The purpose of this paper is to describe verbal and nonverbal expressions of mutual regulation between patients and therapists through the analysis of relevant episodes of five psychotherapy processes. Microanalyses of discourse, vocal quality and facial expression of emotions were conducted on both patients and therapists in 67 Episodes of Change and 86 Episodes of Rupture of the Therapeutic Alliance. The analyses were carried out using hierarchical regression, showing that both Episodes of Change and Episodes of Rupture correspond to interactional scenarios where patients and therapists use different forms of speech, vocal qualities and facial expressions that account for specific regulation processes which are coherent with such scenarios.
Effects of the COVID-19 confinement on mental health among higher education students in ChileBackground: Chilean higher education students have faced highly stressful events in 2020, including confinement and remote education. This population is particularly susceptible to mental health problems, such as high levels of stress, anxiety, and depression. Aim: To evaluate possible negative impacts of confinement by COVID-19 on Chilean higher education students' mental health. Material and Methods: The Center for Epidemiologic Studies Depression Scale (CES-D) Scale and the Profile of Mood States (POMS) were applied to 315 students during 2016 and to 301 students during 2020. Results: In 2020, depression mean scores for men (24.1) and women (29.7) exceeded the cutoff point, therefore suggesting the presence of depressive disorder. Women had higher depressive and anxious symptoms in both years, however, in 2020 a significant increase was observed for depression, indicating interaction between the year of assessment and gender (β = 6.74; p <.001). In both samples, first-year students had significantly higher depression scores (β = -1,909; p = 0.05). Conclusions: An increase in depression was observed in 2020. Confinement by COVID-19 had a high impact on mental health in female students. Women and first-year students appear to be high risk groups for developing depressive symptoms.
The study of the ruptures of the therapeutic alliance has impacted research in psychotherapy by highlighting the relational nature of this phenomenon. Despite ruptures are frequent and relevant during adolescent psychotherapy, most of the empirical evidence in this field has been carried out with adults. Understanding the subjective experience of the therapist during ruptures while working with adolescent is proposed as a starting point for the study of this type of interactional scenarios. The study examined the meanings that emerge from the therapists’ experience in terms of their explanations about the causes and effects of ruptures with adolescents. Eight psychotherapists were interviewed about their experiences during ruptures with young patients. The data was qualitatively analyzed through the Interpretive Phenomenological Analysis method. Four categories emerged: the failure to recognize the adolescent’s experience, the intensity of the affective experience of adolescents in psychotherapy, therapeutic boundaries as an articulator of the therapeutic purpose and, the obstacles that family generates during the therapeutic process. This study concurs with the literature on the need to make explicit with the family about the meaning, roles and limits of the therapy, and to prevent the exercise of control from an adultcentered position. It is concluded that in order to avoid and repair ruptures with adolescents in psychotherapy, an approach that integrates a sensitive attitude, an ecological point of view and mentalizing about the origin of the rupture is needed.
History of child abuse among patients with bipolar disorders Background: A history of child abuse is common and has a significant impact in the clinical course of patients diagnosed with bipolar disorders (BD). Aims: To assess the frequency of child abuse experiences in patients BD type I and to evaluate its association with clinical course and cognitive functioning variables. Material and Methods: 117 patients with BD aged 45 ± 14 years (66% women) answered the Childhood Trauma Questionnaire (CTQ). The clinical course (illness onset, history of suicide attempts and number of hospitalizations) was obtained from medical records. Cognitive functioning was evaluated through social and non-social cognition tasks. Results: 64% of participants reported some type of child abuse. This variable was associated with an early onset of the disease (Odds ratio (OR) = 3.3; p < 0.02), increased risk of suicide attempts (OR = 2.4; p < 0.04) and specific disturbances in social cognitive tasks. Conclusions: Our study supports evidence of a common history of child abuse in patients with BD. Although child abuse predicts a worse clinical course, major clinical practice guidelines, as well as research designs, do not highlight this evidence.
The present single case study explored and described the intervention process and therapeutic change expression through the Generic Change Indicators model (GCI) aiming to answer the question of “What changes when you change?”. We reasoned that psychotherapy process research in child and dyadic psychotherapy is scarce, as well as needed because it accounts for the content and mechanisms related to the therapeutic change and its association with interventions’ effectiveness.
To explore this possibility, we conducted a single case qualitative study to explore and describe the intervention process through the GCI within a brief intervention mentalization-informed with video-feedback, with a depressive mother and her baby. Specifically, Patient’s ongoing change was determined through the identification of Episodes of Change (EC) and the Moment of Change (MC) that occurs within it. Each MC was then labeled with one of the 19 GCIs.
Results of the single case study showed that the GCI model is a feasible model to observe and comprehend dyadic interventions. GCI were observed from the beginning of the intervention, increasing the hierarchical level of the GCI throughout the intervention, and associated with the video-feedback situation.
To investigate processes of intervention using the methodology here proposed, allows us to understand the intervention not only from a perspective of effectivity and outcomes but considering the ongoing therapeutic change. In this sense, research like this contributes to the growing body of evidence supporting the training and supervision of psychotherapists.
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