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Formulación de Caso en Psicoterapia: "La Cosa se Mueve" 心理治疗中的案例表述:“事物在移动”
IF 0.3 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2022-11-01 DOI: 10.33898/rdp.v33i123.35974
Ciro Caro García, Álvaro Quiñones
Editorial
社论
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引用次数: 0
Data-Informed Case Formulation with the Trier Treatment Navigator 数据知情的病例配方与特里尔治疗导航
IF 0.3 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2022-11-01 DOI: 10.33898/rdp.v33i123.35971
Danilo Moggia, Jana Schaffrath, Jana Bommer, Birgit Weinmann-Lutz, Wolfgang Lutz
The current article presents a way of practising case formulation using technology augmentation in the context of data-informed psychotherapy. First, we explain how case formulation guides the decision-making processes in psychotherapy and how decisions made under an intuitive clinical judgement can be biased. The use of actuarial methods is pointed out as a way of addressing these biases, mainly through clinical decision support systems based on statistical tools and machine learning algorithms. We present the Trier Treatment Navigator (TTN), a clinical decision support system developed in a University research-based clinical training programme. We show how the TTN can contribute to an initial case formulation and its dynamic adaptations during treatment with a clinical case. Finally, we discuss how case formulation and data-informed psychotherapy are aimed at the same goal: treatment personalisation. We argue that case formulation and data-informed psychotherapy enrich and feedback on each other.
目前的文章提出了一种在数据知情心理治疗的背景下使用技术增强实践案例制定的方法。首先,我们解释了案例制定如何指导心理治疗中的决策过程,以及在直观的临床判断下做出的决策如何可能有偏见。指出精算方法的使用是解决这些偏差的一种方法,主要是通过基于统计工具和机器学习算法的临床决策支持系统。我们提出的特里尔治疗导航(TTN),一个临床决策支持系统开发的大学研究为基础的临床培训计划。我们展示了TTN如何有助于初步病例制定及其在临床病例治疗期间的动态适应。最后,我们讨论了案例制定和数据知情的心理治疗如何瞄准同一个目标:治疗个性化。我们认为,案例制定和数据知情的心理治疗相互丰富和反馈。
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引用次数: 0
La formulación del caso desde la perspectiva de una mente gobernada por objetivos y creencias 从一个受目标和信念支配的头脑的角度来阐述案例
IF 0.3 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2022-11-01 DOI: 10.33898/rdp.v33i123.35674
Angelo Maria Saliani, Benedetto Astiaso Garcia, Claudia Perdighe, B. Barcaccia, Francesco Mancini
La formulación del caso (FC) es el requisito necesario de cada tratamiento psicoterapéutico,independientemente de la orientación teórica del clínico. Sin una FC no hay un mapa delfuncionamiento del problema que aflige al paciente y, en consecuencia, no hay posibilidad de unaestrategia terapéutica clara derivada de ella. En este artículo se presenta un método de FC en cinco puntos adaptado a la singularidad delpaciente que tenga en consideración la descripción del problema, su posible clasificacióndiagnóstica y, sobre todo, su explicación. La explicación se refiere a las causas psicológicaspróximas y remotas del problema concreto, las que determinan su mantenimiento y, por último, lasprecipitantes, es decir, las que provocaron su aparición. Llamamos a los cinco puntos de la FC: 1)descripción del problema y diagnóstico clínico; 2) perfil interno; 3) mantenimiento; 4)descompensación; 5) vulnerabilidad. El marco teórico en el que se inscribe este tipo de FC es el de una psicoterapia cognitiva (TC)inspirada en un modelo finalista de la mente (Miller, Galanter, Pribram 1960), en el que, en laexplicación del comportamiento individual, junto a las creencias, juegan un papel fundamental losobjetivos sobrevalorados por el individuo.Por último, se discutirán las importantes implicaciones de la estrategia terapéutica que involucraneste tipo de formulación y la necesidad de conocer y aplicar los principios que rigen los procesos deaceptación cognitiva.
