios de inclusión; estableciendo como punto de corte puntuaciones moderadas de malestar psicológico. Los empleados recibieron una intervención basada en un programa breve con la combinación de la Terapia de Aceptación y Compromiso junto con la Psicoterapia Analítica-Funcional (FACT). Material y Métodos: Los participantes recibieron 3 sesiones, 2 individuales y 1 grupal. Se evaluaron con el Cuestionario de Salud General (GHQ-12); la Escala de Observación de Recompensa Ambiental (EROS); y la satisfacción laboral, que se evaluó con la subescala de bienestar laboral de la Escala de Bienestar Psicológico (EBP). Se utilizó un diseño intra-grupos con evaluación pre y post intervención. Resultados: Los participantes mejoraron en las variables analizadas, siendo estadísticamente significativos para las variables: GHQ-12 (W = -3.34, gl = 14, p = .001), EROS (W = -3.05, gl = 14, p = .002) y EBP (W = -3.08, gl = 14, p = .002). Conclusiones: Se discuten las implicaciones de la combinación de ambas aproximaciones que comparten las raíces filosóficas y analíticas basadas en el contextualismo funcional. Esta intervención se plantea como un modelo efectivo para producir cambios en la salud de los trabajadores/as en breves periodos de tiempo, de forma rápida y no invasiva para empleados y empresas.(AU)

Introduction and aims: This study examines the efficiency and effectiveness of a brief program based on the two most representative contextual therapies in order to improve the general health and well-being at the workplace with employees of an agricultural cooperative. The pre-test evaluation was carried out with 25 employees from the same company, of whom 15 met the inclusion criteria with moderate scores for psychological distress as the cut-off point. The employees received an intervention based on a brief program combining of Acceptance and Commitment Therapy and also Analytical-Functional Psychotherapy. Material and Methods: The employees received 3 sessions, 2 individual and 1 group session. They were assessed with the General Health Questionnaire (GHQ-12); the Environmental Reward Observation Scale (EROS); and job satisfaction, which was evaluated with the job well-being subscale of the Psychological Well-being Scale (EBP). An intra-group design with pre and post intervention assessment was used. Results: Participants improved statistically in the variables analyzed: GHQ-12 (W = -3.34, gl = 14, p = .001), EROS (W = -3.05, gl = 14, p = .002) and EBP (W = -3.08, gl = 14, p = .002). Conclusions: The implications of the combination of both approaches that share philosophical and analytical roots based on functional contextualism are discussed. This treatment is proposed as an effective model to produce changes in workers' health in short periods of time, in a fast and non-invasive way for employees and companies.(AU)

Importance of the therapeutic relationship: efficacy of functional analytic psychotherapy with different problems / La importancia de la relación terapéutica: la eficacia de la psicoterapia analítica funcional en distintos problemas

Functional Analytical Psychotherapy (FAP) is a third generation and contextual therapy. It is based on therapeutic interaction, verbal and emotional client-therapist relationships. It also uses functional analysis of behaviour, and live on-going modification of clinical problem behaviours. The aim of this research was to study the efficacy of FAP with different types of psychological problems (anxiety, depression, obsession, sexual, personality, emotional control). An intra-group design (10 participants, 36 years old average) was used with pre-post and follow-up measurements. Different questionnaires have been used as common assessment tools for all clinical cases. The results showed a statistically significant change in all the standardised questionnaires, with a considerable size effect (d from -2.01 to -3.80) and maintained one year later. Also, as clinical change, the participants had improved in their daily lives. We conclude on the efficacy of FAP, focusing on the therapeutic relationship, regardless of diagnostic categories. (AU)

La Psicoterapia Analítica Funcional (FAP) es una terapia contextual y de tercera generación que se basa en la interacción terapéutica y las relaciones verbales y emocionales cliente-terapeuta. También utiliza el análisis funcional del comportamiento y la modificación en vivo de los comportamientos clínicos problemáticos. El objetivo de esta investigación es estudiar la eficacia de la FAP ante diferentes tipos de problemas psicológicos (ansiedad, depresión, obsesión, sexual, personalidad, control emocional). Se utilizó un diseño intragrupo (10 participantes, con un promedio de edad de 36 años) con mediciones previas, posteriores y de seguimiento. Se han utilizado diferentes cuestionarios como herramientas de evaluación comunes para todos los casos clínicos. Los resultados mostraron un cambio estadísticamente significativo en todos los cuestionarios estandarizados, con un efecto de tamaño considerable (d de -2.01 a -3.80) que se mantenía un año más tarde. Además, como cambio clínico, los participantes habían mejorado en su vida diaria. Concluimos sobre la eficacia de la FAP, centrándonos en la relación terapéutica, independientemente de las categorías diagnósticas. (AU)

Meta-analysis of the Efficacy and Effectiveness of Parent Child Interaction Therapy (PCIT) for Child Behaviour Problems.

