RESUMEN
OBJECTIVE: The aim of this study is to identify the main processes and outcomes related to family-centred care (FCC) in neuromotor and functional rehabilitation of preschool children with cerebral palsy (CP). BACKGROUND: FCC is considered a reference for best practices in child rehabilitation. CP is the most common cause of physical disability in childhood with repercussions on functionality. There is a gap in knowledge of the practical principles of FCC, and it is necessary to develop a reference model for the practice of child rehabilitation professionals. METHODS: In this scoping review, the main databases selected were as follows: LILACS; Pubmed; Embase; The Cochrane Library; CINAHL (EBSCO); Scopus; Web of Science; PEDro (Physiotherapy Evidence Database); Open Gray and other banks of thesis. The terms combined in the search strategy were as follows: 'Family-centered', 'Family-centred' and 'CP'. Inclusion criteria are as follows: studies on preschool-aged children with CP, undergoing family-centred functional therapeutic interventions (FCFTI) with outcomes on bodily structures and functions and/or activities and/or participation. RESULTS: The main participatory care methods identified were home intervention, environmental enrichment, collaborative realistic goal setting, planning of home-based activities and routine, child assessment feedback, family education/training, family coaching, encouraging discussion, observation of therapist and supervised practice. The main relational care qualities identified were as follows: respect, active listening, treat parents as equals, clear language, respect parents' ability to collaborate, demonstrate genuine care for the family, appreciate parents' knowledge and skills, demonstrate competence, experience and commitment. The main outcomes identified in children were improvement in motor and cognitive function and the child's functional ability. The main parentaloutcomes identified were empowerment, feeling of competence, self-confidence, motivation and engagement. CONCLUSION: The main differences in FCFTI programs refer to the parental education/guidance component and the amount of intervention carried out by parents. It is possible that the elements chosen by the therapist in a FCFTI depend on characteristics of the child and caregivers.
Asunto(s)
Parálisis Cerebral , Humanos , Parálisis Cerebral/rehabilitación , Preescolar , Niño , Atención Dirigida al Paciente , Terapia Familiar/métodos , Relaciones Profesional-FamiliaRESUMEN
La alianza terapéutica en pacientes con Anorexia Nerviosa constituye un desafío debido a la gravedad de muchos de estos pacientes, a la falta de conciencia de enfermedad que poseen y a la resistencia al cambio, tanto del paciente como de sus familias. Frecuentemente, existe un desconocimiento por parte de los equipos médicos, de dicha patología y de su manejo. Diversos autores han aportado elementos necesarios para una adecuada alianza terapéutica y proponen estrategias que faciliten la construcción de esta alianza. En este artículo se lleva a cabo una revisión de las observaciones ofrecidas por varios autores, desde donde se reflexiona acerca de la importancia de la alianza terapéutica en pacientes con Anorexia Nerviosa y sus familias.
The therapeutic alliance in patients with Anorexia Nervosa constitutes a challenge due to several factors such as the severity of the illness that most of these patients suffer, their lack of awareness of disease, and the resistance to change in the patient and their family. Medical teams are frequently ignorant of this pathology and its treatment. Various authors have contributed in terms of the necessary elements for an adequate therapeutic alliance and in terms of delivering strategies to facilitate this alliance. In this article we will review several authors and reflect on the importance of the therapeutic alliance in patients with Anorexia Nervosa and their families.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Anorexia Nerviosa/terapia , Terapia Familiar/métodos , Alianza Terapéutica , Anorexia Nerviosa/psicología , Relaciones Padre-HijoRESUMEN
Culturally adapted evidence-based parenting interventions constitute a key strategy to reduce widespread mental health disparities experienced by Latinx populations throughout the United States. Most recently, the relevance of culturally adapted parenting interventions has become more prominent as vulnerable Latinx populations are exposed to considerable contextual stressors resulting from an increasingly anti-immigration climate in the country. The current study was embedded within a larger NIMH-funded investigation, aimed at contrasting the differential impact of two culturally adapted versions of the evidence-based parenting intervention known as GenerationPMTO©. Specifically, a sample of low-income Mexican-origin immigrants was exposed either to a culturally adapted version of GenerationPMTO primarily focused on parent training components, or to an enhanced culturally adapted version in which parenting components were complemented by sessions focused on immigration-related challenges. The sample for the study consisted of 103 Mexican-origin immigrant families (190 individual parents). Descriptive analysis and generalized estimating equations (GEEs) indicated that exposure to the enhanced intervention, which included context- and culture-specific sessions, resulted in specific benefits for parents. However, the magnitude of the impact was not uniform for mothers and fathers and differed according to the type of immigration-related stress being examined (i.e., intrafamilial vs. extrafamilial stress). Overall, findings indicate the relevance of overtly addressing contextual (e.g., discrimination) and cultural challenges in culturally adapted interventions, as well as the need to increase precision according to the extent to which immigration-related stressors impact immigrant mothers and fathers in common and contrasting ways. Implications for family therapy practice and research are discussed.
Las intervenciones basadas en evidencia, dirigidas a padres y adaptadas a la cultura son una estrategia clave para reducir las desigualdades en salud mental generalizadas que las poblaciones de latin@s experimentan en los Estados Unidos. Más recientemente, la relevancia de intervenciones dirigidas a padres adaptadas a la cultura ha adquirido más peso al estar las poblaciones de latin@s expuestas a factores estresantes contextuales considerables como resultado de un ambiente cada vez más contrario a la inmigración en el país. Este estudio fue incluido dentro de una investigación de mayor escala financiada por NIMH cuyo objetivo era contrastar el impacto diferencial de dos versiones adaptadas a la cultura de la intervención basada en evidencia y dirigida a padres conocida como GenerationPMTO© . En específico, se expuso una muestra de inmigrantes de origen mexicano de bajo ingreso, o a una versión de GenerationPMTO adaptada a la cultura y enfocada principalmente en elementos de entrenamiento de padres, o a una versión reforzada adaptada a la cultura en la cual los elementos de padres se complementaron con sesiones enfocadas en retos asociados a la inmigración. La muestra para el estudio consistió de 103 familias inmigrantes de origen mexicano (190 padres individuales). Análisis descriptivos y ecuaciones de estimación generalizadas indicaron que la exposición una intervención reforzada, que incluía sesiones contextual y culturalmente específicas, generaron beneficios específicos para los padres. Sin embargo, la magnitud del impacto no fue uniforme para madres y padres y fue distinta según el tipo de estrés por inmigración examinado (p.ej., estrés intrafamiliar versus estrés extrafamiliar). En general, los hallazgos indican la relevancia de enfrentar abiertamente retos contextuales (p.ej., discriminación) y culturales en intervenciones adaptadas a la cultura, así como la necesidad de aumentar la precisión conforme a cómo los factores estresantes asociados a la inmigración afectan a madres y padres inmigrantes de la misma y diferentes maneras. Se discuten las implicaciones para la práctica e investigación de terapia familiar.
