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1.
BMC Psychol ; 12(1): 192, 2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38589939

RESUMO

BACKGROUND: While adverse impacts of climate change on physical health are well-known, research on its effects on mental health is still scarce. Thus, it is unclear whether potential impacts have already reached treatment practice. Our study aimed to quantify psychotherapists' experiences with patients reporting climate change-related concerns and their views on dealing with this topic in psychotherapy. METHODS: In a nationwide online survey, responses were collected from 573 psychotherapists from Germany. Therapists reported on the presence of such patients, their socio-demographic characteristics, and climate change-related reactions. Psychotherapists' views on dealing with this topic in psychotherapy were also assessed. Descriptive statistics were used to analyse the responses. RESULTS: About 72% (410/573) of psychotherapists indicated having had patients expressing concerns about climate change during treatment. Out of these therapists, 41% (166/410) stated that at least one patient sought treatment deliberately because of such concerns. Patients were mainly young adults with higher education. Most frequent primary diagnoses were depression, adjustment disorder, and generalized anxiety disorder. Psychotherapists having encountered such patients differed from those without such encounters in their views on potential functional impairment and the necessity to target the concerns in treatment. Although 79% (326/415) of all respondents felt adequately prepared by their current therapeutic skills, 50% (209/414) reported a lack of information on how to deal with such concerns in therapy. CONCLUSIONS: Results indicate that psychotherapists are frequently confronted with climate change-related concerns and regard the mental health impact of climate change on their patients as meaningful to psychotherapeutic care. Regular care could be improved by a continuous refinement of the conceptualization and knowledge of the mental health influences of climate change. This would allow providing tailored methods of assessing and addressing climate change-related concerns in practice.


Assuntos
Mudança Climática , Psicoterapia , Adulto Jovem , Humanos , Psicoterapia/métodos , Inquéritos e Questionários , Alemanha
2.
Z Psychosom Med Psychother ; 70(1): 77-93, 2024 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-38598707

RESUMO

Does the therapeutic style differ in age-homogeneous and age-heterogeneous therapeutic dyads? BACKGROUND AND AIMS: Differences between age-homogeneous and age-heterogeneous therapeutic dyads have rarely been the subject of research.The present study aimed to investigate differences in therapeutic style (Healing and Stressful Involvement). METHOD: A sample of 527 questionnaires completed by therapists of different ages was available. Therapy style was compared between two patient groups (under 40 and over 65 years old) and three therapist groups (25-39, 40-59, ≥ 60). RESULTS: The results show in particular more stress experienced by younger therapists in the treatment of older patients, while older therapists report less stress.There were no or fewer differences in the treatment of younger patients.The regression-analytical results show that the experience of stress in the therapy of older people is associated with a greater fear of old age. CONCLUSION: Finally, some conclusions are discussed with regard to training and supervision of therapists in the treatment of older people.


Assuntos
Medo , Psicoterapia , Humanos , Idoso , Psicoterapia/métodos , Inquéritos e Questionários , Relações Profissional-Paciente
3.
Front Psychiatry ; 15: 1296449, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38550532

RESUMO

Theoretical background: Research of E-Mental Health (EMH) interventions remains a much-studied topic, as does its acceptance in different professional groups as psychotherapists-in-training (PiT). Acceptance among clinicians may vary and depend on several factors, including the characteristics of different EMH services and applications. Therefore, the aims of this study were to investigate the factors that predict acceptance of EMH among a sample of PiT using a latent class analysis. The study will 1) determine how many acceptance prediction classes can be distinguished and 2) describe classes and differences between classes based on their characteristics. Methods: A secondary analysis of a cross-sectional online survey was conducted. N = 216 PiT (88.4% female) participated. In the study, participants were asked to rate their acceptance of EMH, as operationalized by the Unified Theory of Acceptance and Use of Technology (UTAUT) model, along with its predictors, perceived barriers, perceived advantages and additional facilitators. Indicator variables for the LCA were eight items measuring the UTAUT-predictors. Results: Best model fit emerged for a two-class solution; the first class showed high levels on all UTAUT-predictors, the second class revealed moderate levels on the UTAUT-predictors. Conclusion: This study was able to show that two classes of individuals can be identified based on the UTAUT-predictors. Differences between the classes regarding Performance Expectancy and Effort Expectancy were found. Interestingly, the two classes differed in theoretical orientation but not in age or gender. Latent class analysis could help to identify subgroups and possible starting points to foster acceptance of EMH.

