Annales medico-psychologiques最新文献

Introduction

Cognitive and Behavioral Therapies (CBT) explore thought patterns related to psychological disorders, acting on the cognitive, behavioral, and emotional levels, according to structured and validated protocols. The patient's cultural representations can be questioned as early as the initial stage of Functional Analysis (FA), enabling CBT models to be adapted to transcultural situations.

Context

FA examines the disorder and its context. Synchrony, based on Cottraux's SECCA model, addresses the cognitions, emotions and beliefs associated with the problematic situation. Diachrony collects structural and anamnestic data related to the disorder. A model of FA can be proposed in a transcultural context, taking into account the social and cultural construction of the symptom, illness, disorder or crisis.

Methodology

By adapting the SECCA model and the diachronic reading grid, FA is adjusted to the transcultural situation, considering aspects relating to culture, exile, migration, the etiological model, the therapeutic itinerary, the traditional treatment of the illness, and the patient's representations and beliefs. It also questions the notion of family and affiliations, transmission, and what, for some patients, is the “invisible world”.

Discussion

The adjustment of FA in a transcultural context raises questions about representations, belief systems and the individual, and the collective history of the patient. Raising the clinicians’ awareness of the cultural issue in CBT helps them to better understand its influence on the clinical expression of psychiatric disorders and their conceptualization by patients, over and above stereotypes and the therapist's own representations.

Conclusion

The theoretical model of FA conceptualized in this way takes into account the subjectivity of the patient, combining the transcultural approach with cognitive-behavioral methodology; and thus making it possible to adapt to our global patients and their singularities.

Context

There is a gap in the literature that qualitatively explores the effects of psychoeducation on siblings who serve as caregivers for persons with schizophrenia. Therefore, this study aims to investigate the qualitative effects of brief need-based psychoeducation on sibling family caregivers of persons with schizophrenia from southern India.

Methods

Ten sibling family caregivers of persons with schizophrenia were recruited for the study, with five in each group receiving either brief need-based psychoeducation or standard care. The participants were interviewed and their responses were recorded. Qualitative data analysis was performed using a combination of thematic and summative content analysis.

Results

The study found that both the intervention and standard care groups of sibling family caregivers of persons with schizophrenia reported similar themes. However, the frequency and prominence of the themes were greater among those in the intervention group, as shown by the summative content analysis. The thematic analysis revealed four major themes: 1) personal experiences with the treatment process, including reduced stigma, active caregiving involvement, bonding, reduced criticality, and coping; 2) improved understanding and management of illness; 3) service satisfaction, and 4) indirect effects on symptomatic and functional recovery.

Conclusion

Brief need-based psychoeducation was found to be more beneficial for sibling family caregivers of persons with schizophrenia, as evidenced by the greater prominence of themes in the intervention group. This study adds to the limited literature on psychoeducation for sibling family caregivers of persons with schizophrenia. Further studies utilizing rigorous qualitative methods are needed to explore the full scope of the intervention's effects.

In at least 67 countries, LGBTQ+ individuals face discrimination and persecution due to their sexual and gender identity. For this reason, some decide to leave their countries of origin to escape violence and to seek better living conditions. Regardless of their reasons for migration, it significantly impacts the expression of their sexual orientation and gender identity. Once they arrive in the host country, they often experience other forms of hardship or violence due to socio-cultural differences, the perception of otherness, and hosting conditions. These factors can have either a positive or a negative impact on their identities. In this context, migration leads to a process of questioning and reconstruction of identity, which needs to be understood in all its complexity if we are to adequately meet their needs for psychosocial support. To gain a better understanding of the impact of migration on the identities of LGBTQ+ migrants, we have based our study on the concepts of the Dialogical Self proposed by H. Hermans, and those of Intersectionality developed by K. Crenshaw. On the one hand, the Dialogical Self depicts identity as a dynamic ensemble of relational Self “voices” that can change, be challenged or reinforced based on time and context, allowing for the development of a complex and harmonious perception of the Self. On the other hand, Intersectionality underscores how different systems of oppression operate to create novel experiences for individuals with multiple marginalized identities. Taking into account the complex and multiple identities that engage in dialogue and that intersect with each other seems to us to be essential for the elaboration of a more decentralized and well-founded clinical and psychosocial approach.