BACKGROUND: Parent-Child Interaction Therapy (PCIT) is a well-established treatment for behavioural, hyperactivity and oppositional-defiant problems in children. Previous meta-analyses are scarce, and they have tended to mix problems and measures. OBJECTIVE: A meta-analysis study was conducted with all available studies on PCIT (1980 to 2020) to determine its specific efficacy and effectiveness for child behavioural problems. METHOD: Selection from databases collected a total of 100 studies. The inclusion criteria were to compare PCIT in children with behavioural problems between 2 and 12 years of age; comparing groups and using standardized instruments. RESULTS: PCIT exhibited a significant mean effect size ( d = -0.87 [95% CI: -1.10, -0.63] versus control and/or treatment-as-usual groups, but the effect size was smaller and not significant in follow-ups ( d = -0.23 [95% CI: -0.49, 0.04]). The within-group studies, comparing versions of PCIT, also demonstrated a significant effect size ( d = -0.26 (95% CI: -0.43, -0.08), and in pre-post comparisons this effect was greater ( d = -1.40 [95% CI: -1.69, -1.10]). CONCLUSIONS: PCIT is an effective intervention for treating child behaviour problems such as disruptive, hyperactive, negative, and externalizing problems. It is supported by 40 years of experimental and clinical studies, and also by this meta-analysis.

Cognitive defusion as a verbal exercise: an experimental approach / Defusión Cognitiva como Ejercicio Verbal: un Enfoque Experimental

BACKGROUND: As one of the founding principles of Acceptance and Commitment Therapy (ACT), cognitive defusion is a contextual control of language, but it is not clear which behavioural process would allow such defusion. Two experiments are presented which analyse that process using a word repetition exercise. METHOD: Experiment 1 was performed with 30 randomised participants, using a factorial between-groups (4×2) with repeated measures design: Group 1 = milk-milk-milk exercise; 2 = emotional word repetition; 3 = milk-to-emotional word shaping; and 4 = control without intervention. Questionnaires were applied on thoughts, emotional regulation, and experiential avoidance, in addition to the evaluation of 20 images suggesting emotions. In Experiment 2, 78 participants were randomised using the same 4×2 design, and also 60 images with a proven emotional reactivity were used. RESULTS: Experiment 1 did not show changes in any of the variables, nor a decrease in emotional assessment, which should occur according to the theory behind ACT. In Experiment 2, no significant changes between the groups and no pre-post changes appeared, except in latency time. CONCLUSIONS: The lack of replication of the defusion process is discussed, along with the mixed results of other studies

ANTECEDENTES: desde la Terapia de Aceptación y Compromiso (ACT), la defusión cognitiva es un proceso de control contextual del lenguaje, aunque no está claro cuál sería el proceso conductual de esa defusión. Se presentan dos experimentos analizando ese proceso mediante un ejercicio de repetición de palabras. MÉTODO: el primer experimento se realizó con 30 participantes aleatorizados, con un diseño factorial entre-grupos con medidas repetidas (4×2): Grupo 1 = ejercicio leche-leche; 2 = repetición de palabra emocional; 3 = moldeamiento leche-palabra emocional; y 4 = control. Se han utilizado cuestionarios sobre pensamientos, regulación emocional y evitación experiencial, junto con la valoración de 20 imágenes que sugerían emociones. En el segundo experimento se aleatorizaron 78 participantes con el mismo diseño 4×2, y se utilizaron 60 imágenes con una reactividad emocional ya comprobada. RESULTADOS: en el primer experimento no hubo cambios en ninguna de las variables, ni la disminución de la valoración emocional que debería producirse según la teoría de ACT. Tampoco en el segundo experimento aparecieron cambios significativos entre los grupos, ni pre-post, excepto en el tiempo de latencia. CONCLUSIONES: se discute la falta de replicación del proceso de defusión que defiende ACT, siguiendo también los resultados dispares de otros estudios

Cognitive Defusion as a Verbal Exercise: An Experimental Approach.