4.
Artigo em Inglês | MEDLINE | ID: mdl-38353832

RESUMO

Psychotherapists' attitudes and expectations towards routine outcome monitoring can impact the likelihood of its fruitful implementation. While existing studies have predominantly focused on Europe and North America, research in Latin America remains limited. The aim of this study is to explore therapists' expected benefits and difficulties prior to implementing a routine outcome monitoring system in a university psychotherapy service in Ecuador. An exploratory and descriptive cross-sectional qualitative study was carried out with 20 participants aged 21 to 47. Semi-structured interviews were conducted to explore participants' knowledge about routine outcome monitoring, their expectations of the difficulties, benefits, usability and risks of using a monitoring system, as well as their expectations about their role in the process. The data analysis adhered to the framework analysis methodology, leading to the identification of six overarching themes, 36 specific themes and 82 subthemes. The interviews highlighted a spectrum of positive and negative expectations at several levels: institutional/general, therapeutic process, therapists, and clients. Perceived benefits encompassed various aspects, including the availability of supplementary information, continuous adaptation of the therapeutic process, facilitation of organization and treatment planning, opportunities for professional development, and fostering patient trust and empowerment. On the other hand, anticipated difficulties comprised concerns such as discomfort among therapists and clients, increased workload, system usage and technical difficulties, and the risk of excessive quantification. Overall, participants expressed more anticipated benefits than difficulties. We present recommendations that can support and optimize the current local implementation efforts of routine outcome monitoring, both within this service and in other settings. These recommendations consider ways to meet positive expectations and address or mitigate negative ones.

5.
PeerJ ; 11: e16235, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38099307

RESUMO

The ability to recognize and work with patients' emotions is considered an important part of most psychotherapy approaches. Surprisingly, there is little systematic research on psychotherapists' ability to recognize other people's emotional expressions. In this study, we compared trainee psychotherapists' nonverbal emotion recognition accuracy to a control group of undergraduate students at two time points: at the beginning and at the end of one and a half years of theoretical and practical psychotherapy training. Emotion recognition accuracy (ERA) was assessed using two standardized computer tasks, one for recognition of dynamic multimodal (facial, bodily, vocal) expressions and one for recognition of facial micro expressions. Initially, 154 participants enrolled in the study, 72 also took part in the follow-up. The trainee psychotherapists were moderately better at recognizing multimodal expressions, and slightly better at recognizing facial micro expressions, than the control group at the first test occasion. However, mixed multilevel modeling indicated that the ERA change trajectories for the two groups differed significantly. While the control group improved in their ability to recognize multimodal emotional expressions from pretest to follow-up, the trainee psychotherapists did not. Both groups improved their micro expression recognition accuracy, but the slope for the control group was significantly steeper than the trainee psychotherapists'. These results suggest that psychotherapy education and clinical training do not always contribute to improved emotion recognition accuracy beyond what could be expected due to time or other factors. Possible reasons for that finding as well as implications for the psychotherapy education are discussed.


Assuntos
Psicoterapeutas , Psicoterapia , Humanos , Psicoterapia/educação , Emoções , Estudantes , Expressão Facial
6.
Int J Clin Exp Hypn ; 71(4): 350-357, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37682078

RESUMO

The aim of the present study is to examine beliefs about hypnosis in a Polish sample, with a focus on possible misconceptions. The research included groups with different backgrounds regarding hypnosis: 1st- and 5th-year psychology students, psychotherapists using hypnosis, people interested in paranormal phenomena, and people from the general population. The results demonstrated mild misconceptions about hypnosis and significant differences in beliefs about hypnosis between the aforementioned groups. Additionally, within a Polish sample, psychotherapists using hypnosis and 5th-year students' views were most similar in their current scientific knowledge about hypnosis, while the groups targeting individuals unexposed to hypnosis and followers of paranormal beliefs showed significantly more misconceptions.