病例的制定是每种心理治疗治疗的必要要求,无论临床医生的理论指导如何。没有CF,就没有困扰患者的问题的功能图,因此不可能从中得出明确的治疗策略。本文提出了一种适应患者独特性的五点FC方法,该方法考虑到问题的描述、可能的诊断分类,尤其是对问题的解释。解释涉及特定问题的精神和遥远的心理原因,决定其持续存在的原因,最后是沉淀剂,即导致其出现的原因。我们称FC的五点为:1)问题描述和临床诊断;2) 内部概况;3) 维护;4) 失代偿;5) 脆弱性。这类FC的理论框架是一种认知心理疗法(TC),其灵感来自一种最终的思维模式(Miller,Galanter,Pribram 1960),在这种模式中,个人高估的目标与信仰一起在解释个人行为方面发挥着关键作用。最后,将讨论涉及配方类型的治疗策略的重要含义,以及了解和应用指导认知接受过程的原则的必要性。
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引用次数: 0
Formulación de Caso: Disolviendo Temáticas Disfuncionales Mediante Regulación de Dominios de Conocimiento Intersubjetivo 案例制定:通过调节主体间知识领域来解决功能失调的主题
IF 0.3 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2022-11-01 DOI: 10.33898/rdp.v33i123.35620
Álvaro Quiñones, Carla Ugarte
El presente texto surge de un programa de investigación en procesos de psicoterapia cuyo principal objetivo es contribuir a comprender y cambiar el significado intersubjetivo que implica malestar y/o desregulación psicológica, y que denominamos Tema Intersubjetivo Disfuncional. Concretamente, abordamos lo siguiente: a) se plantea un modelo de formulación de caso con sello evolucionista que esencialmente emerge de la investigación cualitativa de procesos psicoterapéuticos completos, relaciona e integra lo nomotético e idiográfico y lo paradigmático y narrativo, b) se describe el protocolo de formulación de caso evolucionista (FCE) compuesto de tres secciones: Formulación de Caso_Evaluación, Formulación de Caso_Intervención y Entrevista de Valoración de Proceso, y c) se presenta un caso clínico que ejemplifica la elaboración de la conceptualización inicial, utilizando el FCE_Evaluación.
本文来自一个心理治疗过程研究计划,其主要目的是帮助理解和改变心理不适和/或放松调节所涉及的主观间意义,我们称之为功能失调的主观间主题。具体而言,我们解决了以下问题:(a)提出了一种具有进化印记的案例制定模型,该模型基本上源于对完整心理治疗过程的定性研究,将规范和具体以及范式和叙事联系起来并整合在一起;(b)描述了由三个部分组成的进化案例制定协议:案例制定评估,案例制定-干预和过程评估面试,以及(c)介绍了一个临床案例,该案例举例说明了使用FCE评估进行初始概念化的开发。
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引用次数: 0
Innovative Moments and Case Formulation 创新时刻和案例制定
IF 0.3 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2022-11-01 DOI: 10.33898/rdp.v33i123.35947
Carina Magalhães, Patrícia Pinheiro, M. Gonçalves, Jéssica Silva
At the beginning of the therapeutic process, clients frequently feel immersed in their problems, and demoralized, with a negative perspective of different areas of their lives. The clients´ discourse is specially focused on difficulties and previous ineffective attempts to overcome their problems. Even though positive aspects of the clients’ life continue to exist, such as resources and strengths, they have little visibility in the clients’ speech and, consequently, in the therapist’s assessment and intervention planning. Moreover, most psychotherapy models emphasize a focus on the deficits of the clients, centered on the correction of difficulties as a way to achieve mental health. In this context, we highlight the importance of integrating resources and strengths of the clients’ life in case assessment, clinical formulation, and treatment planning. This information can be collected in the assessment phase, but in order to make it explicit the relevance of this information we created a protocol designed for this purpose (Feedback Initiated Narrative Development Protocol [FIND]). The first component of FIND invites clients to reflect on aspects beyond their problem like their personal strengths, significant values, positive autobiographical episodes, and useful strategies that have been adopted in the past. This interview was largely influenced by narrative therapy and innovative moments research, and it provides information regarding clients’ resources that may be useful to psychotherapists from different approaches. In this paper, we presented a clinical case formulation considering resources evaluated with the FIND protocol.