Asunto(s)
Asistencia Sanitaria Culturalmente Competente/métodos , Educación no Profesional/métodos , Terapia Familiar/métodos , Americanos Mexicanos/psicología , Estrés Psicológico/terapia , Adulto , Niño , Trastornos de la Conducta Infantil/etnología , Trastornos de la Conducta Infantil/terapia , Preescolar , Emigrantes e Inmigrantes/psicología , Femenino , Humanos , Masculino , México/etnología , Aceptación de la Atención de Salud/etnología , Aceptación de la Atención de Salud/psicología , Pobreza/etnología , Pobreza/psicología , Estrés Psicológico/etnología , Estrés Psicológico/psicología , Estados Unidos , Poblaciones Vulnerables/etnología , Poblaciones Vulnerables/psicologíaRESUMEN
Behavioral health and substance use centers have started focusing efforts on creating, adopting, and implementing evidence-based practices and programs that effectively address the needs of women and, particularly, mothers entering treatment with children. However, women with substance use disorders (SUDs) remain an underserved and understudied population; even less studied are the complexities and unique SUD treatment needs of women who have children. Family therapists' systemic training is a valued approach in conceptualizing and implementing treatment for mothers with SUDs and their families. This study explored the construct of mothering children during family-centered substance use treatment using a transcendental phenomenological approach. Analysis revealed themes related to motherhood, parenting, and support for mothers and children. Two themes emerged from the data: (a) grappling with motherhood and addiction leading to the decision for treatment and (b) specific aspects of the treatment program conducive to motherhood. Results indicated the positive impact of mothers' experiences in family-centered substance use treatment, aligning with previous literature that suggests mothers are more engaged in treatment when their children remain in their care. The insights gleaned from the participants in this study provide suggestions for further improving programming that supports mothers and their children during the recovery process. Treatment considerations are offered for family therapists working with mothers with SUDs and their families.
Los centros para la salud conductual y el consumo de sustancias han comenzado a centrar sus esfuerzos en la creación, la adopción y la implementación de prácticas y programas factuales que aborden eficazmente las necesidades de las mujeres y, particularmente, de las madres que ingresan en un tratamiento con hijos. Sin embargo, las mujeres con trastorno por consumo de sustancias siguen siendo una población marginada y poco estudiada; y aun menos estudiadas son las complejidades y las necesidades exclusivas de tratamiento para los trastornos por consumo de sustancias de las mujeres que tienen hijos. La capacitación sistémica de los terapeutas familiares es un enfoque valioso a la hora de conceptualizar e implementar el tratamiento para las madres con trastornos por consumo de sustancias y sus familias. Este estudio analizó el constructo de la maternidad durante el tratamiento para el consumo de sustancias centrado en la familia utilizando un enfoque fenomenológico trascendental. El análisis reveló temas relacionados con la maternidad, la paternidad y el apoyo para las madres y los hijos. De los datos surgieron dos temas: (a) la lucha con la maternidad y la adicción conducente a la decisión de recibir tratamiento y (b) aspectos específicos del programa de tratamiento favorables para la maternidad. Los resultados indicaron el efecto positivo de las experiencias de las madres en el tratamiento para el consumo de sustancias centrado en la familia en consonancia con bibliografía anterior que sugiere que las madres se comprometen más con el tratamiento cuando sus hijos quedan a su cuidado. Las apreciaciones recogidas de los participantes de este estudio ofrecen sugerencias para mejorar más las programaciones que apoyen a las madres y a sus hijos durante el proceso de recuperación. Se ofrecen consideraciones sobre el tratamiento para los terapeutas familiares que trabajan con madres con trastornos por abuso de sustancias y sus familias.
Asunto(s)
Terapia Familiar/métodos , Madres/psicología , Responsabilidad Parental/psicología , Tratamiento Domiciliario/métodos , Trastornos Relacionados con Sustancias/terapia , Adulto , Femenino , Humanos , Relaciones Madre-Hijo/psicología , Aceptación de la Atención de Salud/psicología , Evaluación de Programas y Proyectos de Salud , Apoyo Social , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
Family therapy has often been conceptualized as a conversational process whereby therapists and clients generate new meanings. Based on a 3-year study of conversational practices observable in successful family therapy processes of Chilean families with a child/adolescent who is engaged in disruptive behaviors, we looked for clinical examples of Transforming Interpersonal Patterns (TIPs). TIPs are a key aspect of the IPscope, a framework we used to explore the meaning-making processes in family therapy. TIPs constitute a novel approach to explore therapeutic processes by identifying empirically traceable conversational practices involved in generating "new meanings." TIPs are involved in bringing forth and discursively articulating ("talking-into-being") clients' preferred ways of relating and living (i.e., relational preferences or RPs). We analyze conversational data from successful family therapy sessions/treatments, and present an emergent model of five categories of conversational practices making up TIPs, namely: Preparatory TIPs, Identifier TIPs, Tracker TIPs, Transformer TIPs, and Consolidator TIPs. We have called them "realizers" because these conversational practices help families talk-into-being (or "make real") particular relational preferences. We also offer user-friendly descriptors of realizers' subcategories (e.g., Measuring TIPs) which may help practitioners to recognize, learn, and perform these conversational invitations. Theoretical consequences and future lines of research are discussed.