Assuntos
Hipnose , Humanos , Polônia , Inquéritos e Questionários , Psicoterapeutas , Estudantes
7.
Front Public Health ; 11: 1216833, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37693716

RESUMO

Introduction: The COVID-19 pandemic has exacerbated the mental health burden on the general population, resulting in increased demands on mental healthcare professionals, including psychotherapists. This cross-sectional study assessed the challenges and resources encountered by 513 psychotherapists based on an online survey conducted between April and May 2022. Methods: Qualitative methods content analysis of written reports was employed to investigate the emerging challenges and sources of support during the pandemic. A comparative analysis of burdens, resources, sociodemographic factors and daily physical activity was conducted to discern patterns of good and poor well-being. Results: The predominant burden identified was mental health-related issues, followed by global crises and government-imposed restrictions to mitigate virus transmission. Essential resources encompassed social connections, mindfulness, work satisfaction, and internal processes. Notably, psychotherapists demonstrating good well-being were older, more physically active, had a lower proportion of females, were employed in private practices rather than in institutionalized settings, had more years of professional experience and treated more patients weekly than their counterparts with poor well-being. Furthermore, they exhibited greater optimism, health focus, and satisfaction with their coping methods. Discussion: These findings can help develop support systems, policies, and educational programs to better support mental health professionals during global crises and offer strategies for individual practitioners to maintain their well-being.


Assuntos
COVID-19 , Psicoterapeutas , Feminino , Humanos , Pandemias , Áustria , Estudos Transversais , COVID-19/epidemiologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-37658701

RESUMO

OBJECTIVE: Therapeutic boundaries are limits to appropriate behaviours within a therapist-client relationship (e.g. related to accepting gifts, self-disclosures, therapist neutrality and advocacy). Therapeutic boundary considerations are fundamental in the care of refugees and asylum seekers. Research on the experiences of therapists navigating such boundaries is sparse and warrants further exploration. The aim of this qualitative systematic review was to thematically synthesise literature regarding therapists' (psychologists, psychotherapists, counsellors) experiences of implementing flexible therapeutic boundaries with refugee and asylum seeker clients and determine how such applications have been helpful for therapeutic interventions. METHOD: Six databases were searched. Following full-text screening, 21 papers were included in the analysis. Boundary theory underpinned the analysis. RESULTS: Three major themes were developed: (i) Changes to Therapeutic Practice & Therapeutic Intervention, (ii) Re-Conceptualisation of Therapy as 'Clinical Political' and Re-Conceptualisation of Therapist Identity and (iii) Careful Monitoring of Personal Boundaries-Not becoming 'Hardened' or 'Haunted'. Papers described how, when used in a reflective, considerate way, flexible therapeutic boundaries can strengthen the therapist-client alliance and positively impact therapeutic interventions. Many therapists acknowledged making conscious efforts to re-conceptualise therapeutic work with refugee and asylum seeker clients from advocacy standpoints. However, systemic constraints, and lack of guidance, made this difficult to navigate and contributed to therapist burn-out. CONCLUSIONS: Boundary considerations manifested as interpersonal, structural and cultural changes to practice. These have implications for clinical practice and developing guidelines on boundary practices with refugees and asylum seekers. Future research should explore promoting therapist well-being and training needs for therapists supporting this population.