在治疗过程开始时,客户经常感到沉浸在自己的问题中,情绪低落,对生活的不同领域持负面看法。客户的谈话特别集中在困难和以前克服问题的无效尝试上。尽管客户生活中的积极方面仍然存在,如资源和优势,但它们在客户的演讲中几乎没有可见性,因此在治疗师的评估和干预计划中也没有可见性。此外,大多数心理治疗模式都强调关注客户的缺陷,以纠正困难为中心,以此实现心理健康。在这种情况下,我们强调在病例评估、临床制定和治疗计划中整合客户生活资源和优势的重要性。这些信息可以在评估阶段收集,但为了明确这些信息的相关性,我们创建了一个为此目的设计的协议(反馈启动叙事发展协议[FIND])。FIND的第一个组成部分邀请客户反思问题之外的方面,如他们的个人优势、重要价值观、积极的自传情节和过去采用的有用策略。这次采访在很大程度上受到了叙事疗法和创新时刻研究的影响,它提供了关于客户资源的信息,这些信息可能对不同方法的心理治疗师有用。在这篇论文中,我们提出了一个临床病例公式,考虑到用FIND方案评估的资源。
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引用次数: 0
Terminación Prematura en Psicoterapia y Características de los Pacientes: un estudio empírico 心理治疗过早终止与患者特征的实证研究
IF 0.3 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2022-11-01 DOI: 10.33898/rdp.v33i123.35623
P. Santangelo, Karina Conde, Marcos Emanuel Mattiello
Considerar la terminación prematura en psicoterapia es esencial cuando hablamos de eficacia y efectividad. El objetivo de este trabajo fue evaluar la relación entre las características demográficas de los pacientes y el nivel de severidad al inicio del tratamiento con la terminación prematura en psicoterapia. Método. Estudio longitudinal, con una muestra clínica de N = 134 pacientes. Se administraron en el proceso de admisión el PID – 5 y el OQ.45.2 y en la tercera sesión de psicoterapia, octava y última sesión el OQ.45.2.  Se realizaron análisis de regresión logística con deserción como variable de resultado, y correlaciones de Spearman para estimar la relación entre las características personales y la cantidad de sesiones en el grupo que abandonó el proceso psicoterapéutico. Resultados. El malestar al inicio del proceso psicoterapéutico no se relacionó con la deserción. La única faceta de personalidad relacionada con la deserción fue Labilidad Emocional, a menor Labilidad Emocional, hubo una probabilidad 16% menor de deserción. Un mayor nivel socioeconómico y nivel de instrucción redujeron en un 42% y 16% las probabilidades de deserción, respectivamente. Los varones, por su parte, tuvieron 3 veces más probabilidad de abandonar el tratamiento que las mujeres.
当我们谈论有效性和有效性时,考虑心理治疗的过早终止是至关重要的。在心理治疗中,患者的人口统计学特征与治疗开始时的严重程度和过早终止之间的关系。方法。纵向研究,临床样本N = 134例患者。在入院过程中给予PID - 5和OQ.45.2,在第三次、第八次和最后一次心理治疗中给予OQ.45.2。采用logistic回归分析,以遗弃为结果变量,并采用Spearman相关方法估计个人特征与离开心理治疗过程组的治疗次数之间的关系。结果。心理治疗过程开始时的不适与遗弃无关。唯一与被遗弃相关的人格方面是情绪不稳定,情绪不稳定越低,被遗弃的可能性就越低16%。社会经济地位的提高和教育水平的提高使辍学的可能性分别降低了42%和16%。男性放弃治疗的可能性是女性的3倍。
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引用次数: 0
Apropiación de Sí 占有自己
IF 0.3 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2022-11-01 DOI: 10.33898/rdp.v33i123.35624
Danilo Andrés Rodríguez Lizana, A. J. Duarte Soto
Que el sujeto consultante desarrolle -a lo largo de su tratamiento- una comprensión de los fundamentos subjetivos de su padecimiento, es considerado como un variable relevante por la investigación en proceso psicoterapéutico, y una cualidad transversal en modelos psicoterapéuticos fundamentados en el paradigma Constructivista. Desde el método psicoterapéutico Posracionalista Fenomenológico Hermenéutico, a este fenómeno se le denomina: Apropiación de sí. Al ser un fenómeno que ocurre en la esfera privada de la experiencia, se estima relevante su estudio desde una metodología que acceda a éste, desde la primera persona que lo experimenta. De esta manera, se realizó un estudio cualitativo, de alcance descriptivo, utilizando la metodología de Entrevista Micro-fenomenológica. Se recolectó y analizó, bajo esta metodología, los resultados de diez entrevistas a sujetos que hayan cursado una psicoterapia de corte constructivista. Los resultados obtenidos permiten comprender la apropiación de sí como un fenómeno transversal en los sujetos entrevistados, caracterizándose como una transformación en el modo de acceder comprensiblemente a su propio padecer. Esta inteligibilidad permite una posición en propiedad respecto a sus circunstancias, que orienta a la acción renovadora, abriendo posibilidades a través de la transformación personal.
在心理治疗过程中,咨询主体在整个治疗过程中发展对其疾病的主观基础的理解,被认为是心理治疗过程研究的相关变量,也是基于建构主义范式的心理治疗模型的横向质量。从解释学现象学的后理性主义心理治疗方法来看,这种现象被称为自我占有。作为一种发生在私人经验领域的现象,它被认为是相关的研究方法,从第一个经历它的人。因此,本研究采用微观现象学访谈的方法,进行描述性定性研究。本研究采用建构主义心理治疗方法,对10名接受建构主义心理治疗的受试者进行访谈。本研究的目的是分析在接受采访的受试者中,自我占有是一种横向现象,其特征是对自身疾病的理解方式的转变。这种可理解性允许对其环境的所有权地位,引导更新行动,通过个人转变打开可能性。
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引用次数: 0
Terapia de Aceptación y Compromiso en un niño con celos y rumia disfuncionales 对功能失调的嫉妒和反刍儿童的接受和承诺治疗
IF 0.3 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2022-07-01 DOI: 10.33898/rdp.v33i122.1146
Angel Alonso Sanz, Adrian Barbero-Rubio
Acceptance and Commitment Therapy (ACT) is becoming a promising intervention in childhood psychological problems. This study addresses the intervention from ACT in a case of a 9-year-old child (J) who shows multiple disruptive behaviors in the family context, especially in situations involving his younger brother, and who also has a very extended rumination pattern. An A-B single case design with follow-up measures was used. The results show a significant improvement in the intervention objectives. The main exercises and metaphors that were used to increase the psychological flexibility of J are presented, as well as the intervention carried out with the parents: both in the management of their own psychological barriers as well as the guidelines that were provided to them to promote a more flexible behavior in their child.
