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Behav Ther ; 50(2): 340-352, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30824250


The purpose of this study was to test whether Parent-Child Interaction Therapy (PCIT), a widely used effective therapy for children's externalizing behaviors and parenting problems, was associated with improvements in parents' emotion regulation and reflective functioning. We also investigated whether these improvements had unique associations with children's improvements in externalizing and internalizing symptoms. Participants were 139 Australian children aged 29 to 83 months and their caregivers; all were referred for child externalizing behavior problems coupled with parenting skill deficits or high parent stress. All data were gathered via a questionnaire completed prior to and after completion of PCIT. Significant improvements were found in parents' self-reported emotion dysregulation and capacity to use cognitive reappraisal for emotion regulation. There was also improvement in parents' self-report of children's symptoms, parenting practices, and reflective functioning in the form of prementalizing, which measured a low capacity to understand the emotional world of the child. Multiple regression showed that improvements in cognitive reappraisal, prementalizing, and negative parenting practices were associated with improvement in children's symptoms. The findings extend the existing evidence for PCIT as an effective parenting intervention, adding parents' perceived emotion regulation and reflective functioning to the list of positive outcomes from PCIT. Improved emotion regulation and reflective functioning, unique from changes in parenting practices, could be mechanisms that help explain why PCIT has been associated with improvements in children's externalizing behaviors.

Comportamento Infantil/psicologia , Emoções , Terapia Familiar/métodos , Relações Pais-Filho , Pais/psicologia , Percepção , Austrália/epidemiologia , Criança , Comportamento Infantil/fisiologia , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/terapia , Educação Infantil/psicologia , Educação Infantil/tendências , Pré-Escolar , Emoções/fisiologia , Terapia Familiar/tendências , Feminino , Humanos , Masculino , Poder Familiar/psicologia , Poder Familiar/tendências , Percepção/fisiologia , Inquéritos e Questionários , Resultado do Tratamento
J Marital Fam Ther ; 45(2): 206-218, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29682781


The field of couple, marital, and family therapy (CMFT) is at an important juncture of identity development and synthesis. Integrative Systemic Therapy (IST) is a problem-centered metaframeworks approach that meets the growing needs of family therapists working with diverse and complex family systems and restores the field to its original focus on collaboration. This paper describes the process by which IST developed featuring anecdotes from live interviews with the founders. We briefly outline IST's theoretical pillars and the essential way IST practitioners deliver treatment including a blueprint for therapy. Finally, we propose that IST is a comprehensive, systemic guide uniquely beneficial to CMFT training and discuss our approach to integrating IST into our training of students in a COAMFTE accredited program.

Terapia de Casal , Currículo , Educação de Pós-Graduação/métodos , Terapia Familiar , Adulto , Terapia de Casal/educação , Terapia de Casal/métodos , Terapia de Casal/tendências , Terapia Familiar/educação , Terapia Familiar/métodos , Terapia Familiar/tendências , Humanos , Colaboração Intersetorial
Cult Med Psychiatry ; 42(4): 821-839, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29845519


The increasing acceptance and use of psychotherapy in contemporary China powerfully attests to the "psychologization" of Chinese society. Yet attending therapy is only one aspect of psychologization. Analyzing the practice of therapy through case examples illuminates the broader sociocultural context of China's "psycho-boom." This includes insight into what I term an expansive-I notion of personhood. This non-singular notion of personhood is a major challenge for Chinese therapists. Therapists' attempts to resolve clients' problems by reorienting them according to psychological ideals highlight the multiple, at times contradictory relationships between psychotherapy, the state and families.

Relações Familiares , Terapia Familiar , Pessoalidade , Adulto , Criança , Terapia Familiar/tendências , Feminino , Humanos , Masculino
Psychiatry Res ; 260: 116-122, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29179016