9.
Front Psychol ; 14: 1188634, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37546436

RESUMO

Introduction: Psychotherapists' emotional and empathic competencies have a positive influence on psychotherapy outcome and alliance. However, it is doubtful whether psychotherapy education in itself leads to improvements in trainee psychotherapists' emotion recognition accuracy (ERA), which is an essential part of these competencies. Methods: In a randomized, controlled, double-blind study (N = 68), we trained trainee psychotherapists (57% psychodynamic therapy and 43% cognitive behavioral therapy) to detect non-verbal emotional expressions in others using standardized computerized trainings - one for multimodal emotion recognition accuracy and one for micro expression recognition accuracy - and compared their results to an active control group one week after the training (n = 60) and at the one-year follow up (n = 55). The participants trained once weekly during a three-week period. As outcome measures, we used a multimodal emotion recognition accuracy task, a micro expression recognition accuracy task and an emotion recognition accuracy task for verbal and non-verbal (combined) emotional expressions in medical settings. Results: The results of mixed multilevel analyses suggest that the multimodal emotion recognition accuracy training led to significantly steeper increases than the other two conditions from pretest to the posttest one week after the last training session. When comparing the pretest to follow-up differences in slopes, the superiority of the multimodal training group was still detectable in the unimodal audio modality and the unimodal video modality (in comparison to the control training group), but not when considering the multimodal audio-video modality or the total score of the multimodal emotion recognition accuracy measure. The micro expression training group showed a significantly steeper change trajectory from pretest to posttest compared to the control training group, but not compared to the multimodal training group. However, the effect vanished again until the one-year follow-up. There were no differences in change trajectories for the outcome measure about emotion recognition accuracy in medical settings. Discussion: We conclude that trainee psychotherapists' emotion recognition accuracy can be effectively trained, especially multimodal emotion recognition accuracy, and suggest that the changes in unimodal emotion recognition accuracy (audio-only and video-only) are long-lasting. Implications of these findings for the psychotherapy education are discussed.

10.
Clin Psychol Psychother ; 30(6): 1369-1379, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37394242

RESUMO

INTRODUCTION: This study explored the current knowledge, attitudes, and clinical practices regarding psychedelics among mental health professionals in California, where state legislation to decriminalize psychedelics has been proposed. METHOD: Two hundred thirty-seven mental health providers (74% female; mean age 54; 83% White; 46% psychologists) completed a 37-item online survey between November 2021 and February 2022, disseminated through local and state-wide professional organizations in California. RESULTS: Providers endorsed limited knowledge about the risks and benefits of psychedelic use (M = 4.7 and 5.4, respectively, with 10 = high knowledge) and inadequate knowledge to counsel patients on use (45%). Gaps in knowledge related to psychedelic drug scheduling and current use in clinical research were identified. Providers expressed support for additional psychedelic research (97%), approval of recreational (66%) and medical (91%) psychedelic use, belief in the potential therapeutic benefits of psychedelics (89%), and concerns about safety (33%) and potential psychiatric risks (27%). Results indicated that most providers discuss psychedelic use with patients (73%), yet many do not feel comfortable addressing the effects of use (49%). There were significant correlations between knowledge and attitudes towards psychedelics (r = 0.2, p = .006; r = 0.31, p < .001) and attitudes and clinical practices (r = 0.34, p < .001). CONCLUSIONS: Findings suggest that providers are interested in psychedelic-assisted treatments and hold favourable attitudes towards the therapeutic use of psychedelics yet lack the knowledge to appropriately counsel patients, highlighting the need for additional provider education about psychedelics.


Assuntos
Alucinógenos , Síndrome de Abstinência a Substâncias , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Alucinógenos/farmacologia , Alucinógenos/uso terapêutico , Psicoterapeutas , Conhecimentos, Atitudes e Prática em Saúde , Emoções , Saúde Mental , Síndrome de Abstinência a Substâncias/tratamento farmacológico
11.
Omega (Westport) ; : 302228231180784, 2023 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-37247512

RESUMO

The present study explored mental health professionals' experiences of working with terminally ill patients in Greece, how they make sense of their lived experiences of working with the dying, and investigated how they relate to their personal and professional growth. Semi-structured interviews were conducted with five mental health professionals who work or have worked with terminally ill patients in Greece. Their responses were analyzed using Interpretative Phenomenological Analysis (IPA). The main themes that emerged were (1) Emergence of opportunities for growth and transformation; (2) Finding satisfaction and fulfillment; (3) Openly addressing the negative side of challenges; and (4) Tuning into the spiritual side. Overall, the participants emphasized the importance of the different types of relationships these experiences touched upon, and highlighted the effect of their line on work on the relationship with their patients, their relationships with significant others and coworkers, and their relationship with their own selves.

