RESUMO

Resumen Investigaciones recientes en psicoterapia muestran que el estudio de la interacción psicoterapéutica al centrar su atención en la conversación de interlocutores, entrega señales que permiten analizar el cambio terapéutico. El propósito del presente estudio de caso es analizar el movimiento de una Estructura de Intercambios Terapéuticos en la conversación de procesos psicoterapéuticos completos de adolescentes depresivos con intento de suicidio en contexto hospitalario. Se analizó el uso del tiempo de los intercambios comunicacionales entre terapeuta y paciente durante las sesiones, que fueron segmentadas en inicio, desarrollo y cierre. Los resultados muestran que los intercambios se producen según su utilidad en la psicoterapia y que su ocupación es sensible y ajustada al trabajo y objetivos terapéuticos que van surgiendo en la interacción. Adicionalmente se identificaron intercambios que son funcionales al inicio, desarrollo y cierre de cada sesión, y otros que deben utilizarse con cautela por parte del psicoterapeuta. La investigación verifico que el psicoterapeuta debe saber cuál, cuándo y cómo utilizar la Estructura de Intercambios Terapéuticos.

Abstract Recent research in psychotherapy shows that the study of psychotherapeutic interaction by focusing attention on the conversation of interlocutors, provides signals to analyze the therapeutic change. The purpose of the present case study is to understand the movement of a Therapeutic Exchange Structure in the conversation of complete psychotherapeutic processes of depressed adolescents with attempted suicide in a hospital context, analyzing the use of the time of the exchanges in the sessions, which were segmented in start, development and closure. The results show that the exchanges are managed according to their usefulness in psychotherapy that their occupation is sensitive and adjusted to the work and therapeutic objectives that arise in the interaction. In addition, there would be exchanges that are functional at the beginning, development and closure of each session, and others that should be used with caution. The psychotherapist must know what, when and how to use the Structure of Therapeutic Exchanges.

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RESUMO

The aim of this research was to identify the meanings of psychotherapeutic change of children and adolescents who have suffered sexual abuse and were in psychotherapy. In order to do this, a qualitative study was carried out in which in-depth interviews complemented with drawings were conducted with 10 children and adolescents, aged between 6 and 16 years, who were taking part in psychotherapy due to sexual abuse. The interviews took place between 6 and 10 months after the start of the therapy and before it ended. Thematic narrative analysis was used for the interviews and visual narrative analysis for the drawings. The main findings showed that children and adolescents visualized psychotherapeutic change as a process in which gradual progress is made. The participants notice changes from an initial state of sadness and distress, mainly describing a positive shift in terms of emotional well-being. In addition, in this phase of the therapy only a few participants identified changes in their feelings regarding the abusive experience. The participants identified aspects of the therapy and supportive relationships with significant others as elements that foster these changes. In their view, hindering elements include changes of therapist, legal factors, and not being believed by their family. It is discussed the importance of knowing the children and adolescents' perspective regarding psychotherapeutic change while participating in therapy processes, using multiple methodologies, to generate interventions that suit the needs of this population and match the pace of children and adolescents' change.

RESUMO

Mulheres vítimas de violência são assistidas por diferentes instituições, entretanto a qualidade das mudanças que apresentam geralmente é desconhecida. O objetivo da pesquisa foi avaliar mudanças em aspectos psicológicos de mulheres vítimas de violência em fase final de atendimentoquando comparadas com mulheres em início de atendimento, em uma organização não governamental.Compuseram a amostra um grupo pré-assistência (Gr. 1), com nove mulheres, M =36,7, d.p. = 8,68 anos, e um grupo pós-assistência (Gr. 2), com nove mulheres, com idade M = 41, d.p. = 11,28 anos. Foram avaliadas com a Escala de Avaliação de Sintomas (EAS-40), Escala de Estágio de Mudança (EEM) e Escala Diagnóstica Adaptativa Operacionalizada Redefinida (EDAO-R).Os resultados apontaram melhora na eficácia da adaptação e nos sintomas psicopatológicos, que se mantiveram severos. Não houve alterações nos estágios de mudança. Sugerem-se adequação dos atendimentos às necessidades psicológicas das mulheres e realização de pesquisas sistemáticas de acompanhamento dos resultados.

Women victims of violence are assisted by different institutions with different types of intervention, however, the quality of changes that is presented are not always recognized. The aim of this study was to evaluate changes in the psychological aspects of women who are victim of violence before being assisted and compare them to those women who have already been assisted by the institution. The sample comprised of a group pre-assistance (Gr. 1), with nine women, M = 36.7, d.p. = 8.68 years old, and a group post-assistance (Gr. 2), with nine women, M = 41, d.p. = 11.28 years old. They were evaluated with the scale of symptoms (EAS-40), Stage of Change Scale (EEM) and Operational Adaptive Diagnostic Scale Redefined (EDAO-R). The results indicated improvement in the effectiveness of adaptation and psychopathological symptoms, which nevertheless remained severe. No change in stages of change. Suggestions are made to fit the psychological needs of the care of women and implementation of systematic research to monitor the results.

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