Context and/or stakes

The psychological treatment of young, recently migrated mothers who are suffering from multiple problems (social isolation, precariousness, complex traumas, bereavement, and major depression) represents a real challenge for mental health care professionals. This clinical undertaking requires an understanding of the various vulnerabilities associated with traumatic migratory journeys, social and cultural ruptures, precariousness, and the difficulties of giving birth to a child in such a context.

Objective

The aim of this study is to demonstrate the interest in a transcultural clinical paradigm in order to better take into account the articulation of the problems encountered and to propose appropriate psychological care adapted to these cases.

Materials and methods

We present a protocol of treatment inspired by the transcultural approach which we have illustrated with two paradigmatic clinical follow-ups.

Discussion

We discuss the three dimensions of this system, which we believe to be essential therapeutic levers: the supportive function of the collective, the support provided to improve maternal competency, and narrative skills.

Conclusion

We have determined that by stressing the importance of working on developing maternal and narrative skills. We can help these women in their process of adaptation and improvement so that they can build a better future for themselves and their children.

Context

This article is based on research exploring the impact of external reality, including multiple global crises such as the COVID-19 pandemic, social movements, and political crises, on the therapeutic relationship and the analytical framework. This collaborative study, carried out by researchers from different countries, took shape in response to the COVID-19 health crisis. It aims to understand how psychoanalysts and psychotherapists have had to adapt their practices in the face of these crises, highlighting the importance of improvisation and creativity in maintaining the continuity of the therapeutic process.

Objectives

The principal objective of the study is to identify the impact of shared external realities on the therapeutic process, highlighting the challenges faced by practitioners in a context of multiple crises. The researchers also seek to explore how psychoanalysts and psychotherapists have had to call into question and adapt their practices and frameworks in order to continue working with their patients in an environment marked by uncertainty and the need to improvise.

Methodology

The research is based on qualitative interviews with psychoanalysts and psychotherapists from different countries facing various crises. The researchers analyzed the participants’ responses to identify emerging themes and understand how practitioners navigated these challenges, highlighting coping strategies and adjustments to the therapeutic framework.

Results

The findings confirm the profound impact of external crises on therapeutic practice, particularly in terms of challenging practitioners’ professional identities and the need to adapt therapeutic frameworks to maintain the continuity of the analytical process. Participants expressed a sense of insecurity, frustration and a loss of rituals associated with the move to working online. However, they also showed great creativity in designing their workplace and exploring new therapeutic approaches.

Discussion and conclusion

The discussion underlines the importance of recognizing and addressing the challenges posed by external crises in therapeutic practice, while also highlighting the crucial role of improvisation and creativity in maintaining the continuity of the analytical process. Practitioners must be prepared to rethink and adapt their therapeutic framework to meet the changing needs of their patients, while preserving the fundamental principles of therapy. Ultimately, the study highlights the importance of collaboration and ongoing development between practitioners in overcoming the challenges posed by external crises in order to ensure the quality of therapeutic care.

Parenthood can be a source of stress, especially for parents with young children. For migrants, the task is made more complex by cultural differences and the child's integration into a psychic filiation. Traditionally, parents rely on a social group to help them cope with the demands of parenthood. However, this support may be lacking in migratory situations. The literature in psychology has little data available on the composition of social support networks, particularly for transnational networks. The aim of this study is therefore to explore both the local and transnational support networks for migrant parents with respect to a sense of stress for parents. The sample consisted of 62 migrant parents living in Switzerland, and a quantitative and qualitative methodology was used to analyze the data. The results revealed that migrant parents maintain both local and transnational social networks to cope with the challenges of parenting. First-time arrivals have a less well-developed local support network and a corresponding higher level of parental stress. The density of the local support network increases with the duration of residency in Switzerland.