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Learning process in psychotherapy 心理治疗的学习过程
Pub Date : 2024-07-02 DOI: 10.55414/aqcx5a34
María-Xesús Froxán-Parga
En este trabajo se expone la necesidad de potenciar la investigación de procesos como el camino más adecuado para conocer y explicar el proceso terapéutico al tiempo que se cuestiona la metodología utilizada en la investigación de resultados, predominante en la actualidad para el estudio de la intervención clínica: la comparación de grupos, la asignación de sujetos al azar o la clasificación con etiquetas diagnósticas que dificultan el estudio del proceso terapéutico y la identificación de los elementos que hacen que un tratamiento tenga determinado efecto. Frente a este tipo de investigaciones, se presentan una serie de trabajos que defienden el uso de metodología observacional para la identificación de los procesos de aprendizaje que serían responsables del cambio en terapia, así como el análisis de la interacción terapéutica desde una perspectiva funcional: teniendo en cuenta que la terapia psicológica es fundamentalmente hablada, se plantea que la forma óptima de analizarla es a partir del estudio del intercambio verbal entre cliente y terapeuta. Se presenta un sistema de codificación de la interacción verbal que los autores proponen como herramienta para identificar las funciones de la conducta verbal del terapeuta durante el proceso de intervención clínica y en los distintos trabajos se analizan, entre otros, el papel que desempeñan las instrucciones, los procesos de reforzamiento y control discriminativo, la transferencia de funciones a través de emparejamientos o el lenguaje como proceso colaborativo. 
本文认为有必要加强过程研究,将其作为理解和解释治疗过程的最合适方法,同时质疑目前在临床干预研究中占主导地位的结果研究方法:分组比较、随机分配受试者或用诊断标签进行分类,这些方法阻碍了对治疗过程的研究,也阻碍了确定使治疗产生某种效果的要素。与这类研究相反,一系列著作主张使用观察法来确定治疗过程中产生变化的学习过程,以及从功能角度分析治疗互动:考虑到心理治疗从根本上说是一种口头治疗,因此提出分析心理治疗的最佳方法是研究求助者与治疗师之间的语言交流。作者提出了一套语言互动的编码系统,作为确定治疗师在临床干预过程中语言行为功能的工具,不同的著作分析了指令所起的作用、强化和辨别控制的过程、通过配对进行的功能转移或作为合作过程的语言等。
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引用次数: 0
Un análisis del estímulo discriminativo durante el debate en contextos clínicos 分析临床讨论中的辨别刺激。
Pub Date : 2024-07-02 DOI: 10.55414/gtvdas80
Daniel Echevarría-Escalante, Víctor Estal-Muñoz, María Fernández-Shaw
The Socratic debate has traditionally been described as a procedure through which the therapist attempts to change the irrational beliefs of their client through questioning and dialogue. From an analytical-functional research perspective, it has been defined as a verbal shaping procedure in which the therapist differentially reinforces protherapeutic utterances. The objective of the present study was to analyze the relationship between the discriminative stimuli emitted by the therapist with and without prompts and the responses emitted by the client based on their approach to the therapeutic goal. Sixty debate recordings from 18 cases, which were classified according to their level of effectiveness, were analyzed. The analyses showed no statistically significant differences in the rate per minute of each type of discriminative stimulus according to the level of debate effectiveness. There was also a strong association of the discriminative category with response options and of discriminative with the description of contingencies with the verbalizations approaching the therapeutic goal. It is concluded that some prompts to the discriminative stimulus may make it more likely to evoke target responses, and thus, clients may more efficiently access the verbal reinforcers presented by therapists, facilitating the verbal shaping procedure.