接受与承诺治疗是治疗儿童心理问题的一种有效方法。本研究针对一名9岁儿童(J)进行ACT干预,该儿童在家庭环境中表现出多种破坏性行为,特别是在涉及其弟弟的情况下,并且还具有非常扩展的反刍模式。采用A-B单病例设计及随访措施。结果显示干预目标有显著改善。本文介绍了用于增加J心理灵活性的主要练习和隐喻,以及与父母一起进行的干预:既包括管理他们自己的心理障碍,也包括提供给他们的指导方针,以促进孩子更灵活的行为。
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引用次数: 0
Salud Espiritual, Clima Organizacional y Funcionamiento Familiar 精神健康、组织气氛和家庭运作
IF 0.3 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2022-07-01 DOI: 10.33898/rdp.v33i122.994
Carlos Marcelo Moroni, Lucio Abdiel Olmedo Espinosa, Victor Andres Korniejczuk
Human beings spend a large part of the day in the workplace. Many of the burdens and concerns that arise there remain on your mind even outside of work hours. These burdens can affect and endanger the physical, emotional and family health of each individual. This study was quantitative, descriptive, correlational, ex post facto and cross-sectional. A total of 232 workers in a dependency relationship with an organization in Mexico participated. In the analysis of the results, a statistically significant relationship was found between spiritual health and the perception of the organizational climate (ρ = .231, p <.001) and with family functioning (ρ = .447, p <.001). These results show that the higher the spiritual health, the better the organizational climate and family functioning. This means that the connection with a supreme being, with the environment and with oneself, on a spiritual level, improves the perception that the individual has of their work and family environment.
人类一天中的大部分时间都在工作场所度过。即使在工作时间之外,那里出现的许多负担和担忧仍然萦绕在你的脑海中。这些负担会影响和危害每个人的身体、情感和家庭健康。这项研究是定量的、描述性的、相关的、事后的和横断面的。共有232名与墨西哥某组织有依赖关系的工作人员参加了会议。在对结果的分析中,精神健康与组织氛围感知(ρ=.231,p<.001)和家庭功能(ρ=.447,p<0.001)之间存在统计学显著关系。这些结果表明,精神健康越高,组织氛围和家庭功能越好。这意味着,在精神层面上,与至高无上的存在、环境和自己的联系,提高了个人对工作和家庭环境的感知。
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引用次数: 0
Co-construcción de la Alianza Terapéutica en Mujeres Jóvenes con Intento suicida. Análisis Discursivo del Diálogo Terapéutico: Estudio de Caso 在有自杀企图的年轻女性中共同建立治疗联盟。治疗对话的话语分析:个案研究
IF 0.3 Q4 PSYCHOLOGY, CLINICAL Pub Date : 2022-07-01 DOI: 10.33898/rdp.v33i122.1105
Bernardo Enrique Roque Tovar, Edgar Antonio Tena Suck, Antonio Sánchez Antillón
This article explores the construction of the therapeutic alliance in young women who have experienced a suicide attempt through the analysis of an episode taken from the psychotherapy treatment of a specific case. We are based on the conception of the therapeutic Alliance as a constant negotiation between therapist and patient and that can be appreciated en their therapeutic dialogue. The selected methodology was discourse analysis based on the speech acts theory.; the used instrument was the David Liberman Algorythm.The results show the importance of linguistic complementarity in the construction of the Alliance and at the same time the speech acts that suggest it. The article finishes with a series of conclusions to be considered for the clinician when building Alliance in general and specifically with cases who have attempted suicide.
本文通过对一个具体案例的心理治疗插曲的分析,探讨了在经历过自杀企图的年轻女性中治疗联盟的构建。我们基于治疗联盟的概念,作为治疗师和患者之间的持续协商,这可以在他们的治疗对话中得到赞赏。本文选择的研究方法是基于言语行为理论的语篇分析。使用的工具是David Liberman算法。研究结果表明语言互补性在联盟建设中的重要性,同时也表明了语言互补性的言语行为。文章以一系列结论结束,临床医生在建立联盟时要考虑到一般情况下,特别是与自杀未遂的病例。
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引用次数: 0
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Revista de Psicoterapia
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