La terapia familiar generalmente se ha conceptualizado como un proceso conversacional por medio del cual los terapeutas y los pacientes generan nuevos significados. Basándose en un estudio de tres años de prácticas conversacionales observables en procesos satisfactorios de terapia familiar de familias chilenas con un niño/adolescente que tiene comportamientos disruptivos, buscamos ejemplos clínicos de patrones interpersonales transformadores (PIT). Estos patrones son un aspecto clave del "IPscope" o instrumento de evaluación de los patrones interpersonales (Tomm, St. George, Wulff, & Strong, 2014), un marco que usamos para analizar los procesos de creación de significado en la terapia familiar. Los patrones interpersonales transformadores constituyen un enfoque innovador para analizar los procesos terapéuticos mediante el reconocimiento de prácticas conversacionales fáciles de seguir empíricamente que participan en la generación de "significados nuevos". Los patrones interpersonales transformadores intervienen en la presentación y la articulación discursiva ("convencer de crear") de las manersa preferidas de los pacientes de relacionarse y vivir (p. ej.: preferencias relacionales o PR). Analizamos datos conversacionales de sesiones/tratamientos satisfactorios de terapia familiar y presentamos un modelo emergente de cinco categorías de prácticas conversacionales que constituyen patrones interpersonales transformadores, por ejemplo: PIT preparatorios, PIT identificadores, PIT localizadores, PIT transformadores y PIT consolidadores. Los hemos llamado "realizadores" porque estas prácticas conversacionales ayudan a las familias a convencerlas de crear (o a "hacer realidad") preferencias relacionales particulares. También ofrecemos descriptores fáciles de usar de las subcategorías de los realizadores (p. ej.: PIT de medición) que pueden ayudar a los profesionales a reconocer, aprender y llevar a cabo estas invitaciones conversacionales. Se debaten las consecuencias teóricas y las futuras líneas de investigación.
Asunto(s)
Relaciones Familiares/psicología , Terapia Familiar/métodos , Teoría Psicológica , Adolescente , Adulto , Niño , Comunicación , Femenino , Humanos , Masculino , Problema de Conducta/psicologíaRESUMEN
The present article introduces a case study and describes a mutually integrative approach to treating a complex presenting problem. This article examines the specific issues surrounding integration when a supervisor and supervisee hold different theoretical perspectives. On occasion, such a relationship demands that the supervisee adhere to the model being taught by the supervisor. Examining integration in this format presents many advantages for both treatment and training. The key to the mutual integration is that two schools of psychotherapy can be combined in a way that creates a synergy; in that, together they are more powerful than either may be in isolation. A genogram with symbols from each model is incorporated to focus the treatment and create a format for the mutual integration.
Este artículo presenta un caso práctico y describe un enfoque mutuamente integrador para el tratamiento de un problema complejo motivo de consulta. Se analizan los problemas específicos en torno a la integración cuando un supervisor y una persona supervisada tienen diferentes perspectivas teóricas. Ocasionalmente, dicha relación exige que la persona supervisada se ajuste al modelo que le enseña el supervisor. El análisis de la integración en este formato presenta muchas ventajas tanto para el tratamiento como para la capacitación. La clave para la integración mutua es que puedan combinarse dos escuelas de psicoterapia de una manera que genere una sinergia; es decir, que juntas sean más poderosas de lo que puede ser cualquiera individualmente. Se incorpora un genograma con símbolos de cada modelo para centrar el tratamiento y crear un formato para la integración mutua. El caso se conceptualiza utilizando una fusión de la teoría de sistemas y la teoría psicoanalítica sobre la base del modelo estratégico de sistemas familiares y de un modelo psicoanalítico tradicional influenciado por la psicología del yo del modelo freudiano (Hall, 1999; Fenichel, 1945) y McWilliams (2011). El genograma sistémico tradicional (con símbolos interaccionales) se transforma en un genograma "integrado", con la incorporación de símbolos nuevos para representar los mecanismos psicoanalíticos de defensa. Los problemas presentados en el caso son preocupaciones relacionales y problemas de autoestima en un "paciente identificado" adolescente, obesidad y antecedentes de trauma sexual. Se proporcionan las razones para la integración mutua en este caso específico junto con las razones para la intervención.
Asunto(s)
Modelos Psicológicos , Psicoterapia/métodos , Adulto , Terapia Familiar/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Organización y Administración , Relaciones Profesional-Paciente , Teoría Psicoanalítica , AutoimagenRESUMEN
This is a longitudinal randomized control trial on the impact of adding a parent psychoeducation intervention (TEPSI) as part of cognitive-behavioral therapy (CBT) for adolescents with Major Depressive Disorder (MDD) in a Puerto Rican sample. We tested the efficacy of adding 8 group sessions of TEPSI to 12 sessions of individual CBT on reducing depressive symptoms, MDD diagnosis, and improving family functioning. Participants (n = 121) were randomized to individual CBT with or without TEPSI. No main group effects were found for most patient domains including depression symptoms, as well as presence of adolescent's MDD diagnosis at posttreatment. Results did show a main effect of CBT over time for depression symptoms, suicide ideation, family criticism, and the presence of MDD diagnosis decreasing from pre- to postintervention. A year post treatment, almost 70% of adolescents in both conditions (CBT and CBT + TEPSI) remained in remission. A main effect was obtained for treatment in the adolescent's perception of familism and family emotional involvement. The primary hypothesis that family psychoeducation would optimize CBT for depression in adolescents was not supported. Both conditions yielded similar clinical end points. The culturally adapted CBT was found effective with Latino/a adolescents showing clinically significant improvements from pretreatment to posttreatment and remained stable at a 1-year follow-up. Regarding family outcomes, adolescents in CBT + TEPSI remained stable from pretreatment to posttreatment on family emotional involvement, while adolescents in CBT-alone showed an increase. The implication of these findings is discussed.
