A home visit intervention program for adolescents throughout their pregnancy and during the early stages of motherhood was evaluated. The participants (N = 90) were part of a larger group of adolescents treated in two health centers in a poor neighborhood in Santiago, Chile. The program was carried out by volunteer community health monitors and evaluated through an experimental, randomized, controlled clinical trial. Cost-effectiveness was examined in comparison with standard health care. Results show higher scores for the intervention group on the mothers' mental health and nutritional state, as well as on the children's levels of linguistic development.
Clients', therapists', and observers' identification of change was studied in 27 therapeutic processes, and agreement on the amount, temporal location, and content of change was related to outcome. Results show that clients reported more changes in successful therapies. Client-therapist temporal match of change moments was low irrespective of outcome. Results from all three perspectives were consistent in that manifestation of new behaviors and emotions was the most representative content of change among all therapies. Meanwhile, client-therapist agreement on the frequency of grouped change indicators reported was associated with positive outcome, whereas client-observer agreement was related to negative outcome. Therapists and observers agreed in both successful and nonsuccessful therapies. The relationship between agreement and therapeutic outcome is discussed in relation to each dimension of analysis.
The present study examines the heterogeneity of the therapeutic process through the analysis of the conversation between therapists and clients in psychotherapy. The Communicative Intentions dimension of the Therapeutic Activity Coding Sys-tem (TACS) was applied to 69 change episodes taken from 100 sessions that belong to five brief psychotherapies. Depending on what the participants are trying to achieve with their communication, the TACS distinguishes three types of Communicative Intentions: Exploring, Attuning, and Resignifying. Client and therapist verbalizations corresponding to these categories were analysed searching for differences between (a) both speakers, (b) initial, middle and final change episode stages, and (c) initial, middle and final phases of the whole therapeutic process. Results indicate that, in general, therapists resignify and attune more frequently, while clients explore more often. The analysis of Communicative Intentions within change episodes and during the whole therapeutic process reveals that there is an evolution in both: Even small therapy segments, as change episodes are, show that the process is not homogeneous, since in initial stages, the use of Exploring is more frequent than the use of Resignifying, especially for clients, while during the end of the episode clients and therapists increase their use of Resignify-ing. The analysis of the whole process confirms that Resignifying surpasses the use of Exploring in the final phases of therapy.
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