This open, uncontrolled study examined the efficacy of a group family-based cognitive behavioral therapy (GF-CBT) protocol in treating pediatric obsessive-compulsive disorder (OCD) and explored predictors of symptom improvement. Eighty-five OCD-affected youth aged 8-18 years (M = 13.9 years, SD = 2.49; 46% male) and their parent(s) participated in a weekly, 12-session GF-CBT program. Data from multiple perspectives were gathered at the beginning and end of treatment, as well as at one-month follow-up. A broad range of assessment measures were utilized to capture clinically-relevant domains and a number of potential predictor variables were explored. Paired t-tests indicated that treatment was associated with significant reductions in clinician- and parent-rated OCD severity (d = 1.47, 1.32), youth and parent-rated functional impairment (d = 0.87, 0.67), coercive/disruptive behaviors (d = 0.75), and family accommodation (d = 1.02), as well as improvements in youth-, mother-, and father-rated family functioning (d = 1.05, 0.50, 0.88). Paired t-tests also indicated that youth remained improved at one-month follow-up. Step-wise regression identified greater homework success as a significant predictor of symptom improvement. This study provides evidence that GF-CBT significantly improves a wide range of domains for youth/families that extends beyond OCD symptom severity and supports homework as a core treatment component.

Terapia Cognitivo-Comportamental/tendências , Terapia Familiar/tendências , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Adolescente , Criança , Terapia Cognitivo-Comportamental/métodos , Terapia Familiar/métodos , Pai/psicologia , Feminino , Humanos , Masculino , Mães/psicologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Pais/psicologia , Valor Preditivo dos Testes , Comportamento Problema/psicologia , Inquéritos e Questionários , Resultado do Tratamento
Fam Process ; 57(1): 70-82, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-28205225


Global mental health (GMH) is an emerging field that focuses on the need for culturally sensitive mental health services in low- and middle-income countries (LMICs). While many new initiatives have been established worldwide to understand GMH needs and to provide care in LMICs, family therapists have primarily worked with families in high-income countries. The few existing family-based initiatives in GMH focus on psychoeducation and are typically not based on general systems theory. However, emerging trends in family therapy may enable family therapists to impact mental health issues in LMICs. These trends, which are shared interests of both family therapy and GMH, include collaborative care, a growing emphasis on the importance of culture in understanding and treating mental health issues, recognition of the ability of families to support or impede recovery from mental illness, and the use of strength-based and evidence-based treatments. This paper describes ways for family therapists to become active in the GMH community.

Países em Desenvolvimento , Terapia Familiar/tendências , Saúde Global , Serviços de Saúde Mental/tendências , Saúde Mental , Humanos , Pobreza/psicologia
Pensando fam ; 21(1): 137-145, jul. 2017.
Artigo em Português | LILACS | ID: biblio-895222


Pretende-se, neste artigo, destacar as possibilidades de diálogos ente duas teorias, contribuindo assim para a prática clínica. Abordaremos o socioconstrucionismo e as afinidades com a teoria da aprendizagem na perspectiva da autoria do pensamento. Entendendo o socioconstrucionismo como uma abordagem teórico-clínica que enfatiza os processos relacionais e estimula as pessoas a serem capazes de construír a si mesmas e o mundo em que vivem, entendendo a aprendizagem como processo de produção de sentido onde o sujeito é protagonista e tem papel ativo, podemos pensar a terapia familiar como um espaço de aprendizagem e ressignificação das relações. O terapeuta pode operar na terapia, tal qual o ensinante opera na relação de aprendizagem: sendo um facilitador das competências. Além disso, o processo terapêutico pode se configurar numa troca onde família e terapeuta se enriquecem. Tanto o ensinante quanto o terapeuta, nestas abordagens, precisam reconhecer a legitimidade do outro e possibilitar a autoria. Dessa forma, a terapia torna-se uma construção conjunta e não um processo linear onde o terapeuta detém o conhecimento e vai transmitir à família. Nesta perspectiva, o terapeuta precisa estar sempre curioso e assumir uma postura de questionamento e reflexão a respeito do que está estabelecido, abrindo assim, espaço para o novo e para a criação.(AU)

It is intended in this article highlight the possibilities of dialogues between two theories, thus contributing to the clinical practice. We discuss the social constructionism and the affinities with learning theory in view of the authorship of thought. Understanding social constructionism as a clinical theoretical approach that emphasizes the relational processes and encourages people to be able to build themselves and the world they live in; understanding learning as meaning production process where the subject is the protagonist and has active role, we may think family therapy as a space for learning and redefinition of relations. The therapist can operate in therapy, like the teaching being active in learning relationship: being a facilitator skills. Moreover, the therapeutic process may be set on an exchange where family and enrich therapist. Both the teaching being as the therapist, these approaches must recognize the legitimacy of the other and enable the authorship. Thus, the therapy becomes a joint construction and not a linear process where the therapist has the knowledge and will convey to the family. In this perspective, the therapist must always be curious and take a questioning attitude and reflection as to what is established, thus opening space for the new and create.(AU)