苏格拉底式辩论历来被描述为治疗师试图通过提问和对话来改变求助者不合理信念的一种程序。从分析功能研究的角度来看,苏格拉底辩论被定义为一种语言塑造程序,在这一程序中,治疗师以不同的方式强化支持治疗的话语。本研究的目的是分析治疗师在有提示和无提示的情况下发出的辨别性刺激与求助者根据其对治疗目标的态度所作出的反应之间的关系。我们分析了 18 个案例中的 60 个辩论记录,并根据其有效性水平进行了分类。分析结果表明,根据辩论效果的高低,每分钟每种辨别刺激的比率在统计学上没有显著差异。此外,在接近治疗目标的语言表达中,辨别类刺激与回答选项之间以及辨别类刺激与或然事件描述之间都有很强的关联。结论是,对辨别性刺激的一些提示可能会使其更有可能唤起目标反应,因此,受试者可能会更有效地获得治疗师提供的言语强化物,从而促进言语塑造程序。
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引用次数: 0
Psychology in the Regulatory Framework of the Social Intervention Professions in Spain 西班牙社会干预专业监管框架中的心理学
Pub Date : 2024-07-02 DOI: 10.55414/ssvac618
Manuel-Francisco Martinez-Garcia
En este artículo se quiere poner de relieve la extensa tradición de la Psicología en la intervención social, así como su relevancia tanto en el ámbito público como privado. Es importante destacar esta circunstancia porque la nueva generación de leyes de servicios sociales, y otros textos normativos vinculados a ellas, están generando una serie de cambios en la estructura y funcionamiento de los equipos de atención primaria, privilegiando la disciplina de Trabajo Social en relación a Psicología y Educación Social. La figura del/a profesional de referencia vinculada en exclusiva al Trabajo Social supone de hecho una inadecuada e injusta reserva de actividad y está poniendo en peligro la interdisciplinariedad y la atención integral a la persona usuaria. Además, el/a profesional de la Psicología está desapareciendo de áreas de atención donde tradicionalmente venían trabajando. Pensamos que una ley reguladora de las profesiones de la intervención social podría ser la oportunidad para abordar los problemas que tiene en la actualidad la intervención social.
本文旨在强调心理学在社会干预方面的悠久传统及其在公共和私人领域的相关性。强调这一点非常重要,因为新一代的社会服务法以及与之相关的其他规范性文件,正在对基层医疗团队的结构和运作产生一系列变化,相对于心理学和社会教育学而言,更有利于社会工作学科。事实上,完全与社会工作相关的参考专业人员的形象是一种不充分和不公平的活动保留,正在损害跨学科性和对用户的全面护理。此外,心理学专业人员正在从他们传统工作的护理领域消失。我们认为,一部规范社会干预专业的法律可以成为解决当前社会干预问题的契机。
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引用次数: 0
Éxito terapéutico e instrucciones: comparación del desempeño del terapeuta a través del análisis de la conducta verbal 治疗成功与指导:通过言语行为分析比较治疗师的表现
Pub Date : 2024-07-02 DOI: 10.55414/pgjbx228
Carmen Martínez-Díaz, G. Pereira, Rosana García-Morales, M. Froxán-Parga
Instructions are used in clinical practice to facilitate the acquisition of new behaviors and eliminate other problematic ones. Despite various studies on instructions in the experimental field, there is not as much research framed within the clinical realm. Therefore, the objective of this article is to explore therapeutic interaction in relation to instructions. Eleven cases of individual psychotherapy were recorded using an observational methodology and the Acoveo category system. The sample was divided into three groups (success, partial success, and failure) based on their percentage of protherapeutic verbalizations, and the significance and Yule’s Q statistic of three sequential analyses were compared. The relationships studied were: Instruction Follow-up and Positive Reinforcement; Non-Instruction Follow-up and Negative Reinforcement; Instruction Follow-up and Discriminative Stimulus; client and therapist categories, respectively. The results showed that in the second and last relationship in the success group, they were significant unlike the others. In conclusion, in all three groups, therapists reinforced follow-up expressions, but only in the success group were non-follow-up expressions punished, and follow-up affirmed by the client was evaluated significantly.