BACKGROUND: As one of the founding principles of Acceptance and Commitment Therapy (ACT), cognitive defusion is a contextual control of language, but it is not clear which behavioural process would allow such defusion. Two experiments are presented which analyse that process using a word repetition exercise. METHOD: Experiment 1 was performed with 30 randomised participants, using a factorial between-groups (4x2) with repeated measures design: Group 1 = milk-milk-milk exercise; 2 = emotional word repetition; 3 = milk-to-emotional word shaping; and 4 = control without intervention. Questionnaires were applied on thoughts, emotional regulation, and experiential avoidance, in addition to the evaluation of 20 images suggesting emotions. In Experiment 2, 78 participants were randomised using the same 4x2 design, and also 60 images with a proven emotional reactivity were used. RESULTS: Experiment 1 did not show changes in any of the variables, nor a decrease in emotional assessment, which should occur according to the theory behind ACT. In Experiment 2, no significant changes between the groups and no pre-post changes appeared, except in latency time. CONCLUSIONS: The lack of replication of the defusion process is discussed, along with the mixed results of other studies.

Spanish Validation of the "Life Snapshot Inventory".

INTRODUCTION: The Life Snapshot Inventory (LSI) is a self-report instrument to measure the meaningful vital, personal, and social directions. It was created in the Functional Analytic Psychotherapy as a continuous evaluation of vital changes in areas of life (family, work, love, spirituality, sexuality, health, etc.). OBJECTIVE: The aim was to validate its psychometric characteristics for the first time. METHOD: This study involved 530 participants (average age 33 years), in a Spanish sample. The questionnaire has been compared with the Rosenberg Self-Esteem Scale (RSES) to obtain convergent validity. RESULTS: The results showed a high internal consistency (α = .93) and a correlation of .61, both statistically significant. The factorial analysis showed only one factor (43.56% of variance). In addition, it was sensitive to changes due to interventions, and made it possible to differentiate those people with vital problems. CONCLUSION: This questionnaire could be a helpful measure for healthcare and clinical contexts.

INTRODUCCIÓN: El Inventario de Instantánea Vital (Life Snapshot Inventory; LSI) es un instrumento de autoinforme para medir las direcciones sociales, personales y vitales significativas para el individuo. Se ha creado desde la Psicoterapia Analítica Funcional (FAP) como una evaluación continua de los cambios en diversas áreas de la vida de un individuo (familia, trabajo, amor, espiritualidad, sexualidad, salud, etc.). Objetivo: Validar por primera vez las características psicométricas de este instrumento. METODOLOGÍA: Este estudio implicó una muestra española donde participaron 530 personas (edad media 33 años). El cuestionario se ha comparado con la Escala de Autoestima de Rosenberg (RSES) para obtener validez convergente. RESULTADOS: Los resultados mostraron una alta fiabilidad como consistencia interna (α = .93) y una correlación de .61, ambas estadísticamente significativas. El análisis factorial mostró un único factor (43.56% de la varianza). Además, el instrumento fue sensible a los cambios originados por la intervención, y permitió diferenciar aquellas personas con problemas vitales. CONCLUSIÓN: Este cuestionario podría ser una medida de gran ayuda para utilizar en contextos clínicos y sanitarios.

Meta-analysis of the Efficacy and Effectiveness of Parent Child Interaction Therapy (PCIT) for Child Behaviour Problems / Meta-análisis Sobre la Eficacia y Efectividad de la Terapia de Interacción Padres-Hijos (PCIT) Para Problemas de Conducta Infantil

Background: Parent-Child Interaction Therapy (PCIT) is a well-established treatment for behavioural, hyperactivity and oppositional-defiant problems in children. Previous meta-analyses are scarce, and they have tended to mix problems and measures. Objective: A meta-analysis study was conducted with all available studies on PCIT (1980 to 2020) to determine its specific efficacy and effectiveness for child behavioural problems. Method: Selection from databases collected a total of 100 studies. The inclusion criteria were to compare PCIT in children with behavioural problems between 2 and 12 years of age; comparing groups and using standardized instruments. Results: PCIT exhibited a significant mean effect size (d = -0.87 [95% CI: -1.10, -0.63] versus control and/or treatment-as-usual groups, but the effect size was smaller and not significant in follow-ups (d = -0.23 [95% CI: -0.49, 0.04]). The within-group studies, comparing versions of PCIT, also demonstrated a significant effect size (d = -0.26 (95% CI: -0.43, -0.08), and in pre-post comparisons this effect was greater (d = -1.40 [95% CI: -1.69, -1.10]). Conclusions: PCIT is an effective intervention for treating child behaviour problems such as disruptive, hyperactive, negative, and externalizing problems. It is supported by 40 years of experimental and clinical studies, and also by this meta-analysis. (AU)