Psicologia Social , Pensamento , Teoria da Construção Pessoal , Terapia Familiar/tendências
Behav Ther ; 47(6): 773-775, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27993331


This is the introduction to the second of two special issues in honor of the 50th anniversary of the Association for Behavioral and Cognitive Therapies. The goal of this issue is to pay tribute to prior seminal Behavior Therapy publications on current therapies and future directions, to provide an updated review of important topics covered by these papers, and to make recommendations for the future. Each invited paper in this issue highlights a particular Behavior Therapy publication's contribution to our understanding and also provides an updated review or meta-analysis on the topic of the original paper. The topics covered here include review papers on current therapies such as cognitive and behavioral therapies, youth and family psychotherapy, unified protocols, and third-wave therapies. In addition, we include a review paper on implementation science, and meta-analyses on individualized psychotherapy, and culturally adapted interventions. With the two 50th anniversary issues of Behavior Therapy, we hope to inspire additional research and discussion.

Terapia Comportamental/tendências , Transtornos Mentais/terapia , Terapia Comportamental/métodos , Terapia Cognitivo-Comportamental/tendências , Terapia Familiar/tendências , Previsões , Humanos , Medicina de Precisão
Fam Process ; 55(3): 558-76, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27565445


This article summarizes the 30+-year evidence base of Multidimensional Family Therapy (MDFT), a comprehensive treatment for youth substance abuse and antisocial behaviors. Findings from four types of MDFT studies are discussed: hybrid efficacy/effectiveness randomized controlled trials, therapy process studies, cost analyses, and implementation trials. This research has evaluated various versions of MDFT. These studies have systematically tested adaptations of MDFT for diverse treatment settings in different care sectors (mental health, substance abuse, juvenile justice, and child welfare), as well as adaptations according to treatment delivery features and client impairment level, including adolescents presenting with multiple psychiatric diagnoses. Many published scientific reviews, including meta-analyses, national and international government publications, and evidence-based treatment registries, offer consistent conclusions about the clinical effectiveness of MDFT compared with standard services as well as active treatments. The diverse and continuing MDFT research, the favorable, multi-source independent evaluations, combined with the documented receptivity of youth, parents, community-based clinicians and administrators, and national and international MDFT training programs (U.S.-based organization is MDFT International,; and Europe-based organization is all support the potential for continued transfer of MDFT to real-world clinical settings.

Transtorno da Personalidade Antissocial/terapia , Prática Clínica Baseada em Evidências/tendências , Terapia Familiar/tendências , Transtornos Relacionados ao Uso de Substâncias/terapia , Adolescente , Transtorno da Personalidade Antissocial/psicologia , Criança , Assistência à Saúde , Prática Clínica Baseada em Evidências/métodos , Terapia Familiar/métodos , Feminino , Implementação de Plano de Saúde , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Transtornos Relacionados ao Uso de Substâncias/psicologia , Resultado do Tratamento
An. sist. sanit. Navar ; 39(2): 203-212, mayo-ago. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-156077


Fundamento. La enfermedad mental grave compromete al 1% de la población, siendo la familia, en gran parte de los casos, la que apoya, cuida y acompaña, y de esta forma convive con la enfermedad. La relación entre la familia y el sistema de salud ha sido poco explorada en España, así como los aprendizajes de la familia puestos al servicio de otras familias, de forma que el objetivo del presente artículo es aportar en estos dos aspectos. Material y métodos. En la Comunidad Foral de Navarra (España) se llevó a cabo un estudio cualitativo de tipo narrativo, realizando entrevistas a profundidad a familias que conviven con la enfermedad mental grave. Se realizaron dos entrevistas a cada familia (incluyendo a la persona con el diagnóstico de enfermedad mental) y posteriormente se realizó un análisis multimodal (estructural, temático y dialógico) de cada familia y un análisis entre familias. Resultados. Se entrevistaron seis familias y dieciocho participantes. Se encontraron dos categorías: requerimientos de las familias y de familia a familia. En los requerimientos se destacan la optimización de la relación con los profesionales de la salud, los medicamentos, los centros de rehabilitación psicosocial y el apoyo a las familias. En la segunda categoría se encuentran recomendaciones desde la perspectiva del familiar con enfermedad y de los familiares sin enfermedad. Conclusiones. Las familias desean mayor acompañamiento por los profesionales sanitarios, y a la vez son una fuente de aprendizajes que pueden ser utilizados para el proceso de recuperación de otras familias (AU)