在临床实践中,指导被用于促进新行为的习得和消除其他有问题的行为。尽管在实验领域有很多关于指导的研究,但在临床领域的研究却不多。因此,本文旨在探讨与指导相关的治疗互动。本文采用观察法和 Acoveo 分类系统记录了 11 个个体心理治疗案例。根据治疗前言语的百分比将样本分为三组(成功组、部分成功组和失败组),并比较了三次序列分析的显著性和尤勒 Q 统计量。研究的关系是跟进指导与正强化;非跟进指导与负强化;跟进指导与辨别性刺激;求助者与治疗师类别。结果表明,在成功组的第二种和最后一种关系中,它们与其他关系不同,具有显著性。总之,在所有三组中,治疗师都强化了跟进表达,但只有在成功组中,非跟进表达受到了惩罚,而客户肯定的跟进表达得到了显著评价。
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引用次数: 0
Estudio de la interacción verbal directa durante la terapia: Efecto del moldeamiento y las contingencias del terapeuta 治疗过程中的直接言语互动研究:塑造和治疗师应急措施的影响。
Pub Date : 2024-07-02 DOI: 10.55414/02t4h932
José Manuel Sánchez-Olid, Luis Valero-Aguayo
Se presenta una investigación sobre la interacción terapéutica directa, cuyo objetivo es analizar el mecanismo de moldeamiento progresivo y las contingencias implementadas por el terapeuta como un posible mecanismo del cambio terapéutico. Han participado tres personas con diferentes problemas psicológicos, en un diseño de caso único con líneas-base concurrentes, a lo largo de ocho sesiones de intervención. Se ha utilizado un sistema de observación, registro y clasificación (SCAFIT) de las respuestas verbales, siguiendo los principios de la Psicoterapia Analítica Funcional. Este sistema implica un análisis meticuloso de las conductas clínicamente relevantes del cliente y las consecuencias de reforzamiento/castigo del terapeuta. Los resultados han mostrado ese efecto de moldeamiento verbal, disminuyendo las conductas poco adecuadas (CCR1) y aumentando progresivamente las conductas adecuadas (CCR1 y 2). La fiabilidad de los observadores, evaluada a través del índice Kappa ha sido elevada (entre 0.56 y 0.65). Las correlaciones entre las conductas de cliente y terapeuta también han sido elevadas (entre r = 0.82 y 0.99). Por su parte, el análisis lag-secuencial y el índice de Q de Yule ha sido significativo y con valores elevados (entre 0.48 y 0.99). Estos resultados confirman la existencia de un proceso de moldeamiento progresivo, que puede atribuirse a las contingencias que va aplicando el terapeuta sesión a sesión. Este sistema introduce una herramienta analítica de utilidad, aplicable para estudiar las interacciones momento a momento que tienen lugar dentro una terapia, y que también podría aplicarse a cualquier otro tipo de terapia verbal.
本文介绍了一项关于直接治疗互动的调查,其目的是分析渐进塑造的机制和治疗师实施的应急措施作为治疗改变的可能机制。三个有不同心理问题的人参与了一个单一病例设计,在八个干预疗程中同时设定基线。根据功能分析心理疗法的原则,采用了一套对言语反应进行观察、记录和分类(SCAFIT)的系统。该系统包括对客户的临床相关行为和治疗师的强化/惩罚后果进行细致分析。结果表明,语言塑造的效果是减少不恰当行为(CCR1),逐步增加恰当行为(CCR1 和 2)。通过 Kappa 指数评估,观察者的可靠性很高(介于 0.56 和 0.65 之间)。客户行为与治疗师行为之间的相关性也很高(r = 0.82 到 0.99 之间)。滞后序列分析和 Yule's Q 指数显著且数值较高(介于 0.48 和 0.99 之间)。这些结果证实了一个渐进的塑造过程的存在,这可以归因于治疗师在每个疗程中采用的应急措施。该系统引入了一种有用的分析工具,可用于研究治疗过程中每时每刻的互动,也可用于任何其他类型的言语治疗。
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引用次数: 0
Aproximación al estudio del reforzamiento verbal en psicoterapia 心理治疗中的语言强化研究方法
Pub Date : 2024-07-02 DOI: 10.55414/0zsymf79
Natalia Andrés López, Víctor Estal-Muñoz, María Fernández-Shaw, Gladis-Lee Pereira
El reforzamiento es uno de los procedimientos que se ha postulado como responsable del cambio conductual en la mayoría de las terapias. Es el principio de conducta más importante y apenas ha sido investigado en su modalidad verbal en contextos clínicos. El objetivo del presente estudio es ahondar sobre este procedimiento y arrojar conocimiento sobre cómo usan los terapeutas el reforzamiento verbal positivo en las diferentes fases de una intervención psicológica. Se analizan 60 sesiones clínicas de terapia conductual mediante un sistema de categorías de la conducta verbal del terapeuta y cliente diseñado para investigar la interacción terapéutica. Los resultados indican que los terapeutas hacen uso de reforzamiento verbal, emitiendo diferentes niveles de aprobación en función del tipo de verbalizaciones de los clientes. Este trabajo permite comprobar la utilidad de la metodología observacional para investigar los procesos que pueden explicar el cambio clínico, entendiendo el papel de los procedimientos de reforzamiento verbal y su relación con otras posibles funciones de la conducta verbal del terapeuta.