Antecedentes: la Terapia de Interacción Padres-Hijos (PCIT) es un tratamiento bien establecido para los problemas de conducta infantil. Los meta-análisis previos son escasos y mezclan problemas y medidas. Objetivo: realizar un meta-análisis con todos los estudios disponibles sobre PCIT (1980 a 2020) para conocer su eficacia y efectividad sobre los problemas de conducta infantil. Método: la selección final recogió 100 estudios. Los criterios de inclusión fueron: comparar la PCIT en niños con diversos problemas de conducta; comparar grupos y utilizar instrumentos estandarizados. Resultados: PCIT ha mostrado un tamaño del efecto medio significativo (d = -0,87 [IC 95%: -1,10, -0,63] frente a grupos de control y/o tratamientos usuales; pero ha sido menor y no significativo en los seguimientos (d = -0,23 [IC 95%: -0,49, 0,04]). Los estudios que comparan versiones de PCIT también han mostrado un tamaño del efecto significativo (d = -0,26 [IC del 95%: -0,43, -0,08]), al igual que los intra-grupo con un efecto mayor (d = -1,40 [IC del 95%: -1,69, -1,10]). Conclusiones: la PCIT es una intervención eficaz para el tratamiento de los problemas de conducta infantil, disruptivas, hiperactivas, negativistas y externalizantes. Está avalada por 40 años de estudios experimentales y clínicos, y también en este meta-análisis. (AU)

Aplicaciones de FACT en el contexto académico para mejorar la salud en estudiantes de bachillerato / Applications of FACT in the academic context to improve health in high school students

Las terapias contextuales o de tercera generación cada vez acumulan más evidencia sobre su eficacia en diferentes contextos y condiciones clínicas. Este estudio compara en estudiantes de primero y segundo de bachillerato (n= 112), la eficacia de un programa basado en la terapia de aceptación y compromiso (ACT) frente a un programa combinado añadiendo estrategias de la psicoterapia analítica funcional (FAP) y resultando en una aproximación denominada terapia funcional de aceptación y compromiso (FACT). El propósito de esta intervención consistió en extraer los procesos más relevantes para el cambio, con el objetivo de diseñar programas de formación basados en la ciencia conductual contextual para mejorar la salud de los estudiantes. Los resultados indicaron que ambas intervenciones produjeron cambios estadísticamente significativos mejorando la salud de los estudiantes. El programa combinado con FACT fue superior en la variable autoconcepto. Se discuten las implicaciones y diferencias de ambos programas breves para mejorar la salud de los estudiantes en breves periodos de tiempo, desde una metodología conductual adaptada al contexto académico (AU)

There is growing evidence showing the efficacy of contextual or third generation therapies in various contexts and clinical conditions. In large groups of first- and second-year high school students (n= 112), the present study compares the efficacy of applying a program based on Acceptance and Commitment Therapy (ACT) versus a combined program using strategies from Functional-Analytical Psychotherapy (FAP), resulting in a so-called FACT approach. The purpose of this intervention was to extract the most relevant processes underpinning clinical changes to design training programs based on contextual behavioral science to improve students' health. The results indicated that both interventions produced statistically significant improvement in the health of the students. The program combined with FACT was superior in the self-concept variable. The implications of both brief programs to improve students' health in short periods are discussed on the basis of a behavioral methodology adapted to the academic context (AU)

Aplicación de la terapia de interacción padres-hijos (PCIT) en dos niñas con problemas de conducta / Application of parent-child interaction therapy (PCIT) to two girls with behavioral problems