Background. It is estimated that 1% of the general population suffers from severe mental illness (SMI). In most cases, families are the ones providing support and direct care to the ill relative, which in turn results in the family being the unit that lives with the mental illness. In Spain, two key aspects have been barely explored: the relationship between the family and the mental health system; and the knowledge of families and the possible transfer of such knowledge to other families. The aim of this paper is to contribute to exploring these two aspects. Methods. A qualitative study with a narrative approach was implemented in the Foral Community of Navarre (Spain). The study consisted of in-depth interviews with families living with SMI. Two interviews were conducted with each family (which included the individual diagnosed with a mental illness). A multimodal analysis (structural, thematic and dialogical) was conducted with each family. Comparative analyses between families were also performed. Results. A total of 6 families were interviewed with a total of 18 participants. Findings were grouped around two central categories: requirements of families and family to family. The first category includes improving relationships with mental health providers, medications, psychosocial rehabilitation centers and supporting families. The second category includes recommendations from the perspective of the relative with a SMI and those without it. Conclusions. Families would like to receive a higher degree of support from mental-health providers. At the same time, families should be considered as important sources of knowledge and support for the treatment of other families living with SMI (AU)

Humanos , Transtornos Mentais/epidemiologia , Características da Família , Relações Familiares , Determinação de Necessidades de Cuidados de Saúde , Pesquisa Qualitativa , Relações Profissional-Família , Terapia Familiar/tendências
Cuad. psiquiatr. psicoter. niño adolesc ; (61): 65-72, ene.-jun. 2016. graf
Artigo em Espanhol | IBECS | ID: ibc-158149


En el presente trabajo se describen algunos tipos de intervenciones con niños y adolescentes y sus familias, en la Unidad de Salud Mental Infanto-Juvenil del Hospital de Valme (Sevilla, España), ya sean grupos de asesoramiento o terapia, terapias familiares, incluso dispositivos organizados combinando intervenciones de arte-terapia y psicoterapia con padres, adolescentes y grupos multifamiliares. Es importante, mejor crucial, contar con la familia para ayudar al niño. En cualquier caso, ayudar al niño es ayudar a la familia (AU)

In this paper some types of interventions with children and adolescents and their families are described in Unit of Child and Adolescent Mental Health, Valme Hospital (Seville, Spain), whether counseling or therapy groups, family therapy, even devices combining interventions organized art therapy and psychotherapy with parents, teens and multi-family groups. It is important, crucial best, count on the family to help the child. In any case, help the child is to help the family (AU)

Humanos , Masculino , Feminino , Criança , Adolescente , Psicoterapia/métodos , Psicoterapia Psicodinâmica/métodos , Psicoterapia Psicodinâmica/organização & administração , Terapia Familiar/instrumentação , Terapia Familiar/métodos , Psicoterapia de Grupo/métodos , Comportamento do Adolescente/psicologia , Psicologia do Adolescente/métodos , Terapia Familiar/organização & administração , Terapia Familiar/tendências , Psicoterapia de Grupo/instrumentação , Psicoterapia de Grupo/organização & administração , Psicologia da Criança/métodos , Integração Comunitária/psicologia
Psychother Res ; 25(3): 348-64, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25506726


OBJECTIVE: In this article we describe and assess the state of the science on systemic psychotherapies. In the quarter century since the first issue of Psychotherapy Research was published, considerable progress has been made. There is an increasingly solid evidence base for systemic treatments, which includes a wide range of approaches to working conjointly with couples and families. Moreover, there are exciting new developments that hold promise for explicating the dynamic processes of therapeutic change in couple and family systems. METHOD: We begin by explaining how we view "systemic therapies" as different from individual approaches and then summarize what we have learned in the past 25 years about this set of treatments, how we have learned it, and what we have yet to learn. RESULTS AND CONCLUSIONS: We consider current trends in research on outcomes and change process mechanisms, and end with speculations about what lies ahead in the interrelated domains of systemic research and practice.