在大多数疗法中,强化都被认为是导致行为改变的程序之一。它是最重要的行为原则,但在临床环境中几乎没有对其口头形式进行过研究。本研究旨在深入探讨这一程序,了解治疗师如何在心理干预的不同阶段使用积极的口头强化。本研究使用一套治疗师与受试者言语行为分类系统分析了 60 个临床行为疗法疗程,该系统旨在研究治疗师与受试者之间的互动。结果表明,治疗师使用了言语强化,并根据客户的言语类型给予不同程度的认可。这项工作使我们能够检验观察法对研究临床变化过程的有用性,了解语言强化程序的作用及其与治疗师语言行为的其他可能功能之间的关系。
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引用次数: 0
Verbal pairing to transfer functions by classical conditioning: An experimental study 通过经典条件反射将语言配对转换为转移功能:实验研究
Pub Date : 2024-07-02 DOI: 10.55414/rc6vst94
Marlon Palomino, María Fernández-Shaw, M. Froxán-Parga
The transfer of functions is key to explain the change in behavior resulting from a therapeutic intervention and has traditionally been explained based on operant conditioning processes. This exploratory study sought to find experimental evidence of transfer of functions using classical conditioning procedures. Three conditioned visual stimuli (EC1, EC2 and EC3) and one aversive unconditioned (EI) auditory stimulus were used. EC1 was associated with EC2, EC3 with EI and then verbally paired EC1 with EC3 seeking to transfer the function of the EI to EC2 without ever having been directly associated. Electrodermal activity was measured in four adults and a transfer test was performed. We found only some evidence of transfer of the function of the elicitor EI of electrodermal activity (a chirp) to a visual image (EC2) through the pairing of the previously conditioned words “Antonio” (EC1) and “chirp” (EC3). This exploratory finding tentatively suggests that Pavlovian conditioning could explain some therapeutic processes, related to the effect that the verbal interaction between client and therapist has on the behavior of the former and its control outside the clinic, completing the traditional explanations based on operant conditioning. However, it is insufficient and limitations and suggestions for the continuity of this line of research are discussed.
功能转移是解释治疗干预所导致的行为变化的关键,传统的解释是基于操作性条件反射过程。这项探索性研究试图利用经典条件反射程序寻找功能转移的实验证据。研究使用了三种条件性视觉刺激(EC1、EC2 和 EC3)和一种厌恶性无条件(EI)听觉刺激。EC1与EC2、EC3与EI相关联,然后用语言将EC1与EC3配对,试图将EI的功能转移到EC2,而无需直接关联。我们测量了四名成年人的皮电活动,并进行了转移测试。我们发现只有一些证据表明,通过将先前的条件词 "安东尼奥"(EC1)和 "啾啾"(EC3)配对,皮电活动的诱发因素 EI(啾啾声)的功能转移到了视觉图像(EC2)上。这一探索性发现初步表明,巴甫洛夫条件反射可以解释某些治疗过程,这些过程与求助者和治疗师之间的言语互动对前者行为的影响及其在诊所外的控制有关,从而完善了基于操作性条件反射的传统解释。然而,这还不够,我们还讨论了这一研究思路的局限性和继续研究的建议。
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引用次数: 0
El lenguaje como un proceso colaborativo: una replicación sobre el modelo colaborativo de Clark (Schober y Clark 1989) 语言是一个协作过程:克拉克协作模式的翻版(Schober 和 Clark,1989 年)。
Pub Date : 2024-07-02 DOI: 10.55414/p2w31r82
Bernardo Sánchez-Ruiz, Alberto Zamanillo
The present study attempts to replicate two experimental designs conducted by Clark and his colleagues in 1989, testing the collaborative model of language. In this study, the Tangram task is replaced by a bomb defusal task using the video game Keep Talking and Nobody Explodes. A total of 20 pairs of participants were analyzed based on time taken, number of errors, number of speaking turns, and word count. Similar to the original 1987 study, in another phase of the experiment, a third person (an overhearer) performed the task by listening to a recording of another pair deactivatingbombs. The results of this study indicate a reduction in the number of interventions and words across the trials, as well as a decrease in the number of errors and time spent. No significant differences were found between the performance of pairs carrying out the task and that of non-communicating listeners. These data suggest that language does indeed tend to follow a collaborative model based on common references.