La terapia de interacción padres-hijos (PCIT) es una forma de terapia conductual para intervenir sobre diversos problemas que aparecen en la población infantil. Trabaja directamente con los padres y la interacción en casa con sus hijos. Este artículo describe la aplicación de la PCIT en una niña de 7 años con trastorno negativista desafiante (TND) y su hermana de 3 años con problemas de comportamiento. Se ha utilizado un diseño de caso único A-B con líneas base concurrentes. Se han evaluado las conductas problemáticas y positivas de ambas niñas a través de autorregistros, observaciones del juego y observaciones naturales en casa grabadas en vídeo. También se han registrado las conductas de interacción positivas y negativas de los padres en vídeo. El tratamiento duró tres meses (12 sesiones). Se observó una evolución progresiva en las líneas base y en las medidas pre y postratamiento de las conductas problema de ambas niñas. Además, se produjo la reducción del estrés y el aumento de la satisfacción y autoeficacia de los padres con relación a sus propias habilidades

Parent-child interaction therapy (PCIT) is a form of behavioral therapy to deal with various behavioral problems in children. It works directly with parents and their home interactions with their children. In this paper the application of PCIT to a seven-year-old girl with oppositional defiant disorder (ODD) and her three year old sister with behavioral problems is described. A single-case A-B design with concurrent baseline was used. The positive behaviors and problems were assessed for both young girls using self-monitoring and parent video recordings during playtime and home interactions. The treatment was developed in 12 sessions during three months. A progressive evolution was observed in both girls' baseline and in pre- and post-treatment measures of the problem behaviors. Finally there was a reduction of stress and an increase in the self-efficacy of the parents' abilities

Eficacia de un programa de intervención grupal con mujeres víctimas de violencia de género en el marco de las terapias contextuales / Efficacy of a group intervention program with women victims of gender violence in the framework of contextual therapies

El objetivo de este trabajo es evaluar empíricamente la eficacia de un programa de intervención con mujeres víctimas de violencia de género. El programa en conjunto se enmarca dentro de las Terapias Contextuales, específicamente se ha utilizado la Psicoterapia Analítica Funcional, combinada con la Terapia de Aceptación y Compromiso y la Activación Conductual. Se ha llevado a cabo en formato grupal, durante 11 sesiones de 2 horas cada una. Participaron un total de 21 mujeres (de una media de edad de 45 años), que habían sufrido violencia física y/o abuso emocional por parte de sus parejas, en diferente grado e intensidad, y en diferentes momentos en sus vidas. Se ha utilizado un diseño intragrupo con medidas pre-post. Se realizaron tres grupos de tratamiento en diferentes ciudades con 6 a 8 mujeres cada uno. Para medir la intervención se ha aplicado el cuestionario Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM). Los resultados han mostrado una disminución estadísticamente significativa en la severidad del malestar, han disminuido los indicadores de riesgo de suicidio, y han mejorado las conductas problemáticas dentro y fuera de las sesiones, además de incrementarse la apertura hacia los demás. Se discute la utilidad de las terapias contextual es para mejorar la calidad de vida de mujeres maltratadas, y su utilidad de aplicación en grupos en las instituciones públicas

The goal of this study is to empirically evaluate the efficacy of an intervention program with women victims of gender violence. Specifically, Functional Analytical Psychotherapy has been used, combined with Acceptance and Commitment Therapy, and Behavioral Activation. It has been carried out in group format, during 11 sessions of 2 hours each. A total of 21 women participated (an average of 45 years-old), who had suffered physical violence and/or emotional abuse by their partners, with different degrees and intensity, and at different moments of their lives. An intra-group design with pre-post measures was used. Three treatment groups were carried out in different cities with 6 to 8 women each one. To measure the intervention, the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) questionnaire was applied. The results has shown a statistically significant decrease in the severity of discomfort, decreased suicide risk indicators, improved problem behavior inside and outside sessions, and increased openness to others. The usefulness of contextual therapies to improve the quality of life of battered women and their usefulness for application in groups in public institutions are discussed

Multimedia intervention for specific phobias: a clinical and experimental study / Intervención multimedia para fobias específicas: un estudio clínico y experimental