12.
Int J Nurs Stud ; 140: 104450, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36796117

RESUMO

BACKGROUND: A recent review shows an interdependence between healthcare providers and relatives in the context of euthanasia. Belgian guidelines do focus on the role of certain healthcare providers (physicians, nurses, and psychologists), yet they hardly specify bereavement care services before, during and after the euthanasia. PURPOSE: A conceptual model showing underlying mechanisms of healthcare providers' experiences regarding the interaction with and the provision of bereavement care to relatives of cancer patients throughout a euthanasia process. METHODS: 47 semi-structured interviews with Flemish physicians, nurses and psychologists working in hospitals and/or homecare, conducted from September 2020 to April 2022. Transcripts were analyzed using the Constructivist Grounded Theory Approach. RESULTS: Participants experienced the interaction with relatives as very diverse, which can be visualized as a continuum ranging from negative to positive, depending on each unique case. The achieved degree of serenity was the main contributor in determining their position on the aforementioned continuum. To create this serene atmosphere, healthcare providers undertook actions underpinned by two attitudes (wariness and meticulousness), which are guided by different considerations. These considerations can be categorized into three groups: 1) ideas about a good death and its importance, 2) having the situation well under control and 3) self-reassurance. CONCLUSIONS: If relatives were not at peace, most participants said that they deny a request or formulate additional requirements. Moreover, they wanted to ensure relatives can cope with the loss, which was often experienced as intense and time-consuming. Our insights shape needs-based care from healthcare providers' perspective in the context of euthanasia. Future research should explore the relatives' perspective regarding this interaction and the provision of bereavement care. TWEETABLE ABSTRACT: Professionals strive for a serene atmosphere throughout a euthanasia process to ensure relatives can cope with the loss, and the way in which the patient died.


Assuntos
Luto , Eutanásia , Cuidados Paliativos na Terminalidade da Vida , Médicos , Humanos , Atitude do Pessoal de Saúde , Pessoal de Saúde , Pesquisa Qualitativa
13.
Clin Psychol Psychother ; 30(3): 587-598, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36610037

RESUMO

OBJECTIVE: This study aims to longitudinally investigate the effects of individual's factors on subsequent burn-out/psychological distress in a sample of mental health practitioners, testing if higher attachment anxiety and avoidance and lower reflective functioning (i.e., certainty and uncertainty of mental states) and well-being at baseline may lead to a greater psychological distress and burn-out 1 year later. METHODS: The sample consisted of 40 experienced psychotherapists (females: 72.5%; mean age: 47.40 ± 9.48 years) who completed a battery of questionnaires at baseline and 1 year later. Statistical analyses were conducted with Bayesian multiple linear regressions. RESULTS: Greater attachment anxiety and certainty about mental states and lower individual's well-being at baseline predicted greater burn-out 1 year later. Similarly, greater attachment anxiety and lower individual's well-being at baseline predicted psychological distress at 1 year follow-up. Of note, uncertainty of mental states and avoidant attachment were not associated with outcomes. CONCLUSION: These findings suggest that the levels of burn-out and psychological distress among psychotherapists may be alleviated with interventions targeting attachment insecurity, specific aspects of reflective functioning (i.e., certainty about mental states) and well-being.


Assuntos
Angústia Psicológica , Psicoterapeutas , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Estudos Longitudinais , Teorema de Bayes , Ansiedade/psicologia , Esgotamento Psicológico
14.
Clin Psychol Psychother ; 30(1): 73-85, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35920059

RESUMO

OBJECTIVE: The aim of this study was to explore psychotherapist characteristics associated with work involvement and work satisfaction among psychotherapists in Germany. METHOD: In total N = 1358 psychotherapeutic practitioners with different levels of training participated in our nationwide online survey, we assessed work involvement and its sub-concepts of healing involvement (HI), stressful involvement (SI) and work satisfaction (WS) using the Therapist Work Involvement Scale (TWIS) and combined HI and SI into practice patterns. RESULTS: In our study, the levels of HI and WS were high, whereas SI was low. The percentage of effective practice patterns was higher than in previous studies, whereas challenging practice patterns were lower. HI, SI and WS were associated with gender and age, indicating that male and younger participants showed more SI but less HI and WS. Psychodynamic therapists reported more SI and WS. The number of weekly therapy sessions was related to HI, SI and WS. Furthermore, HI was positively related to WS and negatively to SI, while SI and WS were negatively correlated. CONCLUSION: Our results indicated that therapist characteristics influenced their work involvement and work satisfaction. Therefore, therapist training and interventions should consider individualized approaches based on the relevant therapist characteristics to foster HI and WS while reducing SI. One could speculate whether the changes in psychotherapeutic training may have already contributed to improved practice patterns over the last decades.