Este es un ensayo clínico longitudinal aleatorizado y controlado sobre el efecto de agregar una intervención psicoeducativa para los padres (TEPSI, en inglés) como parte de la terapia cognitivo-conductual (TCC) para adolescentes con trastorno depresivo mayor (TDM) en una muestra puertorriqueña. Evaluamos la eficacia de agregar 8 sesiones grupales de TEPSI a 12 sesiones de TCC individual en la reducción de síntomas depresivos, en el diagnóstico de TDM y en la mejora del funcionamiento familiar. Los participantes (n = 121) fueron distribuidos al azar a la TCC individual con o sin TEPSI. No se encontraron efectos grupales principales en la mayoría de las áreas de los pacientes, como en los síntomas de depresión ni en la presencia de un diagnóstico de TDM en los adolescentes después del tratamiento. Los resultados sí demostraron un efecto principal de la TCC con el tiempo para los síntomas de depresión, las ideas suicidas, la crítica familiar y la presencia de un diagnóstico de TDM que disminuye desde antes hasta después de la intervención. Un año después del final del tratamiento, casi el 70 % de los adolescentes en ambas condiciones (TCC y TCC + TEPSI) se mantuvo en remisión. Se obtuvo un efecto principal del tratamiento en la percepción de los adolescentes del familismo y la implicación emocional familiar. No se respaldó la hipótesis principal de que la psicoeducación familiar optimizaría la TCC para la depresión en los adolescentes. Ambas condiciones dieron variables clínicas similares. Se descubrió que la TCC culturalmente adaptada fue eficaz con los adolescentes latinos, ya que demostró mejoras clínicas considerables desde antes del tratamiento hasta después del tratamiento y permaneció estable un año después al momento del seguimiento. Con respecto a los resultados familiares, los adolescentes de la TCC + TEPSI se mantuvieron estables desde antes del tratamiento hasta después del tratamiento en la implicación emocional familiar, mientras que los adolescentes de la TCC sola demostraron un aumento. Se debaten las implicancias de estos resultados.
Asunto(s)
Terapia Cognitivo-Conductual/métodos , Trastorno Depresivo Mayor/terapia , Terapia Familiar/métodos , Padres/educación , Educación del Paciente como Asunto/métodos , Adolescente , Adulto , Trastorno Depresivo Mayor/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Padres/psicología , Puerto Rico , Resultado del TratamientoRESUMEN
In this article, we investigate how an increasingly popular therapeutic modality, family constellation therapy (FCT), functions simultaneously as a technology of the self (Foucault, Technologies of the self: a seminar with Michel Foucault, University of Massachusetts Press, Amherst, 1988) as well as what we here call a "technology of the social." In FCT, the self is understood as an assemblage of ancestral relationships that often creates problems in the present day. Healing this multi-generational self involves identifying and correcting hidden family dynamics in high-intensity group sessions where other participants represent the focus client and his/her family members, both alive and deceased. Drawing on ethnographic data collected in multiple FCT workshops in Beijing, China and Oaxaca City, Mexico, we show how FCT ritually reorganizes boundaries between self and other in novel ways, creating a collective space for shared moral reflection on troubling social, historical, and cultural patterns. By demonstrating the ways in which FCT unfolds as both a personal and social technology, this article contributes to ongoing conversations about how to effectively theorize sociality in therapeutic practice, and problematizes critical approaches emphasizing governmentality and commensuration (Mattingly, Moral laboratories family peril and the struggle for a good life, University of California Press, Oakland, 2014; Duncan, Transforming therapy: mental health practice and cultural change in Mexico, Vanderbilt University Press, Nashville, 2018; Matza, Shock therapy: psychology, precarity, and well-being in postsocialist Russia, Duke University Press, Durham, 2018; Pritzker, Presented at "Living Well in China" Conference, Irvine, CA, 2018; Mattingly, Anthropol Theory, 2019; Zigon, "HIV is God's Blessing": rehabilitating morality in neoliberal Russia, University of California Press, Berkeley, 2011).
Asunto(s)
Terapia Familiar/métodos , Personeidad , China , Humanos , Relaciones Interpersonales , MéxicoRESUMEN
PURPOSE: The purpose of the study is to test the effects of a culturally tailored family-based self-management education and social support intervention on family social capital with Mexican American (MA) adults with type 2 diabetes (T2DM) and their family member. METHODS: Using a 2-group, experimental repeated-measures design, 157 dyads were randomly assigned to an intervention (group education and social support, home visits, and telephone calls) or a wait list control group. Data were collected at baseline, immediately postintervention (3 months), and 6 months postintervention. A series of 2 × 3 repeated-measures analyses of variance with interaction contrasts were used to test the hypotheses regarding the differential effects on family social capital. RESULTS: Social capital outcomes included social integration, social support, and family efficacy. Social integration scores, high for family members and friends and low for community engagement, did not change over time for participants or family members. Participants perceived high support from family for physical activity with an immediate increase postintervention and moderate sabotage for healthy eating with no change over time. A sustained intervention effect was noted for family efficacy for general health and total family efficacy in participants and family members. CONCLUSIONS: This family-based culturally tailored intervention demonstrated the potential to improve social capital, specifically social support for physical activity and family efficacy for diabetes management for MA adults with T2DM. Ongoing research that examines the family as a critical context in which T2DM self-management occurs and that targets strategies for sustained family social capital outcomes for T2DM is needed.