Terapia de Casal/métodos , Terapia Familiar/métodos , Terapia Conjugal/métodos , Transtornos Mentais/terapia , Pesquisa/tendências , Terapia de Casal/tendências , Terapia Familiar/tendências , Humanos , Terapia Conjugal/tendências , Psicoterapia/métodos , Psicoterapia/tendências
Adicciones (Palma de Mallorca) ; 27(3): 205-213, 2015. tab
Artigo em Espanhol | IBECS | ID: ibc-146684


El policonsumo de drogas es cada vez más prevalente entre los jóvenes españoles. El Observatorio Europeo de las Drogas y las Toxicomanías establece tres tipologías de policonsumo: Patrón A (consumidores de alcohol y tabaco), Patrón B (consumidores de cannabis junto con alcohol y/o tabaco) y Patrón C (consumidores de cannabis junto con alcohol y tabaco y al menos otra droga ilegal). Los objetivos son: 1) estudiar la frecuencia de consumo de drogas en una muestra de jóvenes universitarios españoles del ámbito de la salud y el deporte según el sexo; 2) describir los patrones de policonsumo; 3) estudiar la relación entre el policonsumo de los participantes y el policonsumo de las personas de su entorno próximo (padres, hermanos, pareja y mejor amigo). La muestra consta de 480 universitarios (43.7% chicas) entre 18 y 36 años. Se administró un autoinforme para evaluar el policonsumo de los participantes y de sus referentes más próximos. Un 46% de los participantes eran consumidores de dos o más sustancias, de los cuales un 29.4% correspondían al Patrón A, un 50.7% al Patrón B, un 16.7% al Patrón C y un 3.2% a otros patrones de policonsumo (alcohol + cocaína; alcohol + cocaína + tabaco; alcohol + inhalantes; anfetaminas + alucinógenos + Spice). Se observa una elevada concordancia entre el policonsumo de los participantes y el de sus referentes próximos, de modo que si el referente es policonsumidor es más probable que el participante también lo sea. El policonsumo de drogas en el entorno próximo de los jóvenes deviene uno de los elementos clave a tener en cuenta en futuras campañas preventivas

The prevalence of polydrug use continues to grow among Spanish college students. The European Observatory for Drugs and Addictions establishes three different types of polydrug use: Pattern A (consumers of alcohol and tobacco), Pattern B (consumers of cannabis plus alcohol and/or tobacco) and Pattern C (consumers of cannabis plus alcohol plus tobacco plus at least one other kind of illegal drug). The objectives are: 1) to study the frequency of substance consumption among a sample of young Spanish undergradudates studying health and sports science according to their sex; 2) to describe the patterns of polydrug use; 3) to study the relationship between the polydrug use of the participants and polydrug use within their closest environment (parents, sisters or brothers, best friend and partner). The sample was composed of 480 Spanish undergraduates (43.7% females) aged 18 to 36. The level of drug consumption of students and their closest reference persons was evaluated by means of a self-report measure. A total of 46% of the participants reported consumption of two or more substances; among them 29.4% corresponded to Pattern A, 50.7% to Pattern B and 16.7% to Pattern C, while 3.2% corresponded to other multiple consumption patterns (alcohol + cocaine; alcohol + cocaine + tobacco; alcohol + inhalants; amphetamines + hallucinogens + Spice). An important correlation was observed concerning polydrug use between participants and their closest reference persons: the more the reference person is a multiple consumer, the more the participant tends to consume. Polydrug use within the closest environment emerges as one of the key elements to be taken into account in further prevention programs

Adulto , Feminino , Humanos , Masculino , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Relações Familiares , Autorrelato , Terapia Familiar/organização & administração , Terapia Familiar/tendências , Família/psicologia , Apoio Social , Impacto Psicossocial , Estudantes/psicologia , Inquéritos e Questionários , Modelos Logísticos