Assuntos
Psicoterapeutas , Psicoterapia , Humanos , Masculino , Satisfação no Emprego , Inquéritos e Questionários , Alemanha , Psicotrópicos
15.
Clin Psychol Psychother ; 30(2): 335-343, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36367388

RESUMO

Numerous randomized controlled trials have shown cognitive behaviour therapy (CBT) to be effective in treating social anxiety disorder (SAD). Yet, less is known about the effectiveness of CBT for SAD conducted by psychotherapists in training in routine clinical practice. In this study, 231 patients with SAD were treated with CBT under routine conditions and were examined at pre- and post-treatment as well as at 6 and 12 months follow-up. We applied self-reports to assess symptoms of SAD (defined as primary outcome), depression and psychological distress (defined as secondary outcome). We conducted both completer and intent-to-treat analyses and also assessed the reliability of change with the reliable change index. Results revealed significant reductions in symptoms of SAD between pre- and post-assessments, with effect sizes ranging from d = 0.9 to 1.2. Depending on the SAD specific questionnaire applied, 47.8% to 73.5% of the sample showed a reliable positive change, whereas 1.9% to 3.8% showed a reliable negative change. Depressive symptoms and psychological distress also decreased significantly from pre- to post-assessment, with large effect sizes. Significant treatment gains regarding both primary and secondary outcomes were further observed at 6 and 12 months follow-up. The current findings based on a large sample of patients suggest that psychotherapists in CBT training working under routine conditions can effectively treat symptoms of SAD, depression and psychological distress.


Assuntos
Terapia Cognitivo-Comportamental , Fobia Social , Humanos , Reprodutibilidade dos Testes , Terapia Cognitivo-Comportamental/métodos , Psicoterapeutas , Inquéritos e Questionários , Resultado do Tratamento , Ansiedade
16.
Front Public Health ; 10: 1011539, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36424964

RESUMO

Although the impact of the COVID-19 pandemic on mental health has been reported in different communities, little is known about the mental health of psychotherapists during the COVID-19 pandemic. This study aimed to assess mental health during the COVID-19 pandemic in Austrian psychotherapists and compare it with the general population. A total of n = 513 psychotherapists (80.5% women; mean age: 53.06 ± 9.94 years) took part in an online survey conducted from April to June 2022. At the same time, a representative sample (N = 1,031) of the Austrian general population was surveyed online. Indicators of mental health were mental wellbeing (WHO-5), depression (PHQ-2), anxiety (GAD-2), insomnia (ISI-2), and stress (PSS-10). The general population sample was matched according to age and gender with the psychotherapist's data using propensity scores, yielding a final sample of n = 513 (80.5% women; mean age: 52.33 ± 13.39 years). Psychotherapists showed lower odds for exceeding cut-offs for clinically relevant depressive, anxiety, insomnia and stress symptoms (0.34-0.58) compared to the general population. Further studies should elucidate the protective factors underlying these findings.


Assuntos
COVID-19 , Distúrbios do Início e da Manutenção do Sono , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Saúde Mental , Psicoterapeutas , COVID-19/epidemiologia , Áustria/epidemiologia , Pandemias
17.
Artigo em Inglês | MEDLINE | ID: mdl-36430057

RESUMO

Non-binary people may face specific challenges in psychological settings. Psychotherapists often display a lack of preparation for non-binary gender identities, resulting in overt or subtle forms of prejudice that compromise the therapeutic alliance. The present study aimed to provide data on non-binary clients' positive and negative experiences within therapeutic relationships. Twenty-five interviews were conducted with non-binary people in the age range of 19-35. Using codebook thematic analysis, the researchers identified three main themes: (1) the self of the psychotherapist, consisting of the impact of the therapist's personal (i.e., sexual identity) and professional (i.e., competence) characteristics on the therapeutic experience; (2) the practice of the psychotherapist, emerging as affirmative (validation and microaffirmations) or negative (gender identity change efforts, manifest aggressions, and microaggressions) approaches toward non-binary identities; (3) the therapeutic relationship, referring to the alliance, rupture, and reparation based on the therapists' openness toward non-binary identities. To provide a safer setting for non-binary clients, psychotherapists should incorporate issues related to gender minority identities in their training, acknowledge clinical errors when they occur and adopt an active predisposition to learn through the client's experience, giving value to their unique contribution.