Asunto(s)
Diabetes Mellitus Tipo 2/psicología , Diabetes Mellitus Tipo 2/terapia , Terapia Familiar/métodos , Americanos Mexicanos/psicología , Automanejo/educación , Capital Social , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Diabetes Mellitus Tipo 2/etnología , Ejercicio Físico/psicología , Familia/psicología , Femenino , Conductas Relacionadas con la Salud , Humanos , Masculino , Persona de Mediana Edad , Apoyo Social , Resultado del Tratamiento , Adulto JovenRESUMEN
RESUMO Introdução: No contexto da Reforma Psiquiátrica Brasileira, a família tem sido convocada a ser corresponsável pela assistência aos usuários de álcool e outras drogas. Objetivo: Compreender a percepção de familiares sobre a reabilitação psicossocial de alcoolistas. Métodos: Estudo fenomenológico, fundamentado no referencial de Maurice Merleau-Ponty, desenvolvido no período de outubro a novembro do ano de 2013, por meio de entrevistas semi-estruturada com sete familiares de alcoolistas usuários de um Centro de Atenção Psicossocial Álcool e outras Drogas (CAPS ad), no estado da Bahia, Brasil. Utilizou-se a técnica Analítica da Ambiguidade para a compreensão dos dados. Resultados: Os resultados evidenciam que a família ao mesmo tempo em que espera a reabilitação e reinserção do alcoolista, não se identifica como corresponsável pelo cuidado; e a depender da postura, poderá tanto contribuir como interferir na efetivação do processo. Conclusões: É imprescindível o desenvolvimento de ações que reforcem a ruptura com a exclusão social nos planos de intervenção frente ao Alcoolismo, o que deve incluir o contexto familiar(AU)
RESUMEN Introducción: En el contexto de la Reforma Psiquiátrica Brasileña, la familia ha sido convocada a ser corresponsable por la asistencia a los usuarios del alcohol y otras drogas. Objetivo: Comprender la percepción de los familiares sobre la rehabilitación psicosocial de los alcohólicos. Métodos: Estudio fenomenológico basado en el studio de Maurice Merleau-Ponty, desarrollado en el periodo de octubre a noviembre de 2013, a través de entrevistas semi-estructuradas con siete familiares de pacientes alcohólicos atendidos en el Center for Psychosocial Care Alcohol and Other Drugs en el estado de Bahía, Brasil. Se usó la técnica analítica de ambigüedad para comprender los datos. Resultados: Los resultados evidencian que la familia al mismo tiempo que espera la rehabilitación y reinserción de su familiar alcohólico, no se identifica como corresponsable por el cuidado; y en dependencia de la postura, podrá tanto contribuir como interferir en la efectividad del proceso. Conclusiones: Es imprescindible el desarrollo de acciones que refuercen la ruptura con la exclusión social en los planes de intervención frente al alcoholismo, lo que debe incluir el contexto familiar(AU)
ABSTRACT Introduction: In the context of the Brazilian Psychiatric Reform, the family has been summoned to be co-responsible for providing assistance to consumers of alcohol and other drugs. Objective: To understand the perception of family members about the psychosocial rehabilitation of alcoholic patients. Methods: Phenomenological study based on the Maurice Merleau-Ponty study, developed in the period from October to November 2013, through semi-structured interviews with seven relatives of alcoholic patients who received care in the Center for Psychosocial Care Alcohol and Other Drugs in the state of Bahia, Brazil. The analytical technique of ambiguity was used to understand the data. Results: The results show that the family, while waiting for the rehabilitation and reintegration of their alcoholic relative, does not identify itself as co-responsible for the care; and depending on the position, it can both contribute and interfere in the effectiveness of the process. Conclusions: It is essential to develop actions that reinforce breaking with social exclusion as part of intervention plans against alcoholism, which should include the family context(AU)
Asunto(s)
Humanos , Trastornos Relacionados con Sustancias/rehabilitación , Alcoholismo/rehabilitación , Terapia Familiar/métodos , Alcohólicos/psicologíaRESUMEN
METHOD: The Open Dialogue Method was developed in Finland in order to deal with severe psychotic crises using dialogue and social network inclusion. By means of a review of the literature on the Open Dialogue Method, this article sought to identify the principles and contributions for deinstitutionalization.The PubMed (365), PsycInfo (134), Lilacs (no articles found) databases and 2 books were consulted. Thirty-four publications that fulfilled the requirements of this review were selected. The search was conducted in October 2015. The key words used were: open dialogue, crisis, first psychotic episode, schizophrenia, family therapy, need-adapted approach. RESULTS: There were 3 reviews, 5 theoretical studies, 21 qualitative studies and 5 quantitative studies. Two of them were written in Italian, one in French and thirty-one in English. The authors were from Norway, the United States, Finland, Australia, the United Kingdom, Belgium, Canada and Poland. The publications were grouped for purposes of analysis into the following categories: Open Dialogue concepts and principles; Open Dialogue contributions; Challenges for Open Dialogue implementation in other countries, realities and contexts.
MÉTODO: O Método Diálogo Aberto foi desenvolvido na Finlândia para atender crises psíquicas graves utilizando diálogo e inclusão da rede social. Este artigo pretende, através de uma revisão da literatura sobre o Método do Diálogo Aberto, identificar seus princípios e contribuições para processos de desisntitucionalização. As bases utilizadas neste artigo de revisão foram: PubMed (365), PsycInfo (134) e Lilacs (nehuma publicação encontrada), além de 2 livros, incluídos por referência cruzada. Foram selecionadas 34 publicações que atendiam ao objetivo proposto. A busca foi realizada em outubro de 2015. Os descritores selecionados foram: open dialogue, crisis, first episode psycosis, schizophrenia, terapy family, need adapted approach. RESULTADOS: Foram encontrados 3 artigos de revisão, 5 estudos teóricos, 21 estudos qualitativos e 5 estudos quantitativos. Destes, 2 foram escritos em italiano, 1 em francês e 31 em inglês. Com relação ao país de origem dos autores temos: Noruega, Estados Unidos, Finlândia, Austrália, Reino Unido, Bélgica, Canadá e Polônia. As produções foram agrupadas para análise em: Concepções e princípios do Diálogo Aberto; Contribuições do diálogo Aberto; Desafios para implementação do Diálogo Aberto em outros países, realidades e contextos.