BACKGROUND: Exposure is the treatment of choice for specific phobias. We present an experimental and clinical study on the efficacy of the progressive multimedia exposure procedure for specific phobias. METHOD: The sample size consisted of 36 individuals, 7 men and 29 women (mean age: 29 years old), with different types of specific phobias. A combined between-groups (3x4) with repeated measures design was used, including several follow-ups up to 3 years. Participants were assigned to different groups: Experimental (10), Waiting List (12), and Control (14). As an evaluation method, a Behavioural Avoidance Test (BAT) with subjective anxiety and heart rate was used for images and videos, plus general and specific anxiety questionnaires for each phobia. The intervention was carried out in four phases of multimedia exposure: photographs, videos, simulated stimuli, and real stimulation. RESULTS: Anxiety and avoidance were significantly reduced in the experimental group, with a very large effect size (between d = 1.37 and 5.37). There were no significant changes in either the Control Group or the Waiting List Group. CONCLUSIONS: The treatment had a clinically significant impact on the daily life of the participants. This multimedia procedure was shown to be effective and to use few resources, thus allowing it to always be adapted to the individual characteristics of the participants

ANTECEDENTES: la exposición es el tratamiento de elección para las fobias específicas. Se presenta un estudio experimental y clínico sobre la eficacia del procedimiento de exposición progresiva multimedia en fobias específicas. MÉTODO: participaron 36 personas, 7 hombres y 29 mujeres (media 29 años), con distintos tipos de fobias específicas. Se utilizó un diseño entre-grupos con medidas repetidas (3×4), incluyendo varios seguimientos hasta 3 años. Los participantes se asignaron a diferentes grupos: Experimental (10), Lista de Espera (12) y Control (14). Como evaluación se utilizó un Test de Evitación Conductual (BAT) con ansiedad subjetiva y tasa cardíaca ante imágenes y vídeos, cuestionarios generales de ansiedad y específicos de cada fobia. La intervención se realizó en cuatro fases de exposición multimedia: fotografías, vídeos, estímulos simulados y estimulación real. RESULTADOS: la ansiedad y la evitación se redujeron de forma significativa en el grupo experimental, con un tamaño del efecto muy elevado (entre d = 1.37 y 5.37). No hubo cambios significativos en el Grupo Control, ni en el Grupo Lista de Espera. CONCLUSIÓN: el tratamiento tuvo una repercusión clínicamente significativa en la vida diaria de los participantes. Este procedimiento multimedia ha mostrado su eficacia, con pocos recursos, permitiendo adaptarse siempre a las características individuales de los participantes

Multimedia intervention for specific phobias: A clinical and experimental study.

BACKGROUND: Exposure is the treatment of choice for specific phobias. We present an experimental and clinical study on the efficacy of the progressive multimedia exposure procedure for specific phobias. METHOD: The sample size consisted of 36 individuals, 7 men and 29 women (mean age: 29 years old), with different types of specific phobias. A combined between-groups (3x4) with repeated measures design was used, including several follow-ups up to 3 years. Participants were assigned to different groups: Experimental (10), Waiting List (12), and Control (14). As an evaluation method, a Behavioural Avoidance Test (BAT) with subjective anxiety and heart rate was used for images and videos, plus general and specific anxiety questionnaires for each phobia. The intervention was carried out in four phases of multimedia exposure: photographs, videos, simulated stimuli, and real stimulation. RESULTS: Anxiety and avoidance were significantly reduced in the experimental group, with a very large effect size (between d = 1.37 and 5.37). There were no significant changes in either the Control Group or the Waiting List Group. CONCLUSIONS: The treatment had a clinically significant impact on the daily life of the participants. This multimedia procedure was shown to be effective and to use few resources, thus allowing it to always be adapted to the individual characteristics of the participants.

Detección de problemas alimentarios y su relación con hábitos alimentarios en adolescentes / Detection of eating problems and their relationship with eating habits in adolescents

Resumen El propósito de este trabajo fue hacer la detección de probables casos de trastornos de la conducta alimentaria (TCA) en adolescentes, así como analizar su relación con los hábitos alimentarios (HA) dentro del contexto escolar. Participaron 3,144 alumnos/as (49.7% chicas y 50.3% chicos), con edades entre 13 y 17 años (M = 14.41, DE = 0.79). Fueron registradas distintas variables: sociodemográficas, índice de masa corporal (IMC) e ingesta alimentaria, además de aplicar el Cuestionario de Actitudes Alimentarias (EAT-40) y el Cuestionario de Imagen Corporal (BSQ). Se identificaron diferencias significativas en EAT-40 y BSQ, con una mayor proporción de chicas vs. chicos que superaron el punto de corte. Respecto al IMC, aunque la mayoría estaba en normopeso, el 17.6% tuvo infrapeso, 20.4% sobrepeso y 7.1% obesidad. El 5.6% de todos los participantes fueron identificados como probables casos de TCA, con una mayor proporción de mujeres (9.6%) que de hombres (1.8%). No hubo correlación con los HA, pero sí mayor proporción de chicas que consumían menos alimentos y bebidas durante el desayuno y el recreo. Un dato alarmante es que 5.6% de las chicas y 2.5% de los chicos no consumían nada durante toda la mañana escolar.