Assuntos
Identidade de Gênero , Aliança Terapêutica , Humanos , Feminino , Masculino , Psicoterapia , Agressão , Pessoal Técnico de Saúde
18.
Arch Sex Behav ; 51(8): 4157-4178, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35939157

RESUMO

Minor-attracted persons (MAPs; i.e., people who are sexually interested in children and adolescents below the age threshold of legal consent for sexual activity) exhibit high psychological distress but report difficulties finding therapeutic help and are reluctant to start treatment due to fears of therapist stigmatization. This research sought to elucidate the link between outpatient therapists' stigmatizing attitudes toward non-offending versus offending MAPs and therapists' willingness to treat MAPs as well as how stigmatization was related to treatment-relevant aspects such as perceived MAP treatment needs, treatment barriers, and specific MAP treatment skills. Results from a brief, anonymous online survey conducted among N = 427 Swiss outpatient therapists working in the primary healthcare system are reported. Although therapists were less stigmatizing than the general public, considerable individual differences in the stigmatization of non-offending MAPs emerged. Stigmatizing attitudes toward non-offending MAPs and a perceived lack of specific treatment competences were negatively related to therapists' willingness to treat MAPs. A network analysis revealed direct links between subjectively perceived MAP treatment competence and treatment willingness and between treatment willingness and social distance attitudes. Other stigmatizing attitudes were only indirectly linked to treatment willingness through preferred social distance. It is a paradox that therapists believe that MAPs should greatly benefit from secondary prevention but many are unwilling to provide therapy (45% in case of non-offending MAPs vs. 63% in case of offending MAPs) or do not feel competent to provide MAPs with professional help (47% with and 88% of therapists without previous MAP treatment experience). Implications for increasing therapists' treatment willingness are discussed.


Assuntos
Atitude do Pessoal de Saúde , Pacientes Ambulatoriais , Adolescente , Criança , Humanos , Inquéritos e Questionários , Estereotipagem , Comportamento Sexual
19.
Interdisciplinaria ; 39(1): 57-76, jun. 2022. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1360480

RESUMO

Resumen A nivel internacional, se han elaborado modelos e instrumentos de evaluación de competencias genéricas y específicas; sin embargo, en Argentina los desarrollos han sido menores. Un relevamiento de psicoterapeutas locales concluye que al menos siete competencias clínicas básicas y cinco indicadores asociados a su desarrollo serían esenciales para desempeñarse como terapeutas (Crocamo, 2019). El objetivo de este trabajo fue construir un instrumento para su evaluación, denominado Escala de Competencias Clínicas Básicas para Psicoterapeutas (ECCBP). Para ello, se utilizó un diseño no experimental, transversal de tipo exploratorio en cuatro fases: (1) elaboración del sistema de evaluación; (2) redacción de ítems; (3) revisión de la versión preliminar; y (4) desarrollo del instrumento definitivo. Se aplicó el instrumento a 534 psicoterapeutas argentinos con título de grado de psicólogo. La versión definitiva quedó conformada por 122 ítems y para completarlo se requirieren aproximadamente 45 minutos. La elaboración de un instrumento local favorece el estudio sistemático del área y permite valorar de manera confiable la efectividad de los programas de entrenamiento.