Asunto(s)
Intervención en la Crisis (Psiquiatría)/métodos , Terapia Familiar/métodos , Trastornos Psicóticos/terapia , Enfermedad Aguda , Finlandia , Humanos , Salud Mental , Trastornos Psicóticos/fisiopatología , Índice de Severidad de la Enfermedad , Apoyo SocialRESUMEN
Introducción: El proceso de asesoría para las personas con VIH/sida es específico y particular, por ello, hay ciertos aspectos muy importantes a tomar en cuenta. Objetivo: Proponen algunos aspectos metodológicos y psicológicos para asesorar y acompañar a las personas que viven con VIH/sida. Método: Se consideraron criterios de varios autores y la revisión bibliográfica según los métodos del nivel teórico de la investigación: análisis-síntesis, inducción-deducción, modelación y enfoque sistémico. Resultados: Se tuvieron en cuenta elementos esenciales según la práctica profesional como: depresión, sentimientos de culpas, indefensos, ansiedad, pobre expectativa de vida, deterioro de la relación de pareja, esperanza de vida, nivel de aceptación, fatalismo o poco optimismo y que no se tienen en cuenta algunos de los aspectos cuando sabemos que debemos hacerlo y para esta labor se sigue también una metodología concreta y particular. Conclusiones: Según lo explicado anteriormente se recomienda iniciar sesiones individuales con las personas que soliciten ayuda. Las reuniones terapéuticas son muy eficaces para disminuir el sufrimiento y la ira que presentan los miembros de la familia(AU)
Introduction: The counseling process for people with HIV/AIDS is specific and particular, so there are certain very important aspects to take into account. Objective: They propose some methodological and psychological aspects to advise and accompany people living with HIV/AIDS. Method: Criteria of several authors and the literature review were considered according to the methods of the theoretical level of research: analysis-synthesis, induction-deduction, modeling and systemic approach. Results: Essential elements were taken into account according to professional practice such as: depression, feelings of guilt, helplessness, anxiety, poor life expectancy, deterioration of the couple's relationship, life expectancy, level of acceptance, fatalism or poor optimism and that some of the aspects are not taken into account when we know that we must do it and, for this work, a specific and particular methodology is also followed. Conclusions: Therapeutic meetings are very effective in reducing the suffering and anger that family members present. It is recommended to start individual sessions with people who ask for help(AU)
Introdução: O processo de aconselhamento para pessoas com HIV/AIDS é específico e particular, portanto, há certos aspectos muito importantes a serem levados em consideração. Objetivo: Eles propõem alguns aspectos metodológicos e psicológicos para aconselhar e acompanhar as pessoas que vivem com HIV/AIDS. Método: Foram considerados critérios de vários autores e a revisão da literatura de acordo com os métodos do nível teórico da pesquisa: análise-síntese, indução-dedução, modelagem e abordagem sistêmica. Resultados: Elementos essenciais foram considerados de acordo com a prática profissional, tais como: depressão, sentimentos de culpa, desamparo, ansiedade, baixa expectativa de vida, deterioração do relacionamento do casal, expectativa de vida, nível de aceitação, fatalismo ou pouco otimismo e que alguns dos aspectos não são levados em consideração quando sabemos que devemos fazê-lo e, para este trabalho, uma metodologia específica e particular também é seguida. Conclusões: As reuniões terapêuticas são muito eficazes na redução do sofrimento e da raiva que os membros da família apresentam. Recomenda-se iniciar sessões individuais com pessoas que solicitam ajuda(AU)
Asunto(s)
Humanos , Síndrome de Inmunodeficiencia Adquirida/psicología , VIH , Terapia Familiar/métodosRESUMEN
Resumo O Método Diálogo Aberto foi desenvolvido na Finlândia para atender crises psíquicas graves utilizando diálogo e inclusão da rede social. Este artigo pretende, através de uma revisão da literatura sobre o Método do Diálogo Aberto, identificar seus princípios e contribuições para processos de desisntitucionalização. Método: As bases utilizadas neste artigo de revisão foram: PubMed (365), PsycInfo (134) e Lilacs (nehuma publicação encontrada), além de 2 livros, incluídos por referência cruzada. Foram selecionadas 34 publicações que atendiam ao objetivo proposto. A busca foi realizada em outubro de 2015. Os descritores selecionados foram: open dialogue, crisis, first episode psycosis, schizophrenia, terapy family, need adapted approach. Resultados: Foram encontrados 3 artigos de revisão, 5 estudos teóricos, 21 estudos qualitativos e 5 estudos quantitativos. Destes, 2 foram escritos em italiano, 1 em francês e 31 em inglês. Com relação ao país de origem dos autores temos: Noruega, Estados Unidos, Finlândia, Austrália, Reino Unido, Bélgica, Canadá e Polônia. As produções foram agrupadas para análise em: Concepções e princípios do Diálogo Aberto; Contribuições do diálogo Aberto; Desafios para implementação do Diálogo Aberto em outros países, realidades e contextos.
Abstract The Open Dialogue Method was developed in Finland in order to deal with severe psychotic crises using dialogue and social network inclusion. By means of a review of the literature on the Open Dialogue Method, this article sought to identify the principles and contributions for deinstitutionalization. Method: The PubMed (365), PsycInfo (134), Lilacs (no articles found) databases and 2 books were consulted. Thirty-four publications that fulfilled the requirements of this review were selected. The search was conducted in October 2015. The key words used were: open dialogue, crisis, first psychotic episode, schizophrenia, family therapy, need-adapted approach. Results: There were 3 reviews, 5 theoretical studies, 21 qualitative studies and 5 quantitative studies. Two of them were written in Italian, one in French and thirty-one in English. The authors were from Norway, the United States, Finland, Australia, the United Kingdom, Belgium, Canada and Poland. The publications were grouped for purposes of analysis into the following categories: Open Dialogue concepts and principles; Open Dialogue contributions; Challenges for Open Dialogue implementation in other countries, realities and contexts.