本研究试图复制克拉克及其同事在 1989 年进行的两项实验设计,以测试语言的协作模式。在本研究中,七巧板任务被使用视频游戏 "继续说话,没人会爆炸 "的拆弹任务所取代。共对 20 对参与者进行了分析,依据的是所用时间、错误次数、发言次数和字数。与 1987 年的最初研究类似,在实验的另一个阶段,第三人(监听者)通过监听另一对参与者拆除炸弹的录音来完成任务。这项研究的结果表明,各次试验的干预次数和字数都有所减少,错误次数和所用时间也有所减少。执行任务的双人和不交流的听者的表现没有明显差异。这些数据表明,语言确实倾向于遵循一种基于共同参照物的协作模式。
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引用次数: 0
How Can We Study Change Processes in Psychotherapy While Addressing Its Interactive Nature 如何在研究心理疗法变化过程的同时解决其互动性问题?
Pub Date : 2024-07-02 DOI: 10.55414/97bvad97
Gladis-Lee Pereira, Natalia Andrés-López, María-Xesús Froxán-Parga
Does the empathy or personality of psychotherapists influence the way they do therapy? Is the therapeutic relationship the key to success? Questions such as these are commonly shared in Change Process Research (CPR) and outcome studies. However, these statements, posed in descriptive cross-sectional terms, often imply the use of strategies grounded in causal-linear explanatory models. The present study offers an alternative tool to measure elements of psychotherapy in dynamic, interactive, and interdependent terms. With nine observational categories defined under analytical-behavioral lens, the Acoveo System is an instrument designed to detect the potential functions of verbal exchanges that take place in the psychotherapeutic context from any theoretical orientation. A guide to its application is provided, and its usefulness is elaborated on two of the pivotal common factors in change process research: empathy and therapeutic alliance.
心理治疗师的同理心或个性会影响他们的治疗方式吗?治疗关系是成功的关键吗?诸如此类的问题在变革过程研究(CPR)和结果研究中很常见。然而,这些以描述性横截面术语提出的问题往往意味着要使用以因果线性解释模型为基础的策略。本研究提供了另一种工具,从动态、互动和相互依存的角度来衡量心理治疗的要素。Acoveo 系统在分析行为学视角下定义了九个观察类别,旨在从任何理论取向检测心理治疗背景下发生的言语交流的潜在功能。该系统提供了应用指南,并就改变过程研究中的两个关键共同因素--移情和治疗联盟--阐述了其实用性。
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引用次数: 0
Sistema de categorías descriptivo-funcional para la conducta verbal en psicoterapia 心理治疗中言语行为的描述性功能分类系统
Pub Date : 2024-07-02 DOI: 10.55414/chj30t78
Jesús Alonso-Vega, Gladis-Lee Pereira, María-Xesús Froxán-Parga
Psychological interventions have shown effectiveness for the treatment of different psychological problems. Now, we need to know what processes make these results possible. The observational analysis of the verbal interaction between therapist and client has been used to analyze the learning processes that underlie the client’s behavioral change. To our knowledge, there is no coding system for therapeutic interaction based on functional descriptions that would allow a common understanding across different behavior therapies. Therefore, the purpose of this article is to develop such functional description-based coding system for clinical psychologists’ verbal behavior in clinical settings. Also, we have analyzed 66 clinical sessions belonging to 23 different cases using this coding system, the results have been compared with previous studies. The main result of this study is a system consisting of 5 functional categories with good reliability indices and methodological properties. The discriminant and cluster analysis have yielded similar results to those of previous studies. Finally, we discuss about conceptual and methodological advances of this functional-based coding system, we list the main limitations, and we propose further studies in this line of research.
心理干预已显示出治疗不同心理问题的有效性。现在,我们需要知道是什么过程使这些结果成为可能。通过观察分析治疗师与求助者之间的言语互动,我们可以分析求助者行为改变的学习过程。据我们所知,目前还没有一个基于功能描述的治疗互动编码系统,可以让不同的行为疗法达成共识。因此,本文旨在为临床心理学家在临床环境中的言语行为开发基于功能描述的编码系统。此外,我们还使用该编码系统分析了属于 23 个不同病例的 66 次临床会话,并将结果与之前的研究进行了比较。本研究的主要成果是建立了一个由 5 个功能类别组成的系统,该系统具有良好的可靠性指数和方法学特性。判别分析和聚类分析的结果与之前的研究结果相似。最后,我们讨论了这一基于功能的编码系统在概念和方法上的进步,列出了其主要局限性,并提出了在这一研究领域开展进一步研究的建议。
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引用次数: 0
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Apuntes de Psicología
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