Abstract At the international level, models and instruments for the evaluation of generic and specific competences have been developed; however, in Argentina the developments have been fewer. A survey of local psychotherapists concludes that at least seven basic clinical competencies would be essential to perform as therapists: diagnostic process and design, interventions and techniques, therapeutic bond, professional role, contextual variables and diversity, interview management and evaluation and completion of the process. Furthermore, five activities and experiences would be linked to their training, called associated indicators: basic training and updating, personal development and work on oneself, belonging to institutions and network of professionals, supervision, and personal and professional experience (Crocamo, 2019). Therefore, the objective of this work was to construct an instrument for its evaluation called Basic Clinical Competences Scale for Psychotherapists (BCCSP). To do this, a non-experimental, cross-sectional exploratory design was used in four phases: (1) development of the evaluation system; (2) writing of items; (3) review of the preliminary version; and (4) development of the final instrument. The instrument was applied to 534 Argentine psychotherapists with a degree in psychology. To attend to the particularity of each phase, three samples were used. The first one was composed of three psychotherapists summoned to participate in the selection of the different methodologies to evaluate each competence and indicator. For the second one, reviewers of the instrument made up of five therapists with different levels of professional experience summoned to assess the preliminary version of the instrument. And the third, to study the psychometric properties of the BCCSP, a snowball sample was used composed of 534 psychotherapists from 19 provinces of Argentina. As a result, different evaluation formats were incorporated in order to favor the effective evaluation of the variables, clinical vignettes, self-evaluation of perception of competences and questionnaire. A systematized procedure was carried out to review and refine the pilot version. The percentage of agreement between the reviewers of the instrument (Herrera Rojas, 1993) and the Aiken's V coefficient were calculated using software called Basic Visual Program for Aiken's V, developed by Merino Soto and Livia Segovia (2009). The final version was made up of 122 items and it takes approximately 45 minutes to complete it. The first part is composed of three vignettes which offer clinical descriptions with 15 questions for each situation. Finally, the responses are scored as correct / complete (2 points), correct / partial (1 point) or incorrect (0 points). Next, the self-assessment scale presents the following Cronbach's alpha coefficients Therapeutic link α = .833; Professional role α = .715; Contextual variables and diversity α = .853; Interview management α = .845; Evaluation and completion of the process α = .845 and Design, interventions and techniques II α = .797. Finally, the questionnaire was made up of 22 items: basic training and updating (5 items), personal and professional experience (5 items), personal development and work on oneself (4 items), supervision (4 items), membership in institutions and professional network (5 items). The answers collected will allow to obtain qualitative information on experiences or activities associated with the development of clinical competencies for psychotherapy. In the first place, it should be noted that the BCCSP is an instrument specially constructed for the local population and the study area that can be generalizable to other similar sociocultural contexts since the vast majority of evaluation models and studies have been developed in Anglo-Saxon countries. At the same time, due to the lack of local evaluation instruments, the BCCSP could become a valuable tool, both to be used in research activities and in training programs and educational monitoring.

20.
Front Psychol ; 13: 864691, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35401345

RESUMO

While psychotherapists are trained to improve their clients' quality of life, little work has examined the quality of life experienced by psychotherapist trainees themselves. Yet their life satisfactions and stresses would plausibly affect both their ability to learn new skills and conduct psychotherapy. Therefore, in the Society for Psychotherapy Research Interest Section on Psychotherapist Development and Training study, we investigated the patterns of self-reported life quality and their correlates in a multinational sample of 1,214 psychotherapist trainees. A comprehensive questionnaire was used at the outset of trainings to assess trainees' professional background, current life situation, personal characteristics, family background, and social and national origin. The findings indicated 54.3% of trainees' lives could be characterized as fortunate or happy (i.e., experiencing great life satisfaction and not much stress), whereas 14.3% could be characterized as clearly distressed or troubled (i.e., experiencing great life stress and not much satisfaction). The strongest correlates of high life stress, a contributor to poor life quality, were economic insecurity, self-protectiveness, and attachment-related anxiety in relationships, and economic or psychological hardship in childhood. In turn, greater wellbeing was most strongly associated with a warm and open interpersonal style, being married, having sufficient economic means, and material and emotional security in childhood. While the results indicate the majority of therapists experience a relatively good quality of life, the findings also suggest potential targets for increasing trainees' life quality when it may be deficient, such as those on a societal level (e.g., availability of low-cost student loans), training program level (e.g., promoting supportive supervision, positive between-trainee relationships and group collaboration), and individual level (e.g., personal therapy and learning self-care), in order to promote effective learning and therapy practice.

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