Asunto(s)
Humanos , Trastornos Psicóticos/terapia , Intervención en la Crisis (Psiquiatría)/métodos , Terapia Familiar/métodos , Trastornos Psicóticos/fisiopatología , Apoyo Social , Índice de Severidad de la Enfermedad , Salud Mental , Enfermedad Aguda , FinlandiaRESUMEN
O resultado do trabalho de luto da perda de um filho depende muito de como a família está encarando essa perda e de qual o ciclo de vida pelo qual o sistema familiar está passando. A presente pesquisa aborda alguns aspectos teóricos importantes relacionados às observações feitas em dois dias de acompanhamento das atividades da Associação dos Familiares de Vítimas e Sobreviventes da Tragédia de Santa Maria (AVTSM), no município de Santa Maria, estado do Rio Grande do Sul, nos dias 11 e 12 de abril de 2017, bem como procede à análise de conteúdo de seis entrevistas realizadas com mães e pai de vítimas. O trabalho realizado pela AVTSM é de fundamental importância aos pais e às mães que participam, pois, além de proporcionar atividades psicossociais para os membros e fortalece o vínculo coletivo entre eles. Além disso, tais atividades têm caráter terapêutico e incentivam os envolvidos a melhorar e a resgatar a vontade de viver e de se adaptar à realidade cruel que é viver sem seus filhos.(AU)
The outcome from the elaboration of mourning of the loss of a son largely depends on how the family is facing this loss and what life cycle the family system is going through. The present research addresses some important theoretical aspects related to observations made in two days of monitoring from the activities of the Association of Families of Victims and Survivors of the Santa Maria's Tragedy (AVTSM), in the city of Santa Maria, in the Rio Grande do Sul State, on 11 and 12 of April in 2017. Together with the analysis of the content of six interviews made with parents of the victims. The work made by AVTSM is of fundamental importance to mothers and fathers that participate in it, because it not only proportionate psychosocial activities to the members, it also strengthens the collective bond between them. Moreover, these activities have a therapeutic character and encourages the involved to get better and recover the will to live and adapt to the cruel reality that is living without their children.(AU)
Asunto(s)
Humanos , Aflicción , Terapia Familiar/métodos , Desastres Provocados por el Hombre , Epidemiología Descriptiva , Recolección de Datos/instrumentación , Sobrevivientes/psicología , Incidentes con Víctimas en Masa/psicologíaRESUMEN
Este artigo tem como objetivo refletir acerca do processo de produção de sentidos sobre a mudança em terapia familiar na perspectiva da responsabilidade relacional. Utilizando o método da poética social, buscou-se identificar momentos marcantes do processo terapêutico de uma família que enfrentava o grave adoecimento de um de seus membros. Esses momentos compreenderam: (a) O agir no adoecimento; (b) Coconstruindo o cuidado; e (c) O cuidado com a vida. A análise desses momentos permitiu identificar como foi possível a promoção de inteligibilidades relacionais relativas a: (i) Outros internos; (ii) Relações conjuntas; (iii) Relações entre os grupos; e (iv) Processo sistêmico. Esse estudo apontou, assim, a viabilidade do uso e a inovação promovida pela perspectiva da responsabilidade relacional na clínica, gerando novas posições para familiares e terapeuta.(AU)
This paper aims to reflect on the process of producing meanings about change in family therapy from the perspective of relational responsibility. Using the method of social poetics. We sought to identify striking moments in the therapeutic process of family that faced the serious illness of one of its members. These moments comprised; (a) The course of illness, (b) Coconstructing care, and (c) Life care. This analysis of these moments allowed us to identify how it was possible to promote relational intelligibilities related to: (i) Other interns; (ii) Joint elations; (iii) Relationship between groups, and (iv) Systemic process. This study thus pointed to be viability of the used and the perspective of relational responsibility in the clinic generating new positions for family members and therapist.(AU)
Asunto(s)
Humanos , Conflicto Familiar/psicología , Terapia Familiar/métodos , Empatía , Relaciones Familiares/psicologíaRESUMEN
Purpose The purpose of the study was to investigate the effects of a family-based self-management support intervention for adults with type 2 diabetes (T2DM). Methods Using a 2-group, experimental repeated measures design, 157 dyads (participant with T2DM and family member) were randomly assigned to an intervention (education, social support, home visits, and telephone calls) or a wait list control group. Data were collected at baseline, postintervention (3 months), and 6 months postintervention. A series of 2 × 3 repeated measures ANOVAs were used to test the hypotheses with interaction contrasts to assess immediate and sustained intervention effects. Results Significant changes over time were reported in diet self-management, exercise self-management, total self-management, diabetes self-efficacy for general health and total diabetes self-efficacy, physician distress, regimen distress, interpersonal distress, and total distress. There were likewise sustained effects for diet self-management, total self-management, diabetes self-efficacy for general health, total self-efficacy, physician distress, regimen distress, and interpersonal distress. Conclusions Results support and extend prior research documenting the value of culturally relevant family-based interventions to improve diabetes self-management and substantiate the need for intensive, longer, tailored interventions to achieve glycemic control.
Asunto(s)
Asistencia Sanitaria Culturalmente Competente/métodos , Diabetes Mellitus Tipo 2/terapia , Terapia Familiar/métodos , Americanos Mexicanos/psicología , Automanejo/métodos , Adulto , Asistencia Sanitaria Culturalmente Competente/etnología , Diabetes Mellitus Tipo 2/etnología , Diabetes Mellitus Tipo 2/psicología , Dieta para Diabéticos/etnología , Dieta para Diabéticos/psicología , Femenino , Humanos , Masculino , Proyectos de Investigación , Autoeficacia , Automanejo/psicología , Apoyo Social , Estrés Psicológico/etnología , Estrés Psicológico/psicologíaRESUMEN
Although weight restoration is a crucial factor in the recovery of anorexia nervosa (AN), there is scarce evidence regarding which components of treatment promote it. In this paper, the author reports on an effort to utilize research methods in her own practice, with the goal of evaluating if the family meal intervention (FMI) had a positive effect on increasing weight gain or on improving other general outcome measures. Twenty-three AN adolescents aged 12-20 years were randomly assigned to two forms of outpatient family therapy (with [FTFM] and without [FT]) using the FMI, and treated for a 6-month duration. Their outcome was compared at the end of treatment (EOT) and at a 6-month posttreatment follow-up (FU). The main outcome measure was weight recovery; secondary outcome measures were the Morgan Russell Global Assessment Schedule (MRHAS), amenorrhea, general psychological symptoms, and eating disorder symptoms. The majority of the patients in both groups improved significantly at EOT, and these changes were sustained through FU. Given its primarily clinical nature, findings of this investigation project preclude any conclusion. Although the FMI did not appear to convey specific benefits in causing weight gain, clinical observation suggests the value of a flexible stance in implementation of the FMI for the severely undernourished patient with greater psychopathology.