Abstract A study of detection of probable cases of eating disorders (ED) in teenagers, studying their possible relationship with their dietary habits (DH) in the school context has been carried out. The participants were 3,144 students (49.7 % girls and 50.3 % boys) aged between 13 and 17 years old (M = 14.41, SD = 0.79). Different variables were recorded: sociodemographic, body mass index (BMI) and dietary intake, in addition to applying the Eating Attitudes Questionnaire (EAT-40) and the Body Shape Questionnaire (BSQ). Significant differences were identified in EAT-40 and BSQ, with a greater proportion of girls vs. boys exceeding the cut-off point. Regarding the BMI, although most were in normal weight, the 17.6% were underweight, 20.4% overweight and 7.1% obese. Based on all the data, 5.6% of all participants were identified as probable cases of ED, with a higher proportion of women (9.6%) that men (1.8%). There was no correlation with DH, but there were a higher proportion of girls who consumed less food and beverages during breakfast and recess. An alarming fact is that 5.6% of girls and 2.5% of boys did not consume anything during the whole school time.

Intervención mediante exposición multimedia en un caso de fobia infantil a las avispas / Intervention through multimedia exposure in a case of child wasp phobia

Se presenta el caso clínico de un adolescente de 13 años, estudiante de secundaria, con una fobia específica de tipo animal, a las avispas (DSM-5). Se realizó un diseño de caso único A-B con seguimiento y se realizó un tratamiento de exposición progresiva. La evaluación incluyó los cuestionarios FSSC-R, STAI-E/R, FSQ-avispas y EI y un test de evitación conductual multimedia en el que se tomaron medidas de ansiedad subjetiva y de tasa cardíaca ante los diversos estímulos presentados. La intervención duró seis sesiones con cuatro fases de exposición multimedia: fotografías, vídeos, avispas simuladas y avispas reales. Se observó un descenso en las puntuaciones de los cuestionarios específicos de ansiedad y de las valoraciones subjetivas de ansiedad a lo largo de las sesiones. No hubo cambios en la tasa cardíaca. El seguimiento a los 9 y a los 16 meses mostró que se mantenían los resultados obtenidos con la terapia. El tratamiento resultó con éxito y al terminar el adolescente podía estar sin paralizarse y sin sentir ansiedad frente a las avispas reales

The clinical case of a 13-year-old high school student with wasp phobia is presented; its characteristics would correspond to a diagnosis of specific phobia of animal type (DSM-5). An A-B single case design with follow-up was performed, and a progressive exposure treatment was performed in different phases. A prepost assessment was also performed with the specific questionnaires (FSS-R, STAIE/ R, FSQ-wasp, and EI) and a multimedia behavioural avoidance test in which measures of subjective anxiety and heart rate were taken during the stimuli presentations. The intervention was designed to run for six sessions in four phases of multimedia exposition: photographs, videos, simulated and real wasps. The results showed a decrease in the scores of specific anxiety questionnaires, also the subjective assessment of anxiety progressively decreased throughout the sessions. There was no change in heart rate. A follow-up was also carried out at 9 and 16 months, where the results obtained with the therapy were maintained. The treatment was successful and at the end the adolescent could be confronted with real wasps without being paralysed or anxious

Creating a Computerized Instrument for the Assessment of Blood-Injury-Injection Phobia.

A new computerized instrument (the Multimedia Behavioral Avoidance Test, or MBAT) for blood-injury-injection phobia (BII) assessment is presented. Analogous stimuli such as images and videos can also elicit anxiety responses; thus, they can be used for the assessment of phobia. The MBAT was applied to participants via computer, and subjective anxiety responses and time latency were recorded. The MBAT was composed of 30 original images and 30 videos related to blood, injury and injections. The MBAT was compared with other pencil-and-paper questionnaires for BII phobia, and heart rate was also measured with a pulsioximeter. The participants included 160 students and professionals (34.5% males, 65.6% females; mean 28.6 years old). The results showed a high reliability for internal consistency in images and videos (α = .98 both), with a single factor that groups all the items. In addition, the MBAT had high concurrent validity (r = .78 to .85) with the different anxiety scales compared. The MBAT diagnosed 12 participants with possible BII phobia. It is a useful instrument in the assessment of this kind of phobia because it is easier and quicker than pencil-and-paper questionnaires, it uses more objective measurements, and it is useful in planning subsequent exposure with images and videos.