Asunto(s)
Anorexia Nerviosa/psicología , Anorexia Nerviosa/terapia , Terapia Familiar/métodos , Comidas/psicología , Aumento de Peso , Adolescente , Amenorrea/etiología , Niño , Femenino , Humanos , Estudios Longitudinales , Masculino , Relaciones Padres-Hijo , Evaluación de Programas y Proyectos de Salud , Escalas de Valoración Psiquiátrica , Evaluación de Síntomas , Resultado del Tratamiento , Adulto JovenRESUMEN
O cuidado e a educação dos filhos destacam-se como importantes desafios de famílias que se encontram em fase de aquisição, sendo esta uma das demandas de trabalho do psicólogo clínico. O presente estudo tem como objetivo apresentar subsídios teóricos e práticos disponíveis na literatura científica a respeito do tema da parentalidade, os quais podem auxiliar o trabalho do terapeuta de famílias com filhos pequenos na avaliação das práticas parentais. Para isso, foi realizada uma revisão de literatura assistemática, com base em autores que trabalham com este tema na abordagem Sistêmica, bem como autores que realizam pesquisas sobre parentalidade nos mais diferentes contextos, sendo selecionado o Modelo de Componentes da Parentalidade de Heidi Keller. A partir disso, foram identificados e sistematizados alguns instrumentos que podem ser utilizados para avaliar as mais diversas dimensões de cuidados parentais. Concluiu-se que, diante das mudanças do mundo contemporâneo, cada vez mais o psicólogo deve recorrer aos achados dos pesquisadores que trabalham com as famílias ao longo das diferentes etapas do ciclo vital. Além disso, a prática deve ser sempre re-pensada e re-construída de acordo com as próprias necessidades das famílias que procuram atendimento psicológico.(AU)
Childrearing and educational practices are important challenges for young children’s parents, and it can be a demand for clinical psychologists. This paper aims to present theoretical models and practical instruments available in the scientific literature on the subject of parenting, which can be used by therapists on their practice with families with young children. A literature review was conducted, based on authors that work with this subject in the Systemic approach, as well as authors who conduct researches about parenting in different contexts, being selected the Parenting Component Model of Heidi Keller. It was also selected and systematized some tools that can be used to assess the various dimensions of parenting. It was concluded that, given fast changes of modern world, even more the psychologist must use new findings from researchers who work with families throughout the different lifecycle stages. Furthermore, clinical practices must always be transformed in accordance with families needs.(AU)
Asunto(s)
Humanos , Crianza del Niño , Responsabilidad Parental/psicología , Cuidado del Niño , Terapia Familiar/métodosRESUMEN
O campo da terapia familiar (TF) é composto por diferentes propostas teóricas e epistemológicas. Recentemente, o construcionismo social tem contribuído para a configuração de novas práticas em TF, levando a uma maior ênfase nos processos de comunicação no contexto terapêutico. O objetivo deste estudo é investigar a difusão do construcionismo entre terapeutas familiares brasileiros. Participaram 14 terapeutas, homens e mulheres, psicólogos, que realizam atendimentos de famílias e são professores em cursos de formação em TF. Realizamos entrevistas semiestruturadas, que foram gravadas em áudio e transcritas literalmente. A partir das propostas construcionistas para a pesquisa científica, realizamos análise temática das informações. Nas cinco temáticas construídas, discutimos como os participantes descrevem o construcionismo e as implicações advindas em sua prática clínica. Concluímos que a difusão deste está atrelada à atribuição de utilidade aos conceitos teóricos, constituindo-se em porta de entrada para reflexões acerca da atuação clínica e cujas contribuições agregam novos elementos ao posicionamento do terapeuta.
The field of family therapy (FT) consists of different theoretical and epistemological proposals. More recently, social constructionism has contributed for the creation of new practices in FT, leading to an emphasis on the communication processes in the therapeutic context. This study aims to comprehend dissemination forms of social constructionist discourse among Brazilian family therapists. We interviewed 14 family therapists, men and women, psychologists, who work with family counseling, and are responsible for teaching social constructionism in FT training institutes. All the interviews were recorded and literally transcribed. A thematic analysis was carried out based on social constructionism contributions for research practice. Throughout these themes, we discuss the participants' definitions of social constructionism and its implications for their positioning in daily practice. We conclude that the dissemination of social constructionist discourse is related to the utility that family therapists attach to these theoretical contributions, turning them into resources for their positioning as family therapists.
El campo de la terapia familiar (TF) es constituido por diferentes propuestas teóricas y epistemológicas. Recientemente, el construccionismo social ha contribuido a la configuración de nuevas prácticas en TF, lo que lleva a un mayor énfasis en los procesos de comunicación en el contexto terapéutico. El objetivo del estudio es investigar la difusión del construccionismo entre terapeutas familiares brasileños. Participaron del estudio catorce terapeutas, hombres y mujeres, psicólogos, que realizan atendimientos familiares y son profesores en cursos de formación en TF. Se realizó entrevistas semiestructuradas, que fueron grabadas en audio y transcritas literalmente. Desde las propuestas construccionistas para la investigación científica, realizamos análisis temático de las informaciones. En los cinco temas creados, discutimos como los participantes describen el construccionismo y las implicaciones desde su práctica clínica. Se concluye que la difusión del construccionismo está vinculada a la distribución de utilidad a los conceptos teóricos, constituyéndose en puerta de entrada para reflexiones acerca de la actuación clínica y cuyas contribuciones abarcan nuevos elementos al posicionamiento del terapeuta.