The efficacy of functional-analytic psychotherapy and acceptance and commitment therapy (fact) for public employees / La eficacia de la psicoterapia analítica-funcional y la terapia de aceptación y compromiso (FACT) para empleados públicos

Background: The literature is replete with evidence regarding the impact of psychological distress in the workplace. Traditionally, worksite interventions to enhance mental health have been carried out in groups. This study aimed to implement a brief individual program in the workplace through the combination of Functional Analytic Psychotherapy (FAP) and Acceptance and Commitment Therapy (ACT) for Public Administration employees. Method: One hundred and six public employees from a Spanish city council completed pretest measures and forty-three met the inclusion criteria. The participants' scores on distress, burnout, psychological flexibility, depression, anxiety and stress were examined in a pretest-posttest design with a waiting list control group and random assignment. Thirty-eight employees completed the intervention (FACT group= 19; Waiting list control group= 19). The intervention lasted three individual sessions using a protocol with the processes of FAP and ACT, resulting in a protocol named FACT. Results: The FACT group showed statistically significant improvements in distress, burnout, psychological flexibility and anxiety compared with the waiting list control group. Conclusion: These results provide a breakthrough and initial support for the inclusion of FAP in the workplace along with the integration with brief ACT in individual sessions to improve employees' mental health

Antecedentes: la literatura está repleta de evidencia sobre las repercusiones del malestar psicológico en el trabajo. Tradicionalmente, las intervenciones para mejorar la salud mental en el trabajo se han llevado a cabo en grupo. El objetivo de este estudio fue implementar un programa individual breve en el entorno laboral, a través de la combinación de la Psicoterapia Analítica Funcional (FAP) y la Terapia de Aceptación y Compromiso (ACT) para empleados de la Administración pública. Método: ciento seis funcionarios de un ayuntamiento español rellenaron las medidas pretest y cuarenta y tres cumplieron los criterios de inclusión. Las puntuaciones de los participantes en malestar, burnout, flexibilidad psicológica, depresión, ansiedad y estrés fueron analizadas en un diseño experimental pre-post con un grupo de control en lista de espera y asignación aleatoria. Treinta y ocho empleados completaron la intervención (grupo FACT= 19; grupo control en lista de espera= 19). Resultados: el grupo FACT tras tres sesiones mostró mejoras estadísticamente significativas en malestar, ansiedad, burnout y flexibilidad psicológica en comparación con el grupo de control en lista de espera. Conclusión: estos resultados proporcionan una innovación y apoyo inicial para la incorporación de FAP en el entorno laboral, además de su integración con ACT breve para mejorar la salud de los empleados

The efficacy of functional-analytic psychotherapy and acceptance and commitment therapy (FACT) for public employees.

BACKGROUND: The literature is replete with evidence regarding the impact of psychological distress in the workplace. Traditionally, worksite interventions to enhance mental health have been carried out in groups. This study aimed to implement a brief individual program in the workplace through the combination of Functional Analytic Psychotherapy (FAP) and Acceptance and Commitment Therapy (ACT) for Public Administration employees. METHOD: One hundred and six public employees from a Spanish city council completed pretest measures and forty-three met the inclusion criteria. The participants´ scores on distress, burnout, psychological flexibility, depression, anxiety and stress were examined in a pretest-posttest design with a waiting list control group and random assignment. Thirty-eight employees completed the intervention (FACT group= 19; Waiting list control group= 19). The intervention lasted three individual sessions using a protocol with the processes of FAP and ACT, resulting in a protocol named FACT. RESULTS: The FACT group showed statistically significant improvements in distress, burnout, psychological flexibility and anxiety compared with the waiting list control group. CONCLUSION: These results provide a breakthrough and initial support for the inclusion of FAP in the workplace along with the integration with brief ACT in individual sessions to improve employees’ mental health.